81_FR_1000 81 FR 995 - Proposed Information Collection (Voice of Veteran Surveys, Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (National Cemetery Administration, Veterans Benefits Affairs, Veterans Health Administration), Survey of Veteran Enrollees' Health and Reliance Upon VA, Bereaved Family Member Satisfaction Survey, Nation-Wide Customer Satisfaction Surveys (Survey of Healthcare Experiences of Patients), Veterans Health Benefits Handbook Satisfaction Survey, Veterans Transportation Service Data Collection, Center for Verification and Evaluation Site Inspections, Post Engagement, Awards & Return on Investment, Center for Verification and Evaluation Verification Survey) Activity: Comment Request

81 FR 995 - Proposed Information Collection (Voice of Veteran Surveys, Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (National Cemetery Administration, Veterans Benefits Affairs, Veterans Health Administration), Survey of Veteran Enrollees' Health and Reliance Upon VA, Bereaved Family Member Satisfaction Survey, Nation-Wide Customer Satisfaction Surveys (Survey of Healthcare Experiences of Patients), Veterans Health Benefits Handbook Satisfaction Survey, Veterans Transportation Service Data Collection, Center for Verification and Evaluation Site Inspections, Post Engagement, Awards & Return on Investment, Center for Verification and Evaluation Verification Survey) Activity: Comment Request

DEPARTMENT OF VETERANS AFFAIRS

Federal Register Volume 81, Issue 5 (January 8, 2016)

Page Range995-997
FR Document2016-00075

The Veteran's Experience Office, 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 non-substantive change request of a currently approved collection, and allow 60 days for public comment in response to the notice. This notice solicits comments on 11 Information collections for the Veteran's Experience Agency Priority Goal, which specifies that four survey questions will be incorporated into existing customer experience surveys by Q1 FY2016. The information collected will be used by VA departmental leadership to track enterprise performance improvements as experienced by our Veterans. This notice will serve as notification for any future Non- substantive Change Information Collection Request adding these four customer service questions in the Information Collection Requests.

Federal Register, Volume 81 Issue 5 (Friday, January 8, 2016) 
[Federal Register Volume 81, Number 5 (Friday, January 8, 2016)]
[Notices]
[Pages 995-997]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2016-00075]


=======================================================================
-----------------------------------------------------------------------

DEPARTMENT OF VETERANS AFFAIRS

[OMB Control Nos., 2900-0782,, 2900-0770, 2900-0609, 2900-0701, 2900-
0712, 2900-0773, 2900-0838, 2900-0834, 2900-0836, 2900-0837, 2900-0835]


Proposed Information Collection (Voice of Veteran Surveys, 
Generic Clearance for the Collection of Qualitative Feedback on Agency 
Service Delivery (National Cemetery Administration, Veterans Benefits 
Affairs, Veterans Health Administration), Survey of Veteran Enrollees' 
Health and Reliance Upon VA, Bereaved Family Member Satisfaction 
Survey, Nation-Wide Customer Satisfaction Surveys (Survey of Healthcare 
Experiences of Patients), Veterans Health Benefits Handbook 
Satisfaction Survey, Veterans Transportation Service Data Collection, 
Center for Verification and Evaluation Site Inspections, Post 
Engagement, Awards & Return on Investment, Center for Verification and 
Evaluation Verification Survey) Activity: Comment Request

AGENCY: Veteran's Experience Office, Department of Veterans Affairs.

ACTION: Notice.

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

SUMMARY: The Veteran's Experience Office, 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 non-substantive 
change request of a currently approved collection, and allow 60 days 
for public comment in response to the notice. This notice solicits 
comments on 11 Information collections for the Veteran's Experience 
Agency Priority Goal, which specifies that four survey questions will 
be incorporated into existing customer experience surveys by Q1 FY2016. 
The information collected will be used by VA departmental leadership to 
track enterprise performance improvements as experienced by our 
Veterans. This notice will serve as notification for any future Non-
substantive Change Information Collection Request adding these four 
customer service questions in the Information Collection Requests.

DATES: Written comments and recommendations on the proposed collection 
of information should be received on or before March 8, 2016.

ADDRESSES: Submit written comments on the collection of information 
through Federal Docket Management System (FDMS) at www.Regulations.gov 
or to Thomas Pasakarnis, Veteran's Experience Office (008VE), 
Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 
20420 or email to [email protected]. Please refer to ``OMB 
Control No. 2900-VE'' in any correspondence. During the comment period, 
comments may be viewed online through the FDMS.

FOR FURTHER INFORMATION CONTACT: Thomas Pasakarnis at (202) 461-5869 or 
FAX (202) 495-5401.

SUPPLEMENTARY INFORMATION: Under the PRA of 1995 (Pub. L. 104-13; 44 
U.S.C. 3501-21), 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, Veteran's 
Experience 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 VA'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.
    Type of Review: Non-Substantive Change of currently approved 
collections.
    Abstract: For FY16-17, VA set Veterans Experience as an agency 
priority goal to improve Veterans Experience with VA. Because this is a 
new measure, VA developed one brand and three experience measures to 
support the Veterans Experience Agency Priority Goal (APG). VA will add 
four APG questions to each survey identified below. One question deals 
with VA brand, and three questions deal with Veterans experience.

