Proposed Information Collection (Request for and Authorization To Release Medical Records or Health Information) Activity: Comment Request, 46484-46485 [E9-21574]

Download as PDF 46484 Federal Register / Vol. 74, No. 173 / Wednesday, September 9, 2009 / Notices Affected Public: Individuals or households. Estimated Annual Burden: a. Annual-Final Report and Account, VA Form 21–4706—1,100. b. Federal Fiduciary’s Account, VA Form 21–4706b—6,300. c. Court Appointed Fiduciary’s Account, VA Form 21–4706c—2,000. d. Account Book, VA Form 21–4718— 20,000. e. Certificate of Balance on Deposit and Authorization To Disclose Financial Records, VA Form 21–4718a–166. Estimated Average Burden per Respondent: a. Annual-Final Report and Account, VA Form 21–4706—30 minutes. b. Federal Fiduciary’s Accounts, VA Form 21–4706b—27 minutes. c. Court Appointed Fiduciary’s Account, VA Form 21–4706c—30 minutes. d. Account Book, VA Form 21–4718– 21⁄2 hours. e. Certificate of Balance on Deposit and Authorization To Disclose Financial Records, VA Form 21–4718a–3 minutes. Frequency of Response: Annually. Estimated Number of Respondents: a. Annual-Final Report and Account, VA Form 21–4706–2,200. b. Federal Fiduciary’s Accounts, VA Form 21–4706b–14,000. c. Court Appointed Fiduciary’s Account, VA Form 21–4706c–4,000. d. Account Book, VA Form 21–4718– 8,000. e. Certificate of Balance on Deposit and Authorization To Disclose Financial Records, VA Form 21–4718a–3,312. Dated: September 2, 2009. By direction of the Secretary. Denise McLamb, Program Analyst, Enterprise Records Service. [FR Doc. E9–21572 Filed 9–8–09; 8:45 am] BILLING CODE 8320–01–P DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900–0427] cprice-sewell on DSK2BSOYB1PROD with NOTICES Agency Information Collection (Former POW Medical History), VA Form 10– 0048 Activities Under OMB Review AGENCY: Veterans Health Administration, Department of Veterans Affairs. ACTION: Notice. In compliance with the Paperwork Reduction Act (PRA) of 1995 (44 U.S.C. 3501–3521), this notice announces that the Veterans Health Administration (VHA), Department of Veterans Affairs, will submit the SUMMARY: VerDate Nov<24>2008 15:47 Sep 08, 2009 Jkt 217001 collection of information abstracted below to the Office of Management and Budget (OMB) for review and comment. The PRA submission describes the nature of the information collection and its expected cost and burden and includes the actual data collection instrument. DATES: Comments must be submitted on or before October 9, 2009. Submit written comments on the collection of information through http://www.Regulations.gov; or to VA’s OMB Desk Officer, OMB Human Resources and Housing Branch, New Executive Office Building, Room 10235, Washington, DC 20503 (202) 395–7316. Please refer to ‘‘OMB Control No. 2900– 0427’’ in any correspondence. ADDRESSES: FOR FURTHER INFORMATION CONTACT: Denise McLamb, Enterprise Records Service (005R1B), Department of Veterans Affairs, 810 Vermont Avenue, NW., Washington, DC 20420, (202) 461– 7485, fax (202) 273–0443 or e-mail denise.mclamb@mail.va.gov. Please refer to ‘‘OMB Control No. 2900–0427.’’ SUPPLEMENTARY INFORMATION: Titles: Former POW Medical History, VA Form 10–0048. OMB Control Number: 2900–0427. Type of Review: Revision of a currently approved collection. Abstract: VA Form 10–0048 is completed by a VA physician during a medical examination of a Former Prisoner of War veteran. VA will use the data collected as a guide and reference for treatment planning for the FPOW veteran. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. The Federal Register Notice with a 60-day comment period soliciting comments on this collection of information was published on June 29, 2009, at pages 31110–31111. Affected Public: Individuals or households. Estimated Total Annual Burden: 113 hours. Estimated Average Burden per Respondent: 90 minutes. Frequency of Response: One time. Estimated Number of Respondents: 75. Dated: September 2, 2009. By direction of the Secretary. Denise McLamb, Program Analyst, Enterprise Records Service. [FR Doc. E9–21573 Filed 9–8–09; 8:45 am] BILLING CODE 8320–01–P PO 00000 Frm 00078 Fmt 4703 Sfmt 4703 DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900–0260] Proposed