Agency Information Collection: (PACT Patient Experiences Survey); Comment Request, 50546-50547 [2012-20455]

Download as PDF pmangrum on DSK3VPTVN1PROD with NOTICES 50546 Federal Register / Vol. 77, No. 162 / Tuesday, August 21, 2012 / Notices Silvana G. Garza, Associate CIO, Affordable Care Act Program Management Office (IT) David A. Grant, Chief, Agency-Wide Shared Services (AWSS) Joseph H. Grant, Deputy Commissioner, Tax Exempt and Government Entities (TE/GE) Rena C. Girinakis, Executive Director, Systemic Advocacy, Taxpayer Advocate Service (TAS) Patricia J. Haynes, Director, Investigative and Enforcement Operations, Criminal Investigation (CI) Shenita L. Hicks, Director, Examination (SB/SE) Debra S. Holland, Deputy Commissioner for Support (W&I) Robert L. Hunt, Director, Collection (SB/ SE) Robin DelRey Jenkins, Director, Office of Business Modernization (SB/SE) Michael D. Julianelle, Director, Enterprise Collection Strategy (SB/SE) Gregory E. Kane, Deputy Chief Financial Officer, Chief Financial Office (CFO) Sheldon M. Kay, Deputy Chief, Appeals (AP) Frank M. 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[FR Doc. 2012–20439 Filed 8–20–12; 8:45 am] BILLING CODE 4830–01–P DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-New (VA Form 10– 0534)] Agency Information Collection: Emergency Submission for OMB Review (CEPACT (Center for Evaluation of PACT) Demographic Questionnaire and Patient Focus Group); Comment Request Veterans Health Administration, Department of Veterans Affairs. ACTION: Notice. AGENCY: In compliance with the Paperwork Reduction Act (PRA) of 1995 (44 U.S.C. 3501–3521), this notice announces that the United States Department of Veterans Affairs (VA), has submitted to the Office of Management and Budget (OMB) the following emergency proposal for the collection of information under the provisions of the Paperwork Reduction Act (44 U.S.C. 3507(j)(1)). An emergency clearance is being requested for information needed to focus on patient experiences with and views on barriers and facilitators to specific aspects of the Patient-Aligned Care Team (PACT) care model: High risk care management, telemedicine and shared medical appointments. SUMMARY: Comments must be submitted on or before August 31, 2012. ADDRESSES: Send comments and recommendations concerning any aspect of the information collection to VA’s OMB Desk Officer, OMB Human Resources and Housing Branch, New DATES: PO 00000 Frm 00090 Fmt 4703 Sfmt 4703 Executive Office Building, Room 10235, Washington, DC 20503 (202) 395–7316 or Fax (202) 395–6974. Please refer to ‘‘2900–New (VA Form 10–0534). FOR FURTHER INFORMATION CONTACT: Denise McLamb, Enterprise Records Service (005R1B), Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 20420, (202) 632– 7479, Fax (202) 632–7583 or email: denise.mclamb@va.gov. Please refer to ‘‘OMB Control No. 2900–New (VA Form 10–0534). SUPPLEMENTARY INFORMATION: Title: CEPACT (Center for Evaluation of PACT) Demographic Questionnaire, VA Form 10–0534 and Patient Focus Group. OMB Control Number: 2900–New (VA Form 10–0534). Type of Review: New data collection. Abstract: The data collected on VA Form 10–0534 will be used to implement the PACT model that will in turn improve health care for Veterans and sustain VA’s leadership in health care quality. This will be done to evaluate the effectiveness of various types of care delivered to patients throughout the PACT model. Affected Public: Individuals or households. Estimated Annual Burden: 226. Estimated Average Burden per Respondent: 85 minutes for focus group; 5 minutes for questionnaire. Frequency of Response: One-time. Estimated Number of Respondents: 150. Estimated Number of Responses: 300. Dated: August 16, 2012. By direction of the Secretary. Denise McLamb, Program Analyst Director, Enterprise Records Service. [FR Doc. 2012–20454 Filed 8–20–12; 8:45 am] BILLING CODE 8320–01–P DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900–New (VA Form 10– 0536)] Agency Information Collection: (PACT Patient Experiences Survey); Comment Request Veterans Health Administration, Department of Veterans Affairs. ACTION: Notice. AGENCY: In compliance with the Paperwork Reduction Act (PRA) of 1995 (44 U.S.C. 3501–3521), this notice announces that the Department of Veterans Affairs (VA), will submit to the SUMMARY: E:\FR\FM\21AUN1.SGM 21AUN1 pmangrum on DSK3VPTVN1PROD with NOTICES Federal Register / Vol. 77, No. 162 / Tuesday, August 21, 2012 / Notices Office of Management and Budget (OMB) the following emergency proposal for the collection of information under the provisions of the Paperwork Reduction Act (44 U.S.C. 3507(j)(1)). An emergency clearance is being requested for information needed to improve patient care through specific mechanisms. VA has undertaken an initiative to implement a patientcentered medical home model, ‘‘Patient Aligned Care Team’’ or PACT at all Veterans Health Administration (VHA) Ambulatory Primary Care sites. This initiative supports the VHA’s Universal Health Care Services Plan to redesign VHA healthcare delivery through increasing access, coordination, communication, and continuity of care. The patient experiences from this data collection are intended to help form future national VA policy. DATES: Comments must be submitted on or before August 31, 2012. ADDRESSES: Send comments and recommendations concerning any aspect of the information collection to VA’s OMB Desk Officer, OMB Human Resources and Housing Branch, New Executive Office Building, Room 10235, Washington, DC 20503 (202) 395–7316 or Fax (202) 395–6974. Please refer to ‘‘2900–New (VA Form 10–0536).’’ FOR FURTHER INFORMATION CONTACT: Denise McLamb, Enterprise Records Service (005R1B), Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 20420, (202) 632– 7479, Fax (202) 632–7583 or email: denise.mclamb@va.gov. Please refer to ‘‘OMB Control No. 2900–New (VA Form 10–0536). SUPPLEMENTARY INFORMATION: Title: PACT Patient Experiences Survey, VA Form 10–0536. OMB Control Number: 2900—New. Type of Review: New data collection. Abstract: The data collected on VA Form 10–0536 will be used to implement a patient-centered medical home at all Veterans Health Administration Ambulatory Primary Care sites. The medical home provides accessible, coordinated, comprehensive, patient-centered care, and is managed by primary care providers with the active involvement of other clinical and non-clinical staff. The medical home allows patients to have a more active role in their health care and is associated with increased quality improvement, patient satisfaction, and a decrease in hospital costs due to fewer hospital visits and readmissions. The information collected will be used by the VAAAHS PACT Demonstration Laboratory and the Ambulatory Care Service to evaluate the universal VHA VerDate Mar<15>2010 15:31 Aug 20, 2012 Jkt 226001 PACT Systems Redesign, document patient experiences over time, and improve patient care through specific mechanisms. Affected Public: Individuals or households. Estimated Annual Burden: 2,400 hours. Estimated Average Burden Per Respondent: 30 minutes. Frequency of Response: On occasion. Estimated Number of Respondents: 2,400. Estimated Number of Responses: 4,800. Dated: August 16, 2012. By direction of the Secretary. Denise McLamb, Program Analyst Director, Enterprise Records Service. [FR Doc. 2012–20455 Filed 8–20–12; 8:45 am] BILLING CODE 8320–01–P DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900—New VA Form (VA Form 10–0532a–k)] Agency Information Collection: Emergency Submission for OMB Review (PACT: Clinical Innovation Study—Helping Veterans Manage Chronic Pain); Comment Request Veterans Health Administration, Department of Veterans Affairs. ACTION: Notice. AGENCY: In compliance with the Paperwork Reduction Act (PRA) of 1995 (44 U.S.C., 3501–3521), this notice announces that the Department of Veterans Affairs (VA), will submit to the Office of Management and Budget (OMB) the following emergency proposal for the collection of information under the provisions of the Paperwork Reduction Act (44 U.S.C. 3507(j)(1)). An emergency clearance is being requested for information needed to assess the effectiveness of pain care management provided to veterans. DATES: Comments must be submitted on or before August 31, 2012. ADDRESSES: Send comments and recommendations concerning any aspect of the information collection to VA’s OMB Desk Officer, OMB Human Resources and Housing Branch, New Executive Office Building, Room 10235, Washington, DC 20503, (202) 395–7316 or Fax (202) 395–6974. Please refer to ‘‘2900—New VA Form (VA Form 10– 0532a–k). FOR FURTHER INFORMATION CONTACT: Denise McLamb, Enterprise Records SUMMARY: PO 00000 Frm 00091 Fmt 4703 Sfmt 4703 50547 Service (005R1B), Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 20420, (202) 632– 7479, Fax (202) 632–7583 or email: denise.mclamb@va.gov. Please refer to ‘‘OMB Control No. 2900—New VA Form (VA Form 10–0532a–k).’’ SUPPLEMENTARY INFORMATION: Titles: Clinical Innovation Study— Helping Veterans Manage Chronic Pain. a. Pain Care Management Tracking Tool, VA Form 10–0532. b. Pain Care Management Self Monitoring Form (unpublished), VA Form 10–0532a. c. Pain Outcomes Questionnaire (Clark, Gironda, & Young, 2003), VA Form 10–0532b. d. The Multidimensional Pain Inventory (MPI; Kearns, Turk, & Rudy, 1985), VA Form 10–0532c. e. Pain Catastrophizing Scale (Osman, Barrios, Gutierrez, Kopper, Merrifield, & Grittmann, 2000), VA Form 10–0532d. f. The Oswestry Disability Index (Fairbank & Pynsent, 2000), VA Form 10–0532e. g. Brief Pain Inventory—Short Form (BPI; Cleeland, 1991). Administered at baseline and each follow-up, VA Form 10–0532f. h. Fear-Avoidance Beliefs Questionnaire (FABQ; Waddell, Newton, et al., 1993), VA Form 10– 0532g. i. The Brief COPE (Carver, 1997), VA Form 10–0532h. j. Depression and Anxiety Stress Scales (DASS–21; Lovibond & Lovibond, 1995), VA Form 10–0532i. k. Patient Health Questionnaire (PHQ–9; Kroenke, Spitzer, & Williams, 2001), VA Form 10–0532j. l. Generalized Anxiety Disorder (GAD–7); Spitzer, Kroenke, Williams, & Lowe, 2006), VA Form 10–0532k. OMB Control Number: 2900–New. Type of Review: New data collection. Abstract: The data collected on VA Forms VA Form 10–0532a–k will be used to: (1) Assess the effectiveness of patient care management (PCM) in increasing patients’ functionality, improving quality of life, and improving paint control relative to usual care and (2) to assess the impact of PCM on depression and anxiety relative to usual care. This data collection’s model has been designed to serve patients by augmenting existing pain management interventions (e.g., medications, physical therapy) by teaching pain care management skills that patients can incorporate into their daily activities. VA will use the information to evaluate the effectiveness of the intervention so that it can most effectively be applied to future patients with chronic pain problems. E:\FR\FM\21AUN1.SGM 21AUN1

