View Information Collection Request (ICR) Package
Skip to main content
An official website of the United States government
The .gov means it's official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.
The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.
Search:
Agenda
Reg Review
ICR
This script is used to control the display of information in this page.
Display additional information by clicking on the following:
All
Brief and OIRA conclusion
Abstract/Justification
Legal Statutes
Rulemaking
FR Notices/Comments
IC List
Burden
Misc.
Common Form Info.
Certification
View Information Collection (IC) List
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:
2900-0793
ICR Reference No:
202212-2900-003
Status:
Active
Previous ICR Reference No:
201904-2900-004
Agency/Subagency:
VA
Agency Tracking No:
2900-0793
Title:
VA Health Professional Scholarship Programs (HPSP, VIOMPSP, VHVMAESP and EACFMAF)
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
Yes
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
03/30/2023
Retrieve Notice of Action (NOA)
Date Received in OIRA:
02/17/2023
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
03/31/2026
36 Months From Approved
03/31/2023
Responses
1,950
0
1,800
Time Burden (Hours)
7,619
0
6,996
Cost Burden (Dollars)
0
0
0
Abstract:
This is a currently approved collection of forms that are used by VHA to administer four health care professional scholarship programs. The Department of Veterans Affairs (VA) Health Professional Scholarship Program (HPSP) and the VA Visual Impairment and Orientation and Mobility Professionals Scholarship Program (VIOMPSP) were authorized under Public Law 111-163 on May 5, 2010 and extended through December 31, 2033, by Section 301 of P.L. 115-182, VA Mission Act of 2018. On June 6, 2018, section 304 of Public Law 115-182, the John S. McCain III, Daniel K. Akaka, and Samuel R. Johnson VA Maintaining Internal Systems and Strengthening Integrated Outside Networks Act of 2018, or the VA MISSION Act of 2018, established the Veterans Healing Veterans Medical Access and Education Scholarship Program (VHVMAESP). The VA Educational Assistance for Certain Former Members of the Armed Forces (EACFMAF) Program was authorized under section 246 of Public Law 115-141, Consolidated Appropriations Act of 2018. Legal authority for this data collection is also found under 38 U.S.C., Part I, Chapter 5, §527, which authorizes the collection of data that will allow measurement and evaluation of VA programs, the goal of which is improved health care for Veterans, and under 38 CFR §17.600-17.612 (HPSP), §17.625-17.636 (VIOMPSP), §17.613-17.618 (VHVMAESP), and §17.535-17.539 (EACFMAF). These programs help address health care workforce needs and allow VA to provide services to the public by awarding scholarships to non-VA employees who will be required to become VA employees in the professions for which they were educated under these programs. This information collection is necessary for VA to determine an applicant's eligibility to receive a scholarship award and compliance with program requirements.
Authorizing Statute(s):
US Code:
38 USC Part 1, Chapter 5, Section 527
Name of Law: Measurement and Evaluation of DVA Programs
PL:
Pub.L. 115 - 182 301
Name of Law: The VA Mission Act of 2018
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:
87 FR 76102
12/12/2022
30-day Notice:
Federal Register Citation:
Citation Date:
88 FR 10215
02/16/2023
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
1
IC Title
Form No.
Form Name
VA Health Professional Scholarship and Visual Impairment and Orientation and Mobility Professional Scholarship Pr
VA Form 10-0491a, VA Form 10-0491c, VA Form 10-0491d, VA Form 10-0491e, VA Form 10-0491f, VA Form 10-0491g, VA Form 10-0491h, VA form 10-0491, VA Form 10-0491i, VA Form 10-0491j, VA Form 10-0491k, VA Form 10-0491L, VA Form 10-0491m, VA Form 10-0491n
HPSP/VIOMPSP Academic Verification
,
HPSP/VIOMPSP Addendum to Application
,
HPSP/VIOMPSP Annual VA Employment Deferment Verification
,
HPSP/VIOMPSP Education Program Completion Notice_Service Obligation Placement
,
HPSP/VIOMPSP Evaluation Recommendation Form
,
HPSP Agreement
,
HPSP/VIOMPSP Application
,
HPSP/VIOMPSP Notice of Approaching Graduation
,
HPSP/VIOMPSP Notice of Change and/or Annual Academic Status Report
,
HPSP/VIOMPSP Request for Deferment for Advanced Education
,
HPSP/VIOMPSP VA Scholarship Offer Response
,
VIOMPSP Agreement
,
HPSP/VIOMPSP Mobility Agreement
,
HPSP VHVMAESP Agreement
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
1,950
1,800
0
150
0
0
Annual Time Burden (Hours)
7,619
6,996
0
623
0
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:
No
Burden Reduction Due to:
Short Statement:
This is a revision to an approved collection for a renewal of the PRA clearance and includes the following Health Professional Scholarship Programs: HPSP, VIOMPSP, VHVMAESP, and EACFMAF. Burden hours have been adjusted based upon program data.
Annual Cost to Federal Government:
$12,094,100
Does this IC contain surveys, censuses, or employ statistical methods?
No
Does this ICR request any personally identifiable information (see
OMB Circular No. A-130
for an explanation of this term)? Please consult with your agency's privacy program when making this determination.
Yes
Does this ICR include a form that requires a Privacy Act Statement (see
5 U.S.C. §552a(e)(3)
)? Please consult with your agency's privacy program when making this determination.
Yes
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?
No
Agency Contact:
Frances O'Donnell 703 405-2449 fran.odonnell@cathexiscorp.com
Common Form ICR:
Yes
Description/Changes for Common Form Usage:
This information collection will not use common forms.
Approved RCFs using this ICR
Agency/Sub Agency
RCF ID
RCF Title
RCF Status
IC Title
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:
02/17/2023
An official website of the United States government
The .gov means it's official.
The site is secure.
