82 FR 27513 - Agency Information Collection Activities: Submission to OMB for Review and Approval; Public Comment Request; Information Collection Request Title: Application and Other Forms Utilized 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-Revision

DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration

Federal Register Volume 82, Issue 114 (June 15, 2017)

Page Range27513-27515
FR Document2017-12382

In compliance with the Paperwork Reduction Act of 1995, HRSA has submitted an Information Collection Request (ICR) to the Office of Management and Budget (OMB) for review and approval. Comments submitted during the first public review of this ICR will be provided to OMB. OMB will accept further comments from the public during the review and approval period.

Federal Register, Volume 82 Issue 114 (Thursday, June 15, 2017)
[Federal Register Volume 82, Number 114 (Thursday, June 15, 2017)]
[Notices]
[Pages 27513-27515]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2017-12382]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Resources and Services Administration


Agency Information Collection Activities: Submission to OMB for 
Review and Approval; Public Comment Request; Information Collection 
Request Title: Application and Other Forms Utilized 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--Revision

AGENCY: Health Resources and Services Administration (HRSA), Department 
of Health and Human Services.

ACTION: Notice.

-----------------------------------------------------------------------

SUMMARY: In compliance with the Paperwork Reduction Act of 1995, HRSA 
has submitted an Information Collection Request (ICR) to the Office of 
Management and Budget (OMB) for review and approval. Comments submitted 
during the first public review of this ICR will be provided to OMB. OMB 
will accept further comments from the public during the review and 
approval period.

DATES: Comments on this ICR should be received no later than July 17, 
2017.

ADDRESSES: Submit your comments, including the ICR Title, to the desk 
officer for HRSA, either by email to [email protected] or by 
fax to 202-395-5806.

FOR FURTHER INFORMATION CONTACT: To request a copy of the clearance 
requests submitted to OMB for review, email the HRSA Information 
Collection Clearance Officer at [email protected] or call (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 
Utilized 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--Revision
    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, postgraduate training, and 
compliance with program requirements. The revisions to this information 
collection request include the removal of two forms for the NHSC S2S 
LRP application section.
    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 (also 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 will enable BHW to 
make selection determinations for the competitive awards, and to 
monitor compliance with program requirements.
    Likely Respondents: Qualified students who are pursuing education 
and training in primary care health professions education and training, 
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 revision contributes to a reduction of 
burden of approximately 100 hours. The total annual burden hours 
estimated for this ICR are summarized in the table below.
Total Estimated Annualized Burden--Hours

[[Page 27514]]



                                      NHSC Scholarship Program Application
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                                                     Number of                    Average burden
            Form name                Number of     responses per       Total       per response    Total burden
                                    respondents     respondent       responses      (in hours)         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
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* Certain documents are submitted by a subset of respondents consistent with program requirements.


                           NHSC Awardees/Schools/Post Graduate Training Programs/Sites
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                                                     Number of                    Average burden
            Form name                Number of     responses per       Total       per response    Total burden
                                    respondents     respondent       responses      (in hours)         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
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* Please note that the same group of respondents may complete each form as necessary.


                           NHSC Students To Service Loan Repayment Program Application
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                                                     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..............
                                 -------------------------------------------------------------------------------
    Total.......................           * 150  ..............             525  ..............          341.25
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* Certain documents are submitted by a subset of respondents consistent with program requirements.


                             Native Hawaiian Health Scholarship Program Application
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                                                     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.



[[Page 27515]]

Jason E. Bennett,
Director, Division of the Executive Secretariat.
[FR Doc. 2017-12382 Filed 6-14-17; 8:45 am]
 BILLING CODE 4165-15-P


Current View
CategoryRegulatory Information
CollectionFederal Register
sudoc ClassAE 2.7:
GS 4.107:
AE 2.106:
PublisherOffice of the Federal Register, National Archives and Records Administration
SectionNotices
ActionNotice.
DatesComments on this ICR should be received no later than July 17, 2017.
ContactTo request a copy of the clearance requests submitted to OMB for review, email the HRSA Information Collection Clearance Officer at [email protected] or call (301) 443- 1984.
FR Citation82 FR 27513 

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