82 FR 19310 - Agency Information Collection Activity Under OMB Review: PACT: Veteran's Health and Well-Being
DEPARTMENT OF VETERANS AFFAIRS Federal Register Volume 82, Issue 79 (April 26, 2017)
Federal Register Volume 82, Issue 79 (April 26, 2017)
| Page Range | 19310-19311 | |
| FR Document | 2017-08442 |
[Federal Register Volume 82, Number 79 (Wednesday, April 26, 2017)] [Notices] [Pages 19310-19311] From the Federal Register Online [www.thefederalregister.org] [FR Doc No: 2017-08442] ======================================================================= ----------------------------------------------------------------------- DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-NEW] Agency Information Collection Activity Under OMB Review: PACT: Veteran's Health and Well-Being AGENCY: Veterans Health Administration, Department of Veterans Affairs. ACTION: Notice. ----------------------------------------------------------------------- SUMMARY: In compliance with the Paperwork Reduction Act (PRA) of 1995, this notice announces that the Veterans Health Administration (VHA), 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; it includes the actual data collection instrument. DATES: Comments must be submitted on or before May 26, 2017. 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- NEW'' 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- NEW.'' SUPPLEMENTARY INFORMATION: Authority: 44 U.S.C. 3501-3521. Titles: PACT: Veteran's Health and Well-Being. OMB Control Number: 2900-NEW. Type of Review: New collection. Abstract: The purpose of the study, which is funded by the PACT Demonstration Lab Coordinating Center, [[Page 19311]] is to conduct a survey of Veterans to capture novel predictors of hospital admission and identify clusters of complex patients based on survey- and claims-based covariates. This study provides the first empirical application of the Cycle of Complexity conceptual model that the study team developed and recently published, which postulates that patient complexity represents more than having multiple chronic conditions. It is critical to evaluate whether complexity defined on the basis of survey-based and claims-based covariates is more predictive than diagnosis of multiple chronic conditions based on claims data alone. The proposed patient survey is designed to measure a broad range of self-reported patient factors that increase Veterans' risk for being admitted to hospital, including life stressors, perceived locus of control, grit, resilience, functional status, social support and loneliness, sleep problems, symptoms, food insecurity, and patient activation. This survey will help us understand, for the first time, the extent to which self-reported factors can markedly improve prediction of patient risk for hospital admission, which may help the PACT Demonstration Lab Coordinating Center Intelligence improve its risk prediction models. This project may also identify patient-reported outcomes (PROs) that can be effectively integrated into routine VA clinical practice, as the VA begins to explore inclusion of PROs into the VA electronic health record. We are requesting approval to conduct this survey to a nationally representative sample of 10,000 patients who obtain primary care in VA because there are no extant VA surveys that capture the range of patient factors that we propose to collect, which are not available in VA administrative databases. If we did not capture these patient factors, our risk prediction analysis might be incorrect or biased. 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 on Thursday, January 26, 2017, Volume 82, No. 16, pages 8563-8564. Affected Public: Individuals or households. Estimated Annual Burden: 2500. Estimated Average Burden per Respondent: 30 minutes. Frequency of Response: Annually. Estimated Annual Responses: 5,000. By direction of the Secretary. Cynthia Harvey-Pryor, Department Clearance Officer, Enterprise Records Service, Office of Quality and Compliance, Department of Veterans Affairs. [FR Doc. 2017-08442 Filed 4-25-17; 8:45 am] BILLING CODE 8320-01-P
![19310 Federal Register / Vol. 82, No. 79 / Wednesday, April 26, 2017 / Notices
the Kimberley Process Certificate Ghana—Precious Minerals Marketing Zimbabwe Revenue Authority (Importing
accompanying the shipment. Company Limited. Authority).
Guinea—Ministry of Mines and Geology.
List of Participants Guyana—Guyana Geology and Mines Patricia M. Haslach,
Commission. Acting Assistant Secretary, Bureau of
Pursuant to Sections 3 and 6 of the India—The Gem and Jewellerry Export Economic and Business Affairs, Department
Act, Section 2 of Executive Order 13312, Promotion Council. of State.
Department of State Delegations of Indonesia—Ministry of Trade—Director [FR Doc. 2017–08385 Filed 4–25–17; 8:45 am]
Authority No. 245–1 (February 13, General for Foreign Trade.
BILLING CODE 4710–AE–P
2009), and No. 376 (October 31, 2011), Israel—Ministry of Economy and Industry—
Office of the Diamond Controller.
