[Federal Register Volume 84, Number 141 (Tuesday, July 23, 2019)]
[Notices]
[Pages 35453-35454]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-15606]
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DEPARTMENT OF VETERANS AFFAIRS
[OMB Control No. 2900-NEW]
Agency Information Collection Activity: Per Diem to States for
Care of Eligible Veterans in State Homes
AGENCY: Veterans Health Administration, Department of Veterans Affairs.
ACTION: Notice.
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SUMMARY: Veterans Health Administration, 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.
DATES: Written comments and recommendations on the proposed collection
of information should be received on or before September 23, 2019.
ADDRESSES: Submit written comments on the collection of information
through Federal Docket Management System (FDMS) at www.Regulations.gov
or to Brian McCarthy, Office of Regulatory and Administrative Affairs
(10B4), Department of Veterans Affairs, 810 Vermont Avenue NW,
Washington, DC 20420 or email to [email protected]. Please refer
to ``OMB Control No. 2900-NEW'' in any correspondence. During the
comment period, comments may be viewed online through FDMS.
FOR FURTHER INFORMATION CONTACT: Brian McCarthy at (202) 615-9241.
SUPPLEMENTARY INFORMATION: Under the PRA of 1995, 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.
Authority: Public Law 104-13; 44 U.S.C. 3501-3521.
Title: Per Diem to States for Care of Eligible Veterans in State
Homes (VA Forms 10-0143, 10-0143A, 10-0144, 10-0144A, 10-0460, and 10-
3567).
OMB Control Number: 2900-NEW.
Type of Review: Reinstatement of previously approved collection as
a new collection.
Abstract: This collection of forms was part of a previously
approved collection under OMB Control Number 2900-0160. However, it has
been determined that these six forms will be separated from the other
three forms in 2900-0160, and renewal is requested under a new OMB
Control Number.
Title 38 CFR part 51 State Veterans Homes (SVH) regulations
published in the Federal Register as final rule on November 28, 2018
(RIN 2900-A088) require the VA to ensure per diem payments are limited
to facilities providing high quality care. These six forms are
presented to and completed by SVH management and then assessed and
utilized by VA SVH Representatives designated by the Medical Center
Director of VA of jurisdiction during the annual VA survey process at
each SVH across the U.S. as a regulatory action. This collection of
forms falls under the auspices of Geriatrics and Extended Care in VA
Central Office (10NC4). As per VHA Directive 1145.01, this collection
of forms is part of the annual VA survey process. The legal
requirements that necessitate this collection of information are found
specifically at 38 CFR parts 51.31, 51.43, and 51.210 for all three
levels of care; nursing home, domiciliary, and adult day health care.
The information required at time of the VA survey includes the
application and justification for medications for a basic rate Veteran;
records and reports that SVH management must maintain regarding
activities of residents or participants; information relating to
whether the SVH meets standards concerning residents' rights and
responsibilities prior to admission or enrollment, during admission or
enrollment, and upon discharge; the records and reports which SVH
management and SVH health care professionals must maintain regarding
residents or participants and employees; various types of documents
pertaining to the management of the SVH; pharmaceutical records; and
staffing documentation.
a. VA Form 10-0143--38 CFR 51.210(c)(9)--is used for the annual
certification pursuant to the Drug-Free Workplace Act of 1988.
b. VA Form 10-0143A--38 CFR 51.210(c)(8)--is used for annual
certification from the responsible State Agency showing compliance with
Section 504 of the Rehabilitation Act of 1973 (Pub. L. 93-112).
c. VA Form 10-0144--38 CFR 51.210(c)(10)--is used for annual
certification regarding lobbying, in compliance with Public Law 101-
121.
d. VA Form 10-0144A--38 CFR 51.210(c)(11)--is used for annual
certification of compliance with Title VI of the Civil Rights Act of
1964, as incorporated in Title 38 CFR 18.1-18.3.
e. VA Form 10-0460--38 CFR 51.43--As a condition for receiving
drugs or medicine under this section or under Sec. 17.96 of this
chapter, the State must
[[Page 35454]]
submit to the VA medical center of jurisdiction a completed VA Form 10-
0460 with the corresponding prescription(s) for each eligible Veteran.
f. VA Form 10-3567--38 CFR 51.31--is completed by SVH management
during the annual VA survey and used to record and then assess the
following: operating beds versus recognized beds, total FTEE authorized
and vacancies, as well as resident census.
VA Form 10-0143
Affected Public: State, Local, and Tribal Governments.
Estimated Annual Burden: 13 hours.
Estimated Average Burden per Respondent: 5 minutes.
Frequency of Response: Once annually.
Estimated Number of Respondents: 156.
VA Form 10-0143A
Affected Public: State, Local, and Tribal Governments.
Estimated Annual Burden: 13 hours.
Estimated Average Burden per Respondent: 5 minutes.
Frequency of Response: Once annually.
Estimated Number of Respondents: 156.
VA Form 10-0144
Affected Public: State, Local, and Tribal Governments.
Estimated Annual Burden: 13 hours.
Estimated Average Burden per Respondent: 5 minutes.
Frequency of Response: Once annually.
Estimated Number of Respondents: 156.
VA Form 10-0144A
Affected Public: State, Local, and Tribal Governments.
Estimated Annual Burden: 13 hours.
Estimated Average Burden per Respondent: 5 minutes.
Frequency of Response: Once annually.
Estimated Number of Respondents: 156.
VA Form 10-0460
Affected Public: State, Local, and Tribal Governments.
Estimated Annual Burden: 5,500 hours.
Estimated Average Burden per Respondent: 30 minutes.
Frequency of Response: Once annually.
Estimated Number of Respondents: 11,000.
VA Form 10-3567
Affected Public: State, Local, and Tribal Governments.
Estimated Annual Burden: 78 hours.
Estimated Average Burden Per Respondent: 30 minutes.
Frequency of Response: Once annually.
Estimated Number of Respondents: 156.
By direction of the Secretary.
Danny S. Green,
Interim VA Clearance Officer, Office of Quality, Performance and Risk
(OQPR), Department of Veterans Affairs.
[FR Doc. 2019-15606 Filed 7-22-19; 8:45 am]
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