Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
2018/2019 PMHCA/2018 MDRBD Care Coordinator SSI Unchanged 28 14 0 Other-Semi Structured Interview
2021 PMHCA Care Coordinator SSI Unchanged 24 24 0 Instruction
2021 PMHCA Program Implementation SSI Unchanged 24 24 0 Other-Semi Structured Interview
2021 PMHCA Program Implementation Survey Unchanged 24 24 0 Other-
2022 PMHCA Care Coordinator SSI New 10 5 0 Form and Instruction 7A 2022 PMHCA Care Coordinator SSI
2022 PMHCA Champion FGD New 5 5 0 Form and Instruction 6A 2022 PMHCA Champion FGD
2022 PMHCA Champion SSI New 10 5 0 Form and Instruction 5A 2022 PMHCA Champion SSI
2022 PMHCA HP Survey New 5019 1255 0 Form and Instruction 1A 2022 PMHCA HP Survey
2022 PMHCA Practice- Level Survey New 1845 461 0 Form and Instruction 2A 2022 PHMCA Practice-Level Survey
2022 PMHCA Program Implementation SSI New 5 5 0 Form and Instruction 4A 2022 PMHCA Program Implementation SSI
2022 PMHCA Program Implementation Survey New 15 5 0 Form and Instruction 3A 2022 PMHCA Program Implementation Survey
Champion and Community Resources SSI Unchanged 204 102 0 Other-Semi Structured Interveiw
Other-Semi Structured Interview
Other-Semi Structured Interview
Other-Semi Structured Interview
FGD Unchanged 52 52 0 Other-
Other-
HP Survey 2021 Unchanged 8031 6023 0 Form and Instruction 1 HP Survey
PMHCA Practice Level Survey Modified 2950 2213 0 Form and Instruction 2 Practice Level Survey
Total burden requested under this ICR: 18246 10217 0  
To view an IC, click on IC Title