The Nursing Scholarship Program

Forms and Documents

Document Name	Status
Form 1 The Nursing Scholarship Program Form and Instruction	Modified
Nursing Scholarship Program Supporting Statement.doc Supporting Statement A	2015-05-28
Attachment A - Nursing Legislation.pdf Supplementary Document	2012-06-21

IC Document Collections

IC ID	Document Title	Status
43610	The Nursing Scholarship Program Form and Instruction	Modified

ICR Details

OMB Control No: 0915-0301	ICR Reference No: 201504-0915-002
Status: Historical Active	Previous ICR Reference No: 201206-0915-004
Agency/Subagency: HHS/HSA	Agency Tracking No:
Title: The Nursing Scholarship Program
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 05/29/2015
	Date Received in OIRA: 04/15/2015
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2018	36 Months From Approved	08/31/2015
Responses	8,050	0	5,700
Time Burden (Hours)	6,891	0	10,200
Cost Burden (Dollars)	0	0	0

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Abstract: The Nursing Scholarship Program's purpose is to provide scholarships to nursing students in exchange for a service commitment at an eligible health facility with a critical shortage of nurses. Under this program, students seeking to become registered nurses are offered the opportunity to enter into a contractural agreement under which HHS agrees to pay the total school tuition required fees, and a stipend for living expenses.

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Authorizing Statute(s): US Code: 42 USC 846 Name of Law: Public Health Service Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 6732	02/06/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 19324	04/10/2015
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
The Nursing Scholarship Program	2, 7, 8, 9, 1, 3, 4, 5, 6	Eligible Application ,   NCSP APG ,   Graduation Close Out Form ,   Confirmation of Interest Form ,   Contract ,   DCW ,   School Enrollment Verification Form ,   Initial Employment Verification Form ,   Participant Service Verification

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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	8,050	5,700	0	2,350	0	0
Annual Time Burden (Hours)	6,891	10,200	0	-3,309	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: The total burden hours have been changed as result of a decrease in the average number of eligible applications from 2012-2014. This is a result of incomplete or ineligible applications not being processed by the online application system allowing the application process to be streamlined and more efficient than the previous paper applications which had been mailed or faxed prior to implementation of the online system. This is a request for a revision as the implementation of the BHW Management Information System Solution as the vehicle to collect online applications has been enhanced with improved IT functionality allowing more forms to be submitted electronically to verify service by the participant and employer, allow recommendation letters to be submitted online, and to allow electronic submission of participants' banking information for stipend payments which previously had to be uploaded.

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Annual Cost to Federal Government: $91,721

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

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Common Form ICR:  No

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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: 04/15/2015

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