    ``I got the service I needed.''
    ``It was easy to get what I needed.''
    ``I felt like a valued customer.''
    ``I trust VA to fulfill our country's commitment to veterans.''
    Strongly agree
    Agree
    Neither Agree nor Disagree
    Disagree
    Strongly disagree

    Adding these questions is necessary to establish an enterprise 
measure of VA's performance as experienced by our Veterans, as is 
needed to support VA's Veterans Experience FY16-17 APG. VA's goal is to 
incorporate these four survey questions into VA's existing customer 
experience by Q1 FY2016. The information collected will be used by VA 
departmental leadership to track enterprise performance improvements as 
experienced by our Veterans.
    VA expects that it will take approximately one minute for each 
survey respondent to answer these new questions. As set forth below, 
this change is expected to affect approximately 132 instruments 
approved under eleven different OMB control numbers. Together, these 
instruments are nearly 1.5 million times per year. The cumulative 
annual burden of this change is more than 24,000 hours ((1 minute per 
submission * 1,462,937 submissions)/60 minutes per hour = 24,382.28 
hours). There is also some annual cost burden associated with this 
request. Specifically, some of these instruments are administered by 
third-party contractors, who will need to revise the instruments.
    VA has provided a table detailing the full burden information for 
each information collection located at http://www.oprm.va.gov/ers/ers_reports.aspx.

[[Page 996]]

Please note, additional instruments approved under these or additional 
control numbers may be included in the Veteran's Experience initiative 
in the future. Therefore, this online table detailing burden 
information will be updated periodically.

