Federal Register / Vol. 62, No. 176 / Thursday, September 11, 1997 / Notices 47879

estimates, and all final or near final

survey instruments covered by the

generic clearance for inclusion in the

OMB public docket prior to their use.

DATES: Comments must be submitted on

or before October 14, 1997.

FOR FURTHER INFORMATION OR A COPY OF

THE SUBMISSION CONTACT: Ron Taylor,

Information Management Service

(045A4), Department of Veterans

Affairs, 810 Vermont Avenue, NW,

Washington, DC 20420, (202) 273–8015

or FAX (202) 273–5981. Please refer to

‘‘OMB Control No. 2900–0570.’’

SUPPLEMENTARY INFORMATION:

Title: Generic Clearance for the

Veterans Health Administration

Customer Satisfaction Surveys.

OMB Control Number: 2900–0570.

Type of Review: Extension of a

currently approved collection.

Abstract: Executive Order 12862,

Setting Customer Service Standards,

requires Federal agencies and

departments to identify and survey its

customers to determine the kind and

quality of services they want and their

level of satisfaction with existing

service. The VHA uses customer

satisfaction surveys to gauge customer

perceptions of VA services as well as

customer expectations and desires. The

results of these information collections

lead to improvements in the quality of

VHA service delivery by helping to

shape the direction and focus of specific

programs and services.

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

12, 1997 at pages 32148–32149.

Affected Public: Individuals or

households.

Special Emphasis (Different Special

Emphasis Programs will be surveyed

annually; for example, in 1997, VHA is

surveying inpatient and outpatient

Persian Gulf Veterans and inpatient and

outpatient Spinal Cord Injury patients.

Special Emphasis program selections

have not been made for FYs 1998–2000.

Burden hours for the out-years are based

on 1997 estimates.)

Year Number of respondents

Estimated annual burden

(hours)

Frequency of response

1998 ............................................................................................................................... 46,800 18,200 Annually.

1999 ............................................................................................................................... 46,800 18,200 Annually.

2000 ............................................................................................................................... 46,800 18,200 Annually.

Local Facilities Surveys:

1998 ........................................................................................................................ 12,000 3,000 One-time.

1999 ........................................................................................................................ 12,000 3,000 One-time.

2000 ........................................................................................................................ 12,000 3,000 One-time.

Most customer satisfaction surveys

will be recurring so that the VHA can

create ongoing measures of performance

and to determine how well the agency

meets customer service standards. Each

collection of information will consist of

the minimum amount of information

necessary to determine customer needs

and to evaluate the VHA’s performance.

The VHA expects to distribute written

surveys with a total annual burden of

approximately 21,200 hours in 1998,

1999, and 2000.

The areas of concern to the VHA and

its customers may change over time, and

it is important to have the ability to

evaluate customer concerns quickly.

Participation in the surveys will be

voluntary and the generic clearance will

not be used to collect information

required to obtain or maintain eligibility

for a VA program or benefit. In order to

maximize the voluntary response rates,

the information collection will be

designed to make participation

convenient, simple, and free of

unnecessary barriers. Baseline data

obtained through these information

collections will be used to improve

customer service standards. The VHA

will consult with OMB regarding each

specific information collection during

this approval period.

Send comments and

recommendations concerning any

aspect of the information collection to

VA’s OMB Desk Officer, Allison Eydt,

OMB Human Resources and Housing

Branch, New Executive Office Building,

Room 10235, Washington, DC 20503

(202) 395–4650. Please refer to ‘‘OMB

Control No. 2900–0570’’ in any

correspondence.

Dated: August 13, 1997.

By direction of the Secretary.

Donald L. Neilson,

Director, Information Management Service.

[FR Doc. 97–24062 Filed 9–10–97; 8:45 am]

BILLING CODE 8320–01–P

DEPARTMENT OF VETERANS

AFFAIRS

[OMB Control No. 2900–0091]

Agency Information Collection

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 et seq.), this notice

announces that the Veterans Health

Administration (VHA), Department of

Veterans Affairs, has submitted 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 October 14, 1997.

FOR FURTHER INFORMATION OR A COPY OF

THE SUBMISSION CONTACT: Ron Taylor,

Information Management Service

(045A4), Department of Veterans

Affairs, 810 Vermont Avenue, NW,

Washington, DC 20420, (202) 273–8015

or FAX (202) 273–5981. Please refer to

‘‘OMB Control No. 2900–0091.’’

SUPPLEMENTARY INFORMATION:

Title and Form Numbers: Application

for Medical Benefits, VA Forms 10–10

and 10–10T; Insurance Information, VA

Form 10–10I; Financial Worksheet, VA

Form 10–10F; and Funeral

Arrangements, VA Form 10–2065.

OMB Control Number: 2900–0091.

Type of Review: Revision of a

currently approved collection.

Abstract: The OMB approvals for use

of these forms is due to expire on

August 31, 1997. Many of these forms

will be redesigned to meet the

requirements of Public Law 104–262,

Veterans’ Health Care Eligibility Reform

Act of 1996. VHA is requesting an

extension until such time as these forms
47880 Federal Register / Vol. 62, No. 176 / Thursday, September 11, 1997 / Notices

are designed and the enrollment process

is implemented.

Title 38, U.S.C., Chapter 17,

authorized VA to provide hospital care,

medical services, domiciliary care and

nursing home care to eligible veterans.

