[Federal Register Volume 84, Number 195 (Tuesday, October 8, 2019)]
[Notices]
[Pages 53740-53742]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-21903]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Resources and Services Administration


Proposed Changes to the Scholarships for Disadvantaged Students 
Program

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

ACTION: Notice.

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SUMMARY: On May 22, 2019, HRSA published a 30-day notice in the Federal 
Register soliciting feedback on a range of issues pertaining to the 
Scholarships for Disadvantaged Students (SDS) Program to assist the 
agency in updating certain SDS policies. HRSA requested feedback on 
adjusting funding allocations to respond to projected workforce 
shortages, transitioning data collection from 1 year of data to a 3-
year average to demonstrate eligibility, and increasing the maximum 
scholarship award from $30,000 to $40,000. As a result of HRSA's 
comprehensive review of existing policies, and taking into 
consideration the comments received, HRSA is issuing this final notice.

ADDRESSES: Further information on SDS Program is available at https://bhw.hrsa.gov/loansscholarships/schoolbasedloans/sds.

FOR FURTHER INFORMATION CONTACT: Denise Sorrell, SDS Project Officer, 
Division of Health Careers and Financial Support, Bureau of Health 
Workforce, HRSA, 5600 Fishers Lane, Room 15N78, Rockville, Maryland 
20857, phone (301) 443-2909, or email [email protected].

SUPPLEMENTARY INFORMATION: SDS Program is authorized by Public Health 
Service Act (PHS Act) section 737 and administered by HRSA. On May 22, 
2019, through a Federal Register Notice (Volume 84, Number 99, pp. 
23571-23572), HRSA solicited input on proposed SDS policy changes. HRSA 
received comments on the proposed funding allocation and 3-year data 
requirement in response to the solicitation for feedback.

Comments on the Proposed Changes to the SDS Program

    HRSA received four comments from two nursing associations, one 
physician assistant association, and one primary care physician 
assistant program.

Funding Allocation

Summary of Comments

    Commenters provided a variety of input on funding allocations among 
health profession disciplines. One commenter suggested that funding 
allocated to schools of nursing should be reduced or eliminated. Others 
expressed concerns that reductions in

[[Page 53741]]

funding to schools of nursing would reduce opportunities for associate 
and bachelor's degree nurses, reduce funding to registered nurses (RNs) 
to Bachelor of Science in Nursing degree programs, and negatively 
affect nursing shortages. Additionally, one commenter expressed concern 
that awarding funding based on projected shortages could be less 
effective in placing SDS graduates in underserved communities.

Response

    Section 740(a) of the PHS Act requires that schools of nursing 
receive at least 16 percent of SDS funding. The SDS program may fund 
students pursuing a broad range of health professions careers under its 
statutory eligibility provisions. HRSA's National Center for Workforce 
Analysis (NCHWA) which provides HRSA with national health workforce 
projections, highlights that the inequitable distribution of RNs 
causing some states to experience an oversupply and others a 
shortage.\1\ Although most states have enough or an oversupply of RNs, 
seven states will have a shortage of RNs.\2\ To address the 
maldistribution of nurses, HRSA continues to provide funding to 
academic institutions, community-based organizations, nursing students, 
and clinicians and faculty through other workforce programs, such as 
the Nurse Corps Scholarship and Loan Repayment Programs; Nurse 
Education, Practice, Quality and Retention Program; and the Nursing 
Workforce Diversity Program. These programs also provide educational 
opportunities to RNs with associate and bachelor's degrees in nursing. 
Specifically, the Nurse Corps Scholarship program provides financial 
assistance to RNs seeking to obtain an associate, bachelor's, or 
master's degree in nursing. Since the SDS statute authorizes funding a 
wide range of health professions programs, the SDS program must balance 
the workforce needs of the nursing professions with those of other 
health professions. Consequently, allocating funding based on projected 
health professional shortage data allows SDS to support all health 
professions as equitably as possible, as demand for certain professions 
changes over time.
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    \1\ U.S. Department of Health and Human Services, Health 
Resources and Services Administration, National Center for Health 
Workforce Analysis. 2017. National and Regional Supply and Demand 
Projections of the Nursing Workforce: 2014-2030. Rockville, 
Maryland. Available at: https://bhw.hrsa.gov/sites/default/files/bhw/nchwa/projections/NCHWA_HRSA_Nursing_Report.pdf.
    \2\ Ibid.
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    HRSA also remains committed to supporting clinicians in rural and 
underserved communities. SDS applicants with a record of placing 
students in medically underserved communities are still eligible to 
receive a funding priority, and the policy changes outlined in this 
notice related to funding allocations will not impact the funding 
priority.