Titles of Affected Collections and Instruments

(1) 2900-0782--Voice of Veteran Surveys
    (1) Compensation Access
    (2) Compensation Servicing
    (3) Pension Access
    (4) Pension Servicing
    (5) Education Access
    (6) Education Servicing
    (7) VR&E Access
    (8) VR&E Servicing
    (9) VR&E Non-Participant
    (10) Loan Guarantee Home Loan Process
    (11) Specialty Adapted Housing Grant Process, mail
(2) 2900-0770--Generic Clearance for the Collection of Qualitative 
Feedback on Agency Service Delivery (National Cemetery Administration, 
Veterans Benefits Affairs, Veterans Health Administration)
    (1) CFM Supplier Satisfaction Survey, form 10-10163
    (2) VLER Program Survey, Undecided Vet Interview, form 10-0457
    (3) Veterans Choice Program Survey, form 10-0450
    (4) Nationwide Dialysis Contracts Program Veterans Survey, form 10-
0455
    (5) VA Courtesy Standards--The Golden Rule Approach Veteran 
Feedback Form, 10-0497
    (6) Phone Apps Focus Group Demographic Questionnaire, form10-0496a
    (7) PTSD Coach App Survey, form 10-0496
    (8) Understanding PTSD for Family Caregivers: Feedback Survey, form 
10-0495
    (9) Building Better Caregivers Satisfaction Survey, form 10-0499
    (10) Building Better Caregiver Phone Survey, form 10-0499
    (11) Clinical Video Telehealth (CVT) Patient Satisfaction Survey, 
form 10-0481a
    (12) Compensation and Pension Examination Program (CPEP) Veterans 
Satisfaction Survey, form 10-0480
    (13) Michael E. DeBakey Patient Satisfaction Survey, form 10-0476
    (14) Food and Nutrition Satisfaction Survey, form 10-0498
    (15) Veterans Transportation Service (VTS) Satisfaction 
Questionnaire, form 10-0517
    (16) Patient Satisfaction Questionnaire: Laboratory P&LMS VA New 
England Healthcare System, form 10-0516
    (17) Project ARCH (Access Received Closer to Home) Patient 
Satisfaction Survey, form 10-0522
    (18) PVAMC Low Vision Patient Satisfaction Survey, form 10-0527
    (19) Vendor Application for Fair, form 10-0528
    (20) Notice Your Nurse: Notice Your NurseThank you card, form 10-
0519
    (21) The Continuity of Medication Management Patient Survey, form 
10-0526
    (22) Caribbean Healthcare System Pathology and Laboratory Medicine, 
form 10-0526
    (23) Tele-Retinal Patient Satisfaction Survey, form 10-0540
    (24) Purchased Care Patient Satisfaction Survey, form 10-0538
    (25) Spinal Cord Home Care Survey, form 10-0542
    (26) Childcare Services Satisfaction Survey, form 10-0531
    (27) Neurology/Rehabilitation Inpatient Program Satisfaction 
Survey, form 10-0546
    (28) Non-VA Care Coordination Veteran Satisfaction Survey, form 10-
0545
    (29) Survey of Veterans' Satisfaction with Income Verification, 
form 10-0541
    (30) Spinal Cord Injury Patient Survey, form 10-0515
    (31) National Family Caregiver Participant Training Feedback Form 
10-0520
    (32) Psychiatric Patient Satisfaction Survey, form 10-0550
    (33) Cardiac Cath Lab Customer Satisfaction Survey, form 10-0547
    (34) Community Living Center (CLC) Satisfaction Survey, form 10-
0548
    (35) Survey of Veterans Perceptions of an Enhanced VA Outpatient 
Prescription Label, form 10-0549
    (36) Dental Service Customer Satisfaction Survey, form 10-0553
    (37) Dental Satisfaction Survey (Spanish version), form 10-0553s
    (38) Office of Mental Health Veteran Satisfaction Survey, form 10-
0554
    (39) Patient Experience of Care Survey, form 10-0552
    (40) VCS Patriot Store and VCS Patriot Cafe Customer Satisfaction 
Survey, form 10-0551
    (41) Epilepsy Centers of Excellence (ECoE) Patient Survey, form10-
0558
    (42) Fraud, Waste and Abuse Complaint Form, 10-0500
    (43) Sodium Dichromate Exposure Exam Feedback Survey, form 10-0559
    (44) Patient Satisfaction Survey- Radiation Oncology WEB survey, 
form 10-10063
    (45) Hem-Oncology Telehealth Satisfaction WEB Survey, form 10-10054
    (46) Vet Appointment Mobile App Survey, form 10-10057
    (47) Telephone Care Services Patient Satisfaction Survey, form 10-
10058
    (48) VISN 20 Telephone Customer Service Experience Satisfaction 
Survey, form 10-10059
    (49) Prosthetics Customer Service Survey, form 10-10125
    (50) Customer Patient Satisfaction Monthly Survey, form 10-10126
    (51) HME Vendor Performance Survey 2014, form 10-10122
    (52) SOU-SORCC Patient Survey, form 10-10145
    (53) Audiology Hearing Aid Questionnaire, form 10-10128
    (54) Advanced Education Veteran Survey -SORCC-Patient, form 10-
10128
    (55) VoV OSI Primary Care Survey--Conjoint Analysis, form 10-10147
    (56) Women's Health Research Network, form 10-10142
    (57) Telehealth Master Preceptor, form 10-10127
    (58) Mental Health Survey, form 10-10129
    (59) Extended Hours Program Evaluation--Non-Users Survey, form 10-
10129
    (60) VISN 1 Extended Hours Evaluation--Users, form 10-10132
    (61) Maternity Care Coordination Experiences of Pregnant Veterans 
Survey, form 10-10131
    (62) State Veterans Home Admin Survey, form 10-10136
    (63) Tobacco and Smoking Cessation Survey, form 10-10136
    (64) Voice of the Veteran (VOV) Satisfaction Survey Office of 
Strategic Integration (OSI) Conjoint Analysis, form 10-10144
    (65) VISN 1 NCL Patient Satisfaction Questionnaire, form 10-10133
    (66) Interview and Discussion Group Protocols for the Institute of 
Medicine: 09-IOM VA MH Services Eval Non-VA Service Users Discussion 
Protocol, form 10-10130
    (67) Battlecreek Urgent Care Survey, form 10-10135
    (68) MEC Notification Survey, form 10-10155
    (69) Caregiver Feedback form. Self-Care Course, form 10-10119
    (70) VISN20 Cancer Care Survey--Veteran Satisfaction, form 10-10164
    (71) Customer Satisfaction Survey on VA Research Communication, VA

[[Page 997]]

