CCBHC Leadership Interviews

Evaluation of the Extension of the Certified Community Behavioral Health Clinic (CCBHC) Demonstration Program

Documents and Forms

Document Name Document Type
Attachment D. CCBHC Leadership Interview Protocol.docx Other-Interview Protocol
Attachment D. CCBHC Leadership Interview Protocol.docx Other-Interview Protocol

Information Collection (IC) Details

IC Title:	CCBHC Leadership Interviews	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Interview Protocol			Attachment D. CCBHC Leadership Interview Protocol.docx		No		Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 10	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	10	10
Annual IC Time Burden (Hours)	10	10
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.