View Information Collection Request (ICR) Package

Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.

View ICR - OIRA Conclusion

OMB Control No: 2900-0160	ICR Reference No: 200906-2900-006
Status: Historical Active	Previous ICR Reference No: 200608-2900-010
Agency/Subagency: VA	Agency Tracking No: 2900-0160
Title: Title 38, Parts 51 and 52, State Home Programs
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 11/09/2009
	Date Received in OIRA: 06/09/2009
Terms of Clearance: OMB approves the collection of information consistent with the Department's final rule, OMB reminds VA to submit changes to existing ICRs as revisions to existing collections rather than extensions.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2012	36 Months From Approved	11/30/2009
Responses	47,838	0	47,658
Time Burden (Hours)	15,550	0	15,535
Cost Burden (Dollars)	0	0	0

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

IC Title	Form No.	Form Name
Title 38, Parts 51 and 52, State Home Program	10-0144A, 10-0143, 10-0143A, 10-0144, 10-5588, 10-0460, 10-10SH, VA Form 10-3567	, , , , , , ,

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	47,838	47,658	180
Annual Time Burden (Hours)	15,550	15,535	15
Annual Cost Burden (Dollars)	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: The adjustment in burden hours is due to the increase of 11 Nursing Homes, 6 Domiciliaries and 2 Adult Day Health Care Centers utilizing this program.

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