Generic Veterans Health Administration Customer Satisfaction Survey - Care Coordination Home Telehealth (CCHT)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
CCHT justification.doc	Justification for No Material/Nonsubstantive Change	Uploaded 2009-01-21	Available
CCHT Memo (v2).doc	Supplementary Document	Uploaded 2009-01-16	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
44127	Generic Veterans Health Administration Customer Satisfaction Surveys	Other-survey	Modified

ICR Details

OMB Control No: 2900-0570	ICR Reference No: 200901-2900-012
Status: Historical Inactive	Previous ICR Reference No: 200812-2900-015
Agency/Subagency: VA	Agency Tracking No: 2900-0570
Title: Generic Veterans Health Administration Customer Satisfaction Survey - Care Coordination Home Telehealth (CCHT)
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OIRA Conclusion Action: Withdrawn and continue	Conclusion Date: 02/24/2009
Retrieve Notice of Action (NOA)	Date Received in OIRA: 01/22/2009
Terms of Clearance: Withdrawn per VA request.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2011	03/31/2011	01/31/2011
Responses	885,797	0	885,797
Time Burden (Hours)	125,347	0	125,347
Cost Burden (Dollars)	0	0	0

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Abstract: Provides procedures for expedited approval of centrally and locally administered customer satisfaction surveys. Information gathered will measure efficacy of process improvements designed around areas of poor performance highlighted in the nationally conducted VHA Customer Satisfaction Surveys.

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Authorizing Statute(s): EO: EO 12862 Name/Subject of EO: SETTING CUSTOMER SERVICE STANDARDS
   US Code: 38 USC 527 Name of Law: Evaluation and data collection
  

Citations for New Statutory Requirements: None

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

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 196	10/11/2007
30-day Notice:	Federal Register Citation:	Citation Date:
	73 FR 5	01/08/2008
Did the Agency receive public comments on this ICR? No

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

table that charts list of burden

IC Title	Form No.	Form Name
Generic Veterans Health Administration Customer Satisfaction Surveys

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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: The figures on this report are actual adjusted Fiscal Year 2007 usage figures. The burden hour decrease is primarily due to a reduced number of ad hoc surveys being approved and conducted. Although we do not project any significant program changes or adjustments in future years, we will continue providing actual usage figures on each future ICB

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Annual Cost to Federal Government: $0

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)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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: 01/22/2009

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