[Federal Register Volume 71, Number 90 (Wednesday, May 10, 2006)]
[Notices]
[Pages 27319-27320]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E6-7057]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0160]


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) 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 whether State 
homes providing nursing home care and adult day health care are 
providing high quality care to eligible veterans.

DATES: Written comments and recommendations on the proposed collection 
of information should be received on or before July 10, 2006.

ADDRESSES: Submit written comments on the collection of information to 
Ann Bickoff, Veterans Health Administration (193E1), Department of 
Veterans Affairs, 810 Vermont Avenue, NW., Washington, DC 20420 or e-
mail [email protected]. Please refer to ``OMB Control No. 2900-
0160'' in any correspondence.

FOR FURTHER INFORMATION CONTACT: Ann Bickoff at (202) 273-8310.

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, 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.
    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 care services to eligible veterans. To ensure high 
quality care is furnished to the veterans, VA requires those facilities 
providing 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;

[[Page 27320]]

pharmaceutical records; and life safety documentation. This information 
is necessary to ensure that VA per diem payments are limited to 
facilities providing high quality care to eligible veterans.
    Affected Public: State, Local or Tribal Government, Individuals or 
households, and Not for profit institutions.
    Estimated Total Annual Burden: 15,535 hours.
    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.

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.
    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.

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.

    Dated: May 2, 2006.

    By direction of the Secretary.
Denise McLamb,
Program Analyst, Records Management Service.
[FR Doc. E6-7057 Filed 5-9-06; 8:45 am]
BILLING CODE 8320-01-P