82_FR_8991 82 FR 8971 - Agency Information Collection Activity: (Application and Renewal for Health Benefits and Request for Hardship Determination)

82 FR 8971 - Agency Information Collection Activity: (Application and Renewal for Health Benefits and Request for Hardship Determination)

DEPARTMENT OF VETERANS AFFAIRS

Federal Register Volume 82, Issue 20 (February 1, 2017)

Page Range8971-8972
FR Document2017-02138

The Veterans Health Administration (VHA) 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 revision of a currently approved collection, and allow 60 days for public comment in response to the notice. This notice solicits comments on information needed to identify areas for improvement in clinical training programs.

Federal Register, Volume 82 Issue 20 (Wednesday, February 1, 2017) 
[Federal Register Volume 82, Number 20 (Wednesday, February 1, 2017)]
[Notices]
[Pages 8971-8972]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2017-02138]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0091]


Agency Information Collection Activity: (Application and Renewal 
for Health Benefits and Request for Hardship Determination)

AGENCY: Veterans Health Administration, Department of Veterans Affairs.

ACTION: Notice.

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

SUMMARY: The Veterans Health Administration (VHA) 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 revision of a currently approved collection, and allow 60 
days for public comment in response to the notice. This notice solicits 
comments on information needed to identify areas for improvement in 
clinical training programs.

DATES: Written comments and recommendations on the proposed collection 
of information should be received on or before April 3, 2017.

ADDRESSES: Submit written comments on the collection of information 
through the Federal Docket Management System (FDMS) at 
www.Regulations.gov; or to Brian McCarthy, Office of Regulatory and 
Administrative Affairs, Veterans Health Administration (10B4), 
Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 
20420 or email: [email protected]. Please refer to ``OMB Control 
No. 2900-0091'' in any correspondence. During the comment period, 
comments may be viewed online through FDMS.

FOR FURTHER INFORMATION CONTACT: Brian McCarthy at (202) 461-6345.

SUPPLEMENTARY INFORMATION: Under the PRA of 1995 (Pub. L. 104-13; 44 
U.S.C. 3501-3521), Federal agencies must obtain approval from 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.

[[Page 8972]]

    With respect to the following collection of information, VHA 
invites comments on:
    (1) Whether the proposed collection of information is necessary for 
the proper performance of VHA's functions, including whether the 
information will have practical utility; (2) the accuracy of VHA'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.
    Titles:
    1. Enrollment Application for VA Health Care--VA Form 10-10EZ.
    2. Application for Renewal of Health Care Benefits--VA Form 10-
10EZR.
    3. Request for Hardship Determination--VA Form 10-10HS.
    OMB Control Number: 2900-0091.
    Type of Review: Revision of a currently approved collection.
    Abstracts:
    a. VA Form 10-10EZ collects information only from new applicants 
for VA medical care, nursing home, domiciliary, dental benefits, and 
new enrollees in the VA health care system.
    b. VA Form 10-10EZR, Health Benefits Renewal Form, is used to 
collect data from those veterans who wish to update their application 
data.
    c. VA Form 10-10HS collects information only from veterans who are 
in a copay required status for hospital care and medical services, but 
due to a loss of income project their income for the current year will 
be substantially below the VA means test limits.
    Affected Public: Individuals or households.
    Estimated Annual Burden:
    a. Enrollment Application for VA Health Care--VA Form 10-10EZ--
270,000 hours.
    b. Application for Renewal of Health Care Benefits--VA Form 10-
10EZR--343,600 hours.
    c. Request for Hardship Determination--VA Form 10-10HS--1,750 
hours.
    Estimated Average Burden per Respondent:
    a. Enrollment Application for VA Health Care--VA Form 10-10EZ--30 
minutes.
    b. Application for Renewal of Health Care Benefits--VA Form 10-
10EZR--24 minutes.
    c. Request for Hardship Determination--VA Form 10-10HS--15 minutes.
    Frequency of Response: Annually.
    Estimated Annual Responses:
    a. Enrollment Application for VA Health Care--VA Form 10-10EZ--
540,000.
    b. Application for Renewal of Health Care Benefits--VA Form 10-
10EZR--859,000.
    c. Request for Hardship Determination--VA Form 10-10HS--7,000.

