[Federal Register Volume 81, Number 167 (Monday, August 29, 2016)]
[Notices]
[Pages 59229-59230]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-20584]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Resources and Services Administration


Agency Information Collection Activities: Proposed Collection: 
Public Comment Request; the National Health Service Corps Loan 
Repayment Program

AGENCY: Health Resources and Services Administration, HHS.

ACTION: Notice.

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SUMMARY: In compliance with the requirement for opportunity for public 
comment on proposed data collection projects (Section 3506(c)(2)(A) of 
the Paperwork Reduction Act of 1995), the Health Resources and Services 
Administration (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 October 28, 
2016.

ADDRESSES: Submit your comments to [email protected] or mail the HRSA 
Information Collection Clearance Officer, 5600 Fishers Lane, Room 14N-
39, 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 ICR title for reference.
    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 NHSC-approved site located 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, and if 
applicable, 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 needed to collect information for 
all participants who have applied for that service option.
    NHSC-approved sites are health care facilities that provide 
comprehensive outpatient, ambulatory, primary health care services to 
populations residing in HPSAs. Related in-patient services may be 
provided by NHSC-approved Critical Access Hospitals (CAHs). In order to 
become an NHSC-approved site, new sites must submit a Site Application 
for review and approval. Existing NHSC-approved sites are required to 
complete a Site Recertification Application in order to maintain their 
NHSC-approved status. Both the NHSC Site Application and Site 
Recertification Application request information on the clinical service 
site, sponsoring agency, recruitment contact, staffing levels, service 
users, charges for services, employment policies, and fiscal management 
capabilities. Assistance in completing these applications may be 
obtained through the appropriate State Primary Care Offices and the 
NHSC. The information collected on the applications is used for 
determining the eligibility of sites for the assignment of NHSC health 
professionals and to verify the need for NHSC clinicians. NHSC service 
site approval is valid for 3 years. Sites wishing to remain eligible 
for the assignment of NHSC providers, must submit a Site 
Recertification Application every 3 years.
    The proposed ICR is a revision to OMB control number 0915-0127 
(NHSC LRP) by combining OMB control number 0915-0230 (NHSC Site 
Application) and adding a new form to the ICR entitled the NHSC 
Comprehensive Behavioral Health Services Checklist.
    Need and Proposed Use of the Information: The need and purpose of 
this information collection is to obtain information that is used to 
assess an LRP applicant's eligibility and qualifications for the LRP 
and to obtain information for NHSC site applicants. Clinicians 
interested in participating in the NHSC LRP must submit an application 
to the NHSC to participate in the program, and health care facilities 
located in HPSAs must submit an NHSC Site Application and Site 
Recertification Application to determine the eligibility of sites to 
participate in the NHSC as an approved service site. The NHSC LRP 
participant application asks for personal, professional and financial 
information needed to determine the applicant's eligibility to 
participate in the NHSC LRP. In addition, applicants must provide 
information regarding the loans for which repayment is being requested. 
NHSC policy requires behavioral health providers to practice in a 
community-based setting that provides access to comprehensive 
behavioral health services. Accordingly, for those sites seeking to be 
assigned behavioral health NHSC participants, additional site 
information collected from an NHSC Comprehensive Behavioral Health 
Services Checklist will be used. NHSC sites that do not directly offer 
all required behavioral health services must demonstrate a

[[Page 59230]]

formal affiliation with a comprehensive, community-based primary 
behavioral health setting or facility to provide these services.
    Likely Respondents: Likely respondents include the following: 
Licensed primary care medical, dental, and mental and behavioral health 
providers who are employed or seeking employment, and are interested in 
serving underserved populations; health care facilities interested in 
participating in the NHSC and becoming an NHSC-approved service site; 
NHSC sites providing behavioral health care services directly, or 
through a formal affiliation with a comprehensive community-based 
primary behavioral health setting or facility providing comprehensive 
behavioral health services.
    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.

                                     Total Estimated Annualized Burden Hours
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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
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NHSC LRP Application............           8,200               1           8,200               1           8,200
Authorization for Disclosure of            6,500               1           6,500             .10             650
 Loan Information Form..........
Privacy Act Release                          275               1             275             .10            27.5
 Authorization Form.............
Verification of Disadvantaged                600               1             600             .50             300
 Background Form................
Private Practice Option Form....             300               1             300             .10              30
NHSC Comprehensive Behavioral              4,000               1           4,000             .13             520
 Health Services Checklist......
NHSC Site Application (including           3,700               1           3,700              .5           1,850
 recertification)...............
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    Total.......................          23,575  ..............          23,575  ..............       11,577.50
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    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. 2016-20584 Filed 8-26-16; 8:45 am]
 BILLING CODE 4165-15-P