Agencies

[Federal Register Volume 77, Number 162 (Tuesday, August 21, 2012)]
[Notices]
[Pages 50546-50547]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2012-20455]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-New (VA Form 10-0536)]


Agency Information Collection: (PACT Patient Experiences Survey); 
Comment Request

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 Department of 
Veterans Affairs (VA), will submit to the

[[Page 50547]]

Office of Management and Budget (OMB) the following emergency proposal 
for the collection of information under the provisions of the Paperwork 
Reduction Act (44 U.S.C. 3507(j)(1)). An emergency clearance is being 
requested for information needed to improve patient care through 
specific mechanisms. VA has undertaken an initiative to implement a 
patient-centered medical home model, ``Patient Aligned Care Team'' or 
PACT at all Veterans Health Administration (VHA) Ambulatory Primary 
Care sites. This initiative supports the VHA's Universal Health Care 
Services Plan to redesign VHA healthcare delivery through increasing 
access, coordination, communication, and continuity of care. The 
patient experiences from this data collection are intended to help form 
future national VA policy.

DATES: Comments must be submitted on or before August 31, 2012.

ADDRESSES: Send comments and recommendations concerning any aspect of 
the information collection to VA's OMB Desk Officer, OMB Human 
Resources and Housing Branch, New Executive Office Building, Room 
10235, Washington, DC 20503 (202) 395-7316 or Fax (202) 395-6974. 
Please refer to ``2900-New (VA Form 10-0536).''

FOR FURTHER INFORMATION CONTACT: Denise McLamb, Enterprise Records 
Service (005R1B), Department of Veterans Affairs, 810 Vermont Avenue 
NW., Washington, DC 20420, (202) 632-7479, Fax (202) 632-7583 or email: 
denise.mclamb@va.gov. Please refer to ``OMB Control No. 2900-New (VA 
Form 10-0536).

SUPPLEMENTARY INFORMATION: 
    Title: PACT Patient Experiences Survey, VA Form 10-0536.
    OMB Control Number: 2900--New.
    Type of Review: New data collection.
    Abstract: The data collected on VA Form 10-0536 will be used to 
implement a patient-centered medical home at all Veterans Health 
Administration Ambulatory Primary Care sites. The medical home provides 
accessible, coordinated, comprehensive, patient-centered care, and is 
managed by primary care providers with the active involvement of other 
clinical and non-clinical staff. The medical home allows patients to 
have a more active role in their health care and is associated with 
increased quality improvement, patient satisfaction, and a decrease in 
hospital costs due to fewer hospital visits and readmissions. The 
information collected will be used by the VAAAHS PACT Demonstration 
Laboratory and the Ambulatory Care Service to evaluate the universal 
VHA PACT Systems Redesign, document patient experiences over time, and 
improve patient care through specific mechanisms.
    Affected Public: Individuals or households.
    Estimated Annual Burden: 2,400 hours.
    Estimated Average Burden Per Respondent: 30 minutes.
    Frequency of Response: On occasion.
    Estimated Number of Respondents: 2,400.
    Estimated Number of Responses: 4,800.

    Dated: August 16, 2012.

    By direction of the Secretary.
Denise McLamb,
Program Analyst Director, Enterprise Records Service.
[FR Doc. 2012-20455 Filed 8-20-12; 8:45 am]
BILLING CODE 8320-01-P
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