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OMB Control No: 2900-0904	ICR Reference No: 202601-2900-003
Status: Received in OIRA	Previous ICR Reference No: 202210-2900-015
Agency/Subagency: VA	Agency Tracking No: VHA-2900-0904
Title: Staff Sergeant Parker Gordon Fox Suicide Prevention Grant Program (SSG Fox SPGP)
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR: No
Type of Review Request: Regular	Date Submitted to OIRA: 05/13/2026

	Requested	Previously Approved
Expiration Date	36 Months From Approved
Responses	54,525	0
Time Burden (Hours)	31,166	0
Cost Burden (Dollars)	0	0

Abstract: On October 17, 2020, the Commander John Scott Hannon Veterans Mental Health Care Improvement Act of 2019, Public Law (P. L.) 116-171 (the Act), codified as a note to section 1720F of title 38, United States Code (U.S.C.), was enacted in law. Section 201 of the Act mandated VA establish the Staff Sergeant Parker Gordon Fox Suicide Prevention Grant Program (SSG Fox SPGP) to reduce Veteran suicide through the provision of community-based grants to certain eligible entities to provide or coordinate the provision of suicide prevention services to eligible individuals and their families. In order to award grants under the Staff Sergeant Parker Gordon Fox Suicide Prevention Grant Program, and assess services and compliance with grants provided, VA will require submission of Applications for grants and Renewals of grants, Eligibility Screening, Suicide Risk Tools, Participant Satisfaction Surveys, Intake Forms, Baseline Mental Health Screening and Program Exit Screening Checklists (which each utilize the same five standardized assessment tools), and Grantee Compliance Reports (performance and financial).

Authorizing Statute(s): US Code: 38 USC 1720F Name of Law: Staff Sergeant Parker Gordon Fox Suicide Prevention Grant Program

Citations for New Statutory Requirements: US Code: 38 USC 1720F Name of Law: Commander John Scott Hannon Veterans Mental Health Care Improvement Act of 2019

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	91 FR 8311	02/20/2026
30-day Notice:	Federal Register Citation:	Citation Date:
	91 FR 27136	05/13/2026
Did the Agency receive public comments on this ICR? No

ICR Summary of Burden

	Total Request	Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses	54,525	48,225	6,300
Annual Time Burden (Hours)	31,166	29,500	1,666
Annual Cost Burden (Dollars)	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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: There are overall increases in the anticipated number of responses and burden hours based upon program data since the last PRA clearance, including an increase in applications. The program requires only one version of the performance report form (10-316b) to be submitted twice annually – at mid-year and end-of-year; the 10-316a form is no longer needed and has been removed from the collection. The program requires only one annual grantee financial report; therefore, VA Form 10-316f is no longer needed and has been removed from the collection. VA Form 10-317b has been split into two forms, with a new 10-317e form being added to the collection.

Annual Cost to Federal Government: $133,675

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

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination. Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination. Yes

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? No

Agency Contact: Frances O'Donnell 703 405-2449 fran.odonnell@cathexiscorp.com

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