Proposed Information Collection (Millennium Bill Emergency Care Provider Satisfaction Survey); Comment Request, 46485-46486 [E9-21575]
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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
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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 https://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
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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
cprice-sewell on DSK2BSOYB1PROD with NOTICES
46486
Federal Register / Vol. 74, No. 173 / Wednesday, September 9, 2009 / Notices
information needed to improve
customer satisfactions with VHA’s claim
reimbursement process.
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 https://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–
0473)’’ 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
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: Millennium Bill Emergency
Care Provider Satisfaction Survey, VA
Form 10–0473.
OMB Control Number: 2900–New
(10–0473).
Type of Review: New collection.
Abstract: VA Form 10–0473 will be
used to survey non-VA healthcare
providers who participate in the
Millennium Bill Fee Reimbursement/
Purchased Care program on their
satisfaction with VHA’s claims
processing services. VA will use the
data collected to improve the claims
processing program.
Affected Public: Individuals or
households.
Estimated Annual Burden: 9 hours.
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Estimated Average Burden per
Respondent: 5 minutes.
Frequency of Response: Annually.
Estimated Number of Respondents:
110.
Dated: September 2, 2009.
By direction of the Secretary.
Denise McLamb,
Program Analyst, Enterprise Records Service.
[FR Doc. E9–21575 Filed 9–8–09; 8:45 am]
BILLING CODE 8320–01–P
DEPARTMENT OF VETERANS
AFFAIRS
[OMB Control No. 2900–0554]
Agency Information Collection
(Homeless Providers Grant and per
diem Program) Activities Under OMB
Review
AGENCY: Veterans Health
Administration, Department of Veterans
Affairs.
ACTION: Notice.
SUMMARY: 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
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.
ADDRESSES: Submit written comments
on the collection of information through
https://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–
0554’’ in any correspondence.
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. 2900–0554.’’
SUPPLEMENTARY INFORMATION:
Titles: a. Homeless Providers Grant
and Per Diem Program, Capital Grant
Application, VA Form 10–0361–CG.
b. Homeless Providers Grant and Per
Diem Program, Life Safety Code
Application, VA Form 10–0361–LSC.
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c. Homeless Providers Grant and Per
Diem Program, Per Diem Only
Application, VA Form 10–0361–PDO.
d. Homeless Providers Grant and Per
Diem Program, Special Needs
Application, VA Form 10–0361–SN.
e. Compliance Reports for Per Diem
and Special Needs Grants. No form
needed. May be reported to VA in
standard business narrative.
f. Homeless Providers Grant and Per
Diem Program, Technical Assistance
Application, VA Form 10–0361–TA.
g. Compliance Reports for Technical
Assistance Grants. No form needed. May
be reported to VA in standard business
narrative.
OMB Control Number: 2900–0554.
Type of Review: Extension of a
currently approved collection.
Abstract: VA Form 10–0361 series,
Homeless Providers Grant and Per Diem
Program, will be used to evaluate
applicant’s eligibility to receive a grant
and/or Per Diem payments which
provide supportive housing and services
to assist homeless veterans transition to
independent living. VA will use the
data to apply specific criteria to rate and
evaluate each application; and to obtain
information necessary to ensure that
Federal funds are awarded to applicants
who are financially stable and who will
conduct the program for which a grant
and/or Per Diem award was made.
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 22, 2009, at pages 29537–29538.
Affected Public: Not-for-profit
institutions.
Estimated Total Annual Burden:
a. Homeless Providers Grant and Per
Diem Program, Capital Grant
Application, VA Form 10–0361–CG—
3,500 hours.
b. Homeless Providers Grant and Per
Diem Program, Life Safety Code
Application, VA Form 10–0361–LSC—
2,000 hours.
c. Homeless Providers Grant and Per
Diem Program, Per Diem Only
Application, VA Form 10–0361–PDO—
3,000 hours.
d. Homeless Providers Grant and Per
Diem Program, Special Needs
Application, VA Form 10–0361–SN—
4,000 hours.
e. Compliance Reports for Per Diem
and Special Needs Grants—1,500 hours.
f. Homeless Providers Grant and Per
Diem Program, Technical Assistance
Application, VA Form 10–0361–TA—
250 hours.
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Agencies
[Federal Register Volume 74, Number 173 (Wednesday, September 9, 2009)]
[Notices]
[Pages 46485-46486]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E9-21575]
-----------------------------------------------------------------------
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
[[Page 46486]]
information needed to improve customer satisfactions with VHA's claim
reimbursement process.
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 https://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 (10-0473)'' 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 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: Millennium Bill Emergency Care Provider Satisfaction Survey,
VA Form 10-0473.
OMB Control Number: 2900-New (10-0473).
Type of Review: New collection.
Abstract: VA Form 10-0473 will be used to survey non-VA healthcare
providers who participate in the Millennium Bill Fee Reimbursement/
Purchased Care program on their satisfaction with VHA's claims
processing services. VA will use the data collected to improve the
claims processing program.
Affected Public: Individuals or households.
Estimated Annual Burden: 9 hours.
Estimated Average Burden per Respondent: 5 minutes.
Frequency of Response: Annually.
Estimated Number of Respondents: 110.
Dated: September 2, 2009.
By direction of the Secretary.
Denise McLamb,
Program Analyst, Enterprise Records Service.
[FR Doc. E9-21575 Filed 9-8-09; 8:45 am]
BILLING CODE 8320-01-P