Agency Information Collection Activities (Per Diem for Nursing Home Care of Veterans in State Homes; Per Diem for Adult Day Care of Veterans in State Homes) Under OMB Review, 64386-64387 [2012-25749]
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64386
Federal Register / Vol. 77, No. 203 / Friday, October 19, 2012 / Notices
to provide evidence that their decision
to submit a prior approval loan
application or close a loan on the
automatic basis is based upon
appropriate application of VA credit
standards.
Affected Public: Federal Government.
Estimated Annual Burden: 62,500
hours.
Estimated Average Burden per
Respondent: 15 minutes.
Frequency of Response: On occasion.
Estimated Number of Respondents:
250,000.
Dated: October 15, 2012.
By direction of the Secretary.
William F. Russo,
Deputy Director, Office of Regulations Policy
and Management, Office of the General
Counsel, Department of Veterans Affairs.
[FR Doc. 2012–25752 Filed 10–18–12; 8:45 am]
BILLING CODE 8320–01–P
DEPARTMENT OF VETERANS
AFFAIRS
[OMB Control No. 2900–0745]
Proposed Information Collection
(Request for Certificate of Veteran
Status) Activity: Comment Request
Veterans Benefits
Administration, Department of Veterans
Affairs.
ACTION: Notice.
AGENCY:
The Veterans Benefits
Administration (VBA), 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
extension of a currently approved
collection, and allow 60 days for public
comment in response to the notice. This
notice solicits comments for information
needed to determine an applicant’s
eligibility for a reduced down payment
when obtaining a loan insured by the
Federal Housing Administration (FHA).
DATES: Written comments and
recommendations on the proposed
collection of information should be
received on or before December 18,
2012.
ADDRESSES: Submit written comments
on the collection of information through
the Federal Docket Management System
(FDMS) at www.Regulations.gov or to
Nancy J. Kessinger, Veterans Benefits
Administration (20M35), Department of
Veterans Affairs, 810 Vermont Avenue
tkelley on DSK3SPTVN1PROD with NOTICES
SUMMARY:
VerDate Mar<15>2010
16:06 Oct 18, 2012
Jkt 229001
NW., Washington, DC 20420 or email to
nancy.kessinger@va.gov. Please refer to
‘‘OMB Control No. 2900–0745’’ in any
correspondence. During the comment
period, comments may be viewed online
through at FDMS.
FOR FURTHER INFORMATION CONTACT:
Nancy J. Kessinger at (202) 632–8924 or
Fax (202) 632–8925.
Under the
PRA of 1995 (Pub. L. 104–13; 44 U.S.C.
3501–21), 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, VBA invites
comments on: (1) Whether the proposed
collection of information is necessary
for the proper performance of VBA’s
functions, including whether the
information will have practical utility;
(2) the accuracy of VBA’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: Request for Certificate of
Veteran Status, VA Form 26–8261a.
OMB Control Number: 2900–0745.
Type of Review: Extension of a
currently approved collection.
Abstract: The data collected on VA
Form 26–8261a will be used to
determine Veteran applicants’ eligibility
to receive a reduced down payment on
a Federal Housing Administration
(FHA) backed loan.
Affected Public: Individuals or
households.
Estimated Annual Burden: 4 hours.
Estimated Average Burden Per
Respondent: 10 minutes.
Frequency of Response: One time.
Estimated Number of Respondents:
25.
SUPPLEMENTARY INFORMATION:
Dated: October 15, 2012.
By direction of the Secretary.
William F. Russo,
Deputy Director, Office of Regulations Policy
and Management, Office of the General
Counsel, Department of Veterans Affairs.
[FR Doc. 2012–25751 Filed 10–18–12; 8:45 am]
BILLING CODE 8320–01–P
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DEPARTMENT OF VETERANS
AFFAIRS
[OMB Control No. 2900–0160]
Agency Information Collection
Activities (Per Diem for Nursing Home
Care of Veterans in State Homes; Per
Diem for Adult Day Care of Veterans in
State Homes) Under OMB Review
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 Veterans Health
Administration, 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; it includes
the actual data collection instrument.
DATES: Comments must be submitted on
or before November 19, 2012.
ADDRESSES: Submit written comments
on the collection of information through
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–
0160’’ in any correspondence.
FOR FURTHER INFORMATION CONTACT:
Crystal Rennie, Enterprise Records
Service (005R1B), Department of
Veterans Affairs, 810 Vermont Avenue
NW., Washington, DC 20420, (202) 632–
7492, fax (202) 632–7583 or email
crystal.rennie@va.gov. Please refer to
‘‘OMB Control No. 2900–0160.’’
