ss 0230 2008.wpd

Health Resources and Services Administration

National Health Service Corps - Recruitment and Retention Assistance Application

SUPPORTING STATEMENT

A. Justification

1. Circumstances of Information Collection

This is a request for an extension without change of approval from the Office of Management and Budget (OMB) to the Health Resources and Services Administration’s (HRSA’s) existing site Recruitment and Retention Assistance Application, OMB Control Number 0915-0230. Approval for the current site application expires 08/31/2008. The legislative authority for the for the need for the information collected in this application is found in Section 333 [254f] (a)(1) of the Public Health Service Act.

The site application is designed to collect data from health care facilities/sites for use in determining the eligibility of clinical practice sites to employ National Health Service Corps (NHSC) supported health care professionals and to verify the need for NHSC supported health professionals at any particular site. Practice sites include Federally Qualified Health Centers (FQHCs), FQHC Look-Alikes, Rural Health Clinics, Indian Health Service Clinics, Public Health Departments, as well as a number of other practices and organizations which are described in the application instructions. These practice sites submit information using the application to become a NHSC clinical practice site.

The NHSC was established by Congress to eliminate Federally designated Health Professional Shortage Areas (HPSAs). HPSAs are geographic areas, facilities or population groups determined by the Secretary of Health and Human Services to have a shortage of health professionals. The NHSC provides funding support to encourage selected primary health care professionals to practice in HPSAs, and the Recruitment and Retention Application is the mechanism by which sites can be approved for NHSC Scholars and Loan Repayors.

To attract health care professionals to serve in HPSAs, the NHSC was authorized to assist selected primary health care professionals with education related costs or student loan repayment. Currently, NHSC Scholarships support the training of primary care physicians, nurse-midwives, nurse practitioners, physicians assistants and dentists. The NHSC Loan Repayment Program is available to the above identified health care professionals as well dental hygienists and Mental and Behavioral Health Professionals upon completion of their training. Both the Scholarship and Loan Repayment assistance programs incorporate a service obligation based on the level of support received.

Every year HRSA provides new scholarship awards and new loan repayment awards. In accordance with the authorizing legislation, HRSA is required to identify sites with vacancies at which Scholarship Recipients and Loan Repayment Program participants are authorized to fulfill their service obligation.

The NHSC Scholarship legislation requires the identification of a total number of site vacancies equal to not less than one but not more than two sites for each available Scholarship recipient in the placement year. The exact number of site vacancies will change throughout any one placement year in accordance with the number of available providers and vacancies.

In order to identify the required number of site vacancies the NHSC program must carefully review site applications. Each year approximately 2,900 new or renewal site applications are reviewed for eligibility to employ NHSC supported health care professionals. Those sites meeting the eligibility criteria are placed on vacancy listings which are made available to the current year health care professional placement cycle participants.

2. Purpose and Use of Information

The data contained in the site application facilitates the process of identifying and communicating the availability of clinical practice vacancies where Scholarship and Loan Repayment Program participants may fulfill their service obligation.

The Recruitment and Retention Assistance Application specifically identifies the current and long term needs of the sites, which facilitates the recruitment of necessary health care professionals; it also indicates the retention of NHSC clinicians who have fulfilled their service obligation and remained at the site.

Collection of site application data allows HRSA to determine the eligibility of the practice for approval as a service site for NHSC clinicians by providing information on full program activities and accomplishments as requested or required.

Information is collected that the program uses for recruitment and matching of clinicians to sites. This activity collects a limited set of information pertaining to the site itself and the different services and privileges that are available at the site. This information is posted online to provide clinicians with a more informative description of the sites that are available on the NHSC opportunities list.

3. Use of Improved Information Technology

The site application is fully electronic. Additional information is available on the NHSC web site at http://nhsc.bhpr.hrsa.gov/. The vacancy listings have been published on the NHSC web page. The web page is highly interactive and user friendly. Users can quickly identify, by discipline and specialty, all current vacancies, which are updated on a weekly basis.

