[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
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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