View Information Collection Request (ICR) Package
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View Supporting Statement and Other Documents
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:
201403-0915-003
Status:
Historical Active
Previous ICR Reference No:
201101-0915-001
Agency/Subagency:
HHS/HSA
Agency Tracking No:
21547
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 with change
Conclusion Date:
04/21/2014
Retrieve Notice of Action (NOA)
Date Received in OIRA:
03/17/2014
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
04/30/2017
36 Months From Approved
04/30/2014
Responses
21,100
0
78,300
Time Burden (Hours)
14,400
0
48,925
Cost Burden (Dollars)
4,125
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):
PL:
Pub.L. 111 - 5 VIII
Name of Law: American Recovery and Reinvestment Act
US Code:
42 USC 297n
Name of Law: Public Health Service 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:
78 FR 77136
12/20/2013
30-day Notice:
Federal Register Citation:
Citation Date:
79 FR 11799
03/03/2014
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
4
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
2
Authorization to Release Employment Information Form
Authorization to Release Information Form
1
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
4
ISV
The Nursing Education Loan Repayment Program Application
3
Application
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
21,100
78,300
0
-57,200
0
0
Annual Time Burden (Hours)
14,400
48,925
0
-34,525
0
0
Annual Cost Burden (Dollars)
4,125
0
0
4,125
0
0
Burden increases because of Program Change due to Agency Discretion:
No
Burden Increase Due to:
Burden decreases because of Program Change due to Agency Discretion:
Yes
Burden Reduction Due to:
Changing Forms
Short Statement:
Currently, there are 48,925 burden hours in the OMB Inventory. The new request is for 14,400 hours, a decrease of 34,525 hours. This substantial decrease in burden accounts for the streamlined application. The current online application incorporates a majority of the supporting and supplemental documents, thereby significantly reducing the number of burden hours spent by respondents.
Annual Cost to Federal Government:
$970,464
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:
Jodi Duckhorn 301 443-1984
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:
03/17/2014
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