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:
0906-0073
ICR Reference No:
202508-0906-003
Status:
Active
Previous ICR Reference No:
202209-0906-002
Agency/Subagency:
HHS/HRSA
Agency Tracking No:
Title:
Scholarships for Disadvantaged Students Program Specific Form
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:
01/15/2026
Retrieve Notice of Action (NOA)
Date Received in OIRA:
08/21/2025
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
01/31/2029
36 Months From Approved
01/31/2026
Responses
340
0
2,392
Time Burden (Hours)
4,760
0
38,979
Cost Burden (Dollars)
0
0
0
Abstract:
The Health Resources and Services Administration (HRSA) seeks to collect data through the Scholarships for Disadvantaged Students (SDS) Program Specific Form. This data collection is essential for HRSA to advance its mission and close critical data gaps in program performance and long-term sustainability. The information will be collected from institutions that apply for SDS program awards. HRSA will use this information to: • Assess applicants' experience, need, and performance in strengthening the health workforce • Evaluate service and progress in serving target populations • Help grant reviewers and policymakers make informed decisions • Determine eligibility for the SDS program
Authorizing Statute(s):
US Code:
42 USC 293a
Name of Law: Scholarships for disadvantaged students
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:
90 FR 22494
05/28/2025
30-day Notice:
Federal Register Citation:
Citation Date:
90 FR 39399
08/15/2025
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
Program Specific Form
1
Program Specific Form
Scholarships for Disadvantaged Students Program Specific Data Forms
1 (Redline), 1
Scholarships for Disadvantaged Students Program Specific Data Forms
,
SDS Program Specific Data 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
340
2,392
0
-2,052
0
0
Annual Time Burden (Hours)
4,760
38,979
0
-34,219
0
0
Annual Cost Burden (Dollars)
0
0
0
0
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:
Miscellaneous Actions
Short Statement:
HRSA will move the BHW Program Specific Data Form to another ICR that reports data outcomes post grant award. As for average burden per response for the SDS Program Specific Form, SDS program staff conducted burden testing performed by eight grantees regarding the format, content of data to be collected, and time to complete the application and report. The SDS Program Specific Form was reduced from sixteen sections to seven sections. The program staff calculated the time for completion of the revised form at 14 hours based upon program experience and past grant recipient comments. This is a reduction from 31 hours in the prior ICR.
Annual Cost to Federal Government:
$189,323
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.
No
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.
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?
No
Agency Contact:
Laura Cooper 301 443-2126 lcooper@hrsa.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:
08/21/2025
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