Proposed Information Collection (Per Diem for Nursing Home Care of Veterans in State Homes; Per Diem for Adult Day Care of Veterans in State Homes): Comment Request, 46421-46422 [2013-18364]

Download as PDF Federal Register / Vol. 78, No. 147 / Wednesday, July 31, 2013 / Notices 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: Application for Conversion (Government Life Insurance), VA Form 29–0152. OMB Control Number: 2900–0149. Type of Review: Extension of a currently approved collection. Abstract: VA Form 29–0152 is completed by insured Veterans to convert his/her term insurance to a permanent plan of insurance. Affected Public: Individuals or households. Estimated Annual Burden: 1,125 hours. Estimated Average Burden per Respondent: 15 minutes. Frequency of Response: On occasion. Estimated Number of Respondents: 4,500. Dated: July 25, 2013. By direction of the Secretary. Crystal Rennie, VA Clearance Officer, U.S. Department of Veterans Affairs. [FR Doc. 2013–18303 Filed 7–30–13; 8:45 am] BILLING CODE 8320–01–P DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900–0160] Proposed Information Collection (Per Diem for Nursing Home Care of Veterans in State Homes; Per Diem for Adult Day Care of Veterans in State Homes): Comment Request Veterans Health Administration, Department of Veterans Affairs. ACTION: Notice. mstockstill on DSK4VPTVN1PROD with NOTICES AGENCY: The Veterans Health Administration (VHA) is announcing an opportunity for public comment on the proposed collection of certain information by the agency. Under the SUMMARY: VerDate Mar<15>2010 16:14 Jul 30, 2013 Jkt 229001 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 on information needed to ensure that nursing home and adult day health care facilities are providing high quality services to Veterans in State homes. Written comments and recommendations on the proposed collection of information should be received on or before September 30, 2013. DATES: Submit written comments on the collection of information through the Federal Docket Management System (FDMS) at www.Regulations.gov; or to Cynthia Harvey-Pryor, Veterans Health Administration (10B4), Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 20420 or email: cynthia.harvey-pryor@va.gov. Please refer to ‘‘2900–0160’’ in any correspondence. During the comment period, comments may be viewed online through FDMS. ADDRESSES: FOR FURTHER INFORMATION CONTACT: Cynthia Harvey-Pryor (202) 461–5870 or Fax (202) 495–5397. 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 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. Title 38, CFR Parts 51 and 52, State Home Programs. b. State Home Inspection—Staffing Profile, VA Form 10–3567. SUPPLEMENTARY INFORMATION: PO 00000 Frm 00110 Fmt 4703 Sfmt 4703 46421 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. 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: Revision 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. Affected Public: State, Local or Tribal Government. Estimated Total Annual Burden: Title 38, CFR Parts 51 and 52, State Home Programs—6,667 hours. a. State Home Inspection Staffing Profile, VA Form 10–3567—69.5 hours. b. State Home Report and Statement of Federal Aid Claimed, VA Form 10– 5588—834 hours. c. State Home Program Application for Veteran Care—Medical Certification, VA Form 10–10SH—5,703 hours. d. Department of Veterans Affairs Certification Regarding Drug-Free E:\FR\FM\31JYN1.SGM 31JYN1 mstockstill on DSK4VPTVN1PROD with NOTICES 46422 Federal Register / Vol. 78, No. 147 / Wednesday, July 31, 2013 / Notices Workplace Requirements for Grantees Other Than Individuals, VA Form 10– 0143—12 hours. e. Statement of Assurance of Compliance with Section 504 of the Rehabilitation Act of 1973, VA Form 10–1043a—12 hours. f. Certification Regarding Lobbying, VA Form 10–0144—12 hours. g. Statement of Assurance of Compliance with Equal Opportunity Laws, VA Form 10–0144a—12 hours. h. Request for Prescription Drugs from an Eligible Veteran in a State Home, VA Form 10–0460—12 hours. Estimated Average Burden per Respondent: Title 38, CFR Parts 51 and 52, State Home Programs—28.76 minutes. a. State Home Inspection Staffing Profile, VA Form 10–3567—30 minutes. b. State Home Report and Statement of Federal Aid Claimed, VA Form 10– 5588—30 minutes. c. State Home Program Application for Veteran Care—Medical Certification, VA Form 10–10SH—30 minutes. d. Department of Veterans Affairs Certification Regarding Drug-Free Workplace Requirements for Grantees Other Than Individuals, VA Form 10– 0143—5 minutes. e. Statement of Assurance of Compliance with Section 504 of the Rehabilitation Act of 1973, VA Form 10–1043a—5 minutes. f. Certification Regarding Lobbying, VA Form 10–0144—5 minutes. g. Statement of Assurance of Compliance with Equal Opportunity Laws, VA Form 10–0144a—5 minutes. h. 