Research Currents, form 10-10167
    (72) Patient Satisfaction Survey Boston VAMC Ophthalmology, form 
10-211001NR
    (73) Anticoagulation (warfarin/Coumadin) Patient Satisfaction 
Survey, form 10-211002
    (74) Patient Survey: Waiting Room Television Video Patient 
Education, form 10-211005
    (75) MSCoE Patient Survey, form 10-211003
    (76) PROJECT ARCH (Access Received Closer to Home) Non-
Participating Veterans Survey, form 10-211004
    (77) Outpatient Pharmacy Customer Satisfaction Survey, form 10-
211006NR
    (78) National Patient Centered Community Care Veterans Survey 
Question, form 10-211009
    (79) OKC Dental (Ambulatory) Patient Satisfaction Survey, form 10-
211008
    (80) HEC Enrollment Survey, form 10-211013
    (81) Non-VA-Purchased Care Veteran Survey, form 10-211013
    (82) Survey of Rehabilitation Care, form 10-211010
    (83) Tele-Dermatology Imaging Patient Satisfaction Survey, form 10-
211016
    (84) Home Based Primary Care Survey, Lawton CBOC, form 10-211014
    (85) Dental Insurance Program Survey, form 10-211011
    (86) Survey of Patient Satisfaction at Surgical Service, form 10-
211015
    (87) Survey of Patient Satisfaction at Surgical Service -Spanish, 
form 10-211015SP
    (88) Oklahoma City VAMC Home Based Primary Care (HBPC) Survey, form 
10-211014a
    (89) Telephone Survey on User Experience with VLER Health Exchange'
    (90) Provider Interview Guide, form 2900-0770
    (91) Veteran (Patient) Interview-Guide, form 2900-0770
    (92)
    (93) Online Survey--VHA Customer Value Survey, form 2900-0770
    (94) State Veterans Home Patient Satisfaction, form 2900-0770
    (95) VISN 1 Call Center Telephone Survey Script (Veteran Women), 
form 2900-0770
    (96) Gulf War Newsletter Survey--Office of Public Health, form 
2900-0770
    (97) My HealtheVet (MHV) Web site Redesign Veteran and Family 
Caregiver Demographic Survey, form 2900-0770
    (98) 2014 Post-911CommunicationSurvey-Questionnaire, form 2900-0770
    (99) Claims Clinic Satisfaction Survey (VBA), form 2900-0770
    (100) Feedback US Survey
    (101) Feedback USA Survey Button--KIOSK, form 2900-0770
    (102) Feedback USA Survey Button--Internet Web site, form 2900-0770
    (103) Business Requirements Sessions
    (104) Awards and ROI-2013NVSB (Small Business), form 2900-0770
    (105) Awards and ROI-2013NVSB (Large Business), form 2900-0770
    (106) 2014 National Veterans Small Business Engagement (NVSBE) 
Events Satisfaction, form 2900-0770
    (107) Business Sessions Satisfaction Survey, form?
    (108) CVE Booth Satisfaction, form 2900-0770
    (109) Exhibitor Satisfaction 2900-0770
    (110) Learning Sessions 2900-0770
    (111) NRT Satisfaction 2900-0770
    (112) Senior Leaders Roundtables, 2900-0770
    (113) 2014 NVSBE Post-Engagement Attendees Survey, 2900-0770
    (114) OSDBU Post-Event Evaluation, 2900-0770
    (115) NAC Customer Response Survey--WEB
(3) 2900-0609--Survey of Veteran Enrollees' Health and Reliance Upon VA
    (1) (CATI) Survey of Veteran Enrollees' Health and Reliance Upon 
VA, form 10-21034G
(4) 2900-0701--Bereaved Family Member Satisfaction Survey
    (1) Bereaved Family Member Satisfaction Survey Administered by 
Facility Staff, form 10-21081
(5) 2900-0712--Nation-wide Customer Satisfaction Surveys (Survey of 
Healthcare Experiences of Patients)
    (1) Recently Discharged Patient, form 10-1465-1
    (2) Recently Discharged Inpatient, form 10-1465-2
    (3) Ambulatory Care, form 10-1465-3
    (4) Ambulatory Care, form 10-1465-4
    (5) Ambulatory Care, form 10-1465-5
    (6) Ambulatory Care, form 10-1465-6
    (7) Home Health Care Survey, form 10-1465-7
    (8) In-Center Hemodialysis Care, form 10-1465-8
(6) 2900-0773--Veterans Health Benefits Handbook Satisfaction Survey
    (1) Veterans Health Benefits Handbook Satisfaction Survey, form 10-
0507
(7) 2900-0838--Veterans Transportation Service Data Collection
    (1) Veterans Transportation Service Data Collection Telephonic 
Script
(8) 2900-0834--Center for Verification and Evaluation Site Inspections
    (1) CVE Site Inspection Survey, Historical
    (2) CVE Site Inspection Survey, Regular
(9) 2900-0836--Post Engagement
    (1) 2015 National Veterans Small Business Engagement Post 
Engagement Survey
(10) 2900-0837--Awards & Return on Investment
    (1) Awards and Return on Investment after 2015 National Veterans 
Small Business Engagement (Small Business)
    (2) Awards and Return on Investment after 2015 National Veterans 
Small Business Engagement (Large Business)
(11) 2900-0835--Center for Verification and Evaluation Verification 
Survey
    (1) CVE Pre-Application Survey
    (2) CVE Exit Survey
    (3) CVE Post-Determination Letter

    By direction of the Secretary.
Crystal Rennie,
Department Clearance Officer, Office of Privacy and Records Management, 
Department of Veterans Affairs.
[FR Doc. 2016-00075 Filed 1-7-16; 8:45 am]
 BILLING CODE 8320-01-P

