Supporting Statement for
Exchange Visitor Waiver Review Board
OMB#0990-0001
Nicole Greene
Department of Health and Human Services
Office of Global Health Affairs
200 Independence Avenue, S.W. 639-H
Washington, DC 20201
Phone: (202) 260-0399
Email: [email protected]
Version: 04/10
Supporting Statement for Exchange Visitor Waiver Review Board
OMB#0990-0001
A. Justification
Circumstances Making the Collection of Information Necessary
The Office of Global Health Affairs is requesting from OMB an approval for a reinstatement without change on a previous approved collection. Under the authority of the Mutual Educational and Cultural Exchange Act of 1961 (75Stat.527) and the Immigration and Nationality Act as amended (843 Stat.166), the Department of health and Human Services acts as an interested U.S. Government agency to request the Department of state to recommend to the Attorney General waiver of the two-year foreign residence requirement for exchange visitors under the Mutual Educational and Cultural Exchange Program. The Departments responsibilities are carried out by the Exchange Visitor Waiver Review Board in accordance with regulations published in 45 CFR Part 50 on December 19, 2002. We are requesting approval for the application form (HHS 426) and the supplementary information instructions.
The information requested by use of this form and supplementary information sheets (Supplement A-Research) and Supplement B-Clinical Care) is used by this Department to make a determination, in accordance with its published regulations, as to whether or not to request from the Department of State, a waiver of the two-year foreign residence requirement for applicants in the United states on a J-l visa. The J-l visa is an exchange visa which carried a two-year return home requirement.
Purpose and Use of Information Collection
Applicant institutions apply to this Department to request a waiver on behalf of foreign medical graduates to work in their medical facilities. Our current program deals with both research and clinical care waivers. Clinical care waivers allow medical centers, etc. to apply for a waiver of the residence requirement for physicians to work in HHS designated health manpower shortage areas doing primary care.
The instructions request a copy of Form G-28 from applicant institutions represented by legal counsel outside of the applying institution. Form G-28, a United States Department of Justice form, is needed so that the Department can ascertain that legal counsel is representing the applicant organization and not only the exchange visitor.
Use of Improved Information Technology and Burden Reduction
Not applicable at this time. However, the Office of Global Health Affairs, OS has begun to look into the possibility of setting up a web-based application process.
Efforts to Identify Duplication and Use of Similar Information
This information is not duplicative of another information collection. This is the only information collection in use by the Department, which is related to the application for waiver of the two-year foreign residence requirement for exchange visitors under the Mutual Educational and Cultural Exchange Program. There is no similar information available. Applications must be submitted on a case-by-case basis.
Impact on Small Businesses or Other Small Entities
The form and supplemental instructions were designed to impose minimal burden on all respondents. Submission of the application is voluntary, at the discretion of the applicant.
Consequences of Collecting the Information Less Frequent Collection
Information is not collected. The application is submitted on a voluntary single-time basis with one reconsideration allowed if application is denied by the Exchange Visitor Waiver Review Board after the initial review.
Special Circumstances Relating to the Guidelines of 5 CFR 1320.5
There are no special circumstances involving this information collection.
Comments in Response to the Federal Register Notice/Outside Consultation
A 60 day FR notice was published on April 02, 2010, pg # 16809, vol. #75. No comments received. This form, except for the current revisions, has been in use for more than 20 years, and we are unaware of any negative response.
Explanation of any Payment/Gift to Respondents
Not applicable.
Assurance of Confidentiality Provided to Respondents
Not applicable.
Justification for Sensitive Questions
Not applicable.
Estimates of Annualized Hour and Cost Burden
The Board has routinely received approximately 200 research applications a year. We are estimating that we will receive approximately 50 additional applications per year for clinical care. We estimate that it takes 10 hours to prepare and assemble the required information and complete each form. This represents 2500 total hours of respondent burden. The cost to all respondents would be $25,000 (2500 burden hours x $10)
12A. Estimated Annualized Burden Hours
Type of Respondent
|
Form Name
|
No. of Respondents |
No. Responses per Respondent |
Average Burden per Response (in hours) |
Total Burden Hours |
Application Waiver /Supplemental A Research
|
HHS 426 |
200 |
1 |
10 hours |
2000 |
Application Waiver /Supplemental B Clinical Care
|
HHS 426 |
50 |
1 |
10 hours |
500 |
Total |
|
|
|
|
2500
|
12B. Provide estimates of annualized cost to respondents for the hour burdens for collections of information, identifying and using appropriate wage rate categories. The cost to the federal government for contracting out or paying outside parties for information collection activities should not be included here. Instead this cost should be included in Item 14. The Department of Labor website can be used to determine appropriate wage rates for respondents.
Estimated Annualized Burden Costs
Type of Respondent
|
Total Burden Hours
|
Hourly Wage Rate
|
Total Respondent Costs
|
Research Applications |
2000 |
$10.00 |
$20,000.00 |
Clinical Care Applications |
500 |
$10.00 |
$5,000.00 |
Total |
|
|
$25,000.00 |
Estimates of other Total Annual Cost Burden to Respondents or Recordkeepers/Capital Costs
We estimate that if the applicant organization voluntarily retains the services of an attorney to prepare the application, their costs could range from $50 to $250 per hour. Using a figure of approximately 10 hours preparation time, the cost could range from $500 to $2500, or whatever the going rate from immigration attorneys might be - $10,000 to $20,000 per case. We are estimating that approximately one half of all the cases 250/2 125 x 10hrs.= total 1,250 hrs. x $250.00= $312,500.00 we will receive will be handled by an attorney.
Annualized Cost to Federal Government
One HHS staff member serves as Executive Secretary to the Board devoting approximately 1200 hours annually to the work of the Board. The Chairman of the Board spends approximately 20 hours annually on the Boards work and the three Board members spend approximately 520 each. In addition, HHS agency staff review applications and make recommendation the Board members, which represents a burden of approximately 520 hours.
The newest portion of this program devoted to clinical care positions requires funding for one FTE, totaling approximately $414,000 and Federal Credentialing checks totaling approximately $300,000 per year. A total amount of $714,000.
Explanation for Program Changes or Adjustments
There are no program changes or adjustments. It remains the same as the previous collections.
Plans for Tabulation and Publication and Project Time Schedule
Not applicable. The results will not be published for statistical use.
Reason(s) Display of OMB Expiration Date is Inappropriate
We are seeking OMB approval to not display the expiration date. Only about 500 will be used on an annual basis, not requiring frequent printing. Respondents may be confused if the only available forms have an expiration date indicating they are obsolete.
Exceptions to Certification for Paperwork Reduction Act Submissions
There are no exceptions to the certification.
Not applicable.
| File Type | application/msword |
| File Title | How to Write and Submit |
| Author | CMS |
| Last Modified By | DHHS |
| File Modified | 2010-07-14 |
| File Created | 2010-06-29 |