82 FR 15225 - Agency Information Collection Activities: Proposed Collection: Public Comment Request; Information Collection Request Title: Application and Other Forms Used by the National Health Service Corps (NHSC) Scholarship Program (SP), the NHSC Students To Service Loan Repayment Program (S2S LRP), and the Native Hawaiian Health Scholarship Program (NHHSP), OMB No. 0915-0146-Extension
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration Federal Register Volume 82, Issue 57 (March 27, 2017)
Health Resources and Services Administration
Federal Register Volume 82, Issue 57 (March 27, 2017)
| Page Range | 15225-15226 | |
| FR Document | 2017-05946 |
[Federal Register Volume 82, Number 57 (Monday, March 27, 2017)] [Notices] [Pages 15225-15226] From the Federal Register Online [www.thefederalregister.org] [FR Doc No: 2017-05946] [[Page 15225]] ----------------------------------------------------------------------- DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Agency Information Collection Activities: Proposed Collection: Public Comment Request; Information Collection Request Title: Application and Other Forms Used by the National Health Service Corps (NHSC) Scholarship Program (SP), the NHSC Students To Service Loan Repayment Program (S2S LRP), and the Native Hawaiian Health Scholarship Program (NHHSP), OMB No. 0915-0146--Extension AGENCY: Health Resources and Services Administration (HRSA), Department of Health and Human Services (HHS). ACTION: Notice. ----------------------------------------------------------------------- SUMMARY: In compliance with the requirement for opportunity for public comment on proposed data collection projects of the Paperwork Reduction Act of 1995, HRSA announces plans to submit an Information Collection Request (ICR), described below, to the Office of Management and Budget (OMB). Prior to submitting the ICR to OMB, HRSA seeks comments from the public regarding the burden estimate, below, or any other aspect of the ICR. DATES: Comments on this ICR must be received no later than May 26, 2017. ADDRESSES: Submit your comments to [email protected] or mail them to the HRSA Information Collection Clearance Officer, Room 14N-29, 5600 Fishers Lane, Rockville, MD 20857. FOR FURTHER INFORMATION CONTACT: To request more information on the proposed project or to obtain a copy of the data collection plans and draft instruments, email [email protected] or call the HRSA Information Collection Clearance Officer at (301) 443-1984. SUPPLEMENTARY INFORMATION: When submitting comments or requesting information, please include the information request collection title for reference, in compliance with Section 3506(c)(2)(A) of the Paperwork Reduction Act of 1995. Information Collection Request Title: Application and Other Forms Used by the National Health Service Corps (NHSC) Scholarship Program (SP), the NHSC Students to Service Loan Repayment Program (S2S LRP), and the Native Hawaiian Health Scholarship Program (NHHSP). OMB No. 0915-0146--Extension Abstract: Administered by HRSA's Bureau of Health Workforce (BHW), the NHSC SP, NHSC S2S LRP, and the NHHSP provide scholarships or loan repayment to qualified students who are pursuing primary care health professions education and training. In return, students agree to provide primary health care services in medically underserved communities located in federally designated Health Professional Shortage Areas once they are fully trained and licensed health professionals. Awards are made to applicants who demonstrate the greatest potential for successful completion of their education and training as well as commitment to provide primary health care services to communities of greatest need. The information from program applications, forms, and supporting documentation is used to select the best qualified candidates for these competitive awards and to monitor program participants' enrollment in school, post graduate training, and compliance with program requirements. Although some program forms vary from program to program (see program-specific burden charts below), required forms generally include: A program application, academic and non-academic letters of recommendation, the authorization to release information, and the acceptance/verification of good standing report. Additional forms for the NHSC SP include the data collection worksheet, which is completed by the educational institutions of program participants; the post graduate training verification form (applicable for NHSC S2S LRP participants), which is completed by program participants and their residency director; and the enrollment verification form, which is completed by program participants and the educational institution for each academic term. Need and Proposed Use of the Information: The NHSC SP, S2S LRP, and NHHSP applications, forms, and supporting documentation are used to collect necessary information from applicants that enable BHW to make selection determinations for the competitive awards and monitor compliance with program requirements. Likely Respondents: Qualified students who are pursuing education and training in primary care health professions and are interested in working in Health Professional Shortage Areas. Burden Statement: Burden in this context means the time expended by persons to generate, maintain, retain, disclose, or provide the information requested. This includes the time needed to review instructions; to develop, acquire, install, and utilize technology and systems for the purpose of collecting, validating, and verifying information, processing and maintaining information, and disclosing and providing information; to train personnel and to be able to respond to a collection of information; to search data sources; to complete and review the collection of information; and to transmit or otherwise disclose the information. The total annual burden hours estimated for this ICR are summarized in the tables below. Total Estimated Annualized Burden Hours [NHSC Scholarship Program Application] ---------------------------------------------------------------------------------------------------------------- Average Number of Number of Total burden per Total burden Form name respondents responses per responses response (in hours respondent hours) ---------------------------------------------------------------------------------------------------------------- NHSC Scholarship Program 1,800 1 1,800 2.0 3,600 Application.................... Letters of Recommendation....... 