Federal Register / Vol. 81, No. 5 / Friday, January 8, 2016 / Notices 995 8. What are the most useful formats SUMMARY: The Veteran’s Experience proposed collection of information; (3) for receiving information from USDOT, Office, Department of Veterans Affairs ways to enhance the quality, utility, and and why (e.g. webinars, in-person (VA), is announcing an opportunity for clarity of the information to be meetings, conference calls, etc.)? public comment on the proposed collected; and (4) ways to minimize the 9. What efforts in your city to improve collection of certain information by the burden of the collection of information bicycle and pedestrian safety in your agency. Under the Paperwork Reduction on respondents, including through the community were already underway at Act (PRA) of 1995, Federal agencies are use of automated collection techniques the time of the Mayors’ Challenge? How required to publish notice in the or the use of other forms of information has the Mayors’ Challenge added value Federal Register concerning each technology. and/or helped to fill any gaps in your proposed collection of information, Type of Review: Non-Substantive city’s efforts to improve bicycle and including each proposed non- Change of currently approved pedestrian safety? substantive change request of a collections. 10. In planning and project delivery of currently approved collection, and Abstract: For FY16–17, VA set pedestrian and/or bicycle infrastructure allow 60 days for public comment in Veterans Experience as an agency projects, to what extent has your city response to the notice. This notice priority goal to improve Veterans coordinated with your Metropolitan solicits comments on 11 Information Experience with VA. Because this is a Planning Organization (MPO), Regional collections for the Veteran’s Experience new measure, VA developed one brand Planning Organization (RPO), State Agency Priority Goal, which specifies and three experience measures to Department of Transportation (DOT), that four survey questions will be support the Veterans Experience Agency and Federal Regional/Division office incorporated into existing customer Priority Goal (APG). VA will add four partners? Please note type of outreach experience surveys by Q1 FY2016. The APG questions to each survey identified and coordination, and outcomes it led information collected will be used by below. One question deals with VA to. VA departmental leadership to track brand, and three questions deal with 11. What have been the key benefits enterprise performance improvements Veterans experience. and lessons learned as a result of the as experienced by our Veterans. This ‘‘I got the service I needed.’’ Mayors’ Challenge? notice will serve as notification for any ‘‘It was easy to get what I needed.’’ 12. Do you think the Mayors’ future Non-substantive Change ‘‘I felt like a valued customer.’’ challenge has helped make any Information Collection Request adding ‘‘I trust VA to fulfill our country’s permanent changes in pedestrian and these four customer service questions in commitment to veterans.’’ bike safety and accommodation in your the Information Collection Requests. Strongly agree city/town? DATES: Written comments and Agree Neither Agree nor Disagree [FR Doc. 2016–00159 Filed 1–7–16; 8:45 am] recommendations on the proposed Disagree BILLING CODE 4910–9X–P collection of information should be Strongly disagree received on or before March 8, 2016. Adding these questions is necessary ADDRESSES: Submit written comments to establish an enterprise measure of DEPARTMENT OF VETERANS on the collection of information through VA’s performance as experienced by our AFFAIRS Federal Docket Management System Veterans, as is needed to support VA’s (FDMS) at www.Regulations.gov or to Veterans Experience FY16–17 APG. [OMB Control Nos., 2900–0782,, 2900–0770, 2900–0609, 2900–0701, 2900–0712, 2900– Thomas Pasakarnis, Veteran’s VA’s goal is to incorporate these four 0773, 2900–0838, 2900–0834, 2900–0836, Experience Office (008VE), Department survey questions into VA’s existing 2900–0837, 2900–0835] of Veterans Affairs, 810 Vermont customer experience by Q1 FY2016. The Avenue NW., Washington, DC 20420 or information collected will be used by Proposed Information Collection email to Thomas.pasakarnis@va.gov. VA departmental leadership to track (Voice of Veteran Surveys, Generic Please refer to ‘‘OMB Control No. 2900– enterprise performance improvements Clearance for the Collection of VE’’ in any correspondence. During the as experienced by our Veterans. Qualitative Feedback on Agency comment period, comments may be VA expects that it will take Service Delivery (National Cemetery viewed online through the FDMS. approximately one minute for each Administration, Veterans Benefits FOR FURTHER INFORMATION CONTACT: survey respondent to answer these new Affairs, Veterans Health Thomas Pasakarnis at (202) 461–5869 or questions. As set forth below, this Administration), Survey of Veteran FAX (202) 495–5401. change is expected to affect Enrollees’ Health and Reliance Upon SUPPLEMENTARY INFORMATION: Under the approximately 132 instruments VA, Bereaved Family Member PRA of 1995 (Pub. L. 104–13; 44 U.S.C. approved under eleven different OMB Satisfaction Survey, Nation-Wide 3501–21), Federal agencies must obtain control numbers. Together, these Customer Satisfaction Surveys approval from the Office of Management instruments are nearly 1.5 million times (Survey of Healthcare Experiences of and Budget (OMB) for each collection of per year. The cumulative annual burden Patients), Veterans Health Benefits information they conduct or sponsor. of this change is more than 24,000 hours Handbook Satisfaction Survey, This request for comment is being made ((1 minute per submission * 1,462,937 Veterans Transportation Service Data pursuant to section 3506(c)(2)(A) of the submissions)/60 minutes per hour = Collection, Center for Verification and PRA. 24,382.28 hours). There is also some Evaluation Site Inspections, Post With respect to the following annual cost burden associated with this mstockstill on DSK4VPTVN1PROD with NOTICES6 Engagement, Awards & Return on collection of information, Veteran’s request. Specifically, some of these Investment, Center for Verification and Experience invites comments on: (1) instruments are administered by third- Evaluation Verification Survey) Whether the proposed collection of party contractors, who will need to Activity: Comment Request information is necessary for the proper revise the instruments. AGENCY: Veteran’s Experience Office, performance of VBA’s functions, VA has provided a table detailing the Department of Veterans Affairs. including whether the information will full burden information for each have practical utility; (2) the accuracy of information collection located at http:// ACTION: Notice. VA’s estimate of the burden of the www.oprm.va.gov/ers/ers_reports.aspx. VerDate Sep<11>2014 23:39 Jan 13, 2016 Jkt 238001 PO 00000 Frm 00094 Fmt 4703 Sfmt 4703 E:\FR\FM\08JAN1.SGM 08JAN1

