Faculty Loan Repayment Program Application

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
30 day FRN.pdf	Supplementary Document	Uploaded 2015-09-21	Available
60-day FRN.pdf	Supplementary Document	Uploaded 2015-09-21	Available
Attachment A - FLRP Authorizing Legislation.docx	Supplementary Document	Uploaded 2015-08-03	Available
FINALFLRP Supporting Statement_clean.doc	Supporting Statement A	Uploaded 2015-09-22	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
6381	Faculty Loan Repayment Program Application	Instruction	Modified

ICR Details

OMB Control No: 0915-0150	ICR Reference No: 201508-0915-001
Status: Historical Active	Previous ICR Reference No: 201208-0915-002
Agency/Subagency: HHS/HSA	Agency Tracking No:
Title: Faculty Loan Repayment Program Application
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: 09/30/2015
	Date Received in OIRA: 08/04/2015
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2018	36 Months From Approved	10/31/2015
Responses	222	0	912
Time Burden (Hours)	250	0	684
Cost Burden (Dollars)	0	0	0

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Abstract: The purpose of the Faculty Loan Repayment Program is to attract disadvantaged health professionals into faculty positions in accredited health professions schools by offering to make partial payments on education loans. In exchange, the graduate health professional agrees to have a contract with an accredited health professions school to serve as a faculty member for a minimum of two years. All FLRP application information is electronic and is essential to determine the applicants' eligibility and the creditability of existing undergraduate and/or graduate health professional educational loans. The respondents are full-time or part-time faculty members and administrators at schools of health professions.

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Authorizing Statute(s): PL: Pub.L. 105 - 392 738(a) Name of Law: Health Professions Education Partnerships Act of 1998
   US Code: 42 USC 293b 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 63	04/02/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 140	07/22/2015
Did the Agency receive public comments on this ICR? No

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

table that charts list of burden

IC Title	Form No.	Form Name
Faculty Loan Repayment Program Application	1, 2, 3	Authorization to Release Information Form ,   Institution Loan Repayment Form ,   FLRP Contract Form

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ICR Summary of Burden

table that charts list 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	222	912	0	-690	0	0
Annual Time Burden (Hours)	250	684	0	-434	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: Using Information Technology

Short Statement: The total burden hours for this activity are 250 hours. This is a decrease from the previously approved annual burden of 684 hours. This decrease is due to a program adjustment and minor change in the electronic application format, which incorporated a majority of the required supporting, screened for ineligible or incomplete applications and supplemental documents as part of the electronic submission of the application.

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Annual Cost to Federal Government: $184,943

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: 08/04/2015

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