81 FR 58558 - Agency Information Collection (Request for Nursing Home Information in Connection With Claim for Aid and Attendance (VA Form 21-0779))

DEPARTMENT OF VETERANS AFFAIRS

Federal Register Volume 81, Issue 165 (August 25, 2016)

Page Range		58558-58558
FR Document		2016-20364

In compliance with the Paperwork Reduction Act (PRA) of 1995 (44 U.S.C. 3501-21), this notice announces that the Veterans Benefits Administration, Department of Veterans Affairs, will submit the collection of information abstracted below to the Office of Management and Budget (OMB) for review and comment. The PRA submission describes the nature of the information collection and its expected cost and burden and it includes the actual data collection instrument.

Federal Register, Volume 81 Issue 165 (Thursday, August 25, 2016)

[Federal Register Volume 81, Number 165 (Thursday, August 25, 2016)]
[Notices]
[Page 58558]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2016-20364]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0652]


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

AGENCY: Veterans Benefits Administration, Department of Veterans 
Affairs.

ACTION: Notice.

-----------------------------------------------------------------------

SUMMARY: In compliance with the Paperwork Reduction Act (PRA) of 1995 
(44 U.S.C. 3501-21), this notice announces that the Veterans Benefits 
Administration, Department of Veterans Affairs, will submit the 
collection of information abstracted below to the Office of Management 
and Budget (OMB) for review and comment. The PRA submission describes 
the nature of the information collection and its expected cost and 
burden and it includes the actual data collection instrument.

DATES: Comments must be submitted on or before September 26, 2016.

ADDRESSES: Submit written comments on the collection of information 
through www.Regulations.gov, or to Office of Information and Regulatory 
Affairs, Office of Management and Budget, Attn: VA Desk Officer; 725 
17th St. NW., Washington, DC 20503 or sent through electronic mail to 
[email protected]. Please refer to ``OMB Control No. 2900-
0652'' in any correspondence.

FOR FURTHER INFORMATION CONTACT: Cynthia Harvey-Pryor, Enterprise 
Records Service (005R1B), Department of Veterans Affairs, 810 Vermont 
Avenue NW., Washington, DC 20420, (202) 461-5870 or email 
[email protected]. Please refer to ``OMB Control No. 2900-
0652'' in any correspondence.

SUPPLEMENTARY INFORMATION: 
    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: Revision 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.
    An agency may not conduct or sponsor, and a person is not required 
to respond to a collection of information unless it displays a 
currently valid OMB control number. The Federal Register Notice with a 
60-day comment period soliciting comments on this collection of 
information was published at 81 FR 109, on June 7, 2016, pages 36659 
and 36660.
    Affected Public: Individuals or Households.
    Estimated Annual Burden: 10,188.
    Estimated Average Burden per Respondent: 10 minutes.
    Frequency of Response: One time.
    Estimated Number of Respondents: 61,125.

    By direction of the Secretary.
Cynthia Harvey-Pryor,
Program Analyst, Office of Privacy and Records Management, Department 
of Veterans Affairs.
[FR Doc. 2016-20364 Filed 8-24-16; 8:45 am]
 BILLING CODE 8320-01-P

