Supporting Statement for VA Form 26-4555d,
Veterans Application for Assistance in Acquiring
Special Housing Adaptations
(2900-0300)
A. JUSTIFICATION
1. Title 38, U.S.C. 2101 authorizes assistance to disabled veterans in acquiring special housing and adaptations to dwellings. Under 38 U.S.C. 2101(b), grants are available to assist veterans in making adaptations to their current residences or one which they intend to live in as long as the home is owned by the veteran or a member of the veteran's family. Personal interview questions associated with the grant program, as outlined in VBA Manual M26-12, paragraph 2.07, are attached. (exhibit A)
2. VA Form 26-4555d is needed because of the difference in disabilities, the amount of alteration/adaptation to the house, and title requirements. In addition, the amount and type of information needed to process either benefit is different, and a separate numbering and filing system will be used to identify the different types of grants. The information contained on a completed VA Form 26-4555d enables field personnel to evaluate the request for adaptations. It also provides information for use in approving or disapproving a veteran's application for a grant under 38 U.S.C. 2101(b). If the information was not collected, VA would be in noncompliance with 38 U.S.C. 2101(b).
3. VA Form 26-4445d available on the One-VA web site in a fillable electronic format. VBA is currently hosting this form on a secure server and does not currently have the technology in place to allow for the complete submission of the form. Validation edits are performed to assure data integrity. Efforts within VA are underway to provide a mechanism to allow the information to be submitted electronically with a recognized signature technology. There currently is no utility process in place that will allow the data submitted on the form to be incorporated with an existing centralized legacy database.
4. No duplication of information is involved.
5. Collection of information does not involve small businesses or other small entities.
6. This information collection is not a recurring or repetitive report. It is accomplished on a one-time basis per individual applicant.
7. There are no special circumstances that require the collection to be conducted in a manner inconsistent with the guidelines in 5 CFR 1320.6.
8. The agency notice was published in the Federal Register on April 2, 2007, page 15761. No outside consultations were solicited since the form is being satisfactorily completed by respondents.
9. No payments or gifts to respondents have been made under this collection of information.
10. "Loan Guaranty Home, Condominium and Manufactured Home Loan Applicant Records, Specially Adapted Housing Applicant Records, and Vendee Loan Applicant Records - VA" (55VA26) contained in the Privacy Act Issuances, 1993 Compilation.
11. No sensitive questions appear on the form.
12. Estimate of Information Collection Burden
a. Number of respondents is estimated at 75 per year.
Frequency of response is generally one time.
c. Annual burden is estimated at 25 hours.
d. The estimated response time of 20 minutes per case is based on the experience of VA Central Office Loan Specialists.
The total estimated cost to respondents is $250.00.
This submission does not involve any recordkeeping costs.
Estimated Annualized Cost to the Federal Government
$591.75 Estimated Loan Guaranty processing cost for FY 2003:
(75 cases x 20 minutes per case x $23.67 per hour (average
Loan Guaranty field salary))
(75 cases x 15 minutes per case x $37.06 per hour
(average Central Office salary for GS-13))
(75 cases x 5 minutes per case x $17.57 per hour
(average Central Office salary for GS-7))
50.00 Estimated printing and mailing cost
$1,446.45 Total Estimated Cost to Federal Government
15. There is no change in burden hours.
16. Information collection is not for tabulation or publication use.
17. The collection instrument, VA Form 26-4555d, may be reproduced and/or stocked by the respondents and veterans service organizations. This form letter does not display an expiration date, and if required to do so it would result in unnecessary waste of existing stocks of this form. This form letter is submitted to OMB for approval every 3 years. As such, this date requirement would also result in an unnecessary burden on the respondents and would delay Department action on the benefit being sought. VA also seeks to minimize its cost to itself of collecting, processing, and using the information by not displaying the expiration date. For the reasons stated, VA continues to seek an exemption that waives the displaying of the expiration date on VA Form 26-4555d.
This submission does not contain any exceptions to the certification statement.
B. STATISTICAL METHODS
1. The Veterans Benefits Administration does not collect information employing statistical methods.
M26-12 December 21, 1981
2.06 DISPOSITION OF CLAIMS FOLDER
The claims folder will be returned to the appropriate regional office with copies of all relevant material including a copy of notification to the veteran of his or her eligibility, FL 26-39 or FL 26-39a.
2.07 INITIAL INTERVIEW WITH VETERAN
The initial interview with the veteran shall be held as soon as possible. It shall be in person, preferably at his or her residence. Its basic purpose is to acquaint the veteran with the nature of the benefit, to explain the ways the VA will assist him or her and to learn about the veteran's housing plans. Much will depend upon how far along the veteran already is in his or her planning. No hard and fast rules apply. However, certain matters should be discussed in order to minimize future problems and obviate misunderstandings. Depending on the benefit, these include, not necessarily in the order listed:
a. The statutory maximum grant.
b. The four plans, in general, under which grants may be made.
c. The locality in which the veteran desires to live.
d. The type of housing and features desired.
e The special housing needs of the family.
f. The adaptive features usually found to be necessary.
g. Special considerations in site selection.
h. Funds available for housing.
i. Expected costs.
j. Furnish VA Pamphlet 26-69-1, Questions and Answers on Specially Adapted Housing for Veterans, which emphasizes that the architect/designer must be informed of the basic requirements for specially adapted housing and also emphasizes the need for incorporation of adaptive features in the home.