996 Federal Register / Vol. 81, No. 5 / Friday, January 8, 2016 / Notices Please note, additional instruments form 10–0517 Exam Feedback Survey, form 10– approved under these or additional (16) Patient Satisfaction 0559 control numbers may be included in the Questionnaire: Laboratory P&LMS (44) Patient Satisfaction Survey- Veteran’s Experience initiative in the VA New England Healthcare Radiation Oncology WEB survey, future. Therefore, this online table System, form 10–0516 form 10–10063 detailing burden information will be (17) Project ARCH (Access Received (45) Hem-Oncology Telehealth updated periodically. Closer to Home) Patient Satisfaction Satisfaction WEB Survey, form 10– Survey, form 10–0522 10054 Titles of Affected Collections and (18) PVAMC Low Vision Patient (46) Vet Appointment Mobile App Instruments Satisfaction Survey, form 10–0527 Survey, form 10–10057 (1) 2900–0782—Voice of Veteran (19) Vendor Application for Fair, form (47) Telephone Care Services Patient Surveys 10–0528 Satisfaction Survey, form 10–10058 (1) Compensation Access (20) Notice Your Nurse: Notice Your (48) VISN 20 Telephone Customer (2) Compensation Servicing NurseThank you card, form 10– Service Experience Satisfaction (3) Pension Access 0519 Survey, form 10–10059 (4) Pension Servicing (21) The Continuity of Medication (49) Prosthetics Customer Service (5) Education Access Management Patient Survey, form Survey, form 10–10125 (6) Education Servicing 10–0526 (50) Customer Patient Satisfaction (7) VR&E Access (22) Caribbean Healthcare System Monthly Survey, form 10–10126 (8) VR&E Servicing Pathology and Laboratory Medicine, (51) HME Vendor Performance Survey (9) VR&E Non-Participant form 10–0526 2014, form 10–10122 (10) Loan Guarantee Home Loan (23) Tele-Retinal Patient Satisfaction (52) SOU–SORCC Patient Survey, Process Survey, form 10–0540 form 10–10145 (11) Specialty Adapted Housing Grant (24) Purchased Care Patient (53) Audiology Hearing Aid Process, mail Satisfaction Survey, form 10–0538 Questionnaire, form 10–10128 (2) 2900–0770—Generic Clearance for (25) Spinal Cord Home Care Survey, (54) Advanced Education Veteran the Collection of Qualitative form 10–0542 Survey -SORCC-Patient, form 10– Feedback on Agency Service (26) Childcare Services Satisfaction 10128 Delivery (National Cemetery Survey, form 10–0531 (55) VoV OSI Primary Care Survey— Administration, Veterans Benefits (27) Neurology/Rehabilitation Conjoint Analysis, form 10–10147 Affairs, Veterans Health Inpatient Program Satisfaction (56) Women’s Health Research Administration) Survey, form 10–0546 Network, form 10–10142 (1) CFM Supplier Satisfaction Survey, (28) Non-VA Care Coordination (57) Telehealth Master Preceptor, form 10–10163 Veteran Satisfaction Survey, form form 10–10127 (2) VLER Program Survey, Undecided 10–0545 (58) Mental Health Survey, form 10– Vet Interview, form 10–0457 (29) Survey of Veterans’ Satisfaction 10129 (3) Veterans Choice Program Survey, with Income Verification, form 10– (59) Extended Hours Program form 10–0450 0541 Evaluation—Non-Users Survey, (4) Nationwide Dialysis Contracts (30) Spinal Cord Injury Patient form 10–10129 Program Veterans Survey, form 10– Survey, form 10–0515 (60) VISN 1 Extended Hours 0455 (31) National Family Caregiver Evaluation—Users, form 10–10132 (5) VA Courtesy Standards—The Participant Training Feedback Form (61) Maternity Care Coordination Golden Rule Approach Veteran 10–0520 Experiences of Pregnant Veterans Feedback Form, 10–0497 (32) Psychiatric Patient Satisfaction Survey, form 10–10131 (6) Phone Apps Focus Group Survey, form 10–0550 (62) State Veterans Home Admin Demographic Questionnaire, (33) Cardiac Cath Lab Customer Survey, form 10–10136 form10–0496a Satisfaction Survey, form 10–0547 (63) Tobacco and Smoking Cessation (7) PTSD Coach App Survey, form 10– (34) Community Living Center (CLC) Survey, form 10–10136 0496 Satisfaction Survey, form 10–0548 (64) Voice of the Veteran (VOV) (8) Understanding PTSD for Family (35) Survey of Veterans Perceptions of Satisfaction Survey Office of Caregivers: Feedback Survey, form an Enhanced VA Outpatient Strategic Integration (OSI) Conjoint 10–0495 Prescription Label, form 10–0549 Analysis, form 10–10144 (9) Building Better Caregivers (36) Dental Service Customer (65) VISN 1 NCL Patient Satisfaction Satisfaction Survey, form 10–0499 Satisfaction Survey, form 10–0553 Questionnaire, form 10–10133 (10) Building Better Caregiver Phone (37) Dental Satisfaction Survey (66) Interview and Discussion Group Survey, form 10–0499 (Spanish version), form 10–0553s Protocols for the Institute of (11) Clinical Video Telehealth (CVT) (38) Office of Mental Health Veteran Medicine: 09–IOM VA MH Services Patient Satisfaction Survey, form Satisfaction Survey, form 10–0554 Eval Non-VA Service Users 10–0481a (39) Patient Experience of Care Discussion Protocol, form 10–10130 (12) Compensation and Pension Survey, form 10–0552 (67) Battlecreek Urgent Care Survey, Examination Program (CPEP) (40) VCS Patriot Store and VCS Patriot form 10–10135 mstockstill on DSK4VPTVN1PROD with NOTICES6 Veterans Satisfaction Survey, form Cafe Customer Satisfaction Survey, (68) MEC Notification Survey, form 10–0480 form 10–0551 10–10155 (13) Michael E. DeBakey Patient (41) Epilepsy Centers of Excellence (69) Caregiver Feedback form. Self- Satisfaction Survey, form 10–0476 (ECoE) Patient Survey, form10– Care Course, form 10–10119 (14) Food and Nutrition Satisfaction 0558 (70) VISN20 Cancer Care Survey— Survey, form 10–0498 (42) Fraud, Waste and Abuse Veteran Satisfaction, form 10–10164 (15) Veterans Transportation Service Complaint Form, 10–0500 (71) Customer Satisfaction Survey on (VTS) Satisfaction Questionnaire, (43) Sodium Dichromate Exposure VA Research Communication, VA VerDate Sep<11>2014 23:39 Jan 13, 2016 Jkt 238001 PO 00000 Frm 00095 Fmt 4703 Sfmt 4703 E:\FR\FM\08JAN1.SGM 08JAN1