    By direction of the Secretary.
Cynthia Harvey-Pryor,
Agency Clearance Officer, Office of Privacy and Records Management, 
Department of Veterans Affairs.
[FR Doc. 2017-02138 Filed 1-31-17; 8:45 am]
 BILLING CODE 8320-01-P

Federal Register / Vol. 82, No. 20 / Wednesday, February 1, 2017 / Notices 8971 the two-year period; and (4) the available through the Federal Dated: January 25, 2017. requirements at 49 CFR 1105.7(c) Information Relay Service (FIRS) at 1– David Motl, (environmental report), 49 CFR 1105.11 800–877–8339. Comments on Acting Deputy Director, United States Mint. (transmittal letter), 49 CFR 1105.12 environmental and historic preservation [FR Doc. 2017–02126 Filed 1–31–17; 8:45 am] (newspaper publication), and 49 CFR matters must be filed within 15 days BILLING CODE P 1152.50(d)(1) (notice to governmental after the EA becomes available to the agencies) have been met. public. As a condition to these exemptions, Environmental, historic preservation, DEPARTMENT OF VETERANS any employee adversely affected by the public use, or trail use/rail banking AFFAIRS abandonment or discontinuance shall be conditions will be imposed, where protected under Oregon Short Line appropriate, in a subsequent decision. [OMB Control No. 2900–0091] Railroad—Abandonment Portion Goshen Branch Between Firth & Pursuant to the provisions of 49 CFR Agency Information Collection Ammon, in Bingham & Bonneville 1152.29(e)(2), B&M shall file a notice of Activity: (Application and Renewal for Counties, Idaho, 360 I.C.C. 91 (1979). To consummation with the Board to signify Health Benefits and Request for address whether this condition that it has exercised the authority Hardship Determination) adequately protects affected employees, granted and fully abandoned the Line. If consummation has not been effected by AGENCY: Veterans Health a petition for partial revocation under Administration, Department of Veterans 49 U.S.C. 10502(d) must be filed. B&M’s filing of a notice of consummation by February 1, 2018, and Affairs. Provided no formal expression of intent to file an offer of financial there are no legal or regulatory barriers ACTION: Notice. assistance (OFA) has been received, to consummation, the authority to abandon will automatically expire. SUMMARY: The Veterans Health these exemptions will be effective on Administration (VHA) is announcing an March 3, 2017, unless stayed pending Board decisions and notices are opportunity for public comment on the reconsideration. Petitions to stay that do available on our Web site at proposed collection of certain not involve environmental issues,1 ‘‘WWW.STB.GOV.’’ information by the agency. Under the formal expressions of intent to file an Decided: January 27, 2017. Paperwork Reduction Act (PRA) of OFA under 49 CFR 1152.27(c)(2),2 and By the Board, Rachel D. Campbell, 1995, Federal agencies are required to trail use/rail banking requests under 49 Director, Office of Proceedings. publish notice in the Federal Register CFR 1152.29 must be filed by February Raina S. Contee, concerning each proposed collection of 13, 2017. Petitions to reopen or requests information, including each proposed Clearance Clerk. for public use conditions under 49 CFR revision of a currently approved [FR Doc. 2017–02115 Filed 1–31–17; 8:45 am] 1152.28 must be filed by February 21, collection, and allow 60 days for public 2017, with the