Exhibit A
M26-12 December 21, 1981
k. Need for competitive bids by contractors, when appropriate.
1. Contractor's agreement to compliance inspections, lien and performance bonds.
m. Emphasis on the veteran's freedom of choice.
n. Furnish and discuss VA Pamphlet 26-13, Handbook for Design-Specially Adapted Housing.
o. When applicable, VA's need for proof of cost of veteran's present home and of any balance of acquisition cost owing thereon.
p. Completion of section I of VA Form 264555c, Veterans Supplemental Application for Assistance in Acquiring Specially Adapted Housing (fig. 5), if veteran's plans have progressed sufficiently at this time or, completion of section I of 26-4555d, veteran.
q. The veteran's eligibility for Veterans Mortgage Life Insurance. The nature and the amount of the coverage shall be explained, with emphasis that this insurance may also cover an existing loan as well as a new loan provided the grant benefit is in conjunction with plan 2, 3 or 4.
r. Advice on State and local tax reliefs (exemptions), grants and similar benefits potentially available.
s. The following VA elements and their basic functions must be explained to the veteran. If he or she desires assistance or additional information from any of these elements concerning proposed house plans, rehabilitation, or any benefit, the SAH agent will make arrangements to have a representative from that element contact the veteran.
(1) The VSD (Veterans Services Division) at VA regional offices is a one-stop service that covers information on the total range of benefits available to veterans.
(2) The VR&C (Vocational Rehabilitation and Counseling) Division is responsible for determining the need for rehabilitation and, through counseling, for assisting eligible veterans in selecting an employment objective and training program. Consideration will be given to homebound training and/or employment out of the home as appropriate to a veteran's situation.
(3) The P&SA (Prosthetic and Sensory Aids) Service, Department of Medicine and Surgery, furnishes eligible veterans with therapeutic or rehabilitative devices such as grab bars, exercise mats, stair transporters, porch lifts, temporary ramps, window air-conditioners, wheelchairs and prosthetic appliances which are reasonable and necessary, and medically prescribed for treatment. Every effort must be made by the SAH agent to anticipate the veteran's present and future needs and eliminate add-on items when the specially adapted home is completed.
(4) The SAH agent will furnish the veteran with IS-1 Fact Sheet, Federal Benefits for Veterans and Dependents; VA Pamphlet 27-82-2, as appropriate; VA Pamphlet 28-82-1, Vocational Rehabilitation; and the toll-free telephone number for the regional office.
The SAH agent must contact the VR&C Officer and the P&SA Service representatives when the initial interview has been completed and advise them of the veteran's SAH eligibility and proposed housing plans. Requests received from the veteran during the interview for more information concerning the P&SA Service and/or VR&C Division will be referred by the SAH agent during this initial contact. The PH file will be documented by the SAH agent with comments or recommendations received from the P&SA Service and the VR&C Division. Judgment must be exercised by the SAH agent, and when circumstances develop during case processing that dictate the need for additional contact with the VR&C Division and/or P&SA Service, the SAH agent will contact the appropriate representatives and document the PH file accordingly.
t. Discuss the HISA (Home Improvement and Structural Alterations) benefit. Inform the veteran that this benefit is administered by MAS (Medical Administration Service) at the nearest VA health care facility and that the benefit offers assistance up to a maximum of $2,500. The veteran must be informed that home improvements or structural alterations must be determined necessary to assure the continuation of treatment or to provide access to the home or to essential lavatory and sanitary facilities. Furnish the veteran with the telephone number for MAS so that additional information can be obtained, if desired.
2.08 PENDING CASES
a. Pending-Inactive Cases. Following the notification to the veteran of basic eligibility and prior to receipt from him or her of a VA Form 26-4555c or 26-4555d, Veterans Application for Assistance in Acquiring Special Housing Adaptations, the case will be regarded as "Pending-Inactive. "During this period, the SAH agent should be in touch with the veteran periodically, either personally or by telephone, not less often than annually to keep informed of the status of the veteran's housing plans. Preliminary to such routine followup contacts, it is advisable to check the claims folder for current address and any other pertinent information concerning possible change of status or address, death, etc., since the prior contact.
b. Status Reports. If it is found that a veteran is no longer living, it should be ascertained, whether a claim for reimbursement of expenses in anticipation of a grant is expected to be received. A report should then be sent to the Director, Loan Guaranty Service (262A). If it is learned that the veteran has moved other than temporarily to a different regional office area, the PH or AH folder will be transferred to the VA office serving such area, and the veteran will be so informed. A copy of the transmittal notice will sent to the Director, Loan Guaranty Service (262A). If the veteran is found to have moved out of the United States, the PH AH folder will be forwarded to the Director, Loan Guaranty Service (262A).
C. Pending-Active Cases. The case becomes "active" upon receipt of the veteran's VA Form 264555c or VA Form 264555d.
| File Type | application/msword |
| File Title | VA Form 26-4555d |
| Author | NOAVA |
| File Modified | 2007-07-11 |
| File Created | 2007-07-11 |