Survey of Veteran Enrollees' Health and Reliance Upon VA

ICR 201601-2900-011

OMB: 2900-0609

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Modified
Supplementary Document
2016-02-01
Supplementary Document
2016-01-29
Supplementary Document
2016-01-29
Supplementary Document
2016-01-29
Supplementary Document
2016-01-25
Supplementary Document
2016-01-25
Supplementary Document
2016-01-14
Supporting Statement A
2016-02-10
Supporting Statement B
2016-01-21
IC Document Collections
ICR Details
2900-0609 201601-2900-011
Historical Active 201212-2900-013
VA 2900-0609
Survey of Veteran Enrollees' Health and Reliance Upon VA
Revision of a currently approved collection   No
Regular
Approved without change 03/07/2016
Retrieve Notice of Action (NOA) 02/11/2016
A separate written authorization must be obtained by VA from OMB prior to the testing or offering of any incentives to respondents.
  Inventory as of this Action Requested Previously Approved
03/31/2019 02/29/2016 03/31/2016
42,000 0 42,080
14,000 0 14,728
0 0 0

Study of enrollees' health status, income, reliance on VA & interest in Prescription-Only Program will provide information for planning & policy development for actuarial projections of enrollment, utilization, expenditures, mandated annual enrollment reforms, & quantitative & qualitative research.

PL: Pub.L. 104 - 262 Entirety Name of Law: Veterans Health Care Eligibility Reform Act of 1996,
  
None

Not associated with rulemaking

  80 FR 72786 11/20/2015
81 FR 6342 02/05/2016
No

1
IC Title Form No. Form Name
Survey of Veteran Enrollees' Health and Reliance Upon VA 10-21034G Survey of Veteran Enrollees w/VE Questions

  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 42,000 42,080 0 -80 0 0
Annual Time Burden (Hours) 14,000 14,728 0 -728 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
Yes
Miscellaneous Actions
The burden decreased by 14,700 to 14,000 making for a 700 hour decrease.

$1,300,000
Yes Part B of Supporting Statement
No
No
No
No
Uncollected
Crystal Rennie 202 632-7492 crystal.rennie@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.
02/11/2016


© 2024 OMB.report | Privacy Policy