SUPPLEMENTARY INFORMATION:
SUMMARY:
Titles
a. Title 38, CFR Parts 51 and 52, State
Home Programs.
b. State Home Inspection—Staffing
Profile, VA Form 10–3567.
c. State Home Report and Statement
of Federal Aid Claimed, VA Form 10–
5588.
d. State Home Program Application
for Veteran Care—Medical Certification,
VA Form 10–10SH.
e. Department of Veterans Affairs
Certification Regarding Drug-Free
Workplace Requirements for Grantees
Other Than Individuals, VA Form 10–
0143.
f. Statement of Assurance of
Compliance with Section 504 of the
Rehabilitation Act of 1973, VA Form
10–0143a.
E:\FR\FM\19OCN1.SGM
19OCN1
tkelley on DSK3SPTVN1PROD with NOTICES
Federal Register / Vol. 77, No. 203 / Friday, October 19, 2012 / Notices
g. Certification Regarding Lobbying,
VA Form 10–0144.
h. Statement of Assurance of
Compliance with Equal Opportunity
Laws, VA Form 10–0144a.
i. Request for Prescription Drugs from
an Eligible Veteran in a State Home, VA
Form 10–0460.
OMB Control Number: 2900–0160.
Type of Review: Extension of a
currently approved collection.
Abstract: VA pays per diem to State
homes providing nursing home and
adult day health services care to
Veterans. VA requires facilities
providing nursing home and adult day
health care to furnish an application for
recognition based on certification;
appeal information, application and
justification for payment; records and
reports which facility management must
maintain regarding activities of
residents or participants; information
relating to whether the facility meets
standards concerning residents’ rights
and responsibilities prior to admission
or enrollment, during admission or
enrollment, and upon discharge; the
records and reports which facilities
management and health care
professionals must maintain regarding
residents or participants and employees;
documents pertain to the management
of the facilities; food menu planning;
pharmaceutical records; and life safety
documentation. Without access to such
information, VA would not be able to
determine whether high quality care is
being provided to Veterans.
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 August
1, 2012, at pages 45719–45720.
Affected Public: State, Local or Tribal
Government.
Estimated Total Annual Burden:
a. Title 38, CFR Parts 51 and 52, State
Home Programs—3,738 hours.
b. State Home Inspection Staffing
Profile, VA Form 10–3567—90 hours.
c. State Home Report and Statement
of Federal Aid Claimed, VA Form 10–
5588—1,080 hours.
d. State Home Program Application
for Veteran Care—Medical Certification,
VA Form 10–10SH—10,566 hours.
e. Department of Veterans Affairs
Certification Regarding Drug-Free
Workplace Requirements for Grantees
Other Than Individuals, VA Form 10–
0143—15 hours.
f. Statement of Assurance of
Compliance with Section 504 of the
VerDate Mar<15>2010
16:06 Oct 18, 2012
Jkt 229001
Rehabilitation Act of 1973, VA Form
10–1043a—15 hours.
g. Certification Regarding Lobbying,
VA Form 10–0144—15 hours.
h. Statement of Assurance of
Compliance with Equal Opportunity
Laws, VA Form 10–0144a—15 hours.
i. Request for Prescription Drugs from
an Eligible Veteran in a State Home, VA
Form 10–0460—15 hours.
Estimated Average Burden per
Respondent:
a. Title 38, CFR Parts 51 and 52, State
Home Programs—7 minutes.
b. State Home Inspection Staffing
Profile, VA Form 10–3567—30 minutes.
c. State Home Report and Statement
of Federal Aid Claimed, VA Form 10–
5588—30 minutes.
d. State Home Program Application
for Veteran Care—Medical Certification,
VA Form 10–10SH—30 minutes.
e. Department of Veterans Affairs
Certification Regarding Drug-Free
Workplace Requirements for Grantees
Other Than Individuals, VA Form 10–
0143—5 minutes.
f. Statement of Assurance of
Compliance with Section 504 of the
Rehabilitation Act of 1973, VA Form
10–1043a—5 minutes.
g. Certification Regarding Lobbying,
VA Form 10–0144—5 minutes.
h. Statement of Assurance of
Compliance with Equal Opportunity
Laws, VA Form 10–0144a—5 minutes.
i. Request for Prescription Drugs from
an Eligible Veteran in a State Home, VA
Form 10–0460—5 minutes.
Frequency of Response: One-time.
