[Federal Register Volume 78, Number 224 (Wednesday, November 20, 2013)]
[Pages 69696-69697]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2013-27840]



Health Resources and Services Administration

Agency Information Collection Activities: Submission to OMB for 
Review and Approval; Public Comment Request

AGENCY: Health Resources and Services Administration, HHS.

ACTION: Notice.


SUMMARY: In compliance with Section 3507(a)(1)(D) of the Paperwork 
Reduction Act of 1995, the Health Resources and Services Administration 
(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 within 30 days of this 

ADDRESSES: Submit your comments, including the Information Collection 
Request 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-

    Information Collection Request Title: The National Health Service 
Corps Loan Repayment Program.
    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 the neediest 
Health Professional Shortage Areas (HPSAs) of the United States. Under 
this program, the Department of Health and Human Services 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 a federally designated HPSA approved by the 
Secretary for LRP participants. The forms utilized by the LRP include 
the following: The NHSC LRP Application, the Authorization for 
Disclosure of Loan Information form, the Privacy Act Release 
Authorization form, the Verification of Disadvantaged Background form, 
and the Private Practice Option form. The first four of the 
aforementioned NHSC LRP forms collect information that is needed for 
selecting participants and repaying qualifying educational loans. The 
last referenced form, the Private Practice Option Form, is required by 
statute (42 U.S.C. 254n(a)) for all participants wishing to exercise 
that service option.
    Need and Proposed Use of the Information: The need and purpose of 
this information collection is to obtain information for the NHSC LRP 
application. The information is used to consider an applicant for a 
NHSC LRP contract award. Applicants must submit an application to the 
NHSC to participate in the program. The application asks for personal, 
professional, and financial information required to determine the 
applicant's eligibility to participate in the NHSC LRP. In addition, 
applicants must enter in information regarding the loans for which 
repayment is being requested.
    Likely Respondents: Licensed primary care medical, dental, and 
mental and behavioral health providers who are employed or seeking 
employment, and are interested in serving underserved populations.
    Burden Statement: Burden in this context means the time expended by 
persons to generate, maintain, retain,

[[Page 69697]]

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.

                                    Total Estimated Annualized Burden--Hours
                                                     Number of                    Average burden
            Form name                Number of     responses per       Total       per response    Total burden
                                    respondents     respondent       responses      (in hours)         hours
NHSC LRP Application............           8,200               1           8,200             1.0           8,200
Authorization for Disclosure of              150               1             150             .10              15
 Loan Information Form..........
Privacy Act Release                          100               1             100             .10              10
 Authorization Form.............
Verification of Disadvantaged                600               1             600             .50             300
 Background Form................
Private Practice Option Form....             300               1             300             .10              30
    Total.......................           9,350  ..............           9,350  ..............           8,555

    Dated: November 12, 2013.
Bahar Niakan,
Director, Division of Policy and Information Coordination.
[FR Doc. 2013-27840 Filed 11-19-13; 8:45 am]