View Information Collection Request (ICR) Package
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Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
0915-0140
ICR Reference No:
201101-0915-001
Status:
Historical Active
Previous ICR Reference No:
200902-0915-001
Agency/Subagency:
HHS/HSA
Agency Tracking No:
Title:
The Nursing Education Loan Repayment Program
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
04/25/2011
Retrieve Notice of Action (NOA)
Date Received in OIRA:
01/25/2011
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
04/30/2014
36 Months From Approved
04/30/2011
Responses
78,300
0
51,952
Time Burden (Hours)
48,925
0
40,528
Cost Burden (Dollars)
0
0
0
Abstract:
Approval is requested for the application and monitoring forms for the Nursing Education Loan Repayment Program (NELRP). Under the NELRP, registered nurses are offered the opportunity to enter into a contractual agreement to receive loan repayment for some of their qualifying education loan balances. This repayment is in exchange for agreeing to servie full-time as a registered nurse for 2-3 years at a health care facilitiy with a critical shortage of nurses.
Authorizing Statute(s):
US Code:
42 USC 297n
Name of Law: Public Health Service Act
PL:
Pub.L. 111 - 5 VIII
Name of Law: American Recovery and Reinvestment Act
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
75 FR 59720
09/28/2010
30-day Notice:
Federal Register Citation:
Citation Date:
75 FR 81623
12/28/2010
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
11
IC Title
Form No.
Form Name
Application Checklist and Self-Certification Form
NELRP_006
Application Checklist and Self-Verification Form
Authorization for Release of Employment Information Form
NELRP_006
Authorization for Release of Employment Information Form
Authorization to Release Information Form
NELRP_008
Authorization to Release Information Form
Certification Of Accreditation Status for School of Nursing Education Programs Form
NELRP_010
Certification Of Accreditation Status for School of Nursing Education Programs Form
Certification Regarding Debarment, Suspension, Disqualification and Related Matters Form
NELRP_009
Certification Regarding Debarment, Suspension, Disqualification and Related Matters Form
Employment Verification and Critical Shortage Facility Form
NELRP_003
Employment Verification and Critical Shortage Facility Form
Employment Verification for Nurse Faculty Appointment Form
NELRP_004
Employment Verification for Nurse Faculty Appointment Form
Loan Information and Verification Form
NELRP_2
Loan Information and Verification Form
Participant Semi-Annual Employment Verification Form
7
Emp Verification Form
Pre-Award Script
6
Pre-Award Script
The Nursing Education Loan Repayment Program Application
NELRP_001
Application Guidance and Forms
The Verification of Acceptance or Decline of Award form
NELRP_11
The Verification of Acceptance or Decline of Award form
ICR Summary of Burden
Total Approved
Previously Approved
Change Due to New Statute
Change Due to Agency Discretion
Change Due to Adjustment in Estimate
Change Due to Potential Violation of the PRA
Annual Number of Responses
78,300
51,952
0
-816
27,164
0
Annual Time Burden (Hours)
48,925
40,528
0
-204
8,601
0
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
Yes
Burden Increase Due to:
Miscellaneous Actions
Burden decreases because of Program Change due to Agency Discretion:
Yes
Burden Reduction Due to:
Changing Forms
Short Statement:
Currently, there are 29,800 burden hours in the OMB Inventory. The new request is for 48,925 hours, an increase of 19,125 hours. There is a substantial increase in burden resulting from a program change that increased the budget and a subsequent increase in interest and application to the program. The budget increase is expected to result in a significant increase in the number of applicants to program, from an estimated 5,000 respondents up to 8,000 respondents, an increase of 3,000 respondents.
Annual Cost to Federal Government:
$1,403,633
Does this IC contain surveys, censuses, or employ statistical methods?
No
Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002?
No
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
No
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
No
Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?
No
Is this ICR related to the Pandemic Response?
Uncollected
Agency Contact:
Amanda Cash 301 443-0208 amanda.cash@hrsa.hhs.gov
Common Form ICR:
No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control number;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
Certification Date:
01/25/2011
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