Information Collection (Request for and Authorization To Release Medical Records or Health Information) Activity: Comment Request AGENCY: Veterans Health Administration, Department of Veterans Affairs. ACTION: Notice. SUMMARY: The Veterans Health Administration (VHA) is announcing an opportunity for public comment on the proposed collection of certain information by the agency. Under the Paperwork Reduction Act (PRA) of 1995, Federal agencies are required to publish notice in the Federal Register concerning each proposed collection of information, including each proposed revision of a currently approved collection, and allow 60 days for public comment in response to the notice. This notice solicits comments on information needed to obtain a patient written consent to disclose medical records or health information to individuals or third parties. DATES: Written comments and recommendations on the proposed collection of information should be received on or before November 9, 2009. ADDRESSES: Submit written comments on the collection of information through Federal Docket Management System (FDMS) at www.Regulations.gov; or to Mary Stout, Veterans Health Administration (193E1), Department of Veterans Affairs, 810 Vermont Avenue, NW., Washington, DC 20420 or e-mail: mary.stout@va.gov. Please refer to ‘‘OMB Control No. 2900–0260’’ in any correspondence. During the comment period, comments may be viewed online through FDMS. FOR FURTHER INFORMATION CONTACT: Mary Stout, (202) 461–5867 or FAX (202) 273–9381. SUPPLEMENTARY INFORMATION: Under the PRA of 1995 (Pub. L. 104–13; 44 U.S.C. 3501–3521), Federal agencies must obtain approval from the Office of Management and Budget (OMB) for each collection of information they conduct or sponsor. This request for comment is being made pursuant to Section 3506(c)(2)(A) of the PRA. With respect to the following collection of information, VHA invites comments on: (1) Whether the proposed collection of information is necessary for the proper performance of VHA’s functions, including whether the E:\FR\FM\09SEN1.SGM 09SEN1 cprice-sewell on DSK2BSOYB1PROD with NOTICES Federal Register / Vol. 74, No. 173 / Wednesday, September 9, 2009 / Notices information will have practical utility; (2) the accuracy of VHA’s estimate of the burden of the proposed collection of information; (3) ways to enhance the quality, utility, and clarity of the information to be collected; and (4) ways to minimize the burden of the collection of information on respondents, including through the use of automated collection techniques or the use of other forms of information technology. Titles: a. Request for and Authorization To Release Medical Records or Health Information, VA Form 10–5345. b. Individual’s Request for a Copy of Their Own Health Information, VA Form 10–5345a. c. My HealtheVet (MHV)— Individuals’ Request for a Copy of Their Own Health Information, VA Form 10– 5345a–MHV. OMB Control Number: 2900–0260. Type of Review: Revision of a currently approved collection. Abstract: a. VA Form 10–5345 is used to obtain a written consent from patients before information concerning his or her treatment for alcoholism or alcohol abuse, drug abuse, sickle cell anemia, or infection with the human immunodeficiency virus (HIV) can be disclosed to private insurance companies, physicians and other third parties. b. Patients complete VA Form 10– 5345a to request a copy of their health information maintained at Department of Veterans Affairs. c. VA Form 10–5345a–MHV is completed by individuals requesting their health information electronically through My HealtheVet. Affected Public: Individuals or households. Estimated Total Annual Burden: a. VA Form 10–5345—15,000 hours. b. VA Form 10–5345a—15,000 hours. c. VA Form 10–5345a–MVH—35,000 hours. Estimated Average Burden per Respondent: a. VA Form 10–5345—3 minutes. b. VA Form 10–5345a—3 minutes. c. VA Form 10–5345a–MVH—3 minutes. Frequency of Response: On occasion. Estimated Number of Respondents: a. VA Form 10–5345—300,000. b. VA Form 10–5345a—300,000. c. 10–5345a–MVH—700,000. Dated: September 2, 2009. By direction of the Secretary. Denise McLamb, Program Analyst, Enterprise Records Service. [FR Doc. E9–21574 Filed 9–8–09; 