I hereby identify the following entities Japan—Ministry of Economy, Trade and
as Participants under section 6(b) of the Industry—Agency for Natural Resources DEPARTMENT OF VETERANS
Act. Included in this List are the and Energy. AFFAIRS
Importing and Exporting Authorities for Kazakhstan—Ministry for Investments and
Participants, as required by Section 6(b) Development—Committee for Technical [OMB Control No. 2900–NEW]
of the Act. This list revises the Regulation and Metrology.
previously published list of May 18, Korea, Republic of (South Korea)—Ministry Agency Information Collection Activity
of Trade, Industry and Energy. Under OMB Review: PACT: Veteran’s
2015 to reflect the reinstatement of the Laos—Ministry of Industry and Commerce—
Central African Republic and Health and Well-Being
Department of Import and Export.
Venezuela. Lebanon—Ministry of Economy and Trade. AGENCY: Veterans Health
Angola—Ministry of Trade, Ministry of Lesotho—Ministry of Mining—Department of Administration, Department of Veterans
Geology and Mines (Exporting Authority), Mines.
Affairs.
no Importing Authority specified. Liberia—Ministry of Lands, Mines and
Energy. ACTION: Notice.
Armenia—Ministry of Economy.
Australia—Department of Industry, Malaysia—Royal Malaysian Customs
Department. SUMMARY: In compliance with the
Innovation and Science (Exporting
Authority), Department of Immigration and Mali—Ministry of Mines—Office of Paperwork Reduction Act (PRA) of
Border Protection (Importing Authority). Expertise, Evaluation and Certification of 1995, this notice announces that the
Bangladesh—Export Promotion Bureau. Rough Diamonds. Veterans Health Administration (VHA),
Mauritius—Ministry of Industry, Commerce Department of Veterans Affairs, will
Belarus—Ministry of Finance.
and Consumer Protection—Trade Division.
Botswana—Ministry of Minerals Energy and
Mexico—Ministry of Economy—Directorate-
submit the collection of information
Water Resources—Diamond Office. abstracted below to the Office of
General for International Trade in Goods.
Brazil—Ministry of Mines and Energy— Management and Budget (OMB) for
Namibia—Ministry of Mines and Energy—
National Department of Mineral Directorate of Diamond Affairs. review and comment. The PRA
Production. New Zealand—New Zealand Customs submission describes the nature of the
Cambodia—Ministry of Commerce. Service.
Cameroon—National Permanent Secretariat
information collection and its expected
Norway—Norwegian Customs Service. cost and burden; it includes the actual
for the Kimberley Process in Cameroon. Panama—National Customs Authority.
Canada—Ministry of Natural Resources data collection instrument.
Russia—Ministry of Finance.
Canada. Sierra Leone—National Minerals Agency, DATES: Comments must be submitted on
Central African Republic—Ministry of Mines, National Revenue Authority. or before May 26, 2017.
Energy and Hydraulics. Singapore—Singapore Customs. ADDRESSES: Submit written comments
China—General Administration of Quality South Africa—South African Diamond and
Supervision, Inspection and Quarantine; in on the collection of information through
Precious Metals Regulator.
the Hong Kong Special Administrative www.Regulations.gov, or to Office of
Sri Lanka—National Gem and Jewellery
Region: Trade and Industry Department. Authority. Information and Regulatory Affairs,
Congo, Democratic Republic of the—Ministry Swaziland—Office of the Commissioner of Office of Management and Budget, Attn:
of Mines—Le Centre d’Expertise, Mines. VA Desk Officer; 725 17th St. NW.,
d’Evaluation et de Certification des Switzerland—State Secretariat for Economic Washington, DC 20503 or sent through
Substances Minérales Précieuses et Semi- Affairs. electronic mail to oira_submission@
précieuses. Taipei—Ministry of Economic Affairs— omb.eop.gov. Please refer to ‘‘OMB
Congo, Republic of the—Ministry of Mines— Bureau of Foreign Trade.
Bureau d’Expertise, d’Evaluation et de
Control No. 2900–NEW’’ in any
Tanzania—Ministry of Energy and correspondence.
Certification des Substances Minérales Minerals—Commissioner for Minerals.
