Non-sub Change Memo

	Department of Veterans Affairs		Memorandum
Date:		November 25, 2015
From:		VHA PRA Compliance Liaison (10B4)
Subject:		Non Substantive Change for OMB Control # 2900-0712
To:		VA Desk Officer, Office of Management & Budget (OMB)
Cc:		VA Clearance Officer, Crystal Rennie (OI&T- 005R1B)

1. See the following new, updated, and additional information for OMB Control # 2900-0712:

A: Updates:

• The Clinician & Group 3.0 (CG3,0) survey will be added to the clearance. CG3.0 is the core of the approved PCMH survey.

• Slight question changes have been made to the PCMH survey

  • The question look-back has changed from 12 to 6 months

  • In the “Access” section, “phoned” was replaced with “contacted”

  • One question added regarding prescription medication

• The SHEP Inpatient long form will no longer be in the field.

• The PCMH SHEP long form will be used in lieu of the Outpatient long form.

• Supporting Statements A and B were updated in accordance with OMB guidance.

B: Supplementary Documents: Data collection materials provided for CG3.0

C New Information: Data collection in Specialty Care population.