Notice2026-09542
Agency Information Collection Activity Under OMB Review: Staff Sergeant Parker Gordon Fox Suicide Prevention Grant Program (SSG Fox SPGP)
Primary source
Metadata and text below are from the Federal Register, a public-domain U.S. government work. Always verify the official published version before relying on it for any legal matter.
Published
May 13, 2026
Issuing agencies
Veterans Affairs Department
Abstract
In compliance with the Paperwork Reduction Act (PRA) of 1995, this notice announces that the Veterans Health Administration (VHA), Department of Veterans Affairs (VA), will submit the collection of information abstracted below to the Office of Management and Budget (OMB) for review and comment. The PRA submission describes the nature of the information collection and its expected cost and burden, and it includes the actual data collection instrument.
Full Text
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<title>Federal Register, Volume 91 Issue 92 (Wednesday, May 13, 2026)</title>
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[Federal Register Volume 91, Number 92 (Wednesday, May 13, 2026)]
[Notices]
[Pages 27136-27138]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2026-09542]
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DEPARTMENT OF VETERANS AFFAIRS
[OMB Control No. 2900-0904]
Agency Information Collection Activity Under OMB Review: Staff
Sergeant Parker Gordon Fox Suicide Prevention Grant Program (SSG Fox
SPGP)
AGENCY: Veterans Health Administration, Department of Veterans Affairs.
ACTION: Notice.
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SUMMARY: In compliance with the Paperwork Reduction Act (PRA) of 1995,
this notice announces that the Veterans Health Administration (VHA),
Department of Veterans Affairs (VA), will submit the collection of
information abstracted below to the Office of Management and Budget
[[Page 27137]]
(OMB) for review and comment. The PRA submission describes the nature
of the information collection and its expected cost and burden, and it
includes the actual data collection instrument.
DATES: Comments and recommendations for the proposed information
collection should be sent by June 12, 2026.
ADDRESSES: To submit comments and recommendations for the proposed
information collection, please type the following link into your
browser: <a href="http://www.reginfo.gov/public/do/PRAMain">www.reginfo.gov/public/do/PRAMain</a>, select ``Currently under
Review--Open for Public Comments'', then search the list for the
information collection by Title or ``OMB Control No. 2900-0904.''
FOR FURTHER INFORMATION CONTACT:
VA PRA information: Dorothy Glasgow, 202-461-1084, <a href="/cdn-cgi/l/email-protection#5a0c1b0a081b1a2c3b743d352c"><span class="__cf_email__" data-cfemail="5f091e0f0d1e1f293e71383029">[email protected]</span></a>.
SUPPLEMENTARY INFORMATION:
Title: Staff Sergeant Parker Gordon Fox Suicide Prevention Grant
Program (SSG Fox SPGP) (VA Forms 10-315a-b, 10-316b-e, and 10-317a-e).
OMB Control Number: 2900-0904. <a href="https://www.reginfo.gov/public/do/PRASearch">https://www.reginfo.gov/public/do/PRASearch</a>.
Type of Review: Reinstatement of a previously approved collection.
Abstract: On October 17, 2020, the Commander John Scott Hannon
Veterans Mental Health Care Improvement Act of 2019, Public Law (Pub.
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 this program, and assess services
and compliance with grants provided, VA requires submission of
Applications for grants and Renewals of grants, Compliance Reports,
Eligibility Screening, Intake Forms, Baseline Mental Health Screening,
Participant Satisfaction Surveys, and Program Exit Screening
Checklists.
VA Form 10-315a--Application: This information is needed to award
SSG Fox SPGP grants to eligible entities. The application requirements
are consistent with section 201(f) of the Act and are designed to
ensure that VA can fully evaluate the ability of applicants to achieve
the goals of the grant program.
VA Form 10-315b--Renewal Application: This data collection
instrument has been developed for grantees to renew grants previously
awarded. The renewal application will allow VA to fully evaluate the
ability of applicants to achieve the goals of the SSG Fox SPGP and
proposed 38 CFR part 78. This information will be used by VA to
determine whether to award renewal funds to existing grantees.
VA Forms 10-316b-e--Compliance Reports: This collection of
information will be required to ensure grantees are complying with all
program requirements set forth in proposed 38 CFR part 78 and their
grant agreements. These reports will allow VA to assess the provision
of services under this grant program. The reports consist of mid-year
and end-of-year Performance Reports, Program & Budget Changes,
Corrective Action Plans, and Annual Financial Expenditure Reports.
VA Form 10-317a--Eligibility Screening Form: This data will be
collected by grantee staff to determine eligibility for the grant
program, prior to enrollment. Suicide risk screening will be
administered by grantees using the existing Columbia Suicide Severity
Rating Scale (C-SSRS) to assess suicide risk of program participants.
VA Form 10-317b--Intake Form: This data collection instrument will
be used by grantee staff to collect demographic and military service.
This information will be used by the VA to identify trends of the
Veteran population the grantees are servicing.
