Agency Information Collection: (PACT Clinical Innovation Study: Engaging Caregivers in the Care of Veterans With Dementia); Comment Request, 50548-50549 [2012-20461]
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50548
Federal Register / Vol. 77, No. 162 / Tuesday, August 21, 2012 / Notices
Affected Public: Individuals or
households.
Estimated Annual Burden:
a. VA Form 10–0532—67 hours.
b. VA Form 10–0532a—80 hours.
c. VA Form 10–0532b—200 hours.
d. VA Form 10–0532c—80 hours.
e. VA Form 10–0532d—53 hours.
f. VA Form 10–0532e—53 hours.
g. VA Form 10–0532f—133 hours.
h. VA Form 10–0532g—19 hours.
i. VA Form 10–0532h—27 hours.
j. VA Form 10–0532i—93 hours.
k. VA Form 10–0532j– 67 hours.
l. VA Form 10–0532k—67 hours.
Estimated Average Burden per
Respondent:
a. VA Form 10–0532—5 minutes.
b. VA Form 10–0532a—10 minutes.
c. VA Form 10–0532b—15 minutes.
d. VA Form 10–0532c—15 minutes.
e. VA Form 10–0532d—10 minutes.
f. VA Form 10–0532e—10 minutes.
g. VA Form 10–0532f—10 minutes.
h. VA Form 10–0532g—7 minutes.
i. VA Form 10–0532h—10 minutes.
j. VA Form 10–0532i—7 minutes.
k. VA Form 10–0532j—5 minutes.
l. VA Form 10–0532k—5 minutes,
Frequency of Response: Monthly.
Estimated Number of Respondents:
a. VA Form 10–0532—800.
b. VA Form 10–0532a—480.
c. VA Form 10–0532b—800.
d. VA Form 10–0532c—320.
e. VA Form 10–0532d—320.
f. VA Form 10–0532e—320.
g. VA Form 10–0532f—800.
h. VA Form 10–0532g—160.
i. VA Form 10–0532h—160.
j. VA Form 10–0532i—800.
k. VA Form 10–0532j—800.
l. VA Form 10–0532k—800
Dated: August 16, 2012.
By direction of the Secretary.
Denise McLamb,
Program Analyst Director, Enterprise Records
Service.
[FR Doc. 2012–20457 Filed 8–20–12; 8:45 am]
BILLING CODE 8320–01–P
DEPARTMENT OF VETERANS
AFFAIRS
pmangrum on DSK3VPTVN1PROD with NOTICES
[OMB Control No. 2900–New (Patient &
Caregiver)]
Agency Information Collection: (PACT
Qualitative Evaluation: Patient &
Caregiver Interviews); Comment
Request
Veterans Health
Administration, Department of Veterans
Affairs.
ACTION: Notice.
AGENCY:
In compliance with the
Paperwork Reduction Act (PRA) of 1995
SUMMARY:
VerDate Mar<15>2010
15:31 Aug 20, 2012
Jkt 226001
(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 evaluate the universal Patient
Aligned Care Teams (PACT) Systems
Redesign, document patients’ and their
informal caregivers’ experience.
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 (Patient & Caregiver).
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 (Patient &
Caregiver).
SUPPLEMENTARY INFORMATION:
Title: PACT Qualitative Evaluation:
Patient & Caregiver Interviews.
OMB Control Number: 2900—New
Type of Review: New data collection.
Abstract: The information collected
will be used assess patients’ and
caregivers’ experiences with the PACT
Systems Redesign and the PACT Demo
Lab innovations and will inform the
redesign and demo lab innovations in
real time. It will also gather information
on patient characteristics and their
experiences with self-managing chronic
conditions, using technology to care for
their health, and involving friends and
family members in their health care.
The information collected will be used
by the PACT Demonstration Laboratory
and the Ambulatory Care Service to
evaluate the universal VHA PACT
Systems Redesign, document patients’
and their informal caregivers’
experiences over time, and improve
patient care through specific
mechanisms.
Affected Public: Individuals or
households.
Estimated Annual Burden: 50 burden
hours.
Estimated Average Burden per
Respondent: 30 minutes.
Frequency of Response: One-time.
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Fmt 4703
Sfmt 4703
Estimated Number of Respondents:
100.
Dated: August 16, 2012.
By direction of the Secretary.
Denise McLamb,
Program Analyst Director, Enterprise Records
Service.
[FR Doc. 2012–20462 Filed 8–20–12; 8:45 am]
BILLING CODE 8320–01–P
DEPARTMENT OF VETERANS
AFFAIRS
[OMB Control No. 2900-New (VA Form 10–
0537)]
Agency Information Collection: (PACT
Clinical Innovation Study: Engaging
Caregivers in the Care of Veterans
With Dementia); 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 improve dementia care for patients
and care givers.
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 10–0537).
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 10–0537).
SUPPLEMENTARY INFORMATION:
Title: PACT Clinical Innovation
Study: Engaging Caregivers in the Care
of Veterans with Dementia, VA Form
10–0537, Appendices a–u.
OMB Control Number: 2900—New.
Type of Review: New data collection.
SUMMARY:
E:\FR\FM\21AUN1.SGM
21AUN1
Federal Register / Vol. 77, No. 162 / Tuesday, August 21, 2012 / Notices
Abstract: The data collected on VA
Form 10–0537, Appendices a–u, will be
used to examine the feasibility and
extent to which a patient-centered and
dementia care management program for
veterans and their caregivers facilitates
access to and use of medical and social
services. The information will help VA
develop and test a care management
intervention that will improve dementia
care for patients and family caregivers.
