Veterans Industries Vocational Rehabilitation: Consumer Satisfaction Survey Research

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form VA Form 10-0470 Veterans Industries Vocational Rehabilitation: Consumer Satisfaction Survey	Form and Instruction	Modified	Repair queued
10-0470_Justification_B_(3).docx	Supporting Statement B	Uploaded 2010-08-31	Repair queued
1.) Justification A rev 7-2010(V3).docx	Supporting Statement A	Uploaded 2010-08-24	Repair queued
6.) VocRehab Customer Satis Guide.pdf	Supplementary Document	Uploaded 2010-07-28	Repair queued
5.) In-patient letter.doc	Supplementary Document	Uploaded 2010-07-28	Repair queued
4.) Outpatient letter.doc	Supplementary Document	Uploaded 2010-07-28	Repair queued
Permission letter.pdf	Supplementary Document	Uploaded 2009-05-04	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
188875	Veterans Industries Vocational Rehabilitation: Consumer Satisfaction Survey	Form and Instruction	Modified

ICR Details

OMB Control No:	ICR Reference No: 201007-2900-005
Status: Historical Inactive	Previous ICR Reference No: 200904-2900-008
Agency/Subagency: VA	Agency Tracking No:
Title: Veterans Industries Vocational Rehabilitation: Consumer Satisfaction Survey Research
Type of Information Collection: Existing collection in use without an OMB Control Number	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Withdrawn	Conclusion Date: 02/27/2011
	Date Received in OIRA: 09/02/2010
Terms of Clearance: Withdrawn per Department of Veterans Affairs request. VA must seek and receive a valid OMB control number prior to collecting information covered by the Paperwork Reduction Act.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date		36 Months From Approved
Responses	0	0	0
Time Burden (Hours)	0	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The Department of Veteran Affairs (VA) is required to assess it consumers’ to assess their consumers’ (veterans/patients) satisfaction, i.e. Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) and Commission on Accreditation of Rehabilitation Facilities (CARF). This research directly benefits Veterans by helping to understand Veteran’s perspectives of the vocational rehabilitation process. Moreover, it is intended to provide a model of successful consumer satisfaction for the Veteran. Further, the research contributes to the quality of services provided by VA by understanding the factors that promote continuity of care and return to VA’s Vocational Rehabilitation Programs.

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Authorizing Statute(s): US Code: 38 USC Part 1, Chapter 5, Section 527 Name of Law: Veterans Benefits
  

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:
	74 FR 89	05/11/2009
30-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 141	07/24/2010
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
Veterans Industries Vocational Rehabilitation: Consumer Satisfaction Survey	VA Form 10-0470	Veterans Industries Vocational Rehabilitation: Consumer Satisfaction Survey

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Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: This is a new collection. All burden hours are considered an increase.

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Annual Cost to Federal Government: $959

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]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

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: 09/02/2010

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