EVALUATION OF EFFECTIVENESS AND COSTS OF ADULT DAY HEALTH CARE (ADHC)

Forms and Documents

Document Name	Status

No forms / supporting documents in this ICR. Check IC Document Collections.

IC Document Collections

IC ID	Document Title	Status
148302	EVALUATION OF EFFECTIVENESS AND COSTS OF ADULT DAY HEALTH CARE (ADHC) Form	Migrated

ICR Details

OMB Control No: 2900-0479	ICR Reference No: 198703-2900-007
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: VA	Agency Tracking No:
Title: EVALUATION OF EFFECTIVENESS AND COSTS OF ADULT DAY HEALTH CARE (ADHC)
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: 06/02/1987
	Date Received in OIRA: 03/04/1987
Terms of Clearance: OMB HAS APPROVED THE STUDY WITH THE FOLLOWING CONDITIONS OF APPROVAL. 1. TO FULFILL THE CONGRESSIONAL MANDATE, OMB REQUIRES THAT THE INITIAL POPULATION POOL FOR THE STUDY WILL CONSIST ONLY OF THOSE PATIENTS WHO AGREE TO ENTER EITHER AN ADHC OR A NH, (NOT TO CUSTOMARY CARE). THIS CRITERION WILL BE ADDED TO EXISTING CRITERIA. FURTHERMORE, DURING THE RANDOMIZED ASSIGNMENT PORTION OF THE STUDY, THE VA PATIENT WILL BE ASSIGNED TO AN ADHC OR NH, (NOT TO AN ADHC OR CC). 2. THE VA WILL SEPERATELY PRESENT, IN THEIR ANALYSIS, ALL ADHC AND NH PATIENTS AS ASSIGNED. THESE DATA WILL BE SEPERATELY ANALYZED FROM THE DATA ON THOSE WHO REJECTED THE ASSIGNED TREATMENT CONDITION AND WHO CHOSE CC OR NH. 3. BECAUSE THE ADL SCALE FALLS SHORT OF ALWAYS MEASURING MEDICAL DETERIORATION, VA MUST INCLUDE THE FOLLOWING ADDITIONAL ITEMS. --REASONS FOR AND NUMBER OF HOSPITILIZATION DAYS AND OUTPATIENT VISITS --NUMBER AND TYPE OF PRESCRIPTION DRUGS USED. 4. HOSPITALIZATION SPECIFICALLY RESULTING FROM AWAITING ENTRY INTO ADH OR NH WILL NOT BE INCLUDED IN THE HOSPITALIZATION DAY MEASURE, BUT SHOULD BE PRESENTED SEPERATELY. 5. THE DIAGNOSIS WILL BE TAKEN FROM EACH PATIENT'S MEDICAL RECORD AND AND THE RELATIONSHIP OF DIAGNOSIS TO THE ABOVE MEDICAL DATA WILL BE ANALYZED. THE VA WILL INCLUDE IN ITS REPORTS AN ANALYSIS OF UTILIZATIO RATES AND CORRESPONDING DIAGNOSES IN THE STUDY. (CONTINUED ON PAGE 2).

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/1990	06/30/1990
Responses	4,647	0	0
Time Burden (Hours)	1,687	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: THIS STUDY IS DESIGNED TO EVALUATE THE MEDICAL EFFICACY AND COST OF PROVIDING ADHC TO FRAIL ELDERLY VETERANS AT HIGH RISK FOR NURSING HOME PLACEMENT AS MANDATED BY CONGRESS. THE FINDINGS WILL BE USED BY THE VA TO MAKE DECISIONS REGARDING THE FUTURE ROLE OF ADHC IN THE LONG-TERM CARE CONTINUUM.

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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

IC Title	Form No.	Form Name
EVALUATION OF EFFECTIVENESS AND COSTS OF ADULT DAY HEALTH CARE (ADHC)	THROUGH, K, 10-20818A

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ICR Summary 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	4,647	0	0	4,647	0	0
Annual Time Burden (Hours)	1,687	0	0	1,687	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:

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: $0

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]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

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: 03/04/1987

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