Federal Register / Vol. 74, No. 173 / Wednesday, September 9, 2009 / Notices 46485 

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: 

a. Request for and Authorization To 

Release Medical Records or Health 

Information, VA Form 10–5345. 

b. Individual’s Request for a Copy of 

Their Own Health Information, VA 

Form 10–5345a. 

c. My HealtheVet (MHV)— 

Individuals’ Request for a Copy of Their 

Own Health Information, VA Form 10– 

5345a–MHV. 

OMB Control Number: 2900–0260. 

Type of Review: Revision of a 

currently approved collection. 

Abstract: 

a. VA Form 10–5345 is used to obtain 

a written consent from patients before 

information concerning his or her 

treatment for alcoholism or alcohol 

abuse, drug abuse, sickle cell anemia, or 

infection with the human 

immunodeficiency virus (HIV) can be 

disclosed to private insurance 

companies, physicians and other third 

parties. 

b. Patients complete VA Form 10– 

5345a to request a copy of their health 

information maintained at Department 

of Veterans Affairs. 

c. VA Form 10–5345a–MHV is 

completed by individuals requesting 

their health information electronically 

through My HealtheVet. 

Affected Public: Individuals or 

households. 

Estimated Total Annual Burden: 

a. VA Form 10–5345—15,000 hours. 

b. VA Form 10–5345a—15,000 hours. 

c. VA Form 10–5345a–MVH—35,000 

hours. 

Estimated Average Burden per 

Respondent: 

a. VA Form 10–5345—3 minutes. 

b. VA Form 10–5345a—3 minutes. 

c. VA Form 10–5345a–MVH—3 

minutes. 

Frequency of Response: On occasion. 

Estimated Number of Respondents: 

a. VA Form 10–5345—300,000. 

b. VA Form 10–5345a—300,000. 

c. 10–5345a–MVH—700,000. 

Dated: September 2, 2009. 

By direction of the Secretary. 

Denise McLamb, 

Program Analyst, Enterprise Records Service. 

[FR Doc. E9–21574 Filed 9–8–09; 8:45 am] 

BILLING CODE P 

DEPARTMENT OF VETERANS 

AFFAIRS 

[OMB Control No. 2900–New (10–0468)] 

Proposed Information Collection 

(Internet Student CPR Web 

Registration Application); Comment 

Request 

AGENCY: Veterans Health 

Administration, Department of Veterans 

Affairs. 

ACTION: Notice. 

SUMMARY: The Veterans Health 

Administration (VHA), Department of 

Veterans Affairs, 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 

new collection, and allow 60 days for 

public comment in response to the 

notice. This notice solicits comments on 

information needed to establish an 

online Web registration application. 

DATES: Written comments and 

recommendations on the proposed 

collection of information should be 

received on or before November 9, 2009. 

ADDRESSES: Submit written comments 

on the collection of information through 

the Federal Docket Management System 

(FDMS) at http://www.Regulations.gov; 

or to Mary Stout, Veterans Health 

Administration (193E1), Department of 

Veterans Affairs, 810 Vermont Avenue, 

NW., Washington, DC 20420 or e-mail: 

mary.stout@va.gov. Please refer to 

‘‘OMB Control No. 2900–New (10– 

0468)’’ in any correspondence. During 

the comment period, comments may be 

viewed online through FDMS. 

FOR FURTHER INFORMATION CONTACT: 

Mary Stout at (202) 461–5867 or FAX 

(202) 273–9381. 

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. 

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. 

Title: Internet Student CPR Web 

Registration Application, VA Form 10– 

0468. 

OMB Control Number: 2900–New 

(10–0468). 

Type of Review: New collection. 

Abstract: The data collected on VA 

Form 10–0468 will be used to establish 

a roster on students attending courses 

provided by the Minneapolis VA 

Medical Center Education Service. 

Students will be able to identify and 

register for a training course online 

without waiting for the Registrar to 

return calls or e-mails to confirm 

enrollment. 

Affected Public: Individuals or 

households. 

Estimated Annual Burden: 125 hours. 

Estimated Average Burden per 

Respondent: 5 minutes. 

Frequency of Response: Bi-Annually. 

Estimated Number of Responses: 

1,500. 

Dated: September 2, 2009. 

By direction of the Secretary. 

Denise McLamb, 

Program Analyst, Enterprise Records Service. 

[FR Doc. E9–21576 Filed 9–8–09; 8:45 am] 

BILLING CODE 8320–01–P 

DEPARTMENT OF VETERANS 

AFFAIRS 

[OMB Control No. 2900–New (10–0473)] 

Proposed Information Collection 

(Millennium Bill Emergency Care 

Provider Satisfaction Survey); 

Comment Request 

AGENCY: Veterans Health 

Administration, Department of Veterans 

Affairs. 

ACTION: Notice. 

SUMMARY: The Veterans Health 

Administration (VHA), 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 

new collection, and allow 60 days for 

public comment in response to the 

notice. This notice solicits comments on 


cprice-sewell on DSK2BSOYB1PROD with NOTICES
46486 Federal Register / Vol. 74, No. 173 / Wednesday, September 9, 2009 / Notices 

information needed to improve 

customer satisfactions with VHA’s claim 

reimbursement process. 

DATES: Written comments and 

recommendations on the proposed 

collection of information should be 

received on or before November 9, 2009. 

