Agency Information Collection: (Per Diem for Nursing Home Care of Veterans in State Homes; Per Diem for Domiciliary Adult Day Health Care of Veterans in State Homes), 50382-50383 [2015-20458]

Download as PDF 50382 Federal Register / Vol. 80, No. 160 / Wednesday, August 19, 2015 / Notices tkelley on DSK3SPTVN1PROD with NOTICES over the Line either is pending with the Surface Transportation Board (Board) or with any U.S. District Court or has been decided in favor of a complainant within the two-year period; and (4) the requirements at 49 CFR 1105.7(c) (environmental report), 49 CFR 1105.11 (transmittal letter), 49 CFR 1105.12 (newspaper publication), and 49 CFR 1152.50(d)(1) (notice to governmental agencies) have been met. As a condition to this exemption, any employee adversely affected by the abandonment shall be protected under Oregon Short Line Railroad— Abandonment Portion Goshen Branch Between Firth & Ammon, in Bingham & Bonneville Counties, Idaho, 360 I.C.C. 91 (1979). To address whether this condition adequately protects affected employees, a petition for partial revocation under 49 U.S.C. 10502(d) must be filed. Provided no formal expression of intent to file an offer of financial assistance (OFA) has been received, this exemption will be effective on September 18, 2015, unless stayed pending reconsideration. Petitions to stay that do not involve environmental issues,1 formal expressions of intent to file an OFA under 49 CFR 1152.27(c)(2),2 and interim trail use/rail banking requests under 49 CFR 1152.29 must be filed by August 31, 2015. Petitions to reopen or requests for public use conditions under 49 CFR 1152.28 must be filed by September 8, 2015, with the Surface Transportation Board, 395 E Street SW., Washington, DC 20423–0001. A copy of any petition filed with the Board should be sent to applicant’s representative: Karl Morell, Karl Morell & Associates, 655 Fifteenth Street NW., Suite 225, Washington, DC 20005. If the verified notice contains false or misleading information, the exemption is void ab initio. BNSF has filed environmental and historic reports that address the effects, if any, of the abandonment on the environment and historic resources. OEA will issue an environmental assessment (EA) by August 24, 2015. Interested persons may obtain a copy of the EA by writing to OEA (Room 1100, 1 The Board will grant a stay if an informed decision on environmental issues (whether raised by a party or by the Board’s Office of Environmental Analysis (OEA) in its independent investigation) cannot be made before the exemption’s effective date. See Exemption of Out-of-Serv. Rail Lines, 5 I.C.C. 2d 377 (1989). Any request for a stay should be filed as soon as possible so that the Board may take appropriate action before the exemption’s effective date. 2 Each OFA must be accompanied by the filing fee, which is currently set at $1,600. See 49 CFR 1002.2(f)(25). VerDate Sep<11>2014 19:14 Aug 18, 2015 Jkt 235001 Surface Transportation Board, Washington, DC 20423–0001) or by calling OEA at (202) 245–0305. Assistance for the hearing impaired is available through the Federal Information Relay Service at (800) 877– 8339. Comments on environmental and historic preservation matters must be filed within 15 days after the EA becomes available to the public. Environmental, historic preservation, public use, or trail use/rail banking conditions will be imposed, where appropriate, in a subsequent decision. Pursuant to the provisions of 49 CFR 1152.29(e)(2), BNSF shall file a notice of consummation with the Board to signify that it has exercised the authority granted and fully abandoned the line. If consummation has not been effected by filing of a notice of consummation by August 19, 2016, and there are no legal or regulatory barriers to consummation, the authority to abandon will automatically expire. Board decisions and notices are available on our Web site at ‘‘WWW.STB.DOT.GOV.’’ Decided: August 14, 2015. By the Board, Rachel D. Campbell, Director, Office of Proceedings. Jeffrey Herzig, Clearance Clerk. Clearance Officer, 1750 Pennsylvania Ave. NW., Suite 8140, Washington, DC 20220, or email at PRA@treasury.gov. FOR FURTHER INFORMATION CONTACT: Copies of the submission(s) may be obtained by emailing PRA@treasury.gov or viewing the entire information collection request at www.reginfo.gov. SUPPLEMENTARY INFORMATION: Departmental Offices, Office of the Procurement Executive OMB Number: 1505–0081. Type of Review: Revision of a currently approved collection. Title: Solicitation of Proposal Information for Award of Public Contracts. Abstract: Information requested of offerors is specific to each procurement solicitation, and is required for Treasury to properly evaluate the capabilities and experience of potential contractors who desire to provide the supplies or services to be acquired. Evaluation will be used to determine which proposal most benefits the Government. Affected Public: Private Sector: Businesses or other for-profits. Estimated Burden Hours: 203,193. Dated: August 13, 2015. Dawn D. Wolfgang, Treasury PRA Clearance Officer. [FR Doc. 2015–20519 Filed 8–18–15; 8:45 am] [FR Doc. 2015–20375 Filed 8–18–15; 8:45 am] BILLING CODE 4915–01–P BILLING CODE 4810–25–P DEPARTMENT OF THE TREASURY DEPARTMENT OF VETERANS AFFAIRS Submission for OMB Review; Comment Request [OMB Control No. 2900–0160] Department of the Treasury Notice. AGENCY: ACTION: The Department of the Treasury will submit the following information collection request to the Office of Management and Budget (OMB) for review and clearance in accordance with the Paperwork Reduction Act of 1995, Public Law 104– 13, on or after the date of publication of this notice. DATES: Comments should be received on or before September 18, 2015 to be assured of consideration. ADDRESSES: Send comments regarding the burden estimate, or any other aspect of the information collection, including suggestions