60-Day FRN - 2900-0652 (2019)

60-Day FRN - 2900-0652 (2019).pdf

Request for Nursing Home Information in Connection with Claim for Aid and Attendance (VA Form 21-0779)

60-Day FRN - 2900-0652 (2019)

OMB: 2900-0652

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jbell on DSKJLSW7X2PROD with NOTICES

Federal Register / Vol. 84, No. 234 / Thursday, December 5, 2019 / Notices
concerning each proposed collection of
information, including each proposed
reinstatement of a currently approved
collection, and allow 60 days for public
comment in response to the notice.
DATES: Written comments and
recommendations on the proposed
collection of information should be
received on or before February 3, 2020.
ADDRESSES: Submit written comments
on the collection of information through
Federal Docket Management System
(FDMS) at www.Regulations.gov or to
Nancy J. Kessinger, Veterans Benefits
Administration (20M33), Department of
Veterans Affairs, 810 Vermont Avenue
NW, Washington, DC 20420 or email to
nancy.kessinger@va.gov. Please refer to
‘‘OMB Control No. 2900–0778’’ in any
correspondence. During the comment
period, comments may be viewed online
through FDMS.
FOR FURTHER INFORMATION CONTACT:
Danny Green at (202) 421–1354.
SUPPLEMENTARY INFORMATION: Under the
PRA of 1995, Federal agencies must
obtain approval from the Office of
Management and Budget (OMB) for each
collection of information they conduct
or sponsor. This request for comment is
being made pursuant to Section
3506(c)(2)(A) of the PRA.
With respect to the following
collection of information, VBA invites
comments on: (1) Whether the proposed
collection of information is necessary
for the proper performance of VBA’s
functions, including whether the
information will have practical utility;
(2) the accuracy of VBA’s estimate of the
burden of the proposed collection of
information; (3) ways to enhance the
quality, utility, and clarity of the
information to be collected; and (4)
ways to minimize the burden of the
collection of information on
respondents, including through the use
of automated collection techniques or
the use of other forms of information
technology.
Authority: Public Law 104–13; 44
U.S.C. 3501–3521.
Title: Disability Benefits
Questionnaires (Group 3).
OMB Control Number: 2900–0778.
Type of Review: Reinstatement of a
currently approved collection.
Abstract: VA Form 21–0960 series
called Disability Benefits Questionnaire
(Group 3) gathers necessary information
from a claimant’s treating physician
regarding the results of medical
examinations. VA will gather medical
information related to the claimant that
is necessary to adjudicate the claim for
VA disability benefits. The Disability
Benefit Questionnaires (Group 3) is
comprised of 17 forms. Each DBQ title

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includes the names of the specific
disability for which it gathers
information. VAF 21–0960C–5, Central
Nervous System and Neuromuscular
Diseases Disability Benefits
Questionnaire, gathers information
related to the claimant’s diagnosis of a
central nervous system disease; VAF
21–0960C–8, Headaches (Including
Migraine Headaches) Disability Benefits
Questionnaire, gathers information
related to the claimant’s diagnosis of
headaches; VAF 21–0960C–9, Multiple
Sclerosis (MS) Disability Benefits
Questionnaire, gathers information
related to the claimant’s diagnosis of
multiple sclerosis; VAF 21–0960G–1,
Esophageal Disorders (including GERD,
Hiatal Hernia, and Other Esophageal
Disorders) Disability Benefits
Questionnaire, gathers information
related to the claimant’s diagnosis of
any esophageal disorders; VAF 21–
0960G–2, Gall Bladder and Pancreas
Conditions Disability Benefits
Questionnaire, gathers information
related to the claimant’s diagnosis of
any gall bladder and pancreas
condition; VAF 21–0960G–3, Intestinal
Conditions (Other than Surgical or
Infectious) Including Irritable Bowel
Syndrome, Crohn’s Disease, Ulcerative
Colitis, and Diverticulitis Disability
Benefits Questionnaire, gathers
information related to the claimant’s
diagnosis of any intestinal conditions
unrelated to surgery or infection; VAF
21–0960G–4, Infectious Intestinal
Disorders (including Bacterial and
Parasitic Infections) Disability Benefits
Questionnaire, gathers information
related to the claimant’s diagnosis of
any infectious intestinal condition; VAF
21–0960G–5, Hepatitis, Cirrhosis and
other Liver Conditions Disability
Benefits Questionnaire, gathers
information related to the claimant’s
diagnosis of any liver condition; VAF
21–0960G–6, Peritoneal Adhesions
Disability Benefits Questionnaire,
gathers information related to the
claimant’s diagnosis of peritoneal
adhesions; VAF 21–0960G–7, Stomach
and Duodenum Conditions (Not
Including GERD or Esophageal
Disorders) Disability Benefits
Questionnaire, gathers information
related to the claimant’s diagnosis of
any stomach or duodenum conditions;
VAF 21–0960G–8, Intestinal Surgery
(Bowel Resection, Colostomy, Ileostomy)
Disability Benefits Questionnaire,
gathers information related to the
claimant’s diagnosis of any surgical
intestinal condition; VAF 21–0960H–2,
Rectum and Anus Conditions (Including
Hemorrhoids) Disability Benefits
Questionnaire, gathers information

