[Federal Register Volume 84, Number 205 (Wednesday, October 23, 2019)]
[Notices]
[Pages 56891-56892]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-23043]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0160]


Agency Information Collection Activity Under OMB Review: State 
Home Programs for Veterans

AGENCY: Veterans Health Administration, Department of Veterans Affairs.

ACTION: Notice.

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SUMMARY: In compliance with the Paperwork Reduction Act (PRA) of 1995, 
this notice announces that the Veterans Health Administration, 
Department of Veterans Affairs, will submit the collection of 
information abstracted below to the Office of Management and Budget 
(OMB) for review and comment. The PRA submission describes the nature 
of the information collection and its expected cost and burden, and it 
includes the actual data collection instrument.

DATES: Comments must be submitted on or before November 22, 2019.

ADDRESSES: Submit written comments on the collection of information 
through www.Regulations.gov, or to Office of Information and Regulatory 
Affairs, Office of Management and Budget, Attn: VA Desk Officer; 725 
17th St. NW, Washington, DC 20503 or sent through electronic mail to 
[email protected]. Please refer to ``OMB Control No. 2900-
0160'' in any correspondence.

FOR FURTHER INFORMATION CONTACT: Danny S. Green, Office of Quality, 
Performance and Risk (OQPR), Department of Veterans Affairs, 810 
Vermont Avenue NW, Washington, DC 20420, (202) 421-1354 or email 
[email protected] Please refer to ``OMB Control No. 2900-0160'' in 
any correspondence.

SUPPLEMENTARY INFORMATION: 
    Authority: 44 U.S.C. 3501-21.
    Title: State Home Programs for Veterans (VA Forms 10-5588, 10-
5588A, and 10-10SH).
    OMB Control Number: 2900-0160.
    Type of Review: Reinstatement with change of a previously approved 
collection.
    Abstract: Congress passed Public Law 115-159, the State Veterans 
Home Adult Day Health Care Improvement Act of 2017, requiring VA to pay 
State homes for medical model adult day health care to certain eligible 
Veterans, and Title 38, CFR part 52, which provides for the payment of 
per diem to State homes that provide adult day health care to eligible 
Veterans. It also continues to provide for the payment of per diem to 
State homes that provide care to eligible Veterans in accordance with 
Title 38, CFR part 51. The intended effect of these provisions is to 
provide a safeguard that Veterans are receiving high quality care in 
State homes.
    This information collection is necessary to ensure that VA per diem 
payments are limited to facilities providing high quality care. To 
verify this level of care, VA requires those facilities providing 
nursing home care, domiciliary, and adult day health care programs to 
Veterans to supply various kinds of information. The information 
required includes an application/eligibility for admission and 
justification for payment; records and reports which facility 
management must maintain regarding activities of payment for eligible 
residents or participants; and the records and reports that facilities 
management and health care professionals must maintain regarding the 
level of care approved for residents or participants.
    This OMB Control Number previously included six additional forms, 
VA Forms 10-0460, 10-0143, 10-0143A, 10-0144, 10-0144A, and 10-3567, 
which have now been separated out into another information collection 
(to be approved under a separate OMB Control Number). This information 
collection, under OMB Control Number 2900-0160, now includes only three 
forms: VA Forms 10-5588, 10-5588A, and 10-10SH.
    a. VA Form 10-5588: State Home Report and Statement of Federal Aid 
Claimed--38 CFR 51, 52 and Title 38, U.S.C., Sections 1741, 1742, 1743 
and 1745--is used to assess and provide per diem to State homes. This 
collection is used by the State home employees and VA Staff.

[[Page 56892]]

    b. VA Form 10-5588A: Claim for Increased Per Diem Payment for 
Veterans Awarded Retroactive Service Connection--38 CFR 51, 52 and 
Title 38, U.S.C., Sections 1741, 1742, 1743 and 1745--is used to assess 
and provide per diem to State homes retroactively. This collection is 
used by the State home employees and VA Staff.
    c. VA Form 10-10SH: State Home Program Application for Veterans 
Care Medical Certification--38 CFR 51, 52 and Title 38, U.S.C., 
Sections 1741, 1742, 1743 and 1745--provides for the collection of 
information to apply for the benefits of this program.
    An agency may not conduct or sponsor, and a person is not required 
to respond to, a collection of information unless it displays a 
currently valid OMB control number. The Federal Register Notice with a 
60-day comment period soliciting comments on this collection of 
information was published at 84 FR 37016 on July 30, 2019, pages 37016 
and 37017.

VA Form 10-5588

    Affected Public: State, Local, and Tribal Governments.
    Estimated Annual Burden: 834 hours.
    Estimated Average Burden per Respondent: 30 minutes.
    Frequency of Response: Monthly.
    Estimated Number of Respondents: 1,668.

VA Form 10-5588A

    Affected Public: State, Local, and Tribal Governments.
    Estimated Annual Burden: 180 hours.
    Estimated Average Burden per Respondent: 20 minutes.
    Frequency of Response: Monthly.
    Estimated Number of Respondents: 540.

VA Form 10-10SH

    Affected Public: State, Local, and Tribal Governments.
    Estimated Annual Burden: 3,802 hours.
    Estimated Average Burden per Respondent: 20 minutes.
    Frequency of Response: Once annually.
    Estimated Number of Respondents: 11,406.

    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. 2019-23043 Filed 10-22-19; 8:45 am]
 BILLING CODE 8320-01-P