Veterans Employment Pay For Success (VEPFS), Grant Program Application

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form VA Form 10193 VA Form 10193 VEPFS Application	Form and Instruction	Modified	Available
60-day FRN 2900-0847.pdf	Supplementary Document	Uploaded 2017-01-31	Repair queued
Standard Form 424.pdf	Supplementary Document	Uploaded 2016-08-09	Available
VBA-26-0967a.pdf	Supplementary Document	Uploaded 2016-08-09	Available
VBA-26-0967.pdf	Supplementary Document	Uploaded 2016-08-09	Available
Emergency Request Memo-VEPFS Interim Final Rule AP72 (003) 882016.docx	Supplementary Document	Uploaded 2016-08-09	Available
White Paper -Correction for IFR Citation date.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2016-08-11	Available
PRA JUSTIFICATION VEPFS 2900-0847.docx	Supporting Statement A	Uploaded 2017-01-31	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
222913	38 CFR 21.447(a)(1) and 21.448(a) Quarterly Fiscal Compliance Reports		Unchanged
222393	VA Form 10193 VEPFS Application	Form and Instruction	Modified

ICR Details

OMB Control No: 2900-0847	ICR Reference No: 201610-2900-002
Status: Historical Active	Previous ICR Reference No: 201608-2900-006
Agency/Subagency: VA	Agency Tracking No:
Title: Veterans Employment Pay For Success (VEPFS), Grant Program Application
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/13/2017
	Date Received in OIRA: 01/31/2017
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2020	36 Months From Approved	06/30/2017
Responses	65	0	65
Time Burden (Hours)	2,040	0	2,040
Cost Burden (Dollars)	0	0	0

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Abstract: Section 3119 of title 38, United States Code, authorizes the Secretary of Veterans Affairs to make grants to or contract with public or nonprofit agencies, including institutions of higher learning, to advance “the knowledge, methods, techniques, and resources available for use in rehabilitation programs for veterans.” Section 3119 specifically authorizes the Secretary to make grants to such agencies to conduct or provide support for projects which are “designed to increase the resources and potential for accomplishing the rehabilitation of disabled veterans.” VA has codified these provisions in its regulations at 38 CFR 21.390 Rehabilitation research and special projects. The purpose of the VEPFS program is to provide one or more grants to fund Outcomes Payments for one or more PFS projects that seek to improve employment outcomes for Veterans with a Service-connected Mental Health Disability.

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Authorizing Statute(s): US Code: 38 USC 3119 Name of Law: Rehabilitation Research and Special Projects
   US Code: 38 USC 501 Name of Law: Rules and Regulations
  

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:
	81 FR 76699	11/03/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 8566	01/26/2017
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
VA Form 10193 VEPFS Application	VA Form 10193	Veterans Employment Pay for Success (VEPFS) Grant Application
38 CFR 21.447(a)(1) and 21.448(a) Quarterly Fiscal Compliance Reports

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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	65	65	0	0	0	0
Annual Time Burden (Hours)	2,040	2,040	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: $6,043

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: 01/31/2017

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