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66707

related to the claimant’s diagnosis of
any rectum or anus condition, which
includes hemorrhoids; VAF 21–0960K–
1, Breast Conditions and Disorders
Disability Benefits Questionnaire,
gathers information related to the
claimant’s diagnosis of a breast
condition or disorder; VAF 21–0960K–
2, Gynecological Conditions Disability
Benefits Questionnaire, gathers
information related to the claimant’s
diagnosis of a gynecological condition;
VAF 21–0960L–2, Sleep Apnea
Disability Benefits Questionnaire,
gathers information related to the
claimant’s diagnosis of sleep apnea;
VAF 21–0960M–11, Osteomyelitis
Disability Benefits Questionnaire,
gathers information related to the
claimant’s diagnosis of osteomyelitis;
and VAF 21–0960N–1, Ear Conditions
(Including Vestibular and Infectious)
Disability Benefits Questionnaire,
gathers information related to the
claimant’s diagnosis of an ear disease.
Affected Public: Individuals and
households.
Estimated Annual Burden: 77,500
hours.
Estimated Average Burden per
Respondent: 19.4 minutes.
Frequency of Response: On occasion.
Estimated Number of Respondents:
250,000.
By direction of the Secretary.
Danny S. Green,
Department Clearance Officer, Office of
Quality, Privacy and Risk (OQPR),
Department of Veterans Affairs.
[FR Doc. 2019–26233 Filed 12–4–19; 8:45 am]
BILLING CODE 8320–01–P

DEPARTMENT OF VETERANS
AFFAIRS
[OMB Control No. 2900–0652]

Agency Information Collection
Activity: Request for Nursing Home
Information in Connection With Claim
for Aid and Attendance
Veterans Benefits
Administration, Department of Veterans
Affairs.
ACTION: Notice.
AGENCY:

Veterans Benefits
Administration, Department of Veterans
Affairs (VA), is announcing an
opportunity for public comment on the
proposed collection of certain
information by the agency. Under the
Paperwork Reduction Act (PRA) of
1995, Federal agencies are required to
publish notice in the Federal Register
concerning each proposed collection of
information, including each proposed

SUMMARY:

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jbell on DSKJLSW7X2PROD with NOTICES

66708

Federal Register / Vol. 84, No. 234 / Thursday, December 5, 2019 / Notices

extension of a currently approved
collection, and allow 60 days for public
comment in response to the notice.
DATES: Written comments and
recommendations on the proposed
collection of information should be
received on or before February 3, 2020.
ADDRESSES: Submit written comments
on the collection of information through
Federal Docket Management System
(FDMS) at www.Regulations.gov or to
Nancy J. Kessinger, Veterans Benefits
Administration (20M33), Department of
Veterans Affairs, 810 Vermont Avenue
NW, Washington, DC 20420 or email to
nancy.kessinger@va.gov. Please refer to
‘‘OMB Control No. 2900–0652’’ in any
correspondence. During the comment
period, comments may be viewed online
through FDMS.
FOR FURTHER INFORMATION CONTACT:
Danny Green at (202) 421–1354.
SUPPLEMENTARY INFORMATION: Under the
PRA of 1995, Federal agencies must
obtain approval from the Office of
Management and Budget (OMB) for each
collection of information they conduct
or sponsor. This request for comment is
being made pursuant to Section
3506(c)(2)(A) of the PRA.
With respect to the following
collection of information, VBA invites
comments on: (1) Whether the proposed
collection of information is necessary
for the proper performance of VBA’s
functions, including whether the
information will have practical utility;
(2) the accuracy of VBA’s estimate of the
burden of the proposed collection of
information; (3) ways to enhance the
quality, utility, and clarity of the
information to be collected; and (4)
ways to minimize the burden of the
collection of information on
respondents, including through the use
of automated collection techniques or
the use of other forms of information
technology.
Authority: Public Law 104–13; 44
U.S.C. 3501–3521.
Title: Request for Nursing Home
Information in Connection with Claim
for Aid and Attendance (VA Form 21–
0779).
OMB Control Number: 2900–0652.
Type of Review: Extension of a
currently approved collection.
Abstract: VA Form 21–0779 is used to
gather the necessary information to
determine eligibility for pension and aid
and attendance benefits based on
nursing home status. The form also
requests information regarding
Medicaid status and nursing home care
charges, so VA can determine the proper
rate of payment.
Affected Public: Individuals and
households.