3-Year Data Exception

Summary of Comment

    HRSA received one comment regarding allowing an exception to the 3-
year data requirement for new health professions programs that have 
fewer than 3 years of enrollment data but that are otherwise able to 
demonstrate success in recruiting disadvantaged students.

Response

    HRSA has considered this comment and agrees that it could give an 
unfair advantage to established programs to require 3 years of data 
from all applicants. To address this concern, as outlined below, the 
SDS program will allow an exception to this requirement for newly 
established schools with less than 3 years of data.

SDS Policy Update

    The following final policy describes the updates HRSA will be 
making to the SDS program in order to increase the impact of the 
program.
    1. In an effort to combat workforce shortages, HRSA will distribute 
SDS funding to award recipients consistent with promoting health 
professions careers projected to experience the most severe shortages 
as determined by the NCHWA. Professions that have shortage projections 
may receive an increased share of SDS, while professions with an 
oversupply may receive a reduced share of funds. Precise distributions 
for each competition will be announced in the relevant Notice of 
Funding Opportunity, which will allow HRSA to ensure program funds are 
supporting the professions most in need of these awards. Section 740(a) 
of the PHS Act requires HRSA to distribute at least 16 percent of SDS 
funding to nursing schools. Section 737 permits the SDS program to fund 
a broad range of health professions programs. This adjustment of 
funding will allow HRSA to support the broad range of health 
professions included in section 737 and to target strategically SDS 
funding for the health professions with a current or projected 
workforce shortage. This new policy allows the SDS program to be 
responsive to changing workforce needs, as well as support programs 
with a strong record of placing graduates in medically underserved 
communities.
    2. To be eligible for SDS at least 20 percent of the school's full-
time enrolled students and graduates must be from a disadvantaged 
background. Applicants are currently required to provide 1 year of data 
to demonstrate this eligibility requirement. Beginning with the next 
grant funding cycle, applicants must provide the average for the most 
recent 3-year period to demonstrate their eligibility. A 3-year average 
is a more accurate portrayal of school enrollment patterns than 1 year. 
This change will allow SDS to support the grantees who have 
demonstrated a commitment over time to serving students from 
disadvantaged backgrounds. The SDS program will allow an exception for 
newly established schools, that is, schools that have not been in 
existence long enough to have 3 years of enrollment and graduation 
data. However, these schools will be required to demonstrate that at 
least 20 percent of the school's full-time students are students from 
disadvantaged backgrounds, through providing data from 2 years of 
student enrollment, and at least 1 year of graduation data. Further 
details about this exception will be provided in the next Notice of 
Funding Opportunity. Any future changes to the disadvantaged student 
percentage or data collection period will be announced through the SDS 
Notice of Funding Opportunity for the relevant grant funding cycle.
    3. HRSA has analyzed SDS award data, compared it with performance 
measures, and discovered that providing amounts to students to cover a 
substantial portion of their education costs positively correlates with 
better graduation rates, consistent with the statutory aims. Data 
suggests the lack of availability or low amounts of scholarships, 
especially for disadvantaged students, continues to limit educational 
opportunities for students \3\. SDS last increased its scholarship 
amount in 2016. Without sufficient financial support, disadvantaged 
students are much more likely to be unable to complete successfully 
their education. Based on this understanding and the steady increase in 
tuition rates nationally, HRSA will increase the maximum

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scholarship award to $40,000 per student, to ensure the SDS program 
will continue to impact students who receive the awards and ensure 
their success in completing the program. HRSA also reserves the right 
to adjust the scholarship award amount as necessary to reflect future 
increases in tuition rates nationwide and will announce any such 
changes in the Notice of Funding Opportunity for the relevant funding 
cycle.
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    \3\ ``Indicators of Higher Education Equity in the United 
States.'' The Pell Institute for the Study of Opportunity in Higher 
Education, Penn Ahead-Alliance for Higher Education and Democracy 
(2015): 1-60. http://www.pellinstitute.org/downloads/publications-Indicators_of_Higher_Education_Equity_in_the_US_45_Year_Trend_Report.pdf.
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    HRSA will announce any future administrative changes to the SDS 
program through the relevant Notice of Funding Opportunity.

    Dated: September 30, 2019.
Thomas J. Engels,
Acting Administrator.
[FR Doc. 2019-21903 Filed 10-7-19; 8:45 am]
BILLING CODE 4165-15-P