Estimated Number of Respondents:
a. Title 38, CFR Parts 51 and 52, State
Home Programs—22,926.
b. State Home Inspection Staffing
Profile, VA Form 10–3567—180.
c. State Home Report and Statement
of Federal Aid Claimed, VA Form 10–
5588—180.
d. State Home Program Application
for Veteran Care—Medical Certification,
VA Form 10–10SH—21,132.
e. Department of Veterans Affairs
Certification Regarding Drug-Free
Workplace Requirements for Grantees
Other Than Individuals, VA Form 10–
0143—180.
f. Statement of Assurance of
Compliance with Section 504 of the
Rehabilitation Act of 1973, VA Form
10–1043a—180.
g. Certification Regarding Lobbying,
VA Form 10–0144—180.
h. Statement of Assurance of
Compliance with Equal Opportunity
Laws, VA Form 10–0144a—180.
i. Request for Prescription Drugs from
an Eligible Veteran in a State Home, VA
Form 10–0460—180.
Estimated Total Annual Responses:
PO 00000
Frm 00079
Fmt 4703
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64387
a. Title 38, CFR Parts 51 and 52, State
Home Programs—23,466
b. State Home Inspection Staffing
Profile, VA Form 10–3567—180.
c. State Home Report and State of
Federal Aid Claimed, VA Form 10–
5588—2,160.
d. State Home Program Application
for Veteran Care—Medical Certification,
VA Form 10–10SH—21,132.
e. Department of Veterans Affairs
Certification Regarding Drug-Free
Workplace Requirements for Grantees
Other Than Individuals, VA Form 10–
0143—180.
f. Statement of Assurance of
Compliance with Section 504 of the
Rehabilitation Act of 1973, VA Form
10–1043a—180.
g. Certification Regarding Lobbying,
VA Form 10–0144—180.
h. Statement of Assurance of
Compliance with Equal Opportunity
Laws, VA Form 10–0144a—180.
i. Request for Prescription Drugs from
an Eligible Veteran in a State Home, VA
Form 10–0460—180.
Dated: October 15, 2012.
By direction of the Secretary.
William F. Russo,
Deputy Director, Office of Regulations Policy
and Management, Office of the General
Counsel, Department of Veterans Affairs.
[FR Doc. 2012–25749 Filed 10–18–12; 8:45 am]
BILLING CODE 8320–01–P
DEPARTMENT OF VETERANS
AFFAIRS
[OMB Control No. 2900–0260]
Agency Information Collection
(Request for and Authorization To
Release Medical Records or Health
Information) Activities Under OMB
Review
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 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.
SUMMARY:
Comments must be submitted on
or before November 19, 2012.
DATES:
E:\FR\FM\19OCN1.SGM
19OCN1
]]>Agencies
[Federal Register Volume 77, Number 203 (Friday, October 19, 2012)]
[Notices]
[Pages 64386-64387]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2012-25749]
-----------------------------------------------------------------------
DEPARTMENT OF VETERANS AFFAIRS
[OMB Control No. 2900-0160]
Agency Information Collection Activities (Per Diem for Nursing
Home Care of Veterans in State Homes; Per Diem for Adult Day Care of
Veterans in State Homes) 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, 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; it includes the actual data collection instrument.
DATES: Comments must be submitted on or before November 19, 2012.
ADDRESSES: Submit written comments on the collection of information
through 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. 2900-0160'' in any correspondence.
FOR FURTHER INFORMATION CONTACT: Crystal Rennie, Enterprise Records
Service (005R1B), Department of Veterans Affairs, 810 Vermont Avenue
NW., Washington, DC 20420, (202) 632-7492, fax (202) 632-7583 or email
crystal.rennie@va.gov. Please refer to ``OMB Control No. 2900-0160.''
SUPPLEMENTARY INFORMATION:
Titles
a. Title 38, CFR Parts 51 and 52, State Home Programs.
b. State Home Inspection--Staffing Profile, VA Form 10-3567.
c. State Home Report and Statement of Federal Aid Claimed, VA Form
10-5588.
d. State Home Program Application for Veteran Care--Medical
Certification, VA Form 10-10SH.
e. Department of Veterans Affairs Certification Regarding Drug-Free
Workplace Requirements for Grantees Other Than Individuals, VA Form 10-
0143.
f. Statement of Assurance of Compliance with Section 504 of the
Rehabilitation Act of 1973, VA Form 10-0143a.
[[Page 64387]]
g. Certification Regarding Lobbying, VA Form 10-0144.
h. Statement of Assurance of Compliance with Equal Opportunity
Laws, VA Form 10-0144a.
i. Request for Prescription Drugs from an Eligible Veteran in a
State Home, VA Form 10-0460.
OMB Control Number: 2900-0160.
Type of Review: Extension of a currently approved collection.
Abstract: VA pays per diem to State homes providing nursing home
and adult day health services care to Veterans. VA requires facilities
providing nursing home and adult day health care to furnish an
application for recognition based on certification; appeal information,
application and justification for payment; records and reports which
facility management must maintain regarding activities of residents or
participants; information relating to whether the facility meets
standards concerning residents' rights and responsibilities prior to
admission or enrollment, during admission or enrollment, and upon
discharge; the records and reports which facilities management and
health care professionals must maintain regarding residents or
participants and employees; documents pertain to the management of the
facilities; food menu planning; pharmaceutical records; and life safety
documentation. Without access to such information, VA would not be able
to determine whether high quality care is being provided to Veterans.