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Estimated Annual Burden: 10,188
hours.
Estimated Average Burden per
Respondent: 10 minutes.
Frequency of Response: On occasion.
Estimated Number of Respondents:
61,125.
By direction of the Secretary:
Danny S. Green,
Department Clearance Officer, Office of
Quality, Privacy and Risk (OQPR),
Department of Veterans Affairs.
[FR Doc. 2019–26240 Filed 12–4–19; 8:45 am]
BILLING CODE 8320–01–P

DEPARTMENT OF VETERANS
AFFAIRS
Funding Availability Under Supportive
Services for Veteran Families Program
Department of Veterans Affairs.
Notice of fund availability.

AGENCY:
ACTION:

The Department of Veterans
Affairs (VA) is announcing the
availability of funds for supportive
services grants under the Supportive
Services for Veteran Families (SSVF)
Program. This Notice of Fund
Availability (NOFA) contains
information concerning the SSVF
Program, renewal of supportive services
grant application processes, and the
amount of funding available. Awards
made for supportive services grants will
fund operations beginning October 1,
2020.

SUMMARY:

Applications for supportive
services grants under the SSVF Program
must be received by the SSVF Program
Office by 4:00 p.m. Eastern Time on
January 31, 2020. In the interest of
fairness to all competing applicants, this
deadline is firm as to date and hour, and
VA will treat as ineligible for
consideration any application that is
received after the deadline. Applicants
should take this practice into account
and make early submission of their
materials to avoid any risk of loss of
eligibility brought about by
unanticipated delays, computer service
outages, or other submission-related
problems.

DATES:

For a Copy of the
Application Package: Copies of the
application can be downloaded from the
SSVF website at www.va.gov/homeless/
ssvf. Questions should be referred to the
SSVF Program Office by email at SSVF@
va.gov. For detailed SSVF Program
information and requirements, see part
62 of Title 38, Code of Federal
Regulations (CFR) (38 CFR part 62).
Submission of Application Package:
Applicants must submit applications

ADDRESSES:

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electronically following instructions
found at www.va.gov/homeless/ssvf.
Applications may not be mailed or sent
by facsimile (FAX). Applications must
be received in the SSVF Program Office
by 4:00 p.m. Eastern Time on the
application deadline date. Applications
must arrive as a complete package.
Materials arriving separately will not be
included in the application package for
consideration and may result in the
application being rejected. See Section
II.C. of this NOFA for maximum
allowable grant amounts.
Technical Assistance: Information
regarding how to obtain technical
assistance with the preparation of a
renewal supportive services grant
application is available on the SSVF
Program website at www.va.gov/
homeless/ssvf.
FOR FURTHER INFORMATION CONTACT: Mr.
John Kuhn, National Director,
Supportive Services for Veteran
Families, by email at SSVF@va.gov.
SUPPLEMENTARY INFORMATION:
Funding Opportunity Title:
Supportive Services for Veteran
Families Program.
Announcement Type: Initial.
Funding Opportunity Number: VA–
SSVF–103119.
Catalog of Federal Domestic
Assistance Number: 64.033, VA
Supportive Services for Veteran
Families Program.
I. Funding Opportunity Description
A. Purpose: The SSVF Program’s
purpose is to provide supportive
services grants to private non-profit
organizations and consumer
cooperatives, who will coordinate or
provide supportive services to very lowincome Veteran families who: (i) Are
residing in permanent housing and at
risk of becoming homeless; (ii) are
homeless and scheduled to become
residents of permanent housing within
a specified time period; or (iii) after
exiting permanent housing within a
specified time period, are seeking other
housing that is responsive to such very
low-income Veteran family’s needs and
preferences. SSVF prioritizes the
delivery of rapid re-housing services to
homeless Veteran households.
Rapid re-housing is an intervention
designed to help individuals and
families quickly exit homelessness,
return to housing in the community,
and avoid homelessness again in the
near term. The core components of a
rapid re-housing program are housing
identification, move-in and rent
financial assistance, and rapid rehousing case management and services.
These core components represent the

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