1,800 2 3,600 .50 1,800 Authorization to Release 1,800 1 1,800 .10 180 Information.................... Acceptance/Verification of Good 1,800 1 1,800 .25 450 Standing Report................ Receipt of Exceptional Financial 200 1 200 .25 50 Need Scholarship............... Verification of Disadvantaged 300 1 300 .25 75 Background Status.............. ------------------------------------------------------------------------------- Total....................... * 1,800 .............. 9,500 .............. 6,155 ---------------------------------------------------------------------------------------------------------------- * Certain documents are submitted by a subset of respondents consistent with program requirements. [[Page 15226]] NHSC Awardees/Schools/Post Graduate Training Programs/Sites ---------------------------------------------------------------------------------------------------------------- Average Number of Number of Total burden per Total burden Form name respondents responses per responses response (in hours respondent hours) ---------------------------------------------------------------------------------------------------------------- Data Collection Worksheet....... 400 1 400 1.0 400 Post Graduate Training 100 1 100 .50 50 Verification Form.............. Enrollment Verification Form.... 600 2 1,200 .50 600 ------------------------------------------------------------------------------- Total....................... * 600 .............. 1,700 .............. 1,050 ---------------------------------------------------------------------------------------------------------------- * Please note that the same group of respondents may complete each form as necessary. NHSC Students to Service Loan Repayment Program Application ---------------------------------------------------------------------------------------------------------------- Number of Average burden Form name Number of responses per Total per response Total burden respondents respondent responses (in hours) hours ---------------------------------------------------------------------------------------------------------------- NHSC Students to Service Loan 100 1 100 2.0 200 Repayment Program Application.. Letters of Recommendation....... 100 2 200 .50 100 Authorization To Release 100 1 100 .10 10 Information.................... Acceptance/Verification of Good 100 1 100 .25 25 Standing Report................ Verification of Disadvantaged 25 1 25 .25 6.25 Background Status.............. Post Graduate Training 150 1 150 .50 75 Verification Form.............. ---------------------------------------------------------------------------------------------------------------- Total....................... * 150 .............. 679 .............. 416.25 ---------------------------------------------------------------------------------------------------------------- * Certain documents are submitted by a subset of respondents consistent with program requirements. Native Hawaiian Health Scholarship Program Application ---------------------------------------------------------------------------------------------------------------- Number of Average burden Form name Number of responses per Total per response Total burden respondents respondent responses (in hours) hours ---------------------------------------------------------------------------------------------------------------- Native Hawaiian Health 250 1 250 1.0 250 Scholarship Program Application Letters of Recommendation....... 250 2 500 .25 125 Authorization To Release 250 1 250 .25 62.50 Information.................... Acceptance/Verification of Good 30 12 360 .25 90 Standing Report................ ------------------------------------------------------------------------------- Total....................... * 250 .............. 1,360 .............. 527.50 ---------------------------------------------------------------------------------------------------------------- * Certain documents are submitted by a subset of respondents consistent with program requirements. HRSA specifically requests comments on (1) the necessity and utility of the proposed information collection for the proper performance of the agency's functions, (2) the accuracy of the estimated burden, (3) ways to enhance the quality, utility, and clarity of the information to be collected, and (4) the use of automated collection techniques or other forms of information technology to minimize the information collection burden. Jason E. Bennett, Director, Division of the Executive Secretariat. [FR Doc. 2017-05946 Filed 3-24-17; 8:45 am] BILLING CODE 4165-15-P
![Federal Register / Vol. 82, No. 57 / Monday, March 27, 2017 / Notices 15225
DEPARTMENT OF HEALTH AND SUPPLEMENTARY INFORMATION: When and the acceptance/verification of good
HUMAN SERVICES submitting comments or requesting standing report. Additional forms for
information, please include the the NHSC SP include the data collection
Health Resources and Services information request collection title for worksheet, which is completed by the
Administration reference, in compliance with Section educational institutions of program
3506(c)(2)(A) of the Paperwork participants; the post graduate training
Agency Information Collection Reduction Act of 1995. verification form (applicable for NHSC
Activities: Proposed Collection: Public Information Collection Request Title: S2S LRP participants), which is
Comment Request; Information Application and Other Forms Used by completed by program participants and
Collection Request Title: Application the National Health Service Corps their residency director; and the
and Other Forms Used by the National (NHSC) Scholarship Program (SP), the enrollment verification form, which is
Health Service Corps (NHSC) NHSC Students to Service Loan completed by program participants and
Scholarship Program (SP), the NHSC Repayment Program (S2S LRP), and the the educational institution for each
Students To Service Loan Repayment Native Hawaiian Health Scholarship academic term.
