[Federal Register Volume 82, Number 57 (Monday, March 27, 2017)]
[Notices]
[Pages 15225-15226]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2017-05946]



[[Page 15225]]

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

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Resources and Services Administration


Agency Information Collection Activities: Proposed Collection: 
Public Comment Request; Information Collection Request Title: 
Application and Other Forms Used 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--Extension

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

ACTION: Notice.

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

SUMMARY: In compliance with the requirement for opportunity for public 
comment on proposed data collection projects of the Paperwork Reduction 
Act of 1995, 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 May 26, 
2017.

ADDRESSES: Submit your comments to [email protected] or mail them to 
the HRSA Information Collection Clearance Officer, Room 14N-29, 5600 
Fishers Lane, 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 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 
Used 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--Extension
    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, post graduate training, and 
compliance with program requirements.
    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 (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 enable BHW to make 
selection determinations for the competitive awards and monitor 
compliance with program requirements.
    Likely Respondents: Qualified students who are pursuing education 
and training in primary care health professions 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 total annual burden hours estimated for 
this ICR are summarized in the tables below.

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


[[Page 15226]]


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


                           NHSC Students to Service Loan Repayment Program Application
----------------------------------------------------------------------------------------------------------------
                                                     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..............
Post Graduate Training                       150               1             150             .50              75
 Verification Form..............
----------------------------------------------------------------------------------------------------------------
    Total.......................           * 150  ..............             679  ..............          416.25
----------------------------------------------------------------------------------------------------------------
* Certain documents are submitted by a subset of respondents consistent with program requirements.


                             Native Hawaiian Health Scholarship Program Application
----------------------------------------------------------------------------------------------------------------
                                                     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.

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. 2017-05946 Filed 3-24-17; 8:45 am]
 BILLING CODE 4165-15-P