NC LRP - Supporting Statement A

Supporting Statement A

The Nurse Corps Loan Repayment Program

OMB Control No. 0915-0140-Revision

Terms of Clearance: None

1. Justification

1. Circumstances Making the Collection of Information Necessary

This is a request for revision of the Nurse Corps Loan Repayment Program (Nurse Corps LRP) application and participant monitoring forms. The Nurse Corps LRP is authorized by 42 USC 297n(a) (section 846(a) of the Public Health Service Act, as amended by Public Law 107-205, and Public Law 111-148. The application and forms are approved under OMB No. 0915-0140, which expires 5/31/2021.

The Nurse Corps Loan Repayment Program (Nurse Corps LRP), assists in the recruitment and retention of professional Registered Nurses (RNs), including advanced practice RNs (i.e., Nurse practitioners, certified registered Nurse anesthetists, certified Nurse-midwives, clinical Nurse specialists), dedicated to working at eligible health care facilities with a critical shortage of Nurses (i.e., a Critical Shortage Facility) or working as Nurse faculty in eligible, accredited schools of nursing, by decreasing the financial barriers associated with pursuing a nursing profession.

Under the Nurse Corps LRP, RNs and Nurse faculty are offered the opportunity to enter into a contractual agreement with the HHS Secretary to receive loan repayment for up to 60 percent of their qualifying student loans in exchange for a 2-year service commitment, and an additional 25 percent of their original loan balance for an optional third year. In exchange, the participants agree to serve full-time for a minimum of 2 years at a public or private nonprofit Critical Shortage Facility or in an eligible, accredited school of nursing. The Nurse Corps LRP statute requires that a funding preference be given to eligible applicants with greatest financial need. HRSA uses financial data provided by applicants to determine which applications meet this preference.

2. Purpose and Use of Information Collection

This information collection is used by the Nurse Corps program to make award decisions about Nurse Corps LRP applicants and to monitor a participant’s compliance with the program’s service requirements. Individuals must submit an application in order to participate in the program. The application asks for personal, professional, educational, and financial information required to determine the applicant's eligibility to participate in the Nurse Corps LRP. This revised information collection request includes a new form and updates to two existing forms for the Nurse Corps LRP in order to expand the service options for awarded participants, promote the use of telehealth for delivering care throughout the nation especially in rural areas, and to reduce the application burden on respondents.

• Disadvantaged Background Form is a new form that will be used to ask the applicant’s site Point of Contact to certify whether the applicant is from a disadvantaged background. This information is currently provided by the applicant’s site Point of Contact on Institutional letterhead and the form will provide a standard mechanism for them to provide this information.

• Participant Semi-Annual Employment Verification Form will be updated to include additional information about the participant’s service including information about telehealth services and whether they work at multiple CSF sites.

• Nurse Corps LRP application will be revised to include questions for applicants to provide information regarding telehealth services, multiple CSF sites, and verification of base salary to determine the debt to salary ratio used to rank applicants for award consideration. The application will also be updated to identify applicants eligible for Nurse Corps LRP psychiatric nurse practitioner funding.

3. Use of Improved Information Technology and Burden Reduction

This information collection activity is web-based (with exception of some forms as previously mentioned); the application, application instructions and forms are available at http://www.hrsa.gov/loanscholarships/repayment/nursing/index.html. This allows HRSA to minimize the burden on applicants only see questions that are relevant to the program they are applying to, import loan data from the Department of Education, and save their application progress so that they can complete it on their own schedule.

4. Efforts to Identify Duplication and Use of Similar Information

The information collected is specific to the applicant and unique to this program. No other source of this information is known to exist for completion of the application and monitoring forms.

5. Impact on Small Businesses or Other Small Entities

The information collection will not have a significant impact on small entities.