Public Law 99–272 amending Title 38,

U.S.C., Section 1729, established new

eligibility assessment procedures, based

on income levels, for determining

whether nonservice-connected veterans

are eligible for cost-free VA medical care

and authorizes VA to recover the cost of

care furnished to veterans from their

health insurance carriers. Public Law

99–272 codified at Title 38, U.S.C.,

Section 1722, authorized VA to provide

care to nonservice-connected veterans

who are unable to defray the necessary

expenses of care if the veteran’s

attributable income is not greater than

the maximum annual pension rate. Title

38 U.S.C., Section 1722a, authorizes

collection of a co-payment for

medications. Public Law 104–262

requires VA to design, establish and

operate a system of annual patient

enrollment in accordance with a series

of priorities stipulated in the law. A

consequence of this law is that many

groups of veterans who are in a lower

priority group (W.W.I veterans, veterans

with disabilities rated as 0% serviceconnected seeking treatment for other

than their service connected conditions,

veterans exposed to a toxic substance,

radiation, or environmental hazard and

nonservice-connected veterans) may

request that they be allowed to be

income tested in order to gain a higher

priority. Title 38, U.S.C., Chapters 23

and 24, authorizes VA to provide burial

benefits and to bury the remains of an

eligible deceased veteran in a National

Cemetery.

VA Forms 10–10, 10–10T, 10–10F,

and 10–10I are generally completed by

clerical staff at the VHA medical facility

where the applicant applies for medical

care benefits; however, the forms may

be completed by veterans in the

convenience of their home. If the

veteran is completing the forms at home

and it is the first time application is

made, the forms are submitted to the

nearest VA health care facility for

processing. VA Form 10–2065 is

generally completed by clerical staff at

the medical center upon the death of a

veteran in a VA medical care facility.

VA Form 10–10 is used to establish a

system of records on veterans applying

for medical care benefits. The

information collected is used to identify

the veteran applying for medical care,

emergency contact data, employment

information, military service data, and

income screening data for pharmacy copayment authorized under Title 38,

U.S.C., Section 1722A. This also

includes the ‘‘missing’’ VA Form 10–

10T data collected at a later date.

VA Form 10–10T is a simplified

version of VA Form 10–10 and was

created to shorten the application

process. VA Form 10–10T is used to

identify the veteran applying for

medical care, establish a veteran’s initial

eligibility and establish a system of

records on veterans applying for

medical care benefits. If the veteran is

eligible for care, any missing data which

in the past would have been collected

on VA Form 10–10, such as an

emergency contacts, employment

information, military service data, and

income screening data for pharmacy copayment authorized under Title 38,

U.S.C., Section 1722A is collected at a

later date.

VA Form 10–10F is used in the

information collection process to obtain

financial information on all veterans

whose eligibility for VA health care

benefits is based on income.

Nonservice-connected veterans and

noncompensable service-connected

veterans rated 0% seeking care for their

nonservice-connected conditions

complete the form to establish their

eligibility for cost-free health care,

mileage reimbursement and prescription

co-payment exemption benefits.

Veterans with compensable serviceconnected disabilities rated 0, 10 or

20%, may provide their income

information to establish their eligibility

for prescription co-payment exemption

and mileage reimbursement. Veterans

with service-connected disabilities rated

30 or 40% may provide their income

information to determine their

eligibility for prescription co-payment

exemption.

VA Form 10–10I is used in the

information collection process to collect

health insurance information and to bill

health insurance carriers to recover the

cost of medical care furnished to

veterans for treatment on nonserviceconnected conditions.

VA Form 10–2065 is used primarily

in VA medical facilities and serves as an

official record of the funeral director to

which the person making funeral

arrangements wishes the remains to be

released. It is used as a control

document when VA is requested to

arrange for the transportation of the

deceased from the place of death to the

place of burial, and/or when burial is

requested in a National Cemetery. This

information is requested under the

authority of Title 38, U.S.C., Chapters 23

and 24.

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 May

27, 1997 at page 28757–28758.

Affected Public: Individuals or

households.

Estimated Annual Burden: 2,766,738

hours.

VA Form 10–10—1,631,250 hours

VA Form 10–10T—60,417 hours

VA Form 10–10F—492,000 hours

VA Form 10–10I—480,000 hours

VA Form 10–2065—3,071 hours

Estimated Average Burden Per

Respondent.

VA Form 10–10—45 minutes

VA Form 10–10T—5 minutes

VA Form 10–10F—20 minutes

VA Form 10–10I—12 minutes

VA Form 10–2064—5 minutes

Frequency of Response: On occasion.

Estimated Number of Respondents:

7,336,850.

VA Form 10–10—2,175,000

VA Form 10–10T—725,000

VA Form 10–10F—1,500,000

VA Form 10–10I—2,900,000

VA Form 10–2064—34,850

Send commends and

recommendations concerning any

aspect of the information collection to

VA’s OMB Desk Officer, Allison Eydt,

OMB Human Resources and Housing

Branch, New Executive Office Building,

Room 10235, Washington, DC 20503,

(202) 395–4650. Please refer to ‘‘OMB

Control No. 2900–0091’’ in any

correspondence.

Dated: August 12, 1997.

By direction of the Secretary.

Donald L. Neilson,

Director, Information Management Service.

[FR Doc. 97–24063 Filed 9–10–97; 8:45 am]

BILLING CODE 82320–01–M

DEPARTMENT OF VETERANS

AFFAIRS

Advisory Committee on Cemeteries

and Memorials, Notice of Meeting

The Department of Veterans Affairs

(VA) gives notice that a meeting of the

Advisory Committee on Cemeteries and

Memorials, authorized by 38 U.S.C.

2401, will be held at Long Island

National Cemetery, 2040 Wellwood

Avenue, Farmingdale, NY, 11735–1211

and Calverton National Cemetery, 210

Princeton Boulevard, Calverton, NY,

11933. This will be the committee’s first

meeting of fiscal year 1998. The purpose

of the committee is to review the

administration of VA’s cemeteries and

burial benefits program. On October 9,