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: Title 38, CFR Parts 51 and 52, State Home Programs—12,379. a. State Home Inspection Staffing Profile, VA Form 10–3567—139. b. State Home Report and Statement of Federal Aid Claimed, VA Form 10– 5588—139. c. State Home Program Application for Veteran Care—Medical Certification, VA Form 10–10SH—11,406. d. Department of Veterans Affairs Certification Regarding Drug-Free Workplace Requirements for Grantees Other Than Individuals, VA Form 10– 0143—139. e. Statement of Assurance of Compliance with Section 504 of the Rehabilitation Act of 1973, VA Form 10–1043a—139. f. Certification Regarding Lobbying, VA Form 10–0144—139. g. Statement of Assurance of Compliance with Equal Opportunity Laws, VA Form 10–0144a—139. VerDate Mar<15>2010 16:14 Jul 30, 2013 Jkt 229001 h. Request for Prescription Drugs from an Eligible Veteran in a State Home, VA Form 10–0460—139. Estimated Total Annual Responses: Title 38, CFR Parts 51 and 52, State Home Programs—13,908. a. State Home Inspection Staffing Profile, VA Form 10–3567—139. b. State Home Report and State of Federal Aid Claimed, VA Form 10– 5588—139. c. State Home Program Application for Veteran Care—Medical Certification, VA Form 10–10SH—11,406. d. Department of Veterans Affairs Certification Regarding Drug-Free Workplace Requirements for Grantees Other Than Individuals, VA Form 10– 0143—139. e. Statement of Assurance of Compliance with Section 504 of the Rehabilitation Act of 1973, VA Form 10–1043a—139. f. Certification Regarding Lobbying, VA Form 10–0144—139. g. Statement of Assurance of Compliance with Equal Opportunity Laws, VA Form 10–0144a—139. h. Request for Prescription Drugs from an Eligible Veteran in a State Home, VA Form 10–0460—139. Dated: July 26, 2013. By direction of the Secretary. Crystal Rennie, VA Clearance Officer, U.S. Department of Veterans Affairs. [FR Doc. 2013–18364 Filed 7–30–13; 8:45 am] BILLING CODE 8320–01–P DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900–0500] Proposed Information Collection (Status of Dependents Questionnaire) Activity: Comment Request Veterans Benefits Administration, Department of Veterans Affairs. ACTION: Notice. AGENCY: The Veterans Benefits Administration (VBA) 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 on information needed to determine a Veteran’s SUMMARY: PO 00000 Frm 00111 Fmt 4703 Sfmt 4703 continued entitlement to benefits based on the number of dependents. DATES: Written comments and recommendations on the proposed collection of information should be received on or before September 30, 2013. Submit written comments on the collection of information through 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 NW., Washington, DC 20420 or email nancy.kessinger@va.gov. Please refer to ‘‘OMB Control No. 2900–0500’’ in any correspondence. During the comment period, comments may be viewed online through the FDMS. FOR FURTHER INFORMATION CONTACT: Nancy J. Kessinger at (202) 632–8924 or fax (202) 632–8925. SUPPLEMENTARY INFORMATION: Under the PRA of 1995 (Public Law 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, 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: Status of Dependents Questionnaire, VA Form 21–0538. OMB Control Number: 2900–0500. Type of Review: Extension of a currently approved collection. Abstract: Veterans receiving compensation for service-connected disability which includes an additional amount for their spouse and/or child(ren) complete VA Form 21–0538 to certify the status of the dependents for whom additional compensation is being paid. Affected Public: Individuals or households. Estimated Annual Burden: 14,083 hours. ADDRESSES: E:\FR\FM\31JYN1.SGM 31JYN1