4. Efforts to Avoid Duplication

The Recruitment and Retention Assistance Application does not duplicate any other application. This application is the only known mechanism which collects the site specific information that can be used for determining eligibility. The data involving staffing levels, NHSC providers needed, projected hire dates, users by certain categories, are not available from any other source. Such data are routinely compiled by the sites for internal management purposes.

5. Involvement of Small Entities

The information required in the application is the minimum amount necessary to determine eligibility and verify need for NHSC supported health care professionals. The information requested does not have a significant or substantial impact on small entities or small businesses.

6. Consequences If Information Collected Less Frequently

If the information were collected less frequently, the NHSC could not provide an accurate and comprehensive listing of clinical practice vacancies. In addition, there would be no method for the program to accurately report on the full scope of supported activities.

Following are three examples that support the need for the data:

A. Health care providers who are in the current year’s placement cycle are within one year of completing their education and training and do not have the time nor means to identify current vacancies on their own. If the NHSC did not facilitate the identification of sites in need a significant segment of the underserved populations would not receive health care services.

B. Data from the Application will be used by the NHSC for internal monitoring and evaluation of program operations and effectiveness. Such data will greatly assist the NHSC in placing health care professionals at sites with the greatest needs based on analysis of the data. The NHSC could identify trends in communities and/or parts of the country as to shifts in population profiles. This would allow the NHSC to respond by directing that more, less, and/or different types of services be provided as appropriate.

C. Based on experience with other data systems, the Application information would be utilized by a number of organizations in establishing national, State and local policy. Such organizations include the Department of Health and Human Services, HRSA, National Association of Community Health Centers (NACHC), National Rural Health Association, Migrant Health Association, American Public Health Association, and State and local governments.

7. Consistency with the Guidelines in 5 CFR 1320.6 (d) (2)

The data will be collected in a manner consistent with guidelines contained in 5 CFR 1320.6.

8. Consultation Outside the Agency

The notice required by 5 CFR 1320.8(d) was published in the Federal Register on April 30, 2008 (Vol. 73, No. 84, pages 23471-23472). No comments were received. Respondents who reviewed the Application for burden, comprehension, and format, are:

Good Samaritan Health Center

405 South Linden Avene

Canton, OH 44601

330-821-2263

Goshen Medical Center Inc

P.O. Box 187

Faison, NC 28341-0187

910-267-1942

9. Remuneration of Respondents

Respondents will not be remunerated.

10. Assurance of Confidentiality

No information identifying individuals is being collected.

11. Questions of a Sensitive Nature

There are no questions of a sensitive nature.

12. Estimates of Annualized Hour Burden

The following table summarizes the annual estimate of burden for completing the Application:

Hour and Cost Estimates

Form	Number of Respondents	Responses per Respondent	Total Responses	Hours per Response	Total hour Burden	Wage Rate	Total Hour Cost
Application	2900	1	2900	.5	1450	$18.00	$26,100

The estimates contained in the table reflect a continuation of the annual number of applicants at around 2,900. The information requested takes approximately 30 minutes to complete by a mid-level administrative staff person at a wage rate of $18.00 per hour.

13. Estimates of Annualized Cost Burden to Respondents

There are no capital or start-up costs nor are there any operation and maintenance costs.

14. Estimates of Annualized Cost to the Government

Based on experience with the Application, it is estimated that the annual cost to the Federal government for data verification and processing will be in the amount of $113,100.

15. Changes in Burden

There are no changes in the estimate of burden. The current burden for this activity in the OMB inventory of approved collections is for 2,900 respondents with 1,450 total burden hours.

16. Time Schedule, Publication and Analysis Plans

Time Schedule: applications are accepted throughout the calendar year, and are renewed every three years. Clinicians serve for fiscal years, from October 1 to September 30. Determination of site eligibility is made within approximately 4 weeks of the application submission. The official site list is published in September and is updated weekly on the Website.

Analysis Plans: Application information is reviewed for determination of eligibility as a NHSC Service Site; internal review of the information includes summarizing numbers of clinicians by discipline and specialty; number of rural and number of urban sites.

17. Exemption for Display of Expiration Date

No exemption is requested. The expiration date will be displayed.

18. Certifications

This information collection fully complies with the guidelines in 5 CFR 1320.9. The required certifications are included in the package.