Federal Register / Vol. 81, No. 5 / Friday, January 8, 2016 / Notices 997 Research Currents, form 10–10167 (98) 2014 Post- (1) Veterans Transportation Service (72) Patient Satisfaction Survey 911CommunicationSurvey- Data Collection Telephonic Script Boston VAMC Ophthalmology, Questionnaire, form 2900–0770 (8) 2900–0834—Center for Verification form 10–211001NR (99) Claims Clinic Satisfaction Survey and Evaluation Site Inspections (73) Anticoagulation (warfarin/ (VBA), form 2900–0770 (1) CVE Site Inspection Survey, Coumadin) Patient Satisfaction (100) Feedback US Survey Historical Survey, form 10–211002 (101) Feedback USA Survey Button— (2) CVE Site Inspection Survey, (74) Patient Survey: Waiting Room KIOSK, form 2900–0770 Regular Television Video Patient Education, (102) Feedback USA Survey Button— (9) 2900–0836—Post Engagement form 10–211005 Internet Web site, form 2900–0770 (1) 2015 National Veterans Small (75) MSCoE Patient Survey, form 10– (103) Business Requirements Sessions Business Engagement Post 211003 (104) Awards and ROI–2013NVSB Engagement Survey (76) PROJECT ARCH (Access (Small Business), form 2900–0770 (10) 2900–0837—Awards & Return on Received Closer to Home) Non- (105) Awards and ROI–2013NVSB Investment Participating Veterans Survey, form (Large Business), form 2900–0770 (1) Awards and Return on Investment 10–211004 (106) 2014 National Veterans Small after 2015 National Veterans Small (77) Outpatient Pharmacy Customer Business Engagement (NVSBE) Business Engagement (Small Satisfaction Survey, form 10– Events Satisfaction, form 2900– Business) 211006NR 0770 (2) Awards and Return on Investment (78) National Patient Centered (107) Business Sessions Satisfaction after 2015 National Veterans Small Community Care Veterans Survey Survey, form? Business Engagement (Large Question, form 10–211009 (108) CVE Booth Satisfaction, form Business) (79) OKC Dental (Ambulatory) Patient 2900–0770 (11) 2900–0835—Center for Verification Satisfaction Survey, form 10– (109) Exhibitor Satisfaction 2900– and Evaluation Verification Survey 211008 0770 (1) CVE Pre-Application Survey (80) HEC Enrollment Survey, form (110) Learning Sessions 2900–0770 (2) CVE Exit Survey 10–211013 (111) NRT Satisfaction 2900–0770 (3) CVE Post-Determination Letter (81) Non-VA-Purchased Care Veteran (112) Senior Leaders Roundtables, By direction of the Secretary. Survey, form 10–211013 2900–0770 Crystal Rennie, (82) Survey of Rehabilitation Care, (113) 2014 NVSBE Post-Engagement Department Clearance Officer, Office of form 10–211010 Attendees Survey, 2900–0770 Privacy and Records Management, (83) Tele-Dermatology Imaging Patient (114) OSDBU Post-Event Evaluation, Department of Veterans Affairs. Satisfaction Survey, form 10– 2900–0770 [FR Doc. 2016–00075 Filed 1–7–16; 8:45 am] 211016 (115) NAC Customer Response BILLING CODE 8320–01–P (84) Home Based Primary Care Survey—WEB Survey, Lawton CBOC, form 10– (3) 2900–0609—Survey of Veteran 211014 Enrollees’ Health and Reliance DEPARTMENT OF VETERANS (85) Dental Insurance Program Upon VA AFFAIRS Survey, form 10–211011 (1) (CATI) Survey of Veteran (86) Survey of Patient Satisfaction at Enrollees’ Health and Reliance Reimbursement for Caskets and Urns Surgical