Women Veterans Healthcare Barriers Survey

Forms and Documents

Document Name	Status
Non Substantive Change Memo OMB _2900-0795.docx Justification for No Material/Nonsubstantive Change	2013-11-08
Non Substantive Change Memo OMB #2900-0795.docx Supplementary Document	2013-11-07
FAQ_061313.pdf Supplementary Document	2013-11-07
ProfileSheet_061313.pdf Supplementary Document	2013-11-07
Public Law 111-163.docx Supplementary Document	2013-10-28
Barriers to care adverse event protocol1 (v3).doc Supplementary Document	2013-01-11
VAWH_Interviewer FAQs1 (v4).docx Supplementary Document	2013-11-07
Barriers pre-Notification Letter - 06SEP2013.docx Supplementary Document	2013-11-07
Justification B_WomensHealthBarriers (v2).docx Supporting Statement B	2013-11-07
Justification A_WomensHealthBarriers Survey (comments (v8)).docx Supporting Statement A	2013-11-07

IC Document Collections

IC ID	Document Title	Status
204873	Women Veterans Healthcare Barriers Other-Telephonic Script	Modified

ICR Details

OMB Control No: 2900-0795	ICR Reference No: 201310-2900-008
Status: Historical Active	Previous ICR Reference No: 201211-2900-009
Agency/Subagency: VA	Agency Tracking No:
Title: Women Veterans Healthcare Barriers Survey
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: 11/12/2013
	Date Received in OIRA: 11/08/2013
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2016	10/31/2016	10/31/2016
Responses	8,400	0	8,400
Time Burden (Hours)	5,600	0	5,600
Cost Burden (Dollars)	0	0	0

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Abstract: VA wishes to conduct an independent comprehensive study of the barriers to the provision of comprehensive health care for women Veterans. Women Veterans comprise one of the fastest growing subpopulations of Veterans. Over the last decade, the number of women Veterans using VA health care has nearly doubled. The study will help VA better understand barriers women Veterans face accessing VA care, the comprehensiveness of care, and improve our understanding of the long-term consequences of military deployment.

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Authorizing Statute(s): PL: Pub.L. 111 - 163 201 Name of Law: Women Veterans Healthcare Matters
  

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:
	78 FR 15	01/23/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 69	04/10/2013
Did the Agency receive public comments on this ICR? Yes

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

IC Title	Form No.	Form Name
Women Veterans Healthcare Barriers

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ICR Summary 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	8,400	8,400	0	0	0	0
Annual Time Burden (Hours)	5,600	5,600	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:

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Annual Cost to Federal Government: $1,127,030

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: 11/08/2013

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