8:45 am] BILLING CODE P VerDate Nov<24>2008 15:47 Sep 08, 2009 Jkt 217001 DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900–New (10–0468)] Proposed Information Collection (Internet Student CPR Web Registration Application); Comment Request AGENCY: Veterans Health Administration, Department of Veterans Affairs. ACTION: Notice. SUMMARY: The Veterans Health Administration (VHA), Department of Veterans Affairs, is announcing an opportunity for public comment on the proposed collection of certain information by the agency. Under the Paperwork Reduction Act (PRA) of 1995, Federal agencies are required to publish notice in the Federal Register concerning each proposed collection of information, including each proposed new collection, and allow 60 days for public comment in response to the notice. This notice solicits comments on information needed to establish an online Web registration application. DATES: Written comments and recommendations on the proposed collection of information should be received on or before November 9, 2009. ADDRESSES: Submit written comments on the collection of information through the Federal Docket Management System (FDMS) at http://www.Regulations.gov; or to Mary Stout, Veterans Health Administration (193E1), Department of Veterans Affairs, 810 Vermont Avenue, NW., Washington, DC 20420 or e-mail: mary.stout@va.gov. Please refer to ‘‘OMB Control No. 2900–New (10– 0468)’’ in any correspondence. During the comment period, comments may be viewed online through FDMS. FOR FURTHER INFORMATION CONTACT: Mary Stout at (202) 461–5867 or FAX (202) 273–9381. SUPPLEMENTARY INFORMATION: Under the PRA of 1995 (Pub. L. 104–13; 44 U.S.C. 3501–3521), Federal agencies must obtain approval from OMB for each collection of information they conduct or sponsor. This request for comment is being made pursuant to Section 3506(c)(2)(A) of the PRA. With respect to the following collection of information, VHA invites comments on: (1) Whether the proposed collection of information is necessary for the proper performance of VHA’s functions, including whether the information will have practical utility; (2) the accuracy of VHA’s estimate of the burden of the proposed collection of information; (3) ways to enhance the PO 00000 Frm 00079 Fmt 4703 Sfmt 4703 46485 quality, utility, and clarity of the information to be collected; and (4) ways to minimize the burden of the collection of information on respondents, including through the use of automated collection techniques or the use of other forms of information technology. Title: Internet Student CPR Web Registration Application, VA Form 10– 0468. OMB Control Number: 2900–New (10–0468). Type of Review: New collection. Abstract: The data collected on VA Form 10–0468 will be used to establish a roster on students attending courses provided by the Minneapolis VA Medical Center Education Service. Students will be able to identify and register for a training course online without waiting for the Registrar to return calls or e-mails to confirm enrollment. Affected Public: Individuals or households. Estimated Annual Burden: 125 hours. Estimated Average Burden per Respondent: 5 minutes. Frequency of Response: Bi-Annually. Estimated Number of Responses: 1,500. Dated: September 2, 2009. By direction of the Secretary. Denise McLamb, Program Analyst, Enterprise Records Service. [FR Doc. E9–21576 Filed 9–8–09; 8:45 am] BILLING CODE 8320–01–P DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900–New (10–0473)] Proposed Information Collection (Millennium Bill Emergency Care Provider Satisfaction Survey); Comment Request AGENCY: Veterans Health Administration, Department of Veterans Affairs. ACTION: Notice. SUMMARY: The Veterans Health Administration (VHA), Department of Veterans Affairs (VA), is announcing an opportunity for public comment on the proposed collection of certain information by the agency. Under the Paperwork Reduction Act (PRA) of 1995, Federal agencies are required to publish notice in the Federal Register concerning each proposed collection of information, including each proposed new collection, and allow 60 days for public comment in response to the notice. This notice solicits comments on E:\FR\FM\09SEN1.SGM 09SEN1