Précieuses. Thailand—Ministry of Commerce— FOR FURTHER INFORMATION CONTACT:
Cote D’Ivoire (Ivory Coast)—General Department of Foreign Trade. Cynthia Harvey-Pryor, Enterprise
Directorate of Customs. Togo—Ministry of Mines and Energy—Head Records Service (005R1B), Department
European Union—European Commission— Office of Mines and Geology.
Foreign Policy Instruments; in Belgium:
of Veterans Affairs, 810 Vermont
Turkey—Borsa Istanbul Precious Metals and
Federal Public Service of Economy; in the Diamond Market.
Avenue NW., Washington, DC 20420,
Czech Republic: General Directorate of Ukraine—State Gemmological Centre of (202) 461–5870 or email cynthia.harvey-
Customs; in Germany: Hauptzollamt Ukraine. pryor@va.gov. Please refer to ‘‘OMB
Koblenz (Exporting Authority), United Arab Emirates—Dubai Multi Control No. 2900–NEW.’’
Generalzolldirektion—Direktion VI Commodities Center Authority. SUPPLEMENTARY INFORMATION:
(Importing Authority); in Portugal: United States of America—U.S. Customs and
Autoridade Tributária e Aduaneira— Border Protection (Importing Authority), Authority: 44 U.S.C. 3501–3521.
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Direção de Serviços de Regulação United States Census Bureau (Exporting Titles: PACT: Veteran’s Health and
Aduaneira; in Romania: General Authority). Well-Being.
Department for Precious Metals, Precious Venezuela—Central Bank of Venezuela.
Stones and the Kimberley Process— Vietnam—Ministry of Industry and Trade—
OMB Control Number: 2900–NEW.
National Authority for Consumer Import Export Management Divisions in Type of Review: New collection.
Protection; in the United Kingdom: Foreign Hanoi and Ho Chi Minh City. Abstract: The purpose of the study,
and Commonwealth Office—Government Zimbabwe—Minerals Marketing Corporation which is funded by the PACT
Diamond Office. of Zimbabwe (Exporting Authority), Demonstration Lab Coordinating Center,
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![Federal Register / Vol. 82, No. 79 / Wednesday, April 26, 2017 / Notices 19311
is to conduct a survey of Veterans to By direction of the Secretary. vascular diseases including varicose
capture novel predictors of hospital Cynthia Harvey-Pryor, veins) Disability Benefits Questionnaire,
admission and identify clusters of Department Clearance Officer, Enterprise will gather information related to the
complex patients based on survey- and Records Service, Office of Quality and claimant’s diagnosis of arteries, veins,
claims-based covariates. This study Compliance, Department of Veterans Affairs. and/or peripheral vascular disease; VAF
provides the first empirical application [FR Doc. 2017–08442 Filed 4–25–17; 8:45 am] 21–0960A–3, Hypertension, Disability
of the Cycle of Complexity conceptual BILLING CODE 8320–01–P Benefits Questionnaire, will gather
model that the study team developed information related to the claimant’s
and recently published, which diagnosis of hypertension; VAF 21–
postulates that patient complexity DEPARTMENT OF VETERANS 0960A–4, Non-ischemic Heart Disease
represents more than having multiple AFFAIRS (including Arrhythmias and Surgery)
chronic conditions. It is critical to [OMB Control No. 2900–0776] Disability Benefits Questionnaire, will
evaluate whether complexity defined on gather information related to the
the basis of survey-based and claims- Agency Information Collection claimant’s diagnosis of any non-
based covariates is more predictive than Activity: Artery and Vein Conditions ischemic heart disease; VAF 21–0960C–
diagnosis of multiple chronic conditions (Vascular Diseases Including Varicose 4, Diabetic Peripheral Neuropathy
based on claims data alone. Veins) Disability Benefits (diabetic sensory-motor peripheral
The proposed patient survey is Questionnaire, Hypertension Disability neuropathy) Disability Benefits
designed to measure a broad range of Benefits Questionnaire, Non-Ischemic Questionnaire will gather information
self-reported patient factors that Heart Disease (Including Arrhythmias related to the claimant’s diagnosis of a
increase Veterans’ risk for being and Surgery) Disability Benefits diabetic sensory-motor peripheral
admitted to hospital, including life Questionnaire, Diabetic Peripheral neuropathy condition; VAF 21–0960E–
stressors, perceived locus of control, Neuropathy (Diabetic Sensory-Motor 1, Diabetes Mellitus Disability Benefits
grit, resilience, functional status, social Peripheral Neuropathy) Disability Questionnaire, will gather information
support and loneliness, sleep problems, Benefits Questionnaire, Diabetes related to the claimant’s diagnosis of
symptoms, food insecurity, and patient Mellitus Disability Benefits diabetes mellitus; VAF 21–0960F–1,
