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Agency Information Collection Activities Under OMB Review: Survey of Veteran Enrollees' Health and Reliance Upon VA

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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; it includes the actual data collection instrument.


Comments must be submitted on or before April 13, 2012.


Submit written comments on the collection of information through or to VA's OMB Desk Officer, Office of Information and Regulatory Affairs, New Executive Office Building, Room 10235, Washington, DC 20503 (202) 395-7316. Please refer to “OMB Control No. 2900-0609” in any correspondence.


Denise McLamb, Enterprise Records Service (005R1B), Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 20420, (202) 632-7479, FAX (202) 632-7583 or email Please refer to “OMB Control No. 2900-0609.


Title: Office of Information and Regulatory Affairs, VA Form 10-21034g.

OMB Control Number: 2900-0609.

Type of Review: Revision of a currently approved collection.

Abstract: Public Law 104-262, the Veterans Health Care Eligibility Reform Act of 1996, requires VA to implement a priority-based enrollment system. VA must enroll Veterans by specified priorities as far down the priorities as the available resources permit. The number of priority levels to which VHA will be able to deliver care will be a function of annual funding levels and utilization of health care services by enrollees. Additionally, eligibility reform has brought about the ever-increasing need for VA to plan and budget for evolving clinical care needs of enrollee population at risk of need or use of VA care. There is no valid, recent information available in administrative databases on all enrollees' health status, income, and their reliance upon the VA system. The magnitude of changes each year in enrollees, their characteristics, and system policies make annual surveys necessary to capture this critical information for input into VHA's Health Care Services Demand Model. The survey will provide VA with current information for sound decisions that affect the entire VA health care delivery system and the veterans it serves. VA Form 10-21034g will be used to provide the survey data on morbidity and reliance that is critical to obtaining accurate projections of VA's ability to service Veterans who are seeking VA health care services. The projections also serve as the basis for VA's emphasis on population-based budget formulation, policy scenario testing, and strategic planning.

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 November 1, 2011, page 67557.

Affected Public: Individuals or Households, and Federal Government.

Estimated Annual Burden: 14,400 hours.

Estimated Average Burden per Respondent: 20 minutes.

Frequency of Response: Annually.

Estimated Number of Respondents: 42,200.

Dated: March 8, 2012.

By direction of the Secretary.

Denise McLamb,

Program Analyst, Enterprise Records Service.

[FR Doc. 2012-6098 Filed 3-13-12; 8:45 am]