Agencies

[Federal Register Volume 74, Number 173 (Wednesday, September 9, 2009)]
[Notices]
[Pages 46484-46485]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E9-21574]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0260]


Proposed Information Collection (Request for and Authorization To 
Release Medical Records or Health Information) Activity: Comment 
Request

AGENCY: Veterans Health Administration, Department of Veterans Affairs.

ACTION: Notice.

-----------------------------------------------------------------------

SUMMARY: The Veterans Health Administration (VHA) is announcing an 
opportunity for public comment on the proposed collection of certain 
information by the agency. Under the Paperwork Reduction Act (PRA) of 
1995, Federal agencies are required to publish notice in the Federal 
Register concerning each proposed collection of information, including 
each proposed revision of a currently approved collection, and allow 60 
days for public comment in response to the notice. This notice solicits 
comments on information needed to obtain a patient written consent to 
disclose medical records or health information to individuals or third 
parties.

DATES: Written comments and recommendations on the proposed collection 
of information should be received on or before November 9, 2009.

ADDRESSES: Submit written comments on the collection of information 
through Federal Docket Management System (FDMS) at www.Regulations.gov; 
or to Mary Stout, Veterans Health Administration (193E1), Department of 
Veterans Affairs, 810 Vermont Avenue, NW., Washington, DC 20420 or e-
mail: mary.stout@va.gov. Please refer to ``OMB Control No. 2900-0260'' 
in any correspondence. During the comment period, comments may be 
viewed online through FDMS.

FOR FURTHER INFORMATION CONTACT: Mary Stout, (202) 461-5867 or FAX 
(202) 273-9381.

SUPPLEMENTARY INFORMATION: Under the PRA of 1995 (Pub. L. 104-13; 44 
U.S.C. 3501-3521), Federal agencies must obtain approval from the 
Office of Management and Budget (OMB) for each collection of 
information they conduct or sponsor. This request for comment is being 
made pursuant to Section 3506(c)(2)(A) of the PRA.
    With respect to the following collection of information, VHA 
invites comments on: (1) Whether the proposed collection of information 
is necessary for the proper performance of VHA's functions, including 
whether the

[[Page 46485]]

information will have practical utility; (2) the accuracy of VHA's 
estimate of the burden of the proposed collection of information; (3) 
ways to enhance the quality, utility, and clarity of the information to 
be collected; and (4) ways to minimize the burden of the collection of 
information on respondents, including through the use of automated 
collection techniques or the use of other forms of information 
technology.
    Titles:
    a. Request for and Authorization To Release Medical Records or 
Health Information, VA Form 10-5345.
    b. Individual's Request for a Copy of Their Own Health Information, 
VA Form 10-5345a.
    c. My HealtheVet (MHV)--Individuals' Request for a Copy of Their 
Own Health Information, VA Form 10-5345a-MHV.
    OMB Control Number: 2900-0260.
    Type of Review: Revision of a currently approved collection.
    Abstract:
    a. VA Form 10-5345 is used to obtain a written consent from 
patients before information concerning his or her treatment for 
alcoholism or alcohol abuse, drug abuse, sickle cell anemia, or 
infection with the human immunodeficiency virus (HIV) can be disclosed 
to private insurance companies, physicians and other third parties.
    b. Patients complete VA Form 10-5345a to request a copy of their 
health information maintained at Department of Veterans Affairs.
    c. VA Form 10-5345a-MHV is completed by individuals requesting 
their health information electronically through My HealtheVet.
    Affected Public: Individuals or households.
    Estimated Total Annual Burden:
    a. VA Form 10-5345--15,000 hours.
    b. VA Form 10-5345a--15,000 hours.
    c. VA Form 10-5345a-MVH--35,000 hours.
    Estimated Average Burden per Respondent:
    a. VA Form 10-5345--3 minutes.
    b. VA Form 10-5345a--3 minutes.
    c. VA Form 10-5345a-MVH--3 minutes.
    Frequency of Response: On occasion.
    Estimated Number of Respondents:
    a. VA Form 10-5345--300,000.
    b. VA Form 10-5345a--300,000.
    c. 10-5345a-MVH--700,000.

    Dated: September 2, 2009.

    By direction of the Secretary.
Denise McLamb,
Program Analyst, Enterprise Records Service.
[FR Doc. E9-21574 Filed 9-8-09; 8:45 am]
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