Evaluation of Veterans Health Administration Mental Health Services

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
2900-0713 OMB description of changes.doc	Justification for No Material/Nonsubstantive Change	Uploaded 2008-09-22	Available
EVHAMHS Justification Part B.doc	Supporting Statement B	Uploaded 2008-01-10	Available
EVHAMHS Justification Part A.doc	Supporting Statement A	Uploaded 2008-01-10	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
182503	Evaluation of Veterans Health Administration Mental Health Services	Other-Survey	Modified

ICR Details

OMB Control No: 2900-0713	ICR Reference No: 200809-2900-012
Status: Historical Active	Previous ICR Reference No: 200710-2900-008
Agency/Subagency: VA	Agency Tracking No: 2900-0713
Title: Evaluation of Veterans Health Administration Mental Health Services
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 09/22/2008
	Date Received in OIRA: 09/22/2008
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2010	07/31/2010	07/31/2010
Responses	8,218	0	8,218
Time Burden (Hours)	4,109	0	4,109
Cost Burden (Dollars)	0	0	0

---

Abstract: This program evaluation of mental health services in VA is a four year study of services and outcomes. The program evaluation is looking at patient-level outcomes to determine what impact our services have on patients with specific mental illnesses. The contractor has proposed a telephone survey of selected veterans to supplement the data found in VA’s administrative databases and patient charts. Two groups of veterans will be surveyed- veterans who use VA services to see how our services have impacted them, and veterans who do not use VA for their health care to find out why they don’t. We are specifically looking a vets with five diagnoses: schizophrenia, bipolar, major depressive disorder, PTSD and substance abuse.

---

Authorizing Statute(s): PL: Pub.L. 103 - 62 entirety Name of Law: Government Performance and esults Act of 1993
   US Code: 38 USC 527 Name of Law: Evaluation and Data Collection
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 162	08/22/2007
30-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 214	11/06/2007
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Evaluation of Veterans Health Administration Mental Health Services

---

ICR Summary of Burden

table that charts list of burden

	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	8,218	8,218	0	0	0	0
Annual Time Burden (Hours)	4,109	4,109	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: There is no change to the burden hours. This is the study’s first submission

---

Annual Cost to Federal Government: $1,725,435

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

---

Common Form ICR:  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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 09/22/2008

---