Agency Information Collection Activity: Per Diem to States for Care of Eligible Veterans in State Homes

Issuing agencies

Abstract

Veterans Health Administration (VHA), Department of Veterans Affairs (VA), is announcing an opportunity for public comment on the proposed collection of certain information by the agency. Under the Paperwork Reduction Act (PRA) of 1995, Federal agencies are required to publish a notice in the Federal Register concerning each proposed collection of information, including each proposed extension of a currently approved collection, and allow 60 days for public comment in response to the notice.

Full Text

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<title>Federal Register, Volume 91 Issue 200 (Monday, October 19, 2026)</title>
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[Federal Register Volume 91, Number 200 (Monday, October 19, 2026)]
[Notices]
[Pages 66201-66202]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2026-21297]



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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0883]


Agency Information Collection Activity: Per Diem to States for 
Care of Eligible Veterans in State Homes

AGENCY: Veterans Health Administration, Department of Veterans Affairs.

ACTION: Notice.

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SUMMARY: Veterans Health Administration (VHA), Department of Veterans 
Affairs (VA), is announcing an opportunity for public comment on the 
proposed collection of certain information by the agency. Under the 
Paperwork Reduction Act (PRA) of 1995, Federal agencies are required to 
publish a notice in the Federal Register concerning each proposed 
collection of information, including each proposed extension of a 
currently approved collection, and allow 60 days for public comment in 
response to the notice.

DATES: Comments must be received on or before December 18, 2026.

ADDRESSES: Comments must be submitted through <a href="http://www.regulations.gov">www.regulations.gov</a>.

FOR FURTHER INFORMATION CONTACT: 
    Program-specific information: Rebecca Mimnall, 202-695-9434, 
<a href="/cdn-cgi/l/email-protection#285e40494b47585a49685e49064f475e"><span class="__cf_email__" data-cfemail="82f4eae3e1edf2f0e3c2f4e3ace5edf4">[email&#160;protected]</span></a>.
    VA PRA information: Dorothy Glasgow, 202-461-1084, <a href="/cdn-cgi/l/email-protection#7e283f2e2c3f3e081f50191108"><span class="__cf_email__" data-cfemail="a3f5e2f3f1e2e3d5c28dc4ccd5">[email&#160;protected]</span></a>.

SUPPLEMENTARY INFORMATION: Under the PRA of 1995, Federal agencies must 
obtain approval from the Office of Management and Budget (OMB) for each 
collection of information they conduct or sponsor. This request for 
comment is being made pursuant to Section 3506(c)(2)(A) of the PRA.
    With respect to the following collection of information, VHA 
invites comments on: (1) whether the proposed collection of information 
is necessary for the proper performance of VHA's functions, including 
whether the information will have practical utility; (2) the accuracy 
of VHA's estimate of the burden of the proposed collection of 
information; (3) ways to enhance the quality, utility, and clarity of 
the information to be collected; and (4) ways to minimize the burden of 
the collection of information on respondents, including through the use 
of automated collection techniques or the use of other forms of 
information technology.
    Title: Per Diem to States for Care of Eligible Veterans in State 
Homes (VA Forms 10-0143, 10-0143A, 10-0144, 10-0144A, 10-0460, and 10-
3567).
    OMB Control Number: 2900-0883. <a href="https://www.reginfo.gov/public/do/PRASearch">https://www.reginfo.gov/public/do/PRASearch</a> (Once at this link, you can enter the OMB Control Number to 
find the historical versions of this Information Collection).
    Type of Review: Revision of a currently approved collection.
    Abstract: Authority for this information collection is found in 
Title 38 Code of Federal Regulations (CFR) Part 51, ``Per Diem for 
Nursing Home, Domiciliary or Adult Day Health Care of Veterans in State 
Veterans Homes.'' Specifically, the legal requirements that necessitate 
this collection of information are found in Title 38 CFR Parts Sec.  
51.31, Sec.  51.43 and Sec.  51.210 for all three levels of care: 
nursing home, domiciliary, and adult day health care. VA requires State 
Veterans Homes (SVHs) to be recognized by the Under Secretary for 
Health as providing safe, high-quality programs in these areas.
    The six forms in this collection (10-0143, 10-0143A, 10-0144, 10-
0144A, 10-0460 and 10-3567) are completed by SVH management as part of 
the VA survey process and ongoing compliance. This information 
collection falls under the auspices of the Office of Geriatrics and 
Extended Care in VA Central Office (12GEC). The information is assessed 
in accordance with the applicable regulations by VA contracted vendors 
during a VA survey at each SVH.
    a. VA Form 10-0143 is used for annual certification pursuant to the 
Drug-Free Workplace Act of 1988.
    b. VA Form 10-0143A is used for annual certification of compliance 
with Section 504 of the Rehabilitation Act of 1973 (Pub. L. 93-112).
    c. VA Form 10-0144 is used for annual certification regarding 
lobbying, in compliance with Public Law 101-121.
    d. VA Form 10-0144A is used for annual certification of compliance 
with Title VI of the Civil Rights Act of 1964, as incorporated in Title 
38 CFR 18.1-18.3.
    e. VA Form 10-0460 is used for the SVH to submit to the VA medical 
center of jurisdiction a monthly itemization of the corresponding 
prescription(s) for each eligible Veteran.
    f. VA Form 10-3567 is completed by SVH management for the annual VA 
survey and is used by VA to record and then assess the following: 
operating beds versus recognized beds, total full-time employee 
equivalent (FTEE) authorized and total FTEE available, and resident 
census.
    Total Annual Burden: 2,248 hours.
    Total Annual Responses: 2,975.

VA Form 10-0143

    Affected Public: State, Local, and Tribal Governments.
    Estimated Annual Burden: 15 hours.
    Estimated Average Burden per Respondent: 5 minutes.
    Frequency of Response: Once annually.
    Estimated Number of Respondents: 175.

VA Form 10-0143A

    Affected Public: State, Local, and Tribal Governments.
    Estimated Annual Burden: 15 hours.
    Estimated Average Burden per Respondent: 5 minutes.
    Frequency of Response: Once annually.
    Estimated Number of Respondents: 175.

VA Form 10-0144

    Affected Public: State, Local, and Tribal Governments.
    Estimated Annual Burden: 15 hours.
    Estimated Average Burden per Respondent: 5 minutes.
    Frequency of Response: Once annually.
    Estimated Number of Respondents: 175.

VA Form 10-0144A

    Affected Public: State, Local, and Tribal Governments.
    Estimated Annual Burden: 15 hours.
    Estimated Average Burden per Respondent: 5 minutes.
    Frequency of Response: Once annually.
    Estimated Number of Respondents: 175.

VA Form 10-0460

    Affected Public: State, Local, and Tribal Governments.
    Estimated Annual Burden: 2,100 hours.
    Estimated Average Burden per Respondent: 60 minutes.
    Frequency of Response: 12 times per year.
    Estimated Number of Respondents: 175.

VA Form 10-3567

    Affected Public: State, Local, and Tribal Governments.
    Estimated Annual Burden: 88 hours.
    Estimated Average Burden per Respondent: 30 minutes.
    Frequency of Response: Once annually.
    Estimated Number of Respondents: 175.


[[Page 66202]]


(Authority: 44 U.S.C. 3501 et seq.)

Lanea Haynes,
Alternate, VA PRA Clearance Officer, Office of Information and 
Technology, Office of Data Governance and Analytics, Department of 
Veterans Affairs.
[FR Doc. 2026-21297 Filed 10-16-26; 8:45 am]
BILLING CODE 8320-01-P


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