Department
of Veterans Affairs
Veterans Health Administration (VHA)
Date: August 15, 2013
From: VHA OMB Liaison (10B4)
Request: OMB review and approval for ICR Non-Substantive Changes
Subject: State Homes Construction and Acquisition Grants Program
Justification for Revision:
The revised VA Forms 10-0388 series simplifies the grant process. The certification of matching funds (10-0388-6) reflects a change to 38 CFR Part 59 and uses language developed by VA Office of General Counsel.
Revisions to VA Form 10-0388-1 (previously dated December 2010)
Page 1 Instruction:
“Grant Type” fillable field : Acquisition and Construction check box fields have been removed.
Section II, no. 7, verbiage change:
Previous: SPACE PROGRAM ANALYSIS-NURSING HOME AND DOMICILIARY (or VA Form 10-0388-4, SPACE PROGRAM ANALYSIS-ADULT DAY HEALTH CARE) for the proposed project that includes a list of each room or area and the square footage proposed. The plan should note special or unusual services or equipment. The information on VA Form 10-0388-3 (or VA Form 10-0388-4) should correspond with the charts contained in 38 CFR 59.140 and 59. 160
Current Revision: Information on VA Form 10-0388-3 and 10-0388-4 should correspond with charts in 140 and 160. Also see the VA community Living Center Design Guide.
Revisions to VA Form 10-0388-2 (previously dated Decemebr 2010)
No change
Revisions to VA Form 10-0388-3 (previously dated December 2010)
No change
Revisions to VA Form 10-0388-4 (previously dated December 2010)
No change
Revisions to VA Form 10-0388-5 (previously dated December 2010)
Page 1.
Section I, Updated Title Change:
Previous: SECTION I - INITIAL REQUIREMENTS TO RECEIVE GRANT
Current Revision: SECTION I - INITIAL REQUIREMENTS DUE AUGUST 1st
Section I: Revised Sentence:
Previous: The
State Representative must submit the following to the Department of
Veterans Affairs (VA) to receive a grant.
Current Revision: The State Representative must submit the following to the Department of Veterans Affairs (VA) Chief, State Home Construction Grant Program (SHCGP) to receive a grant:
Deleted Lines: 3. Updated Form SF 424, 424C and 424D
4. Estimate for equipment
5. State safety Citation Plan
Section II, Updated Title Change:
Previously: SECTION II – REQUIREMENTS DUE BY AUGUST 15 FISCAL YEAR OF AWARD
Current Revision: SECTION II - ADDITIONAL REQUIREMENTS
Page 3 Instruction:
Added Line 16: “Budget Summary Narrative”
Line 17 becomes line 18. Removed text: “VA Form 10-0388-11 as set forth in 38 CFR 160”
Black Box fill has been removed
Revisions to VA Form 10-0388-6 (previously dated December 2010)
Page 1.
Fillable field 4: Revised certification language to read as follows:
“ I certify that State funds totaling $__________ i.e., 35% of the total project cost which is $______________ for FAI # I were available on August 1,_______ and that further State action is not needed to make such funds available (such as further action to issue bonds).”
Caption has been removed: “Description of Funding Source”
Certification Text has been removed:
CERTIFICATION – THE LAW PROVIDES SEVERE PENALTIES FOR WILLFUL SUBMISSION OF FALSE INFORMATION
I certify that the above information submitted to VA is true and correct to the best of my knowledge and ability.
Revisions to VA Form 10-0388-7 (previously dated December 2010)
No change
Revisions to VA Form 10-0388-8 (previously dated December 2010)
No change
Revisions to VA Form 10-0388-9 (previously dated December 2010)
No change
Revisions to VA Form 10-0388-13 (previously dated December 2010)
Page 1.
Section 1. Revised:
Previous text:
A final equipment list. A separate, complete itemized list to include fixed and other equipment (not including equipment in the construction contract) by category with the cost, quantity, and placement in accordance with the final drawings, but not including consumable goods or office supplies. (NOTE: if no equipment is involved in the project, a statement to that effect should be included in the request for the final architectural/engineering inspection). This equipment list must be approved by VA prior to final claim payment.
A request in writing for the final grant program review, including the name and telephone number of the local point of contact for the project.
A final claim for payment on Standard Form SF 271, OUTLAY REPORT AND REQUEST FOR REIMBURSEMENT FOR CONSTRUCTION PROGRAMS. Add the statement "it is hereby agreed that the monetary commitment of the federal government will have been met and the project will be considered terminated upon payment of this voucher."
Evidence that the state has met its responsibility for an audit under the Single Audit Act of 1984 and 59.124 of this part, if applicable.
Revised text:
A final equipment list. A separate, complete itemized list to include fixed and other equipment (not including equipment in the construction contract) by category with the cost, quantity, and placement in accordance with the final drawings, but not including consumable goods or office supplies. (NOTE: if no equipment is involved in the project, a statement to that effect should be included in the request for the final architectural/engineering inspection). This equipment list must be approved by VA prior to final claim payment.
Other equipment not included in the construction contract constituting no more than 10 percent of the total
construction contract cost of the project. Other equipment includes: furniture, furnishings, wheeled equipment, kitchen utensils, linens, draperies, blinds, electric clocks, pictures and trash cans.
A request in writing for the final grant program review, including the name and telephone number of the local point of contact for the project.
A final claim for payment on Standard Form (SF) 271, OUTLAY REPORT AND REQUEST FOR REIMBURSEMENT FOR CONSTRUCTION PROGRAMS. Add the statement "it is hereby agreed that the monetary commitment of the federal government will have been met and the project will be considered terminated upon payment of this voucher."
Evidence that the state has met its responsibility for an audit under the Single Audit Act of 1984 and 59.124 of this part, if applicable.
| File Type | application/msword |
| File Title | Department of Veterans Affairs |
| Author | Karen Guice, MD, MPP |
| Last Modified By | Harvey-Pryor, Cynthia |
| File Modified | 2013-08-13 |
| File Created | 2013-08-13 |