for reducing the burden, to (1) Office of Information and Regulatory Affairs, Office of Management and Budget, Attention: Desk Officer for Treasury, New Executive Office Building, Room 10235, Washington, DC 20503, or email at OIRA_Submission@ OMB.EOP.gov and (2) Treasury PRA SUMMARY: PO 00000 Frm 00121 Fmt 4703 Sfmt 4703 Agency Information Collection: (Per Diem for Nursing Home Care of Veterans in State Homes; Per Diem for Domiciliary Adult Day Health Care of Veterans in State Homes) Veterans Health Administration, Department of Veterans Affairs. ACTION: Notice. AGENCY: 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 and allow 60 days for public comment in response to the notice. This notice solicits comments on the information needed to provide payment of per diem to State homes that provide nursing home care to eligible SUMMARY: E:\FR\FM\19AUN1.SGM 19AUN1 tkelley on DSK3SPTVN1PROD with NOTICES Federal Register / Vol. 80, No. 160 / Wednesday, August 19, 2015 / Notices veterans and payment of per diem to State homes that provide adult day health care to eligible veterans. The intended effect of these provisions was to ensure that veterans receive high quality care in State Homes. DATES: Written comments and recommendations on the proposed collection of information should be received on or before October 19, 2015. ADDRESSES: Submit written comments on the collection of information through Federal Docket Management System (FDMS) at www.Regulations.gov; or Colette Alvarez, Chief Business Office, Purchased Care, Veterans Health Administration (10N21R), Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 20420 or email: Colette.Alvarez@va.gov. Please refer to ‘‘Per Diem for Nursing Home Care of Veterans in State Homes; Per Diem for Domiciliary and Adult Day Health Care of Veterans in State Homes, OMB Control No. 2900–0160’’ in any correspondence. During the comment period, comments may be viewed online through the FDMS. FOR FURTHER INFORMATION CONTACT: Colette Alvarez at (775) 842–5755. 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: (Per Diem for Nursing Home Care of Veterans in State Homes; Per Diem for Domiciliary Adult Day Health Care of Veterans in State Homes). 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. VerDate Sep<11>2014 19:14 Aug 18, 2015 Jkt 235001 d. Claim for Payment for Nursing Home Care Provided to Veterans Awarded Retroactive Service Connection, VA Form 10–5588A. e. State Home Program Application for Veteran Care—Medical Certification, VA Form 10–10SH. f. Department of Veterans Affairs Certification Regarding Drug-Free Workplace Requirements for Grantees Other Than Individuals, VA Form 10– 0143. g. Statement of Assurance of Compliance with Section 504 of the Rehabilitation Act of 1973, VA Form 10–0143a. h. Certification Regarding Lobbying, VA Form 10–0144. i. Statement of Assurance of Compliance with Equal Opportunity Laws, VA Form 10–0144a. j. 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 Veterans Homes (SVHs) providing nursing home, domiciliary and adult day health services care to eligible Veterans. VA pays per diem to SVHs for the care of Veterans irrespective of whether the Veteran has wartime or peacetime service. VA processes two different types of state nursing home per diem payments. Each is determined by a Veteran’s eligibility. One is a higher per diem or prevailing rate for certain Veterans who have service-connected disabilities. The other is a basic rate that is paid to Veterans who are not eligible for the higher rate. VA also ensures that SVHs meet VA standards through surveys, audits, and reconciliation of records. VA requires facilities providing nursing home, domiciliary 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 PO 00000 Frm 00122 Fmt 4703 Sfmt 9990 50383 determine whether high quality care is being provided to Veterans. For an eligible Veteran to be considered for per diem payments for nursing home, domiciliary or ADHC, two forms are required to be submitted to the VA medical center of jurisdiction for each Veteran, at the time of the Veteran’s admission to a SVH (VA Form 10–10EZ, Application for Health Benefits or 10–10EZR, Health Benefits Renewal Form) and VA Form 10–10SH, State Home Program Application for Veteran Care Medical Certification). Affected Public: State, Local or Private Government. Estimated Annual Burden: 6,818 hours. Home Programs: a. State Home Inspection Staffing Profile, VA Form 10–3567—69.5 hrs. b. State Home Report and State of Federal Aid Claimed, VA Form 10– 5588—834 hrs. c. Claim for Payment for Nursing Home Care Provided to Veterans Awarded Retroactive Service Connection, VA Form 10–5588A—180 hrs. d. State Home Program Application for Veteran Care—Medical Certification, VA Form 10–10SH—3,802 hrs. e. Department of Veterans Affairs Certification Regarding Drug-Free Workplace Requirements for Grantees Other Than Individuals, VA Form 10– 0143—12 hrs. f. Statement of Assurance of Compliance with Section 504 of the Rehabilitation Act of 1973, VA Form 10–1043a—12 hrs. g. Certification Regarding Lobbying, VA Form 10–0144—12 hrs. h. Statement of Assurance of Compliance with Equal Opportunity Laws, VA Form 10–0460—12 hrs. i. Request for Prescription Drugs from an Eligible Veteran in a State Home, VA Form 10–0144a—12 hrs. j. Application for Recognition (Letter to Under Secretary for Health)—2 hrs. k. Recognition & Certification (Sections 51.30 and 52.30)—120 hrs. l. Quality of Life (Sections 51.100 and 52.100)—350 hrs. m. Section, Administration and (Section 51.210 and 52.210)—1,400. Estimated Average Burden per Respondent: Frequency of Response: On Occasion. Estimated Number of Respondents: 12,884. By direction of the Secretary. Kathleen M. Manwell, Program Analyst, VA Privacy Service, Office of Privacy and Records Management, Department of Veterans Affairs. [FR Doc. 2015–20458 Filed 8–18–15; 8:45 am] BILLING CODE 8320–01–P E:\FR\FM\19AUN1.SGM 19AUN1