Agencies

[Federal Register Volume 78, Number 147 (Wednesday, July 31, 2013)]
[Notices]
[Pages 46421-46422]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2013-18364]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0160]


Proposed Information Collection (Per Diem for Nursing Home Care 
of Veterans in State Homes; Per Diem for Adult Day Care of Veterans in 
State Homes): 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 extension 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 ensure that nursing home and 
adult day health care facilities are providing high quality services to 
Veterans in State homes.

DATES: Written comments and recommendations on the proposed collection 
of information should be received on or before September 30, 2013.

ADDRESSES: Submit written comments on the collection of information 
through the Federal Docket Management System (FDMS) at 
www.Regulations.gov; or to Cynthia Harvey-Pryor, Veterans Health 
Administration (10B4), Department of Veterans Affairs, 810 Vermont 
Avenue NW., Washington, DC 20420 or email: cynthia.harvey-pryor@va.gov. 
Please refer to ``2900-0160'' in any correspondence. During the comment 
period, comments may be viewed online through FDMS.

FOR FURTHER INFORMATION CONTACT: Cynthia Harvey-Pryor (202) 461-5870 or 
Fax (202) 495-5397.

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 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. 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.
    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: Revision 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.
    Affected Public: State, Local or Tribal Government.
    Estimated Total Annual Burden:
    Title 38, CFR Parts 51 and 52, State Home Programs--6,667 hours.
    a. State Home Inspection Staffing Profile, VA Form 10-3567--69.5 
hours.
    b. State Home Report and Statement of Federal Aid Claimed, VA Form 
10-5588--834 hours.
    c. State Home Program Application for Veteran Care--Medical 
Certification, VA Form 10-10SH--5,703 hours.
    d. Department of Veterans Affairs Certification Regarding Drug-Free

[[Page 46422]]

Workplace Requirements for Grantees Other Than Individuals, VA Form 10-
0143--12 hours.
    e. Statement of Assurance of Compliance with Section 504 of the 
Rehabilitation Act of 1973, VA Form 10-1043a--12 hours.
    f. Certification Regarding Lobbying, VA Form 10-0144--12 hours.
    g. Statement of Assurance of Compliance with Equal Opportunity 
Laws, VA Form 10-0144a--12 hours.
    h. Request for Prescription Drugs from an Eligible Veteran in a 
State Home, VA Form 10-0460--12 hours.
    Estimated Average Burden per Respondent:
    Title 38, CFR Parts 51 and 52, State Home Programs--28.76 minutes.
    a. State Home Inspection Staffing Profile, VA Form 10-3567--30 
minutes.
    b. State Home Report and Statement of Federal Aid Claimed, VA Form 
10-5588--30 minutes.
    c. State Home Program Application for Veteran Care--Medical 
Certification, VA Form 10-10SH--30 minutes.
    d. Department of Veterans Affairs Certification Regarding Drug-Free 
Workplace Requirements for Grantees Other Than Individuals, VA Form 10-
0143--5 minutes.
    e. Statement of Assurance of Compliance with Section 504 of the 
Rehabilitation Act of 1973, VA Form 10-1043a--5 minutes.
    f. Certification Regarding Lobbying, VA Form 10-0144--5 minutes.
    g. Statement of Assurance of Compliance with Equal Opportunity 
Laws, VA Form 10-0144a--5 minutes.
    h. 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:
    Title 38, CFR Parts 51 and 52, State Home Programs--12,379.
    a. State Home Inspection Staffing Profile, VA Form 10-3567--139.
    b. State Home Report and Statement of Federal Aid Claimed, VA Form 
10-5588--139.
    c. State Home Program Application for Veteran Care--Medical 
Certification, VA Form 10-10SH--11,406.
    d. Department of Veterans Affairs Certification Regarding Drug-Free 
Workplace Requirements for Grantees Other Than Individuals, VA Form 10-
0143--139.
    e. Statement of Assurance of Compliance with Section 504 of the 
Rehabilitation Act of 1973, VA Form 10-1043a--139.
    f. Certification Regarding Lobbying, VA Form 10-0144--139.
    g. Statement of Assurance of Compliance with Equal Opportunity 
Laws, VA Form 10-0144a--139.
    h. Request for Prescription Drugs from an Eligible Veteran in a 
State Home, VA Form 10-0460--139.
    Estimated Total Annual Responses:
    Title 38, CFR Parts 51 and 52, State Home Programs--13,908.
    a. State Home Inspection Staffing Profile, VA Form 10-3567--139.
    b. State Home Report and State of Federal Aid Claimed, VA Form 10-
5588--139.
    c. State Home Program Application for Veteran Care--Medical 
Certification, VA Form 10-10SH--11,406.
    d. Department of Veterans Affairs Certification Regarding Drug-Free 
Workplace Requirements for Grantees Other Than Individuals, VA Form 10-
0143--139.
    e. Statement of Assurance of Compliance with Section 504 of the 
Rehabilitation Act of 1973, VA Form 10-1043a--139.
    f. Certification Regarding Lobbying, VA Form 10-0144--139.
    g. Statement of Assurance of Compliance with Equal Opportunity 
Laws, VA Form 10-0144a--139.
    h. Request for Prescription Drugs from an Eligible Veteran in a 
State Home, VA Form 10-0460--139.

    Dated: July 26, 2013.

    By direction of the Secretary.
Crystal Rennie,
VA Clearance Officer, U.S. Department of Veterans Affairs.
[FR Doc. 2013-18364 Filed 7-30-13; 8:45 am]
BILLING CODE 8320-01-P