Service, form 10–211015 Upon VA, form 10–21034G for Burial of Unclaimed Remains in a (87) Survey of Patient Satisfaction at (4) 2900–0701—Bereaved Family National Cemetery Surgical Service -Spanish, form 10– Member Satisfaction Survey 211015SP (1) Bereaved Family Member AGENCY: Department of Veterans Affairs. (88) Oklahoma City VAMC Home Satisfaction Survey Administered ACTION: Notice. Based Primary Care (HBPC) Survey, by Facility Staff, form 10–21081 SUMMARY: The Department of Veterans form 10–211014a (5) 2900–0712—Nation-wide Customer Affairs (VA) is updating the monetary (89) Telephone Survey on User Satisfaction Surveys (Survey of reimbursement rates for caskets and Experience with VLER Health Healthcare Experiences of Patients) urns purchased for the interment in a Exchange’ (1) Recently Discharged Patient, form VA national cemetery of Veterans who (90) Provider Interview Guide, form 10–1465–1 die with no known next of kin and 2900–0770 (2) Recently Discharged Inpatient, where there are insufficient resources (91) Veteran (Patient) Interview- form 10–1465–2 for furnishing a burial container. The Guide, form 2900–0770 (3) Ambulatory Care, form 10–1465–3 (4) Ambulatory Care, form 10–1465–4 purpose of this notice is to notify (92) (93) Online Survey—VHA Customer (5) Ambulatory Care, form 10–1465–5 interested parties of the rates that will Value Survey, form 2900–0770 (6) Ambulatory Care, form 10–1465–6 apply to reimbursement claims that (94) State Veterans Home Patient (7) Home Health Care Survey, form occur during calendar year (CY) 2016. Satisfaction, form 2900–0770 10–1465–7 FOR FURTHER INFORMATION CONTACT: (95) VISN 1 Call Center Telephone (8) In-Center Hemodialysis Care, form Tamula Jones, Budget Operations and Survey Script (Veteran Women), 10–1465–8 Field Support Division, National mstockstill on DSK4VPTVN1PROD with NOTICES6 form 2900–0770 (6) 2900–0773—Veterans Health Cemetery Administration, Department (96) Gulf War Newsletter Survey— Benefits Handbook Satisfaction of Veterans Affairs, 810 Vermont Office of Public Health, form 2900– Survey Avenue NW., Washington, DC 20420. 0770 (1) Veterans Health Benefits Telephone: 202–461–6688 (this is not a (97) My HealtheVet (MHV) Web site Handbook Satisfaction Survey, form toll-free number). Redesign Veteran and Family 10–0507 SUPPLEMENTARY INFORMATION: Title 38, Caregiver Demographic Survey, (7) 2900–0838—Veterans Transportation United States Code, Section 2306(f) form 2900–0770 Service Data Collection authorizes VA National Cemetery VerDate Sep<11>2014 23:39 Jan 13, 2016 Jkt 238001 PO 00000 Frm 00096 Fmt 4703 Sfmt 4703 E:\FR\FM\08JAN1.SGM 08JAN1


Document Created: 2016-01-16 01:14:24
Document Modified: 2016-01-16 01:14:24
CategoryRegulatory Information
CollectionFederal Register
sudoc ClassAE 2.7:
GS 4.107:
AE 2.106:
PublisherOffice of the Federal Register, National Archives and Records Administration
SectionNotices
ActionNotice.
DatesWritten comments and recommendations on the proposed collection of information should be received on or before March 8, 2016.
ContactThomas Pasakarnis at (202) 461-5869 or FAX (202) 495-5401.
FR Citation81 FR 995 
2025 Federal Register | Disclaimer | Privacy Policy
USC | CFR | eCFR