[Federal Register Volume 88, Number 166 (Tuesday, August 29, 2023)]
[Notices]
[Pages 59573-59574]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2023-18533]


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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: Written comments and recommendations for the proposed 
information collection should be sent within 30 days of publication of 
this notice to www.reginfo.gov/public/do/PRAMain. Find this particular 
information collection by selecting ``Currently under 30-day Review--
Open for Public Comments'' or by using the search function. Refer to 
``OMB Control No. 2900-0160.''

FOR FURTHER INFORMATION CONTACT: Maribel Aponte, Office of Enterprise 
and Integration, Data Governance Analytics (008), 810 Vermont Avenue 
NW, Washington, DC 20420, (202) 266-4688 or email 
[email protected]. Please refer to ``OMB Control No. 2900-0160'' in 
any correspondence.

SUPPLEMENTARY INFORMATION: 
    Authority: 44 U.S.C. 3501-3521.
    Title: State Home Programs for Veterans (VA Forms 10-5588, 10-
5588A, and 10-10SH).
    OMB Control Number: 2900-0160.
    Type of Review: Revision of a currently approved collection.
    Abstract: Authority for this information collection can be found in 
two public laws affecting State homes: Public Law 115-159, the State 
Veterans Home Adult Day Health Care

[[Page 59574]]

Improvement Act of 2017, which requires VA to pay State Veteran Homes 
(SVHs) for medical model adult day health care provided to certain 
eligible Veterans; and Public Law 116-315, section 3007, Waiver of 
Requirements of Department of Veterans Affairs for Receipt of Per Diem 
Payments for Domiciliary Care at State Homes and Modification of 
Eligibility for such Payments. This information collection also enables 
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 create a safeguard that Veterans are 
receiving a high quality of care in SVHs.
    To ensure that high quality care is furnished to Veterans, VA 
requires those facilities providing nursing home care, domiciliary 
care, and adult day health care programs to Veterans to supply various 
kinds of information. The information required includes an application 
and justification for payment; records and reports that facility 
management must maintain regarding payment activities of residents or 
participants; and records and reports that facilities management and 
health care professionals must maintain regarding eligible residents or 
participants. The following three forms are included in this 
information collection:
    a. VA Form 10-5588: State Home Report and Statement of Federal Aid 
Claimed--38 CFR 51, 52 and title 38 U.S.C. 1741, 1742, 1743 and 1745--
is used to assess and provide per diem to State homes. This collection 
instrument is used by the State home employees and VA Staff.
    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. 1741, 1742, 1743 and 1745--is used to assess and 
provide per diem to State homes retroactively. This collection 
instrument 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. 1741, 
1742, 1743 and 1745--provides for the collection of information to 
apply for the benefits of this program.
    The State Home Per Diem (SHPD) Program recently automated the 10-
10SH form. The form was converted into a web-based, fillable form that 
can be electronically submitted from the SVH to the appropriate VAMC. 
It includes data field validation, assuring that all required fields 
have been filled before the user can electronically submit the 10-10SH 
form. The VA portion of the application also includes business rules to 
assist the VA representatives in making uniform determinations, allow 
the VA representative to return incomplete applications to the SVH 
along with a notification to them, and record receipt of the completed 
application.
    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 88 FR 118 on June 21, 2023, pages 40402 
and 40403.
    Total Annual Burden: 4,816 hours.
    Total Annual Responses: 13,614.

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: 139.

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: 45.

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:
Maribel Aponte,
VA PRA Clearance Officer, Office of Enterprise and Integration, Data 
Governance Analytics, Department of Veterans Affairs.
[FR Doc. 2023-18533 Filed 8-28-23; 8:45 am]
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