Nurse Anesthetist Traineeship (NAT) Program

Forms and Documents

Document Name	Status
Form 1 NAT Forms Form and Instruction	Modified
NAT FY 2017 Supporting_Statement__.docx Supporting Statement A	2017-01-12

IC Document Collections

IC ID	Document Title	Status
209481	NAT Forms Form and Instruction	Modified

ICR Details

OMB Control No: 0915-0374	ICR Reference No: 201701-0915-004
Status: Historical Active	Previous ICR Reference No: 201311-0915-005
Agency/Subagency: HHS/HSA	Agency Tracking No: 20938
Title: Nurse Anesthetist Traineeship (NAT) 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: 03/09/2017
	Date Received in OIRA: 01/13/2017
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2020	36 Months From Approved	03/31/2017
Responses	100	0	100
Time Burden (Hours)	620	0	774
Cost Burden (Dollars)	0	0	0

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Abstract: HRSA uses the data from the NAT Program Specific Data Forms to determine the award amount, to ensure compliance with programmatic and grant requirements, and to provide information to the public and Congress. Funds appropriated for the NAT Program are distributed among eligible institutions based on a formula, as permitted by PHS Act section 806e(1). Respondents are applicants to the Nurse Anesthetist Traineeship program.

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Authorizing Statute(s): US Code: 42 USC Section 811 296j(a)(2) 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:
	81 FR 75828	11/01/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 3338	01/11/2017
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
NAT Forms	2, 1	NAT TABLE 1 ,   NAT TABLE 2

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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	100	100	0	0	0	0
Annual Time Burden (Hours)	620	774	0	-154	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: Cutting Redundancy

Short Statement: This reduction is due to the changes in Table 1 and the discontinuation of Table 2b.

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Annual Cost to Federal Government: $161,153

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]? Yes

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: 01/13/2017

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