Surface Transportation BILLING CODE 4915–01–P comment in response to the notice. This Board, 395 E Street SW., Washington, notice solicits comments on information DC 20423–0001. needed to identify areas for A copy of any petition filed with the DEPARTMENT OF THE TREASURY improvement in clinical training Board should be sent to applicants’ programs. representative: Robert B. Burns, Pan Am United States Mint DATES: Written comments and Railways, Iron Horse Park, North Billerica, MA 01862. Pricing Changes for 2017 United States recommendations on the proposed If the verified notice contains false or Mint Numismatic Products collection of information should be misleading information, the exemptions received on or before April 3, 2017. are void ab initio. AGENCY: United States Mint, Department ADDRESSES: Submit written comments Applicants have filed a combined of the Treasury. on the collection of information through environmental and historic report that the Federal Docket Management System addresses the effects, if any, of the ACTION: Notice. (FDMS) at www.Regulations.gov; or to abandonment and discontinuance on Brian McCarthy, Office of Regulatory the environment and historic resources. SUMMARY: The United States Mint is and Administrative Affairs, Veterans OEA will issue an environmental announcing pricing changes for some Health Administration (10B4), assessment (EA) by February 6, 2017. 2017 United States Mint Numismatic Department of Veterans Affairs, 810 Interested persons may obtain a copy of Products, in accordance with the list Vermont Avenue NW., Washington, DC the EA by writing to OEA (Room 1100, below: 20420 or email: Surface Transportation Board, • United States Mint Proof Set®— Brian.McCarthy4@va.gov. Please refer to Washington, DC 20423–0001) or by ‘‘OMB Control No. 2900–0091’’ in any $26.95 calling OEA at (202) 245–0305. correspondence. During the comment Assistance for the hearing impaired is • United States Mint Silver Proof period, comments may be viewed online Set®—$47.95 through FDMS. 1 The Board will grant a stay if an informed • United States Mint Uncirculated FOR FURTHER INFORMATION CONTACT: decision on environmental issues (whether raised Set®—$20.95 by a party or by the Board’s Office of Environmental Brian McCarthy at (202) 461–6345. Analysis (OEA) in its independent investigation) FOR FURTHER INFORMATION CONTACT: SUPPLEMENTARY INFORMATION: Under the sradovich on DSK3GMQ082PROD with NOTICES cannot be made before the exemption’s effective Katrina McDow, Marketing Specialist, date. See Exemption of Out-of-Serv. Rail Lines, 5 PRA of 1995 (Pub. L. 104–13; 44 U.S.C. I.C.C.2d 377 (1989). Any request for a stay should Numismatic and Bullion Directorate; 3501–3521), Federal agencies must be filed as soon as possible so that the Board may United States Mint; 801 9th Street NW.; obtain approval from OMB for each take appropriate action before the exemption’s Washington, DC 20220; or call 202–354– collection of information they conduct effective date. 8495. 2 Each OFA must be accompanied by the filing or sponsor. This request for comment is fee, which is currently set at $1,700. See 49 CFR Authority: 31 U.S.C. 5111, 5112, 5132 & being made pursuant to Section 1002.2(f)(25). 9701. 3506(c)(2)(A) of the PRA. VerDate Sep<11>2014 16:23 Jan 31, 2017 Jkt 241001 PO 00000 Frm 00063 Fmt 4703 Sfmt 4703 E:\FR\FM\01FEN1.SGM 01FEN1

