Form 1 ANEW Table 1

Table 1 - ANEW: Rural, Underserved, and/or Public Health Practice Settings Data

Graduate Data from 7/01/201X to 6/30/201X

Practice Settings	NP	CNS	NM	CRNA	Grand Total
State or Local Health Departments
Rural Populations / Settings
Medically Underserved Populations / Settings
1. Total Number of Graduates Employed in these Settings (from 07/01/201X – 06/30/201X)
2. Total Number of Graduates (from 07/01/201X – 06/30/201X)
3. Percentage of Graduates Employed in these Settings (SFP) (Number 1 divided by Number 2)
Health Professional Shortage Areas
4. Percentage of Graduates Employed in HPSAs (SPC) Total Number of Graduates Employed in HPSAs divided by Total Number of Graduates (from 07/01/201X-06/30/201X)

Instructions for Completing Table 1 - ANEW: Rural, Underserved, and/or Public Health Practice Settings & HPSA Data - Graduate Data from 7/01/201X to 6/30/201X

In order to be eligible for the Funding Preference and/or the Special Consideration, applicants must complete Table 1.

Data on Table 1 should reflect graduate totals for nurse practitioners (NP), clinical nurse specialists (CNS), nurse-midwives (NM) and certified registered nurse anesthetists (CRNA) who completed program/degree requirements between 07/01/201X and 6/30/201X.

Complete Table 1, as appropriate, providing data on the number of graduates in academic year 7/1/201X-6/30/201X who spend at least 50 percent of their employment in clinical practice sites substantially benefiting rural or medically underserved populations, or in State or local health departments. Each graduate is to be counted only once. Table 1 is used to determine if the institution meets the Statutory Funding Preference and also used to determine if the institution meets the Special Consideration.

In the “Total Number of Graduates Employed in These Settings” row, the system will automatically calculate the total number of graduates per specialty employed in these settings. The grand total will be system generated. This is a subset of “Total Number of Graduates”.

In the “Total Number of Graduates” row, enter the total number of graduates who completed degree requirements between 7/01/201X and 6/30/201X in the appropriate column. Enter the grand total: The Grand Total will be system generated. Numbers omitted in this row of Table 1 will not be counted.

In the “Percentage of Graduates Employed in these Settings” row, the system will automatically calculate this figure.  Percentage of Graduates Employed in these Settings = Total Number of Graduates Employed in these Settings (from 07/01/201X– 06/30/201X) divided by Total Number of Graduates (from 07/01/201X – 06/30/201X).

In the “Percentage of Graduates Employed in HPSAs” row, the system will automatically calculate this figure.  Percentage of Graduates Employed in HPSA’s = Total Number of graduates employed in HPSAs divided by Total Number of Graduates (from 07/01/201X-06/30/201X).

HRSA-17-067 OMB ANEW Program Specific Data Forms Package.