VA Health Professional Scholarship and Visual Impairment and Orientation and Mobility Professional Scholarship Programs (HPSP and VIOMPSP)

Forms and Documents

Document Name	Status
Form VA form 10-0491 VA Health Professional Scholarship and Visual Impairment and Orientation and Mobility Professional Scholarship Pr Form	Modified
30-day FRN_Published_08192019.pdf Supplementary Document	2019-09-06
60-day FRN_Published_06102019.pdf Supplementary Document	2019-09-06
2900-0793 Justification Statement A_FINAL_AUG 2019.docx Supporting Statement A	2019-09-06

IC Document Collections

IC ID	Document Title	Status
204870	VA Health Professional Scholarship and Visual Impairment and Orientation and Mobility Professional Scholarship Pr Form	Modified

ICR Details

OMB Control No: 2900-0793	ICR Reference No: 201904-2900-004
Status: Active	Previous ICR Reference No: 201604-2900-017
Agency/Subagency: VA	Agency Tracking No: 2900-0793
Title: VA Health Professional Scholarship and Visual Impairment and Orientation and Mobility Professional Scholarship Programs (HPSP and VIOMPSP)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  Yes
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 03/03/2020
	Date Received in OIRA: 09/06/2019
Terms of Clearance: In VA's next revision or extension request for this control number, VA will submit documentation that VA has explored the following: 1. Revising this collection to be less confusing for those with flat rate tuition in form. 2. Revising the language for courses that are repeatable for credit by design rather than because they’ve been failed. 3. VA has monitored to see if respondents understand that VA wants a specialty accreditor rather than a regional accreditor and assess if asking respondents this reduces burden on VA compared to VA comparing schools to established lists of accredited schools. 4. For VA Forms 10-0491e/Form 10-0491f/VA Form 10-0491k/VA Form 10-0491L/VA Form 10-0491m: Analyzing the feasibility of accepting updates through email or some other less burdensome approach rather than mail. 5. VA Form 10-0491e: Explore revising the question about the applicant’s performance to include a reference group so that answers to the questions in order to improve practical utility and construct validity and revising the question around interpersonal skills to be more clear in order to improve practical utility and construct validity. Any information submitted pursuant to the terms and conditions that the awardee shall “Submit required documentation periodically to the Scholarship Office at times determined by VA to continue receiving the scholarship award” is not approved under this control number. Any additional documentation required from 10 or more persons in a 12 month period, other than the items specifically mentioned in the forms and agreement, will need separate OMB approval.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2023	36 Months From Approved	06/30/2020
Responses	1,800	0	6,500
Time Burden (Hours)	6,996	0	24,342
Cost Burden (Dollars)	0	0	0

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Abstract: A collection of information is necessary to implement the Department of Veterans Affairs Visual Impairment and Orientation and Mobility Professional Scholarship Program and the VA Health Professional Scholarship Program authorized under Public Law 111-163. This legislation allows VA to provide services to the public by awarding scholarships to non-VA employees who will be required to become VA employees in the professions for which they were educated under these programs. These programs will help address VA health care workforce needs.

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Authorizing Statute(s): PL: Pub.L. 115 - 182 301 Name of Law: The VA Mission Act of 2018
   US Code: 38 USC Part 1, Chapter 5, Section 527 Name of Law: Measurement and Evaluation of DVA Programs
  

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:
	84 FR 26936	06/10/2019
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 42991	08/19/2019
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
VA Health Professional Scholarship and Visual Impairment and Orientation and Mobility Professional Scholarship Pr	VA form 10-0491, VA Form 10-0491a, VA Form 10-0491c, VA Form 10-0491n, VA Form 10-0491d, VA Form 10-0491e, VA Form 10-0491f, VA Form 10-0491g, VA Form 10-0491h, VA Form 10-0491i, VA Form 10-0491j, VA Form 10-0491k, VA Form 10-0491L, VA Form 10-0491m	HPSP/VIOMPSP Academic Verification ,   HPSP/VIOMPSP Addendum to Application ,   HPSP/VIOMPSP Annual VA Employment Deferment Verification ,   HPSP/VIOMPSP Education Program Completion Notice_Service Obligation Placement ,   HPSP/VIOMPSP Evaluation Recommendation Form ,   HPSP/VIOMPSP Application ,   HPSP/VIOMPSP Notice of Approaching Graduation ,   HPSP/VIOMPSP Notice of Change and/or Annual Academic Status Report ,   HPSP/VIOMPSP Request for Deferment for Advanced Education ,   HPSP/VIOMPSP VA Scholarship Offer Response ,   HPSP/VIOMPSP Mobility Agreement ,   HPSP Agreement ,   VIOMPSP Agreement ,   HPSP VHVMAESP Agreement

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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	1,800	6,500	0	-4,700	0	0
Annual Time Burden (Hours)	6,996	24,342	0	-17,346	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: Miscellaneous Actions

Short Statement: Since the last OMB approval of this information collection, we have adjusted or estimates downward by 3300 HPSP respondents and 400 VIOMPSP respondents. We base our estimate on 3 years of historical data collection and recent budget and regulatory guidance restrictions.

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Annual Cost to Federal Government: $28,516,000

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

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:  Yes

Description/Changes for Common Form Usage:  This is a currently approved collection, but due to recent legislation we are adding two forms and amending existing forms. A collection of information is necessary to implement the Department of Veterans Affairs (VA) Visual Impairment and Orientation and Mobility Professionals Scholarship Program (VIOMPSP) and the VA Health Professional Scholarship Program (HPSP) that were authorized under Public Law 111-163 on May 5, 2010 and extended through December 31, 2033, by Section 301 of P.L. 115-182, The VA Mission Act of 2018. The passage of this legislation allows VA to provide services to the public by awarding scholarships to non-VA employees who will be required to become VA employees in the professions for which they were educated under these programs. Section 304 of The Mission Act of 2018, authorized the creation of the Veterans Healing Veterans Medical Access and Education Scholarship Program (VHVMAESP).

Approved RCFs using this ICR

Agency/Sub Agency	RCF ID	RCF Title	RCF Status	IC Title

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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: 09/06/2019

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