VA Form 10-317c--Participant Satisfaction Survey: This data
collection instrument has been developed to capture participant
feedback about services and to evaluate the SSG Fox SPGP. This
information will be used by VA to determine the satisfaction of
Veterans participating in the grant program funded services and the
effectiveness of those services provided under the SSG Fox SPGP.
VA Form 10-317d--Program Exit Screening Checklist: This data
collection instrument will be used by grantee staff at the completion
of the program to track the following assessments upon program exit:
Social Economic Status (SES); Patient Health Questionnaire (PHQ-9);
Short Warwick-Edinburgh Mental Wellbeing Scale (SWEMWS); and
Interpersonal Support Evaluation List (ISEL-12).
VA Form 10-317e--Baseline Mental Health Screening: This screening
is required for all eligible individuals upon enrollment in the
program. The screening includes the following assessments: Social
Economic Status (SES); Patient Health Questionnaire (PHQ-9); Warwick-
Edinburgh Mental Wellbeing Scale (WEMWS); and Interpersonal Support
Evaluation List (ISEL-12).
The program has streamlined certain requirements by consolidating
the Performance Reports into one form that is submitted twice per year
and requiring only one Annual Financial Report. The prior Intake Form
and Assessments has been split into two forms that have the same total
burden, with one form used only for intake information and a new form
that captures baseline mental health assessment information. Several of
the remaining forms have been updated with required PRA information and
other minor changes for clarity and ease of use by respondents.
Overall, there is an increase in the number of respondents and burden
hours for the SSG Fox SPGP based upon program data, which includes an
increase in the number of applicants.
An agency may not conduct or sponsor, and a person is not required
to respond to a collection of information unless it displays a
currently valid OMB control number. The Federal Register Notice with a
60-day comment period soliciting comments on this collection of
information was published at 91 FR 8311, February 20, 2026.
Total Annual Number of Responses = 54,525.
Total Annual Time Burden = 31,166 hours.
VA Form 10-315a:
Affected Public: Private Sector.
Estimated Annual Burden: 12,600 hours.
Estimated Average Burden per Respondent: 35 hours.
Frequency of Response: Once annually.
Estimated Number of Respondents: 360.
VA Form 10-315b:
Affected Public: Private Sector.
Estimated Annual Burden: 900 hours.
Estimated Average Burden per Respondent: 10 hours.
Frequency of Response: Once annually.
Estimated Number of Respondents: 90.
VA Form 10-316b:
Affected Public: Private Sector.
Estimated Annual Burden: 90 hours.
Estimated Average Burden per Respondent: 30 minutes.
Frequency of Response: Twice annually.
Estimated Number of Respondents: 90.
VA Form 10-316c:
Affected Public: Private Sector.
Estimated Annual Burden: 45 hours.
[[Page 27138]]
Estimated Average Burden per Respondent: 15 minutes.
Frequency of Response: Twice annually.
Estimated Number of Respondents: 90.
VA Form 10-316d:
Affected Public: Private Sector.
Estimated Annual Burden: 13 hours.
Estimated Average Burden per Respondent: 30 minutes.
Frequency of Response: Once annually.
Estimated Number of Respondents: 25.
VA Form 10-316e:
Affected Public: Private Sector.
Estimated Annual Burden: 68 hours.
Estimated Average Burden per Respondent: 45 minutes.
Frequency of Response: Once annually.
Estimated Number of Respondents: 90.
VA Form 10-317a:
Affected Public: Individuals or Households.
Estimated Annual Burden: 8,100 hours.
Estimated Average Burden per Respondent: 30 minutes.
Frequency of Response: 180 times annually.
Estimated Number of Respondents: 90.
VA Form 10-317b:
Affected Public: Individuals or Households.
Estimated Annual Burden: 2,700 hours.
Estimated Average Burden per Respondent: 10 minutes.
Frequency of Response: 180 times annually.
Estimated Number of Respondents: 90.
VA Form 10-317c:
Affected Public: Individuals or Households.
Estimated Annual Burden: 1,250 hours.
Estimated Average Burden per Respondent: 15 minutes.
Frequency of Response: Once annually.
Estimated Number of Respondents: 5,000.
VA Form 10-317d:
Affected Public: Individuals or Households.
Estimated Annual Burden: 2,700 hours.
Estimated Average Burden per Respondent: 20 minutes.
Frequency of Response: 90 times annually.
Estimated Number of Respondents: 90.
VA Form 10-317e:
Affected Public: Individuals or Households.
Estimated Annual Burden: 2,700 hours.
Estimated Average Burden per Respondent: 20 minutes.
Frequency of Response: 90 times annually.
Estimated Number of Respondents: 90.
(Authority: 44 U.S.C. 3501 et seq.)
Lanea Haynes,
Alternate, VA PRA Clearance Officer, Office of Information Technology,
Data Governance Analytics Department of Veterans Affairs.
[FR Doc. 2026-09542 Filed 5-12-26; 8:45 am]
BILLING CODE 8320-01-P
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