[Federal Register Volume 64, Number 181 (Monday, September 20, 1999)]
[Notices]
[Pages 50868-50869]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 99-24398]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0205]


Proposed Information Collection Activity: Proposed Collection; 
Comment Request

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, including each proposed 
reinstatement, without change, of a previously approved collection for 
which approval has expired, and allow 60 days for public comment in 
response to the notice. This notice solicits comments for information 
needed to evaluate applicant's education, professional experience and 
credentials to determine suitability and grade level.

DATES: Written comments and recommendations on the proposed collection 
of information should be received on or before November 19, 1999.

ADDRESSES: Submit written comments on the collection of information to 
Ann W. Bickoff, Veterans Health Administration (193B1), Department of 
Veterans Affairs, 810 Vermont Avenue, NW, Washington, DC 20420. Please 
refer to ``OMB Control No. 2900-0205'' in any correspondence.

FOR FURTHER INFORMATION CONTACT: Ann W. Bickoff at (202) 273-8310 or 
FAX (202) 273-9381.

SUPPLEMENTARY INFORMATION: Under the PRA of 1995 (Pub. L. 104-13; 44 
U.S.C., 3501--3520), 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.

Form Numbers and Titles

a. VA Form 10-2850, Application for Physicians, Dentists, Podiatrists 
and Optometrists.
b. VA Form 10-2850a, Application for Nurses and Nurse Anesthetists.
c. VA Form 10-2850b, Application for Residents.
d. VA Form 10-2850c, Application for Associated Health Occupations.
e. VA Form FL 10-341a, Appraisal of Applicant.
    OMB Control Number: 2900-0205.
    Type of Review: Reinstatement, without change, of a previously 
approved collection for which approval has expired.
    Abstract: VA Forms 10-2850 and 10-2850a through c are applications 
designed specifically to elicit appropriate information about each 
candidate's qualifications for employment with VA. VHA officials use 
the information to evaluate education, professional experience and 
credentials and to determine suitability and grade level of 
applications of physicians, dentists, podiatrists, optometrists, nurses 
and nurse anesthetists, residents, and associated health occupations, 
and appraisal of applicants. The forms require disclosure of details 
about all licenses ever held, Drug Enforcement Administration 
certification, board certification, clinical privileges, revoked 
certification or registrations, liability insurance history, and 
involvement in malpractice proceedings. Form Letter 10-341a is a pre 
employment reference form used to elicit information concerning the 
prior education and/or performance of the Title 38 applicant.
    Affected Public: Individuals or households, Business or other for-
profit, Not-for-profit Institutions, Federal Government, State, Local 
or Tribal Government.
    Estimated Annual Burden: 68,610 hours.
a. VA Form 10-2850, Application for Physicians, Dentists, Podiatrists 
and Optometrists--12,900 hours.
b. VA Form 10-2850a, Application for Nurses and Nurse Anesthetists--
51,600 hours.
c. VA Form 10-2850b, Application for Residents--27,520 hours.
d. VA Form 10-2850c, Application for Associated Health Occupations--
17,200 hours.
e. VA Form FL 10-341a, Appraisal of Applicant--42,000 hours.
    Estimated Average Burden Per Respondent: 27 minutes.
a. VA Form 10-2850, Application for Physicians, Dentists, Podiatrists 
and Optometrists--30 minutes.
b. VA Form 10-2850a, Application for Nurses and Nurse Anesthetists--30 
minutes.
c. VA Form 10-2850b, Application for Residents--30 minutes.

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d. VA Form 10-2850c, Application for Associated Health Occupations--30 
minutes.
e. VA Form FL 10-341a, Appraisal of Applicant--20 minutes.
    Frequency of Response: On occasion.
    Estimated Number of Respondents: 151,220.
a. VA Form 10-2850, Application for Physicians, Dentists, Podiatrists 
and Optometrists--6,450.
b. VA Form 10-2850a, Application for Nurses and Nurse Anesthetists--
25,800.
c. VA Form 10-2850b, Application for Residents--13,760.
d. VA Form 10-2850c, Application for Associated Health Occupations--
8,600.
e. VA Form FL 10-341a, Appraisal of Applicant--14,000.

    Dated: August 13, 1999.

    By direction of the Secretary
Barbara Epps,
Management Analyst Information Management Service.
[FR Doc. 99-24398 Filed 9-17-99; 8:45 am]
BILLING CODE 8320-01-P