Affected Public: Individuals or
households.
Estimated Annual Burden: 704 hours.
Estimated Average Burden per
Respondent: 88 minutes.
Frequency of Response: On occasion.
Estimated Number of Respondents:
160.
Estimated Number of Responses: 480.
Dated: August 16, 2012.
By direction of the Secretary.
Denise McLamb,
Program Analyst Director, Enterprise Records
Service.
[FR Doc. 2012–20461 Filed 8–20–12; 8:45 am]
BILLING CODE 8320–01–P
DEPARTMENT OF VETERANS
AFFAIRS
[OMB Control No. 2900—New (VA Form 10–
0533a–c)]
Agency Information Collection:
Emergency Submission for OMB
Review (Telehealth in the Parkinson’s
Disease Research, Education and
Clinical Center (PADRECC): The Key to
the Patient-Centered Medical Home?);
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),
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 improve the care and clinical
outcomes of patients with Parkinson’s
disease.
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
pmangrum on DSK3VPTVN1PROD with NOTICES
SUMMARY:
VerDate Mar<15>2010
15:31 Aug 20, 2012
Jkt 226001
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 10–0533a–c).
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 10–0533a–c).’’
SUPPLEMENTARY INFORMATION:
Dated: August 16, 2012.
By direction of the Secretary.
Denise McLamb,
Program Analyst Director, Enterprise Records
Service.
[FR Doc. 2012–20456 Filed 8–20–12; 8:45 am]
BILLING CODE 8320–01–P
PO 00000
Frm 00093
Fmt 4703
Sfmt 4703
DEPARTMENT OF VETERANS
AFFAIRS
[OMB Control No. 2900—New (VA Form (10–
0530a–b)]
Agency Information Collection:
Emergency Submission for OMB
Review (VISN 23 PACT Demonstration
Lab: Patient Care Preferences
Surveys); 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 improve health care for 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 10–0530a–b).
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
(10–0530a–b).
SUPPLEMENTARY INFORMATION:
Title: VISN 23 PACT Demonstration
Lab: Patient Care Preferences Survey.
a. Multidimensional Health Locus of
Control, VA Form 10–0530.
b. General Adherence Scale, VA Form
10–0530a.
c. Demographic Data: Patient
Background Information, VA Form 10–
0530b.
OMB Control Number: 2900–New.
Type of Review: New data collection.
Abstract: This patient self-assessment
of health study and patient satisfaction
questionnaire seek to collect individual,
primary data from patients concerning
attitudes toward healthcare. The VHA
PACT Demo Lab is a new grant-funded
project. No existing information can be
SUMMARY:
Titles:
a. PACT ‘‘Telehealth in the
Parkinson’s Disease Research, Education
and Clinical Center (PADRECC): The
Key to the Patient-Centered Medical
Home?’’, VA Form 10–0533.
b. Geriatric Depression Scale (GDS)
Short Form, VA Form 10–5033a.
c. Quality of Life in Parkinson’s
Disease, VA Form 10–0533b.
d. Cost and Patient Outcomes
Questions, VA Form 10–0533c.
OMB Control Number: 2900—New
(VA Form 10–0533a–c).
Type of Review: New data collection.
Abstract: The data collected on VA
Forms 10–0533a-c will be used to obtain
data on the cost, clinical outcomes, and
patient satisfaction associated with
expanded access to PADRECC care
through the use of telehealth. VA will
use the information to assess whether or
not the use of telehealth is feasible, costeffective, and clinically equivalent
alternative to routine face-to-face care
for patients with Parkinson’s disease.
Affected Public: Individuals or
households.
Estimated Annual Burden: 116
burden hours.
Estimated Average Burden per
Respondent: 4.4 minutes.
Frequency of Response: On occasion.
Estimated Number of Respondents:
400.
Estimated Number of Responses:
1,600.
50549
E:\FR\FM\21AUN1.SGM
21AUN1
]]>Agencies
[Federal Register Volume 77, Number 162 (Tuesday, August 21, 2012)]
[Notices]
[Pages 50548-50549]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2012-20461]
-----------------------------------------------------------------------
DEPARTMENT OF VETERANS AFFAIRS
[OMB Control No. 2900-New (VA Form 10-0537)]
Agency Information Collection: (PACT Clinical Innovation Study:
Engaging Caregivers in the Care of Veterans With Dementia); 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 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 dementia care for patients and care
givers.
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 10-0537).
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 10-0537).
SUPPLEMENTARY INFORMATION:
Title: PACT Clinical Innovation Study: Engaging Caregivers in the
Care of Veterans with Dementia, VA Form 10-0537, Appendices a-u.
OMB Control Number: 2900--New.
Type of Review: New data collection.
[[Page 50549]]
Abstract: The data collected on VA Form 10-0537, Appendices a-u,
will be used to examine the feasibility and extent to which a patient-
centered and dementia care management program for veterans and their
caregivers facilitates access to and use of medical and social
services. The information will help VA develop and test a care
management intervention that will improve dementia care for patients
and family caregivers.
Affected Public: Individuals or households.
Estimated Annual Burden: 704 hours.
Estimated Average Burden per Respondent: 88 minutes.
Frequency of Response: On occasion.
Estimated Number of Respondents: 160.
Estimated Number of Responses: 480.
Dated: August 16, 2012.
By direction of the Secretary.
Denise McLamb,
Program Analyst Director, Enterprise Records Service.
[FR Doc. 2012-20461 Filed 8-20-12; 8:45 am]
BILLING CODE 8320-01-P