Agencies

[Federal Register Volume 80, Number 160 (Wednesday, August 19, 2015)]
[Notices]
[Pages 50382-50383]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2015-20458]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0160]


Agency Information Collection: (Per Diem for Nursing Home Care of 
Veterans in State Homes; Per Diem for Domiciliary Adult Day Health Care 
of Veterans in State Homes)

AGENCY: Veterans Health Administration, Department of Veterans Affairs.

ACTION: Notice.

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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 and allow 60 days for public comment 
in response to the notice. This notice solicits comments on the 
information needed to provide payment of per diem to State homes that 
provide nursing home care to eligible

[[Page 50383]]

veterans and payment of per diem to State homes that provide adult day 
health care to eligible veterans. The intended effect of these 
provisions was to ensure that veterans receive high quality care in 
State Homes.

DATES: Written comments and recommendations on the proposed collection 
of information should be received on or before October 19, 2015.

ADDRESSES: Submit written comments on the collection of information 
through Federal Docket Management System (FDMS) at www.Regulations.gov; 
or Colette Alvarez, Chief Business Office, Purchased Care, Veterans 
Health Administration (10N21R), Department of Veterans Affairs, 810 
Vermont Avenue NW., Washington, DC 20420 or email: 
Colette.Alvarez@va.gov. Please refer to ``Per Diem for Nursing Home 
Care of Veterans in State Homes; Per Diem for Domiciliary and Adult Day 
Health Care of Veterans in State Homes, OMB Control No. 2900-0160'' in 
any correspondence. During the comment period, comments may be viewed 
online through the FDMS.