6. Consequences of Collecting the Information Less Frequently

This program has a yearly application cycle, so it is necessary to collect this information from each year’s applicants. If not selected, the applicant may reapply in the next yearly cycle. In the absence of this information collection, the Nurse Corps LRP could not make any awards. In addition, the monitoring process for compliance with contractual requirements necessitates semi-annual employment verification. The consequence of less frequent monitoring is reduced oversight and the potential for funds to go to participants who should not receive them.

7. Special Circumstances Relating to the Guidelines of 5 CFR 1320.5

This information collection fully complies with 5 CFR 1320.5(d)(2).

8. Comments in Response to the Federal Register Notice/Outside Consultation

The notice required in 5 CFR 1320.8(d) was published in the Federal Register on October, 10, 2019, Vol. 84, No. 197, p. 54617 (https://www.govinfo.gov/content/pkg/FR-2019-10-10/pdf/2019-22166.pdf). There were no comments.

Additionally, this program has consulted with the following individuals to obtain constructive feedback to improve the application, improve efficiency, and minimize the collection burden. The comments on clarity of the application and forms were positive. The applicants found the application instructions and materials to be clear and straight forward. There were no suggestions for improvement.

Applicants contacted included:

1. Kathleen Danhausen

Nursing Faculty

Vanderbilt University – School of Nursing

(615) 934 – 7322

2. Jessica Beerup

Nurse Practitioner (NP)

John J. Pershing VA Medical Center – Cape Giradeau

(573) 300-1134

3. Heather Massengill

Nurse Practitioner (NP)

University of Tennessee Medical Center

(865) 227-8296

4. Willard Will

Nurse Practitioner (NP)

John Hopkins Hospital

(281) 736-1249

5. Tracie Holbert

Nurse Practitioner (NP)

Rural Health Center of Roodhouse

(618) 920-0282

9. Explanation of any Payment/Gift to Respondents

Respondents will not receive any payments or gifts.

10. Assurance of Confidentiality Provided to Respondents

Data collected on the individual Nurse Corps LRP application and monitoring forms is housed in a system of record under the Privacy Act of 1974 - the “Public Health Service and National Health Service Corps Health Care Provider Records System” (09-15-0037). Information provided on each selected application will be maintained for at least 2 years and up to 10 years. This is necessary to permit the monitoring of NURSE Corps LRP participants through the completion of the Program’s service commitments.

11. Justification for Sensitive Questions

The applicant’s social security number is required for purposes of reporting the amount of loan repayments received by an individual to the Internal Revenue Service. It is also required by the Debt Collection Act of 1982, to permit collection of claims resulting from a participant’s breach of the Nurse Corps LRP contract.

The applicant’s annual gross salary and outstanding educational loan balances are required to determine whether the applicant meets the statutory funding preference. The loan information is also needed to determine whether the loans are eligible for repayment. The Right to Financial Privacy Act (RFPA), Public Law 95-630, regulates the Federal Government's access to the financial records of individuals maintained by a financial institution. The financial information collected through the application complies with the RFPA requirements for customer authorization for disclosure of financial records.

The applicant’s banking information is necessary to electronically transmit loan repayments to the individual’s financial institution, as required by the Debt Collection Improvement Act of 1996 and 31 CFR Parts 208 and 210.

The Nurse Corps LRP obtains a Credit Bureau Report (CBR) as part of the application review process. The CBR is cross-referenced with the financial information provided by the applicant, and is also used to verify whether the applicant has a Federal judgment lien. The Privacy Act Notification Statement in the Application and Program Guidance advises applicants that a CBR will be obtained.