activation. This survey will help us Questionnaire, Scars/Disfigurement Scars/Disfigurement Disability Benefits
understand, for the first time, the extent Disability Benefits Questionnaire, Skin Questionnaire will gather information
to which self-reported factors can Diseases Disability Benefits related to the claimant’s diagnosis of
markedly improve prediction of patient Questionnaire, Amputations Disability any scars or disfigurement; VAF 21–
risk for hospital admission, which may Benefits Questionnaire, Muscles 0960F–2, Skin Diseases Disability
help the PACT Demonstration Lab Injuries Disability Benefits Benefits Questionnaire, will gather
Coordinating Center Intelligence Questionnaire, Temporomandibular information related to the claimant’s
improve its risk prediction models. This Joint (TMJ) Conditions Disability diagnosis of any skin disease. VAF 21–
project may also identify patient- Benefits Questionnaire, Eye 0960M–1 Amputations Disability
reported outcomes (PROs) that can be Conditions Disability Benefits Benefits Questionnaire, will gather
effectively integrated into routine VA Questionnaire information related to the claimant’s
clinical practice, as the VA begins to amputations; VAF 21–0960M–10
AGENCY: Veterans Benefits
explore inclusion of PROs into the VA Muscle Injuries Disability Benefits
Administration, Department of Veterans
electronic health record. We are Questionnaire, will gather information
Affairs.
requesting approval to conduct this related to the claimant’s diagnosis of a
ACTION: Notice. muscle injury disability. VAF 21–
survey to a nationally representative
sample of 10,000 patients who obtain SUMMARY: The Veterans Benefits 0960M–15 Temporomandibular Joint
primary care in VA because there are no Administration (VBA), Department of (TMJ) Conditions Disability Benefits
extant VA surveys that capture the range Veterans Affairs (VA), is announcing an Questionnaire, will gather information
of patient factors that we propose to opportunity for public comment on the related to the claimant’s diagnosis of
collect, which are not available in VA proposed collection of certain temporomandibular joint dysfunction or
administrative databases. If we did not information by the agency. Under the TMJ. VAF 21–0960N–2 Eye Conditions
capture these patient factors, our risk Paperwork Reduction Act (PRA) of Disability Benefits Questionnaire will
prediction analysis might be incorrect or 1995, Federal agencies are required to gather information related to the
biased. publish notice in the Federal Register claimant’s diagnosis of an eye
An agency may not conduct or concerning each proposed collection of condition.
sponsor, and a person is not required to information, including each proposed
respond to a collection of information DATES: Written comments and
revision of a currently approved recommendations on the proposed
unless it displays a currently valid OMB collection, and allow 60 days for public
control number. The Federal Register collection of information should be
comment in response to the notice. received on or before June 26, 2017.
Notice with a 60-day comment period VA Form 21–0960 series is used to
soliciting comments on this collection gather necessary information from a ADDRESSES: Submit written comments
of information was published on claimant’s treating physician regarding on the collection of information through
Thursday, January 26, 2017, Volume 82, the results of medical examinations. VA Federal Docket Management System
No. 16, pages 8563–8564. gathers medical information related to (FDMS) at www.Regulations.gov or to
mstockstill on DSK30JT082PROD with NOTICES
Affected Public: Individuals or the claimant that is necessary to Nancy J. Kessinger, Veterans Benefits
households. adjudicate the claim for VA disability Administration (20M33), Department of
Estimated Annual Burden: 2500. benefits. The Disability Benefit Veterans Affairs, 810 Vermont Avenue
Estimated Average Burden per Questionnaire title will include the NW., Washington, DC 20420 or email to
Respondent: 30 minutes. name of the specific disability for which nancy.kessinger@va.gov. Please refer to
Frequency of Response: Annually. it will gather information. VAF 21– ‘‘OMB Control No. 2900–0776’’ in any
Estimated Annual Responses: 5,000. 0960A–2, Artery and Vein Conditions correspondence. During the comment
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Document Created: 2017-04-26 03:15:30
Document Modified: 2017-04-26 03:15:30
| 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 May 26, 2017. | |
| 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- NEW.'' | |
| FR Citation | 82 FR 19310 |
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