VA Preparedness Communications Survey

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
201410_2900-003_VA Prep Comm Survey Justification B_ 2015-04-15_edits.docx	Supporting Statement B	Uploaded 2015-05-04	Available
201410-2900-003_VA Prep Comm Survey Justification A (CR 2 10 15)_2015-05... rev.doc	Supporting Statement A	Uploaded 2015-06-12	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
213369	VA Preparedness Survey	Instruction	New

ICR Details

OMB Control No: 2900-0833	ICR Reference No: 201410-2900-003
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: VA	Agency Tracking No: 2900-
Title: VA Preparedness Communications Survey
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 without change	Conclusion Date: 06/22/2015
	Date Received in OIRA: 02/22/2015
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2018	36 Months From Approved
Responses	2,272	0	0
Time Burden (Hours)	379	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: VA PREPAREDNESS COMMUNICATIONS SURVEY This collection is being conducted by the Veterans Emergency Management Evaluation Center (VEMEC) at the request of the Department of Veterans Affairs (VA), Veterans Health Administration (VHA), Office of Emergency Management (OEM) to support current and future operations. VA does not currently have a natural disaster preparedness plan to communicate with patients and ensure their continuity of care. The proposed study will support VA/VHA Office of Emergency Management operations by assessing how best to communicate news of medical facility closures to patients during and after a natural disaster. The proposed survey will support this effort by providing VA stakeholders with high-quality information to inform the development of a disaster preparedness communication plan to reach Veterans with different communication needs. Principal Investigator: Aram Dobalian, PhD, JD Veterans Emergency Management Evaluation Center (VEMEC) 16111 Plummer St. MS-152 North Hills, CA 91343 phone: 818.891.7711 ext. 7182 fax: 818.895.9578 email: [email protected]

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Authorizing Statute(s): US Code: 38 USC 1784 Name of Law: Continuity of Hospital Operations During Disaster or Emergency
  

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 67242	11/12/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 3014	01/21/2015
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
VA Preparedness Survey	10-0528, 10-0208, 10-0485, 10-0485, 10-0485, 10-0485	Group 5 web survey ,   Group 6 CATI Survey ,   Group 2 Print Survey ,   Group 12 Survey ,   Group 13 CATI Survey ,   Group 19 CATI Survey

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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	2,272	0	0	2,272	0	0
Annual Time Burden (Hours)	379	0	0	379	0	0
Annual Cost Burden (Dollars)	0	0	0	0	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 data collection; all hours are considered a program increase.

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Annual Cost to Federal Government: $40,997

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: 02/22/2015

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