[Federal Register Volume 82, Number 3 (Thursday, January 5, 2017)]
[Notices]
[Pages 1352-1353]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-31723]


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

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; The National Health 
Service Corps Loan Repayment Program

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

ACTION: Notice.

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

SUMMARY: In compliance with Section 3507(a)(1)(D) of 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 February 
6, 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.
    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 an NHSC-approved site located in a 
federally-designated HPSA approved by the Secretary for LRP 
participants. The forms used 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). 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 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 HRSA's 
NHSC program office. 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 previously approved OMB number 0915-0230 (NHSC 
Site Application and Site Recertification Application forms) and adding 
a new form to the ICR called 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 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

[[Page 1353]]

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 
community-based settings that provide 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 is used. NHSC sites that do not directly offer all 
required behavioral health services must demonstrate a formal 
affiliation with a comprehensive, community-based primary behavioral 
health setting or facility to provide these services.
    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 underserved 
populations; health care facilities interested in participating in the 
NHSC and becoming an NHSC-approved service site; and 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 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 Information Collection Request 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           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)...............
                                 -------------------------------------------------------------------------------
    Total.......................          19,875  ..............          19,875  ..............       11,577.50
----------------------------------------------------------------------------------------------------------------
* The same respondents are completing the NHSC Comprehensive Behavioral Services Checklist and the NHSC Site
  Application.

    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.

Amy McNulty,
Deputy Director, Division of the Executive Secretariat.
[FR Doc. 2016-31723 Filed 1-4-17; 8:45 am]
 BILLING CODE 4165-15-P