8972 Federal Register / Vol. 82, No. 20 / Wednesday, February 1, 2017 / Notices With respect to the following Estimated Annual Responses: brian.mccarthy4@va.gov. Please refer to collection of information, VHA invites a. Enrollment Application for VA ‘‘OMB Control No. 2900–0757, Proposed comments on: Health Care—VA Form 10–10EZ— Information Collection (Supportive (1) Whether the proposed collection 540,000. Services for Veteran Families (SSVF) of information is necessary for the b. Application for Renewal of Health Program) Application For Supportive proper performance of VHA’s functions, Care Benefits—VA Form 10–10EZR— Services Grant). including whether the information will 859,000. SUPPLEMENTARY INFORMATION: Under the have practical utility; (2) the accuracy of c. Request for Hardship PRA of 1995 (Pub. L. 104–13; 44 U.S.C. VHA’s estimate of the burden of the Determination—VA Form 10–10HS— 3501–3521), Federal agencies must proposed collection of information; (3) 7,000. obtain approval from the Office of ways to enhance the quality, utility, and By direction of the Secretary. Management and Budget (OMB) for each clarity of the information to be Cynthia Harvey-Pryor, collection of information they conduct collected; and (4) ways to minimize the or sponsor. This request for comment is Agency Clearance Officer, Office of Privacy burden of the collection of information and Records Management, Department of being made pursuant to Section on respondents, including through the Veterans Affairs. 3506(c)(2)(A) of the PRA. use of automated collection techniques [FR Doc. 2017–02138 Filed 1–31–17; 8:45 am] With respect to the following or the use of other forms of information collection of information, VHA invites BILLING CODE 8320–01–P technology. comments on: (1) Whether the proposed Titles: collection of information is necessary 1. Enrollment Application for VA for the proper performance of VHA’s DEPARTMENT OF VETERANS Health Care—VA Form 10–10EZ. functions, including whether the AFFAIRS 2. Application for Renewal of Health information will have practical utility; Care Benefits—VA Form 10–10EZR. [OMB Control No. 2900–0757] (2) the accuracy of VHA’s estimate of 3. Request for Hardship the burden of the proposed collection of Determination—VA Form 10–10HS. Agency Information Collection Activity information; (3) ways to enhance the OMB Control Number: 2900–0091. Under OMB Review: (Supportive quality, utility, and clarity of the Type of Review: Revision of a Services for Veteran Families (SSVF) information to be collected; and (4) currently approved collection. Program Application for Supportive ways to minimize the burden of the Abstracts: Services Grant) collection of information on a. VA Form 10–10EZ collects respondents, including through the use information only from new applicants AGENCY: Veterans Health Administration, Department of Veterans of automated collection techniques or for VA medical care, nursing home, the use of other forms of information domiciliary, dental benefits, and new Affairs. ACTION: Notice. technology. The 60-day Federal Register enrollees in the VA health care system. Notice published on Monday, November b. VA Form 10–10EZR, Health 28, 2016, Vol. 81, Pages 85693–85694. Benefits Renewal Form, is used to SUMMARY: In compliance with the Paperwork Reduction Act (PRA) of 1995 Title: Supportive Services for Veteran collect data from those veterans who Families (SSVF) Program. wish to update their application data. (44 U.S.C. 3501–3521), this notice announces that the Veterans Health a. Application for Supportive Services c. VA Form 10–10HS collects Grants VA Form 10–10072. information only from veterans who are Administration (VHA), Department of Veterans Affairs, will submit the b. Participant Satisfaction Survey, VA in a copay required status for hospital Form 10–10072a. care and medical services, but due to a collection of information abstracted c. Quarterly Grantee Performance loss of income project their income for below to the Office of Management and Report, VA Form 10–10072b. the current year will be substantially Budget (OMB) for review and comment. d. Renewal Application. VA Form 10– below the VA means test limits. The PRA submission describes the 10072c. Affected Public: Individuals or nature of the information collection and e. Applicant Budget Template Excel households. its expected cost and burden and Worksheet. Estimated Annual Burden: includes the actual data collection f. FY16 Financial Report. a. Enrollment Application for VA instrument. g. Grantee Certification. Health Care—VA Form 10–10EZ— DATES: Comments must be submitted on OMB Control Number: 2900–0757 270,000 hours. or before March 3, 2017. (Supportive Services for Veteran b. Application for Renewal of Health Families (SSVF) Program). ADDRESSES: Submit written comments Care Benefits—VA Form 10–10EZR— Type of Review: Revision. on the collection of information through Abstract: The purpose of the 343,600 hours. www.Regulations.gov, or to Office of c. Request for Hardship Supportive Services for Veteran Information and Regulatory Affairs, Families (SSVF) Program is to provide Determination—VA Form 10–10HS— Office of Management and Budget, Attn: 1,750 hours. supportive services grants to private VA Desk Officer; 725 17th St. NW., non-profit organizations and consumer Estimated Average Burden per Washington, DC 20503 or sent through cooperatives who will coordinate or Respondent: electronic mail to oira_submission@ provide supportive services to very low- a. Enrollment Application for VA omb.eop.gov. Please refer to ‘‘OMB income veteran families who are Health Care—VA Form 10–10EZ—30 Control No. 2900–0757’’ in any residing in permanent housing, are sradovich on DSK3GMQ082PROD with NOTICES minutes. correspondence. homeless and scheduled to become b. Application for Renewal of Health Care Benefits—VA Form 10–10EZR—24 FOR FURTHER INFORMATION CONTACT: residents of permanent housing within minutes. Brian McCarthy, Office of Regulatory a specified time period, or after exiting c. Request for Hardship and Administrative Affairs (10B4) permanent housing, are seeking other Determination—VA Form 10–10HS—15 Department of Veterans Affairs, 810 housing that is responsive to such very minutes. Vermont Avenue NW., Washington, DC low-income veteran family’s needs and Frequency of Response: Annually. 20420, (202) 461–6345 or email preferences. VerDate Sep<11>2014 16:23 Jan 31, 2017 Jkt 241001 PO 00000 Frm 00064 Fmt 4703 Sfmt 4703 E:\FR\FM\01FEN1.SGM 01FEN1


Document Created: 2017-02-01 00:06:19
Document Modified: 2017-02-01 00:06:19
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 April 3, 2017.
ContactBrian McCarthy at (202) 461-6345.
FR Citation82 FR 8971 
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