FOR FURTHER INFORMATION CONTACT: Colette Alvarez at (775) 842-5755.

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: (Per Diem for Nursing Home Care of Veterans in State Homes; 
Per Diem for Domiciliary Adult Day Health Care of Veterans in State 
Homes).
    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. Claim for Payment for Nursing Home Care Provided to Veterans 
Awarded Retroactive Service Connection, VA Form 10-5588A.
    e. State Home Program Application for Veteran Care--Medical 
Certification, VA Form 10-10SH.
    f. Department of Veterans Affairs Certification Regarding Drug-Free 
Workplace Requirements for Grantees Other Than Individuals, VA Form 10-
0143.
    g. Statement of Assurance of Compliance with Section 504 of the 
Rehabilitation Act of 1973, VA Form 10-0143a.
    h. Certification Regarding Lobbying, VA Form 10-0144.
    i. Statement of Assurance of Compliance with Equal Opportunity 
Laws, VA Form 10-0144a.
    j. 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 Veterans Homes (SVHs) providing 
nursing home, domiciliary and adult day health services care to 
eligible Veterans. VA pays per diem to SVHs for the care of Veterans 
irrespective of whether the Veteran has wartime or peacetime service.
    VA processes two different types of state nursing home per diem 
payments. Each is determined by a Veteran's eligibility. One is a 
higher per diem or prevailing rate for certain Veterans who have 
service-connected disabilities. The other is a basic rate that is paid 
to Veterans who are not eligible for the higher rate. VA also ensures 
that SVHs meet VA standards through surveys, audits, and reconciliation 
of records. VA requires facilities providing nursing home, domiciliary 
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.
    For an eligible Veteran to be considered for per diem payments for 
nursing home, domiciliary or ADHC, two forms are required to be 
submitted to the VA medical center of jurisdiction for each Veteran, at 
the time of the Veteran's admission to a SVH (VA Form 10-10EZ, 
Application for Health Benefits or 10-10EZR, Health Benefits Renewal 
Form) and VA Form 10-10SH, State Home Program Application for Veteran 
Care Medical Certification).
    Affected Public: State, Local or Private Government.
    Estimated Annual Burden: 6,818 hours.
    Home Programs:
    a. State Home Inspection Staffing Profile, VA Form 10-3567--69.5 
hrs.
    b. State Home Report and State of Federal Aid Claimed, VA Form 10-
5588--834 hrs.
    c. Claim for Payment for Nursing Home Care Provided to Veterans 
Awarded Retroactive Service Connection, VA Form 10-5588A--180 hrs.
    d. State Home Program Application for Veteran Care--Medical 
Certification, VA Form 10-10SH--3,802 hrs.
    e. Department of Veterans Affairs Certification Regarding Drug-Free 
Workplace Requirements for Grantees Other Than Individuals, VA Form 10-
0143--12 hrs.
    f. Statement of Assurance of Compliance with Section 504 of the 
Rehabilitation Act of 1973, VA Form 10-1043a--12 hrs.
    g. Certification Regarding Lobbying, VA Form 10-0144--12 hrs.
    h. Statement of Assurance of Compliance with Equal Opportunity 
Laws, VA Form 10-0460--12 hrs.
    i. Request for Prescription Drugs from an Eligible Veteran in a 
State Home, VA Form 10-0144a--12 hrs.
    j. Application for Recognition (Letter to Under Secretary for 
Health)--2 hrs.
    k. Recognition & Certification (Sections 51.30 and 52.30)--120 hrs.
    l. Quality of Life (Sections 51.100 and 52.100)--350 hrs.
    m. Section, Administration and (Section 51.210 and 52.210)--1,400.
    Estimated Average Burden per Respondent:
    Frequency of Response: On Occasion.
    Estimated Number of Respondents: 12,884.

    By direction of the Secretary.
Kathleen M. Manwell,
Program Analyst, VA Privacy Service, Office of Privacy and Records 
Management, Department of Veterans Affairs.
[FR Doc. 2015-20458 Filed 8-18-15; 8:45 am]
 BILLING CODE 8320-01-P