Program (S2S LRP), and the Native Program (NHHSP). OMB No. 0915– Need and Proposed Use of the
Hawaiian Health Scholarship Program 0146—Extension Information: The NHSC SP, S2S LRP,
(NHHSP), OMB No. 0915–0146— Abstract: Administered by HRSA’s
and NHHSP applications, forms, and
Extension Bureau of Health Workforce (BHW), the
supporting documentation are used to
NHSC SP, NHSC S2S LRP, and the
AGENCY: Health Resources and Services collect necessary information from
NHHSP provide scholarships or loan
Administration (HRSA), Department of applicants that enable BHW to make
repayment to qualified students who are
Health and Human Services (HHS). selection determinations for the
pursuing primary care health
ACTION: Notice. competitive awards and monitor
professions education and training. In
compliance with program requirements.
SUMMARY: In compliance with the return, students agree to provide
primary health care services in Likely Respondents: Qualified
requirement for opportunity for public students who are pursuing education
comment on proposed data collection medically underserved communities
located in federally designated Health and training in primary care health
projects of the Paperwork Reduction Act professions and are interested in
of 1995, HRSA announces plans to Professional Shortage Areas once they
are fully trained and licensed health working in Health Professional Shortage
submit an Information Collection Areas.
Request (ICR), described below, to the professionals. Awards are made to
applicants who demonstrate the greatest Burden Statement: Burden in this
Office of Management and Budget
potential for successful completion of context means the time expended by
(OMB). Prior to submitting the ICR to
their education and training as well as persons to generate, maintain, retain,
OMB, HRSA seeks comments from the
commitment to provide primary health disclose, or provide the information
public regarding the burden estimate,
care services to communities of greatest requested. This includes the time
below, or any other aspect of the ICR.
need. The information from program needed to review instructions; to
DATES: Comments on this ICR must be develop, acquire, install, and utilize
applications, forms, and supporting
received no later than May 26, 2017. documentation is used to select the best technology and systems for the purpose
ADDRESSES: Submit your comments to qualified candidates for these of collecting, validating, and verifying
paperwork@hrsa.gov or mail them to the competitive awards and to monitor information, processing and
HRSA Information Collection Clearance program participants’ enrollment in maintaining information, and disclosing
Officer, Room 14N–29, 5600 Fishers school, post graduate training, and and providing information; to train
Lane, Rockville, MD 20857. compliance with program requirements. personnel and to be able to respond to
FOR FURTHER INFORMATION CONTACT: To Although some program forms vary a collection of information; to search
request more information on the from program to program (see program- data sources; to complete and review
proposed project or to obtain a copy of specific burden charts below), required the collection of information; and to
the data collection plans and draft forms generally include: A program transmit or otherwise disclose the
instruments, email paperwork@hrsa.gov application, academic and non- information. The total annual burden
or call the HRSA Information Collection academic letters of recommendation, the hours estimated for this ICR are
Clearance Officer at (301) 443–1984. authorization to release information, summarized in the tables below.
TOTAL ESTIMATED ANNUALIZED BURDEN HOURS
[NHSC Scholarship Program Application]
Average
Number of
Number of Total burden per Total burden
Form name responses per
respondents responses response hours
respondent (in hours)
NHSC Scholarship Program Application ............................. 1,800 1 1,800 2.0 3,600
Letters of Recommendation ................................................. 1,800 2 3,600 .50 1,800
asabaliauskas on DSK3SPTVN1PROD with NOTICES
Authorization to Release Information .................................. 1,800 1 1,800 .10 180
Acceptance/Verification of Good Standing Report .............. 1,800 1 1,800 .25 450
Receipt of Exceptional Financial Need Scholarship ............ 200 1 200 .25 50
Verification of Disadvantaged Background Status .............. 300 1 300 .25 75
Total .............................................................................. * 1,800 ........................ 9,500 ........................ 6,155
* Certain documents are submitted by a subset of respondents consistent with program requirements.
VerDate Sep<11>2014 18:02 Mar 24, 2017 Jkt 241001 PO 00000 Frm 00047 Fmt 4703 Sfmt 4703 E:\FR\FM\27MRN1.SGM 27MRN1](https://thefederalregister.org/doc/82_FR_15282/page/1.svg)
![15226 Federal Register / Vol. 82, No. 57 / Monday, March 27, 2017 / Notices
NHSC AWARDEES/SCHOOLS/POST GRADUATE TRAINING PROGRAMS/SITES
Average
Number of
Number of Total burden per Total burden
Form name responses per
respondents responses response hours
respondent (in hours)
Data Collection Worksheet .................................................. 400 1 400 1.0 400
Post Graduate Training Verification Form ........................... 100 1 100 .50 50
Enrollment Verification Form ............................................... 600 2 1,200 .50 600
Total .............................................................................. * 600 ........................ 1,700 ........................ 1,050
* Please note that the same group of respondents may complete each form as necessary.
