OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Operation Enduring Freedom/Operation Iraqi Freedom Veterans Health Needs Assessment Survey

ICR 200808-2900-003 · OMB 2900-0728 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form VA Form Number 10- Operation Enduring Freedom/Operation Iraqi Freedom Veterans Health Needs Assessment Survey Form and Instruction New Repair queued
VA Response EF.doc Supplementary Document Uploaded 2009-04-16 Available
followup.letter03.30.09.trk.doc Supplementary Document Uploaded 2009-04-16 Repair queued
Survey Protocol 3 30 09 underline.kst.doc Supplementary Document Uploaded 2009-04-16 Available
advance letter03.30.09.trk.doc Supplementary Document Uploaded 2009-04-16 Available
Survey Protocol 3 30 09 underline.kst.doc Supplementary Document Uploaded 2009-04-16 Available
Supporting Statement B (V3).doc Supporting Statement B Uploaded 2008-09-08 Available
VA Form 10-21091.doc Supporting Statement A Uploaded 2008-11-20 Available
VA Cover Letter (sample).pdf Supplementary Document Uploaded 2008-08-15 Available
IC Document Collections
IC IDCollectionTypeStatusForm
186170 Operation Enduring Freedom/Operation Iraqi Freedom Veterans Health Needs Assessment Survey Form and Instruction New
ICR Details
2900-0728 200808-2900-003
Historical Active
VA
Operation Enduring Freedom/Operation Iraqi Freedom Veterans Health Needs Assessment Survey
New collection (Request for a new OMB Control Number)   No
Regular
Approved with change 05/03/2009
Retrieve Notice of Action (NOA) 11/20/2008
Approved consistent with revisions submitted by VA and included in the docket.
  Inventory as of this Action Requested Previously Approved
05/31/2012 36 Months From Approved
3,000 0 0
1,000 0 0
0 0 0
The work of the VA Mid-Atlantic Region's Mental Illness Research, Education and Clinical Center is focused on identifying, refining and disseminating best practices for assisting returning war zone veterans and their families who are facing general readjustment issues and often clinical problems such as Post Traumatic Stress Disorder (PTSD) and Traumatic Brain Injury (TBI). This needs assessment will also support compliance in providing access for mental health and the use of mental health supplemental facilities funding. The needs, concerns and health care preferences for VA services among this group of veterans have largely been inferred from medical records, without direct input from veterans. The proposed regional needs assessment survey will provide this important direct input, will help guide Veterans Integrated Service Network (VISN) VISN 6 program development and will pilot the survey instrument for a future national effort.
US Code: 38 USC Part 1, Chapter 5, Section 527 Name of Law: Veterans Benefits, Evaluation and Data Collection
  
None
Not associated with rulemaking
  73 FR 177 09/11/2008
73 FR 224 11/19/2008
No
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 3,000 0 0 3,000 0 0
Annual Time Burden (Hours) 1,000 0 0 1,000 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This is a new collection and all burden hours are considered a program increase.
$48,471
Yes Part B of Supporting Statement
No
Uncollected
Uncollected
No
Uncollected
Denise McLamb 202-565-8374 [email protected]
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
11/20/2008