Survey of Veteran Enrollees' Health and Use of Health Care

Forms and Documents

Document Name	Status
30-day FRN_Survey of Veteran Enrollees' Health & Use of Health Care_2900-0609_published 11302021.pdf Supplementary Document	2021-12-03
60-day FRN_Survey of Veteran Enrollees' Health & Use of Health Care_2900-0609_published 09232021.pdf Supplementary Document	2021-09-28
Supporting Statement A_Survey of Veteran Enrollees' Health & Use of Care_updated Dec 2021.docx Supporting Statement A	2021-12-03
Supporting Statement B_Survey of Enrollees' Health & Use of Health Care 2022_updated Aug 2021.docx Supporting Statement B	2021-09-28

IC Document Collections

IC ID	Document Title	Status
28855	Survey of Veteran Enrollees' Health Questionnaire Other-Survey	Modified

ICR Details

OMB Control No: 2900-0609	ICR Reference No: 202109-2900-006
Status: Received in OIRA	Previous ICR Reference No: 201807-2900-002
Agency/Subagency: VA	Agency Tracking No: 2900-0609
Title: Survey of Veteran Enrollees' Health and Use of Health Care
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 12/16/2021

	Requested	Previously Approved
Expiration Date	36 Months From Approved	03/31/2022
Responses	42,000	42,000
Time Burden (Hours)	14,000	14,000
Cost Burden (Dollars)	0	0

---

Abstract: The VA Survey of Veteran Enrollees' Health and Use of Health Care gathers information from Veterans enrolled in the VA Health Care System about factors which influence their health care utilization choices. Data collected are used to gain insights into Veteran preferences and to provide VA and Veterans Health Administration (VHA) management guidance in preparing for future Veteran needs. In addition to factors influencing health care choices, the data collected include enrollees’ perceived health status and need for assistance, available insurances, self-reported utilization of VA services versus other health care services, reasons for using VA, barriers to seeking care, ability and comfort level with accessing virtual care, as well as general demographics and family characteristics that may influence utilization but cannot be accessed elsewhere. Information provided by the Survey of veteran Enrollees supports critical VA policy decisions.

---

Authorizing Statute(s): PL: Pub.L. 104 - 262 Entirety Name of Law: Veterans Health Care Eligibility Reform Act of 1996,
  

Citations for New Statutory Requirements: None

---

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:
	86 FR 52948	09/23/2021
30-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 68048	11/30/2021
Did the Agency receive public comments on this ICR? No

---

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

IC Title	Form No.	Form Name
Survey of Veteran Enrollees' Health Questionnaire

---

ICR Summary of Burden

	Total Request	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	42,000	42,000	0	0	0	0
Annual Time Burden (Hours)	14,000	14,000	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:

---

Annual Cost to Federal Government: $1,100,000

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

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.     No

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.     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? No

---

Common Form ICR:  No

---

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: 12/16/2021

---