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 August 1, 2012, at pages 45719-45720.
Affected Public: State, Local or Tribal Government.
Estimated Total Annual Burden:
a. Title 38, CFR Parts 51 and 52, State Home Programs--3,738 hours.
b. State Home Inspection Staffing Profile, VA Form 10-3567--90
hours.
c. State Home Report and Statement of Federal Aid Claimed, VA Form
10-5588--1,080 hours.
d. State Home Program Application for Veteran Care--Medical
Certification, VA Form 10-10SH--10,566 hours.
e. Department of Veterans Affairs Certification Regarding Drug-Free
Workplace Requirements for Grantees Other Than Individuals, VA Form 10-
0143--15 hours.
f. Statement of Assurance of Compliance with Section 504 of the
Rehabilitation Act of 1973, VA Form 10-1043a--15 hours.
g. Certification Regarding Lobbying, VA Form 10-0144--15 hours.
h. Statement of Assurance of Compliance with Equal Opportunity
Laws, VA Form 10-0144a--15 hours.
i. Request for Prescription Drugs from an Eligible Veteran in a
State Home, VA Form 10-0460--15 hours.
Estimated Average Burden per Respondent:
a. Title 38, CFR Parts 51 and 52, State Home Programs--7 minutes.
b. State Home Inspection Staffing Profile, VA Form 10-3567--30
minutes.
c. State Home Report and Statement of Federal Aid Claimed, VA Form
10-5588--30 minutes.
d. State Home Program Application for Veteran Care--Medical
Certification, VA Form 10-10SH--30 minutes.
e. Department of Veterans Affairs Certification Regarding Drug-Free
Workplace Requirements for Grantees Other Than Individuals, VA Form 10-
0143--5 minutes.
f. Statement of Assurance of Compliance with Section 504 of the
Rehabilitation Act of 1973, VA Form 10-1043a--5 minutes.
g. Certification Regarding Lobbying, VA Form 10-0144--5 minutes.
h. Statement of Assurance of Compliance with Equal Opportunity
Laws, VA Form 10-0144a--5 minutes.
i. Request for Prescription Drugs from an Eligible Veteran in a
State Home, VA Form 10-0460--5 minutes.
Frequency of Response: One-time.
Estimated Number of Respondents:
a. Title 38, CFR Parts 51 and 52, State Home Programs--22,926.
b. State Home Inspection Staffing Profile, VA Form 10-3567--180.
c. State Home Report and Statement of Federal Aid Claimed, VA Form
10-5588--180.
d. State Home Program Application for Veteran Care--Medical
Certification, VA Form 10-10SH--21,132.
e. Department of Veterans Affairs Certification Regarding Drug-Free
Workplace Requirements for Grantees Other Than Individuals, VA Form 10-
0143--180.
f. Statement of Assurance of Compliance with Section 504 of the
Rehabilitation Act of 1973, VA Form 10-1043a--180.
g. Certification Regarding Lobbying, VA Form 10-0144--180.
h. Statement of Assurance of Compliance with Equal Opportunity
Laws, VA Form 10-0144a--180.
i. Request for Prescription Drugs from an Eligible Veteran in a
State Home, VA Form 10-0460--180.
Estimated Total Annual Responses:
a. Title 38, CFR Parts 51 and 52, State Home Programs--23,466
b. State Home Inspection Staffing Profile, VA Form 10-3567--180.
c. State Home Report and State of Federal Aid Claimed, VA Form 10-
5588--2,160.
d. State Home Program Application for Veteran Care--Medical
Certification, VA Form 10-10SH--21,132.
e. Department of Veterans Affairs Certification Regarding Drug-Free
Workplace Requirements for Grantees Other Than Individuals, VA Form 10-
0143--180.
f. Statement of Assurance of Compliance with Section 504 of the
Rehabilitation Act of 1973, VA Form 10-1043a--180.
g. Certification Regarding Lobbying, VA Form 10-0144--180.
h. Statement of Assurance of Compliance with Equal Opportunity
Laws, VA Form 10-0144a--180.
i. Request for Prescription Drugs from an Eligible Veteran in a
State Home, VA Form 10-0460--180.
Dated: October 15, 2012.
By direction of the Secretary.
William F. Russo,
Deputy Director, Office of Regulations Policy and Management, Office of
the General Counsel, Department of Veterans Affairs.
[FR Doc. 2012-25749 Filed 10-18-12; 8:45 am]
BILLING CODE 8320-01-P
