The Veterans' Outcome Assessment (VOA) (Veteran Survey Interview)

Forms and Documents

Document Name	Status
Justification A Veterans Outcome Assessment_20140603 (CR).docx Supporting Statement A	2014-07-24
Justification B Veterans Outcome Assessment (2).doc Supporting Statement B	2014-02-26

IC Document Collections

IC ID	Document Title	Status
211770	Veterans Outcome Assessment Other-Script	New

ICR Details

OMB Control No: 2900-0825	ICR Reference No: 201402-2900-006
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: VA	Agency Tracking No:
Title: The Veterans' Outcome Assessment (VOA) (Veteran Survey Interview)
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 11/19/2014
	Date Received in OIRA: 07/25/2014
Terms of Clearance: VA will report to OMB on the response rates and non-response bias analysis after the first two quarters of data are available.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2017	36 Months From Approved
Responses	4,280	0	0
Time Burden (Hours)	2,140	0	0
Cost Burden (Dollars)	51,360	0	0

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Abstract: This collection is in response to the requirements set out by The National Defense Authorization Act of Fiscal Year 2013 (NDAA), Pub. L. 112-239. Section 726 of the NDAA requires VA to "develop and implement a comprehensive set of measures to assess mental health care services furnished by the Department of Veterans Affairs." Responding to this requirement, a VA workgroup therefore developed a plan for a brief survey of a representative sample of patients who are new to mental health treatment. Data collected will allow the program office to ensure that the target audience is being reached, effective treatments are being offered, and tangible, quantitative results are being measured and tracked for continual program improvement.

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Authorizing Statute(s): PL: Pub.L. 112 - 239 726 Name of Law: National Defense Authorization Act for Fiscal Year 2013
  

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:
	79 FR 16102	03/24/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 32824	06/06/2014
Did the Agency receive public comments on this ICR? No

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

IC Title	Form No.	Form Name
Veterans Outcome Assessment

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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	4,280	0	0	4,280	0	0
Annual Time Burden (Hours)	2,140	0	0	2,140	0	0
Annual Cost Burden (Dollars)	51,360	0	0	51,360	0	0

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 therefore an increase in burden hours.

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Annual Cost to Federal Government: $668,000

Does this IC contain surveys, censuses, or employ statistical methods? No

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: 07/25/2014

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