Health Eligibility Center (HEC) New Enrollee Survey

ICR 201008-2900-001

OMB: 2900-0758

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Unchanged
Supporting Statement B
2010-11-19
Supporting Statement A
2010-11-19
Supplementary Document
2010-11-23
IC Document Collections
IC ID
Document
Title
Status
191196 Unchanged
ICR Details
2900-0758 201008-2900-001
Historical Active 200911-2900-005
VA
Health Eligibility Center (HEC) New Enrollee Survey
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 12/05/2010
Retrieve Notice of Action (NOA) 08/26/2010
  Inventory as of this Action Requested Previously Approved
12/31/2013 36 Months From Approved
1,614 0 0
153 0 0
0 0 0

The HEC seeks approval for this information collection that will allow Veterans an opportunity to provide anonymous feedback on how well the HEC enrolls new Veterans. HEC will use this feedback to improve the enrollment processes. VA will use the information gathered to determine where and to what extent services are satisfactory, and where and to what extent they are in need of improvement. The information may lead to policy changes which improve Veteran satisfaction with VA Healthcare benefits.

EO: EO 12862 Name/Subject of EO: Setting Customer Service Standards
  
None

Not associated with rulemaking

  74 FR 218 11/13/2009
75 FR 13 01/21/2010
No

1
IC Title Form No. Form Name
HEC New Enrollee Survey VA Form 10-0479 Health Eligibility Center (HEC) New Enrollee Survey

  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 1,614 0 0 1,614 0 0
Annual Time Burden (Hours) 153 0 0 153 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This is a new collection, so all burden hours are considered an increase.

$3,500
No
No
No
No
No
Uncollected
Denise McLamb 202-565-8374 denise.mclamb@mail.va.gov

  No

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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
08/26/2010


© 2024 OMB.report | Privacy Policy