58558 Federal Register / Vol. 81, No. 165 / Thursday, August 25, 2016 / Notices

By direction of the Secretary. the contractor, after award of the ADDRESSES: Submit written comments
Cynthia Harvey-Pryor, contract, to submit descriptive literature on the collection of information through
Program Specialist, Office of Privacy and on the equipment the contractor intends www.Regulations.gov, or to Office of
Records Management, Department of to furnish to show how that equipment Information and Regulatory Affairs,
Veterans Affairs. meets the specification requirements of Office of Management and Budget, Attn:
[FR Doc. 2016–20342 Filed 8–24–16; 8:45 am] the solicitation. The information is VA Desk Officer; 725 17th St. NW.,
BILLING CODE 8320–01–P needed to ensure that the equipment Washington, DC 20503 or sent through
proposed by the contractor meets the electronic mail to oira_submission@
specification requirements. Failure to omb.eop.gov. Please refer to ‘‘OMB
DEPARTMENT OF VETERANS require the information could result in Control No. 2900–0652’’ in any
AFFAIRS the installation of equipment that does correspondence.
not meet contract requirements, with
[OMB Control No. 2900–0588]
significant loss to the contractor if the FOR FURTHER INFORMATION CONTACT:
Proposed Information Collection contractor subsequently had to remove Cynthia Harvey-Pryor, Enterprise
(Acquisition Regulation (VAAR) the equipment and furnish equipment Records Service (005R1B), Department
Provision 852.211–71, Special Notice); that did meet the specification of Veterans Affairs, 810 Vermont
Activity: Comment Request requirements. The contracting officer Avenue NW., Washington, DC 20420,
will use the information to evaluate (202) 461–5870 or email cynthia.harvey-
AGENCY: Office of Acquisition and whether or not the item offered meets pryor@va.gov. Please refer to ‘‘OMB
Logistics, Department of Veterans the specification requirements. Control No. 2900–0652’’ in any
Affairs. Affected Public: Private Sector— correspondence.
ACTION: Notice. Business or other for-profit and not-for-
profit institutions. SUPPLEMENTARY INFORMATION:
SUMMARY: In compliance with the Estimated Annual Burden: 875 hours.
Paperwork Reduction Act (PRA) of 1995 Estimated Average Burden per Title: Request for Nursing Home
(44 U.S.C. 3501–3521), the Office of Respondent: 300 minutes. Information in connection with Claim
Acquisition and Logistics (OAL), Frequency of Response: On occasion. for Aid and Attendance (VA Form 21–
Department of Veterans Affairs (VA), Estimated Number of Respondents: 0779).
will submit the collection of 175. OMB Control Number: 2900–0652.
information abstracted below to the By direction of the Secretary. Type of Review: Revision of a
Office of Management and Budget Cynthia Harvey-Pryor, currently approved collection.
(OMB) for review and comment. The Program Specialist, Office of Privacy and
PRA submission describes the nature of Abstract: VA Form 21–0779 is used to
Records Management, Department of
the information collection and its Veterans Affairs.
gather the necessary information to
expected cost and burden; it includes determine eligibility for pension and aid
[FR Doc. 2016–20343 Filed 8–24–16; 8:45 am]
the actual data collection instrument. and attendance benefits based on
BILLING CODE 8320–01–P
nursing home status. The form also
DATES: Comments must be submitted on
or before September 26, 2016. requests information regarding
DEPARTMENT OF VETERANS Medicaid status and nursing home care
ADDRESSES: Submit written comments
AFFAIRS charges, so VA can determine the proper
on the collection of information through
rate of payment.
www.Regulations.gov, or to Office of [OMB Control No. 2900–0652]
Information and Regulatory Affairs, An agency may not conduct or
Office of Management and Budget, Attn: Agency Information Collection sponsor, and a person is not required to
VA Desk Officer; 725 17th St. NW., (Request for Nursing Home respond to a collection of information
Washington, DC 20503 or sent through Information in Connection With Claim unless it displays a currently valid OMB
electronic mail to oira_submission@ for Aid and Attendance (VA Form 21– control number. The Federal Register
omb.eop.gov. Please refer to ‘‘OMB 0779)) Notice with a 60-day comment period
Control No. 2900–0588’’ in any soliciting comments on this collection
AGENCY: Veterans Benefits of information was published at 81 FR
correspondence. Administration, Department of Veterans
109, on June 7, 2016, pages 36659 and
FOR FURTHER INFORMATION CONTACT: Affairs.
36660.
Cynthia Harvey-Pryor, Enterprise ACTION: Notice.
Records Service (005R1B), Department Affected Public: Individuals or
of Veterans Affairs, 810 Vermont SUMMARY: In compliance with the Households.
Avenue NW., Washington, DC 20420, Paperwork Reduction Act (PRA) of 1995 Estimated Annual Burden: 10,188.
(202) 461–5870 or email cynthia.harvey- (44 U.S.C. 3501–21), this notice
announces that the Veterans Benefits Estimated Average Burden per
pryor@va.gov . Please refer to ‘‘OMB
Administration, Department of Veterans Respondent: 10 minutes.
Control No. 2900–0588.’’
SUPPLEMENTARY INFORMATION:
Affairs, will submit the collection of Frequency of Response: One time.
Title: Veterans Affairs Acquisition information abstracted below to the Estimated Number of Respondents:
Office of Management and Budget
asabaliauskas on DSK3SPTVN1PROD with NOTICES

Regulation (VAAR) Provision 852.211– 61,125.
71, Special Notice. (OMB) for review and comment. The
PRA submission describes the nature of By direction of the Secretary.
OMB Control Number: 2900–0588.
Type of Review: Extension without the information collection and its Cynthia Harvey-Pryor,
change of a previously approved expected cost and burden and it Program Analyst, Office of Privacy and
collection. includes the actual data collection Records Management, Department of
Abstract: VAAR provision 852.211–71 instrument. Veterans Affairs.
is used only in VA’s telephone system DATES: Comments must be submitted on [FR Doc. 2016–20364 Filed 8–24–16; 8:45 am]
acquisition solicitations and requires or before September 26, 2016. BILLING CODE 8320–01–P

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Document Created: 2016-08-25 00:34:32
Document Modified: 2016-08-25 00:34:32

Category		Regulatory Information
Collection		Federal Register
sudoc Class		AE 2.7: GS 4.107: AE 2.106:
Publisher		Office of the Federal Register, National Archives and Records Administration
Section		Notices
Action		Notice.
Dates		Comments must be submitted on or before September 26, 2016.
Contact		Cynthia Harvey-Pryor, Enterprise Records Service (005R1B), Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 20420, (202) 461-5870 or email [email protected] Please refer to ``OMB Control No. 2900- 0652'' in any correspondence.
FR Citation		81 FR 58558