NHSC STUDENTS TO SERVICE LOAN REPAYMENT PROGRAM APPLICATION
Average
Number of
Number of Total burden per Total burden
Form name responses per
respondents responses response hours
respondent (in hours)
NHSC Students to Service Loan Repayment Program Ap-
plication ............................................................................ 100 1 100 2.0 200
Letters of Recommendation ................................................. 100 2 200 .50 100
Authorization To Release Information ................................. 100 1 100 .10 10
Acceptance/Verification of Good Standing Report .............. 100 1 100 .25 25
Verification of Disadvantaged Background Status .............. 25 1 25 .25 6.25
Post Graduate Training Verification Form ........................... 150 1 150 .50 75
Total .............................................................................. * 150 ........................ 679 ........................ 416.25
* Certain documents are submitted by a subset of respondents consistent with program requirements.
NATIVE HAWAIIAN HEALTH SCHOLARSHIP PROGRAM APPLICATION
Average
Number of
Number of Total burden per Total burden
Form name responses per
respondents responses response hours
respondent (in hours)
Native Hawaiian Health Scholarship Program Application .. 250 1 250 1.0 250
Letters of Recommendation ................................................. 250 2 500 .25 125
Authorization To Release Information ................................. 250 1 250 .25 62.50
Acceptance/Verification of Good Standing Report .............. 30 12 360 .25 90
Total .............................................................................. * 250 ........................ 1,360 ........................ 527.50
* Certain documents are submitted by a subset of respondents consistent with program requirements.
HRSA specifically requests comments DEPARTMENT OF HEALTH AND Request (ICR), described below, to the
on (1) the necessity and utility of the HUMAN SERVICES Office of Management and Budget
proposed information collection for the (OMB). Prior to submitting the ICR to
proper performance of the agency’s Health Resources and Services OMB, HRSA seeks comments from the
functions, (2) the accuracy of the Administration public regarding the burden estimate,
estimated burden, (3) ways to enhance below, or any other aspect of the ICR.
Agency Information Collection
the quality, utility, and clarity of the DATES: Comments on this ICR should be
Activities: Proposed Collection: Public
information to be collected, and (4) the received no later than May 26, 2017.
Comment Request; Ryan White HIV/
use of automated collection techniques ADDRESSES: Submit your comments to
AIDS Program Client-Level Data
or other forms of information Reporting System, OMB No. 0915– paperwork@hrsa.gov or mail the HRSA
technology to minimize the information 0323—Extension Information Collection Clearance
collection burden. Officer, Room 14N39, 5600 Fishers
AGENCY: Health Resources and Services Lane, Rockville, MD 20857.
Jason E. Bennett,
Administration (HRSA), Department of FOR FURTHER INFORMATION CONTACT: To
Director, Division of the Executive Secretariat. Health and Human Services (HHS). request more information on the
asabaliauskas on DSK3SPTVN1PROD with NOTICES
[FR Doc. 2017–05946 Filed 3–24–17; 8:45 am] proposed project or to obtain a copy of
ACTION: Notice.
BILLING CODE 4165–15–P the data collection plans and draft
SUMMARY: In compliance with the instruments, email paperwork@hrsa.gov
requirement for opportunity for public or call the HRSA Information Collection
comment on proposed data collection Clearance Officer at (301) 443–1984.
projects of the Paperwork Reduction Act SUPPLEMENTARY INFORMATION: When
of 1995, HRSA announces plans to submitting comments or requesting
submit an Information Collection information, please include the
VerDate Sep<11>2014 18:02 Mar 24, 2017 Jkt 241001 PO 00000 Frm 00048 Fmt 4703 Sfmt 4703 E:\FR\FM\27MRN1.SGM 27MRN1](https://thefederalregister.org/doc/82_FR_15282/page/2.svg)
Document Created: 2017-03-25 00:21:35
Document Modified: 2017-03-25 00:21:35
| Category | Regulatory Information | |
| Collection | Federal Register | |
| sudoc Class | AE 2.7: GS 4.107: AE 2.106: | |
| Publisher | Office of the Federal Register, National Archives and Records Administration | |
| Section | Notices | |
| Action | Notice. | |
| Dates | Comments on this ICR must be received no later than May 26, 2017. | |
| Contact | To request more information on the proposed project or to obtain a copy of the data collection plans and draft instruments, email [email protected] or call the HRSA Information Collection Clearance Officer at (301) 443-1984. | |
| FR Citation | 82 FR 15225 |
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