OMB control number

State Mental Institution Policy Review

OMB 0960-0110 · SSA.

OMB 0960-0110

SSA makes annual grants to the Protection and Advocacy Agencies (P&A) in each state to conduct, for SSA, all representative payee reviews. The collection of this information is mandatory for the completion of onsite reviews of State mental institutions. The P&As use Form SSA-9584-BK to collect information during State mental institutions onsite reviews. The P&As use the SSA-9584-BK to: (1) to determine if the policies and practices of a State mental institution acting as a representative payee for SSA beneficiaries conform to SSA’s regulations in the use of benefits; (2) to confirm that institutions are performing other duties and responsibilities required of representative payees; and (3) as the basis for conducting onsite reviews of the Institutions and preparing subsequent reports of findings. The respondents are State mental institutions serving as representative payees for Social Security beneficiaries and Supplemental Security Income (SSI) recipients.

The latest form for State Mental Institution Policy Review expires 2026-11-30 and can be found here.

All Historical Document Collections
Revision of a currently approved collection 2020-08-24
Approved with change
Revision of a currently approved collection 2017-04-28
Approved without change
Revision of a currently approved collection 2014-03-10
Approved without change
Revision of a currently approved collection 2010-12-30
Approved without change
Extension without change of a currently approved collection 2008-02-06
Approved without change
Revision of a currently approved collection 2005-01-24
Approved without change
Extension without change of a currently approved collection 2004-01-28
Approved without change
Extension without change of a currently approved collection 2002-07-29
Approved without change
Extension without change of a currently approved collection 1999-03-26
Approved without change
Revision of a currently approved collection 1996-04-29
Approved without change
Reinstatement with change of a previously approved collection 1993-03-17
Approved without change
Extension without change of a currently approved collection 1991-08-07
Approved without change
Extension without change of a currently approved collection 1988-11-10
Approved without change
Extension without change of a currently approved collection 1985-11-26
Approved without change
Revision of a currently approved collection 1983-03-15
Approved without change
Revision of a currently approved collection 1982-09-27
Approved without change
Reinstatement with change of a previously approved collection 1980-08-12
Approved with change
No material or nonsubstantive change to a currently approved collection 1980-05-29
Approved with change
No material or nonsubstantive change to a currently approved collection 1979-03-29
Approved without change
Revision of a currently approved collection 1975-04-14
Approved with change
No material or nonsubstantive change to a currently approved collection 1975-03-18