Generic Clearance for the Veterans Health Administration Customer Satisfaction Surveys

Forms and Documents

Document Name	Status

No forms / supporting documents in this ICR. Check IC Document Collections.

IC Document Collections

IC ID	Document Title	Status
28765	Generic Clearance for the Veterans Health Administration Customer Satisfaction Surveys	Migrated

ICR Details

OMB Control No: 2900-0570	ICR Reference No: 199702-2900-004
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: VA	Agency Tracking No:
Title: Generic Clearance for the Veterans Health Administration Customer Satisfaction Surveys
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Emergency	Approval Requested By: 03/10/1997
OIRA Conclusion Action: Approved without change	Conclusion Date: 04/15/1997
	Date Received in OIRA: 02/14/1997
Terms of Clearance: Approved for use through 10/97 under the following conditions: 1) the next submission for OMB review describes the VHA's plans for tracking the response rates achieved by each of these surveys, evaluating nonresponse bias, and addressing these and other issues that may impede the VA's ability to make statistical inferences from these customer satisfaction data; 2) for each survey instrument, the VHA immediately incorporates the new disclosure statements mandated by the Paperwork Reduction Act of 1995. For the public record, the VHA must submit to OMB the revised forms/instructions; and 3) while evaluating the response rates, the VHA also must reevaluate each survey's design and its practical utility. For example, the Anchorage VAM/ROC medical survey's question 29 requires that the respondent choose between an HMO and other categories of health insurance such as Medicare although it is possible to receive care through an HMO and to be insured through an employer plan, Medicare, etc. Another example is the Beckley VAMC Pathology and Laboratory Medicine External Customer Satisfaction Survey which offers scaled responses that fail to logically answer the questions as worded. Prior to the next submissions for OMB review, the VA/ VHA should address these and other design issues that may diminish the practical utility of these customer satisfaction efforts. The VHA will send advance copies of all future requests under this generic clearance for OMB review; OMB will provide comments or clear these requests within 10 working days.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/1997	12/31/1997
Responses	9,400	0	0
Time Burden (Hours)	22,350	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The information will be used to determine where and to what extent VHA services are satisfactory and where and to what extent they are in need of improvement.

Emergency Justfication:

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Generic Clearance for the Veterans Health Administration Customer Satisfaction Surveys

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	9,400	0	0	9,400	0	0
Annual Time Burden (Hours)	22,350	0	0	22,350	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 02/14/1997

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