12. Estimates of Annualized Hour and Cost Burden

The estimates of reporting burden for Applications are as follows;

Form Name	Number of Respondents	Number of Responses per Respondent	Total Responses	Average Burden per Response (in hours)	Total Burden Hours
Nurse Corps LRP Application*	7,100	1	7,100	2.00	14,200
Authorization to Release Information Form**	7,100	1	7,100	.10	710
Employment Verification Form**	7,100	1	7,100	.10	710
Disadvantaged Background Form	450	1	450	.20	90
Confirmation of Interest Form	500	1	500	.20	100
Total for Applicants	22,250	------------------	22,250	-------------	15,810

_{*The burden hours associated with this instrument account for both new and continuation applications. Additional supporting documentation is included as part of this instrument are reflected in the burden hours.}

_{**The same respondents are completing these instruments.}

The estimates of reporting for Participants are as follows:

Form Name	Number of Respondents	Number of Responses per Respondent	Total Responses	Average Burden per Response (in hours)	Total Burden Hours
Participant Semi-Annual In Service Verification Form	500	2	1,000	.50	500
Nurse Corps CSF Verification Form	500	1	500	.10	50
Nurse Corps Nurse Faculty Employment Verification Form	450	1	450	.20	90
Total for Participants	1,450	____________	1,950	_______	640
Total for Applicants and Participants	23,700	___________	24,200	________	16,450*

_{*The total burden hour estimate is a combination of burden hours for both applicants and participants. This revision adds an additional form (the Disadvantaged Background Form).}

Basis for estimates:

Applicants: Based on previous responses, the number of applicants is estimated to average 7,100 per year for the next 3 years. Nurse Corps LRP applicants and participants consist of a diverse nursing workforce (e.g. RNs, Advanced Practice RNs, and nurse faculty). Based on data from the Bureau of Labor Statistics’ (BLS) Occupational Outlook Handbook, the national average hourly wage for registered nurses and nurse faculty is approximately $34.48 and $42.67 per hour. For advanced practice nurses the average hourly wage is $54.78 per hour. Overall, the nursing workforce (as mentioned above) would earn a mean, hourly wage of approximately $39.33 per hour ($34.48 + $42.67 + $54.78 = $131.93; $131.93/3 = $43.98). As per calculations based on the BLS wage data, it is estimated that the hour cost associated with completion of the NURSE Corps LRP application and forms would be $43.98 per hour. As such, the combined total burden hours and total hour cost for the Nurse Corps LRP (including both applicant and participant burden hours) would be 16,450 hours and $723,471 respectively. To include fringe benefits and employee overhead, this figure is doubled for a total of $1,446,942.

Each applicant may only complete one online application per fiscal year. The application consists of eligibility requirements (license, citizenship, service agreement, employment); general information (name, address, school attended, degree(s) obtained, employment, etc.); educational loan information to be considered (average of 3 documents per applicant), plus any necessary supporting documentation.

13. Estimates of other Total Annual Cost Burden to Respondents or Recordkeepers/Capital Costs

All equipment and software are internally maintained at the Nurse Corps LRP as part of its normal business practice. There will be no operation or maintenance costs to lenders; all information is maintained for usual business purposes. Other than their time, there is no cost to respondents.

14. Annualized Cost to Federal Government

Instrument	Base Pay Rate	Project Time per FTE	Number of FTEs	Total Annual Cost
Nurse Corps Loan Repayment Program Application	$97,300 GS-12, Step 6	1.0	10	$973,000

15. Explanation for Program Changes or Adjustments

Currently, there are 13,850 burden hours in the OMB Inventory. The new request is for 16,450 hours. This is primarily driven by an increase in the number of applicants from 5,500 to 7,100. The online application also incorporates many of the supporting and supplemental documents allowing applicants to complete application more quickly.

16. Plans for Tabulation, Publication, and Project Time Schedule

The Nurse Reinvestment Act requires annual reports to Congress regarding participant demographics, service sites, default information, etc. These reports provide information tables as well as analysis of trends and evaluation of the program.

17. Reason(s) Display of OMB Expiration Date is Inappropriate

The OMB number and Expiration date will be displayed on every page of every form/instrument.

18. Exceptions to Certification for Paperwork Reduction Act Submissions

There are no exceptions to the certification.

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