SUPPLEMENTARY INFORMATION:

When submitting comments or requesting information, please include the ICR title for reference.

Information Collection Request Title: The National Health Service Corps Loan Repayment Programs, OMB No. 0915-0127—Revision.

Abstract: The National Health Service Corps (NHSC) Loan Repayment Program (LRP) was established to assure an adequate supply of trained primary care health professionals to provide services in Health Professional Shortage Areas (HPSAs) of the United States with the greatest need. The NHSC Substance Use Disorder Workforce LRP and the NHSC Rural Community LRP were established to recruit and retain a health professional workforce with specific training and credentials to provide evidence-based substance use disorder treatment in HPSAs. Under these programs, HHS agrees to repay the qualifying educational loans of selected primary care health professionals. In return, the health professionals agree to serve for a specified period of time in an NHSC-approved site located in a federally-designated HPSA approved by the Secretary of HHS for NHSC LRP participants. ( printed page 55610)

The forms used by each NHSC LRP include the following: (1) the NHSC LRP Application; (2) the Authorization for Disclosure of Loan Information Form; (3) the Privacy Act Release Authorization Form, and, if applicable; (4) the Certification of Vulnerable Background Form; (5) the Private Practice Option Form; (6) the NHSC Comprehensive Behavioral Health Services Checklist; (7) the NHSC Spanish Language Assessment Proficiency Test Form; and (8) the NHSC Site Application. The first four of these NHSC LRP forms collect information that is needed for selecting participants and repaying qualifying educational loans. The Private Practice Option and Spanish Language Assessment forms are needed to collect information from applicants who wish to be considered for those options. The NHSC Comprehensive Behavioral Health Services Checklist collects information to ascertain whether behavioral health providers are practicing in a community-based setting that provides access to comprehensive behavioral health services. The NHSC Site Application collects information used for determining the eligibility of sites for the assignment of NHSC health professionals and to verify the need for NHSC clinicians.

In this revision, the NHSC seeks to update the terminology with respect to Disadvantaged Background and accompanying definitions. More specifically, the Verification of Disadvantaged Background Form, which is used to determine whether an applicant qualifies for a funding priority on the basis that the applicant is from a disadvantaged background (42 U.S.C. 254l-1(d)(2)(C)), has been changed in the following ways: updated the name to “Certification of Vulnerable Background”, updated “disadvantaged” to “vulnerable”, and updated “educational/environmental and or economic factors” to “educationally/geographically vulnerable background” and “economically vulnerable background.” These changes are being made to align with the Administration's priority of reinforcing programs that direct resources to areas of greatest need to improve health outcomes.

Previously, the NHSC used the same definition of “disadvantaged background” as that used by the Scholarships for Disadvantaged Students Program, which is authorized by Sec. 737 of the Public Health Service Act (42 U.S.C. 293a). HRSA's use of “vulnerable background” operationalizes the statutory term by identifying individuals whose geographic or economic circumstances inhibited them from obtaining the knowledge, skills, and abilities required to enroll in and graduate from an eligible health profession school. This approach remains consistent with the statute's intent while incorporating more current terminology. These updates were made throughout the revised Certification of Vulnerable Background Form to improve consistency and help ensure that applicants and reviewers understand the criteria using current terminology.

NHSC will define “vulnerable background” as “coming from an educationally/geographically vulnerable background or an economically vulnerable background that has inhibited the individual from obtaining the knowledge, skills, and abilities required to enroll in and graduate from a health profession school.”

NHSC will define “educationally/geographically vulnerable background” as “a background that has inhibited the individual from obtaining the knowledge, skills, and abilities required to enroll in and graduate from a health profession school, or from a program providing education or training in an allied health profession.” Examples of indicators that an individual comes from an educationally/geographically vulnerable background include, but are not limited to:

• Attending/graduating from a high school with low average SAT/ACT scores or below the average state test results.
• Having lived in a school district where 50 percent or less of graduates go to college.
• Diagnosed with a physical or mental impairment that substantially limits participation in educational experiences.
• Having a primary language other than English and for whom language is still a barrier to academic performance.
• Being the first generation to attend college.
• Attending/graduating from a high school where at least 30 percent of enrolled students are eligible for free or reduced-price lunches.
• Being from a rural, remote, or geographically isolated community where access to quality education, health care, transportation, or broadband is limited.

NHSC will define “economically vulnerable background” as:

• Coming from a family with an annual income that does not exceed 200 percent of the HHS Poverty Guidelines. A family is a group of two or more individuals related by birth, marriage, or adoption who live together, or an individual who is not living together with any relatives.

Need and Proposed Use of the Information: The need and proposed use of this information collection is to assess an NHSC LRP applicant's eligibility and qualifications for the NHSC LRP, and to determine NHSC LRP applicants' Spanish language proficiency if relevant to their application, and to obtain information for NHSC site applicants. The NHSC LRP application asks for personal, professional, and financial/loan information.

Likely Respondents: Likely respondents include licensed primary care medical, dental, and behavioral health providers who are employed or seeking employment and are interested in serving in HPSAs.

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 table below.

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.

91 FR 55609