VA Advance Directive - Durable Power of Attorney for Health Care and Living Will

ICR 202005-2900-003

OMB: 2900-0556

Federal Form Document

ICR Details
2900-0556 202005-2900-003
Historical Active 201704-2900-012
VA 2900-0556
VA Advance Directive - Durable Power of Attorney for Health Care and Living Will
Revision of a currently approved collection   No
Emergency 05/08/2020
Approved without change 06/02/2020
Retrieve Notice of Action (NOA) 05/07/2020
Emergency approval is granted. VA shall proceed with the normal clearance process in order to avoid a lapse in OMB approval. VA shall accept the close personal friend statement approved under this control number in any reasonable manner. If VA wishes to require a specific format or method of submission, VA shall submit for OMB review.
  Inventory as of this Action Requested Previously Approved
12/31/2020 6 Months From Approved 12/31/2020
300 0 343,622
50 0 171,811
0 0 0

Section 7331 of title 38, United States Code (U.S.C.), requires, in relevant part, that the Secretary of Veterans Affairs, upon the recommendation of the Under Secretary for Health, prescribe regulations to ensure, to the maximum extent practicable, that all VA patient care be carried out only with the full and informed consent of the patient, or in appropriate cases, a representative thereof. Based on VA’s interpretation of this statute and our mandate in 38 U.S.C. 7301(b) to provide a complete medical and hospital service, we recognize that patients with decision-making capacity have the right to state their treatment preferences in a VA or other valid advance directive. The VA advance directive form (both English and Spanish language versions) is VA Form 10-0137. These forms have a current OMB Paperwork Reduction Act (PRA) clearance under OMB Control Number 2900-0556. When a Veteran is incapacitated and does not have an advance directive, the VA regulations allow a statement to be submitted from a “Close Personal Friend” who will be responsible for making health care decisions on behalf of the Veteran. This request for an emergency PRA clearance applies to the addition of the collection of a “Close Personal Friend Statement” to 2900-0556.
This request for an emergency PRA clearance applies to the addition of the collection of a “Close Personal Friend Statement” to 2900-0556. It is estimated that 300 statements will be collected annually, with a burden of 10 minutes per statement. This information collection is noticed in the interim final rule associated with RIN 2900-AQ97. Emergency clearance is requested because AQ97 changed from a proposed rule to an interim final rule that will soon be cleared for publication in the Federal Register. The use of regular OMB clearance procedures will not allow for coordination of the PRA clearance with publication of the rule.

US Code: 38 USC 7331 Name of Law: Informed consent
  
None

2900-AQ97 Final or interim final rulemaking 85 FR 31690 05/27/2020

No

  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 300 343,622 0 -343,322 0 0
Annual Time Burden (Hours) 50 171,811 0 -171,761 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
Yes
Miscellaneous Actions
VA Forms 10-0137, English and Spanish language versions, are currently approved for a PRA clearance until 12/31/2020. Therefore, the burden for these forms has been removed from this emergency clearance request. VA is requesting this emergency PRA clearance for the addition of the collection of a Close Personal Friend Statement from approximately 300 persons per year, pursuant to interim final rule with RIN 2900-AQ97. Only the burden for this additional information collection is included in this request for emergency PRA clearance.

$0
No
    Yes
    Yes
No
No
No
No
Frances O'Donnell 703 405-2449 fran.odonnell@cathexiscorp.com

  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.
05/07/2020


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