ADDRESSES: Submit written comments 

on the collection of information through 

the Federal Docket Management System 

(FDMS) at http://www.Regulations.gov; 

or to Mary Stout, Veterans Health 

Administration (193E1), Department of 

Veterans Affairs, 810 Vermont Avenue, 

NW., Washington, DC 20420 or e-mail: 

mary.stout@va.gov. Please refer to 

‘‘OMB Control No. 2900–New (10– 

0473)’’ in any correspondence. During 

the comment period, comments may be 

viewed online through FDMS. 

FOR FURTHER INFORMATION CONTACT: 

Mary Stout at (202) 461–5867 or FAX 

(202) 273–9381. 

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. 

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. 

Title: Millennium Bill Emergency 

Care Provider Satisfaction Survey, VA 

Form 10–0473. 

OMB Control Number: 2900–New 

(10–0473). 

Type of Review: New collection. 

Abstract: VA Form 10–0473 will be 

used to survey non-VA healthcare 

providers who participate in the 

Millennium Bill Fee Reimbursement/ 

Purchased Care program on their 

satisfaction with VHA’s claims 

processing services. VA will use the 

data collected to improve the claims 

processing program. 

Affected Public: Individuals or 

households. 

Estimated Annual Burden: 9 hours. 

Estimated Average Burden per 

Respondent: 5 minutes. 

Frequency of Response: Annually. 

Estimated Number of Respondents: 

110. 

Dated: September 2, 2009. 

By direction of the Secretary. 

Denise McLamb, 

Program Analyst, Enterprise Records Service. 

[FR Doc. E9–21575 Filed 9–8–09; 8:45 am] 

BILLING CODE 8320–01–P 

DEPARTMENT OF VETERANS 

AFFAIRS 

[OMB Control No. 2900–0554] 

Agency Information Collection 

(Homeless Providers Grant and per 

diem Program) Activities Under OMB 

Review 

AGENCY: Veterans Health 

Administration, Department of Veterans 

Affairs. 

ACTION: Notice. 

SUMMARY: In compliance with the 

Paperwork Reduction Act (PRA) of 1995 

(44 U.S.C. 3501–3521), 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 and 

includes the actual data collection 

instrument. 

DATES: Comments must be submitted on 

or before October 9, 2009. 

ADDRESSES: Submit written comments 

on the collection of information through 

http://www.Regulations.gov; or to VA’s 

OMB Desk Officer, OMB Human 

Resources and Housing Branch, New 

Executive Office Building, Room 10235, 

Washington, DC 20503, (202) 395–7316. 

Please refer to ‘‘OMB Control No. 2900– 

0554’’ in any correspondence. 

FOR FURTHER INFORMATION CONTACT: 

Denise McLamb, Enterprise Records 

Service (005R1B), Department of 

Veterans Affairs, 810 Vermont Avenue, 

NW., Washington, DC 20420, (202) 461– 

7485, fax (202) 273–0443 or e-mail 

denise.mclamb@mail.va.gov. Please 

refer to ‘‘OMB Control No. 2900–0554.’’ 

SUPPLEMENTARY INFORMATION: 

Titles: a. Homeless Providers Grant 

and Per Diem Program, Capital Grant 

Application, VA Form 10–0361–CG. 

b. Homeless Providers Grant and Per 

Diem Program, Life Safety Code 

Application, VA Form 10–0361–LSC. 

c. Homeless Providers Grant and Per 

Diem Program, Per Diem Only 

Application, VA Form 10–0361–PDO. 

d. Homeless Providers Grant and Per 

Diem Program, Special Needs 

Application, VA Form 10–0361–SN. 

e. Compliance Reports for Per Diem 

and Special Needs Grants. No form 

needed. May be reported to VA in 

standard business narrative. 

f. Homeless Providers Grant and Per 

Diem Program, Technical Assistance 

Application, VA Form 10–0361–TA. 

g. Compliance Reports for Technical 

Assistance Grants. No form needed. May 

be reported to VA in standard business 

narrative. 

OMB Control Number: 2900–0554. 

Type of Review: Extension of a 

currently approved collection. 

Abstract: VA Form 10–0361 series, 

Homeless Providers Grant and Per Diem 

Program, will be used to evaluate 

applicant’s eligibility to receive a grant 

and/or Per Diem payments which 

provide supportive housing and services 

to assist homeless veterans transition to 

independent living. VA will use the 

data to apply specific criteria to rate and 

evaluate each application; and to obtain 

information necessary to ensure that 

Federal funds are awarded to applicants 

who are financially stable and who will 

conduct the program for which a grant 

and/or Per Diem award was made. 

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 

June 22, 2009, at pages 29537–29538. 

Affected Public: Not-for-profit 

institutions. 

Estimated Total Annual Burden: 

a. Homeless Providers Grant and Per 

Diem Program, Capital Grant 

Application, VA Form 10–0361–CG— 

3,500 hours. 

b. Homeless Providers Grant and Per 

Diem Program, Life Safety Code 

Application, VA Form 10–0361–LSC— 

2,000 hours. 

c. Homeless Providers Grant and Per 

Diem Program, Per Diem Only 

Application, VA Form 10–0361–PDO— 

3,000 hours. 

d. Homeless Providers Grant and Per 

Diem Program, Special Needs 

Application, VA Form 10–0361–SN— 

4,000 hours. 

e. Compliance Reports for Per Diem 

and Special Needs Grants—1,500 hours. 

f. Homeless Providers Grant and Per 

Diem Program, Technical Assistance 

Application, VA Form 10–0361–TA— 

250 hours. 


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