SUPPLEMENTARY INFORMATION:

Title: Staff Sergeant Parker Gordon Fox Suicide Prevention Grant Program (SSG Fox SPGP) (VA Forms 10-315a-b, 10-316b-e, and 10-317a-e).

OMB Control Number: 2900-0904. https://www.reginfo.gov/​public/​do/​PRASearch.

Type of Review: Reinstatement of a previously approved collection.

Abstract: On October 17, 2020, the Commander John Scott Hannon Veterans Mental Health Care Improvement Act of 2019, Public Law (Pub. L.) 116-171 (the Act), codified as a note to section 1720F of title 38, United States Code (U.S.C.), was enacted in law. Section 201 of the Act mandated VA establish the Staff Sergeant Parker Gordon Fox Suicide Prevention Grant Program (SSG Fox SPGP) to reduce Veteran suicide through the provision of community-based grants to certain eligible entities to provide or coordinate the provision of suicide prevention services to eligible individuals and their families.

In order to award grants under this program, and assess services and compliance with grants provided, VA requires submission of Applications for grants and Renewals of grants, Compliance Reports, Eligibility Screening, Intake Forms, Baseline Mental Health Screening, Participant Satisfaction Surveys, and Program Exit Screening Checklists.

VA Form 10-315a—Application: This information is needed to award SSG Fox SPGP grants to eligible entities. The application requirements are consistent with section 201(f) of the Act and are designed to ensure that VA can fully evaluate the ability of applicants to achieve the goals of the grant program.

VA Form 10-315b—Renewal Application: This data collection instrument has been developed for grantees to renew grants previously awarded. The renewal application will allow VA to fully evaluate the ability of applicants to achieve the goals of the SSG Fox SPGP and proposed 38 CFR part 78. This information will be used by VA to determine whether to award renewal funds to existing grantees.

VA Forms 10-316b-e—Compliance Reports: This collection of information will be required to ensure grantees are complying with all program requirements set forth in proposed 38 CFR part 78 and their grant agreements. These reports will allow VA to assess the provision of services under this grant program. The reports consist of mid-year and end-of-year Performance Reports, Program & Budget Changes, Corrective Action Plans, and Annual Financial Expenditure Reports.

VA Form 10-317a—Eligibility Screening Form: This data will be collected by grantee staff to determine eligibility for the grant program, prior to enrollment. Suicide risk screening will be administered by grantees using the existing Columbia Suicide Severity Rating Scale (C-SSRS) to assess suicide risk of program participants.

VA Form 10-317b—Intake Form: This data collection instrument will be used by grantee staff to collect demographic and military service. This information will be used by the VA to identify trends of the Veteran population the grantees are servicing.

VA Form 10-317c—Participant Satisfaction Survey: This data collection instrument has been developed to capture participant feedback about services and to evaluate the SSG Fox SPGP. This information will be used by VA to determine the satisfaction of Veterans participating in the grant program funded services and the effectiveness of those services provided under the SSG Fox SPGP.

VA Form 10-317d—Program Exit Screening Checklist: This data collection instrument will be used by grantee staff at the completion of the program to track the following assessments upon program exit: Social Economic Status (SES); Patient Health Questionnaire (PHQ-9); Short Warwick-Edinburgh Mental Wellbeing Scale (SWEMWS); and Interpersonal Support Evaluation List (ISEL-12).

VA Form 10-317e—Baseline Mental Health Screening: This screening is required for all eligible individuals upon enrollment in the program. The screening includes the following assessments: Social Economic Status (SES); Patient Health Questionnaire (PHQ-9); Warwick-Edinburgh Mental Wellbeing Scale (WEMWS); and Interpersonal Support Evaluation List (ISEL-12).

The program has streamlined certain requirements by consolidating the Performance Reports into one form that is submitted twice per year and requiring only one Annual Financial Report. The prior Intake Form and Assessments has been split into two forms that have the same total burden, with one form used only for intake information and a new form that captures baseline mental health assessment information. Several of the remaining forms have been updated with required PRA information and other minor changes for clarity and ease of use by respondents. Overall, there is an increase in the number of respondents and burden hours for the SSG Fox SPGP based upon program data, which includes an increase in the number of applicants.

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 at 91 FR 8311, February 20, 2026.

Total Annual Number of Responses = 54,525.

Total Annual Time Burden = 31,166 hours.

VA Form 10-315a:

Affected Public: Private Sector.

Estimated Annual Burden: 12,600 hours.

Estimated Average Burden per Respondent: 35 hours.

Frequency of Response: Once annually.

Estimated Number of Respondents: 360.

VA Form 10-315b:

Affected Public: Private Sector.

Estimated Annual Burden: 900 hours.

Estimated Average Burden per Respondent: 10 hours.

Frequency of Response: Once annually.

Estimated Number of Respondents: 90.

VA Form 10-316b:

Affected Public: Private Sector.

Estimated Annual Burden: 90 hours.

Estimated Average Burden per Respondent: 30 minutes.

Frequency of Response: Twice annually.

Estimated Number of Respondents: 90.

VA Form 10-316c:

Affected Public: Private Sector.

Estimated Annual Burden: 45 hours. ( printed page 27138)

Estimated Average Burden per Respondent: 15 minutes.

Frequency of Response: Twice annually.

Estimated Number of Respondents: 90.

VA Form 10-316d:

Affected Public: Private Sector.

Estimated Annual Burden: 13 hours.

Estimated Average Burden per Respondent: 30 minutes.

Frequency of Response: Once annually.

Estimated Number of Respondents: 25.

VA Form 10-316e:

Affected Public: Private Sector.

Estimated Annual Burden: 68 hours.

Estimated Average Burden per Respondent: 45 minutes.

Frequency of Response: Once annually.

Estimated Number of Respondents: 90.

VA Form 10-317a:

Affected Public: Individuals or Households.

Estimated Annual Burden: 8,100 hours.

Estimated Average Burden per Respondent: 30 minutes.

Frequency of Response: 180 times annually.

Estimated Number of Respondents: 90.

VA Form 10-317b:

Affected Public: Individuals or Households.

Estimated Annual Burden: 2,700 hours.

Estimated Average Burden per Respondent: 10 minutes.

Frequency of Response: 180 times annually.

Estimated Number of Respondents: 90.

VA Form 10-317c:

Affected Public: Individuals or Households.

Estimated Annual Burden: 1,250 hours.

Estimated Average Burden per Respondent: 15 minutes.

Frequency of Response: Once annually.

Estimated Number of Respondents: 5,000.

VA Form 10-317d:

Affected Public: Individuals or Households.

Estimated Annual Burden: 2,700 hours.

Estimated Average Burden per Respondent: 20 minutes.

Frequency of Response: 90 times annually.

Estimated Number of Respondents: 90.

VA Form 10-317e:

Affected Public: Individuals or Households.

Estimated Annual Burden: 2,700 hours.

Estimated Average Burden per Respondent: 20 minutes.

Frequency of Response: 90 times annually.

Estimated Number of Respondents: 90.

(Authority: 44 U.S.C. 3501 et seq.)