VA Health Professional Scholarship Programs - EACFMAF (AQ74)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form VA Form 10-0491 VA Health Professional Scholarship and Visual Impairment and Orientation and Mobility Professional Scholarship Pr	Form	Modified	Repair queued
AQ74 PRA Supporting Statement_EACFMAF_revised July 2020.docx	Supporting Statement A	Uploaded 2020-08-06	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
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: 202006-2900-006
Status: Received in OIRA	Previous ICR Reference No: 201904-2900-004
Agency/Subagency: VA	Agency Tracking No: 2900-0793
Title: VA Health Professional Scholarship Programs - EACFMAF (AQ74)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  Yes
Type of Review Request: Regular	Date Submitted to OIRA: 08/06/2020

table that charts list comparision

	Requested	Previously Approved
Expiration Date	36 Months From Approved	03/31/2023
Responses	100	1,800
Time Burden (Hours)	413	6,996
Cost Burden (Dollars)	0	0

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Abstract: A collection of information is necessary to implement the Department of Veterans Affairs (VA) Educational Assistance for Certain Former Members of the Armed Forces (EACFMAF) that was authorized under Public Law 115-141, Consolidated Appropriations Act 2018. The passage of this legislation allows VA to establish a pilot program that will provide educational assistance through the Health Professional Scholarship Program (HPSP) to certain former members of the Armed Forces for education and training leading to employment as a VA physician assistant, the EACFMAF program. This program will help address the VA health care workforce needs by increasing the PA workforce. The legal authority for this data collection is also found under 38 U.S.C., Part I, Chapter 5, §527 that authorizes the collection of data that will allow measurement and evaluation of the Department of Veterans Affairs Programs, the goal of which is improved health care for Veterans and 38 U.S.C. §7611 (HPSP), for VA, to determine the applicant's eligibility to receive a scholarship award. The EACFMAF program will be included in a currently approved collection under OMB Control Number 2900-0793. In order to efficiently respond to the described recent legislation, VHA is utilizing these existing forms (with minor modification) to administer the EACFMAF program.

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Authorizing Statute(s): US Code: 38 USC Part 1, Chapter 5, Section 527 Name of Law: Measurement and Evaluation of DVA Programs
   PL: Pub.L. 115 - 141 246 Name of Law: Consolidated Appropriations Act 2018
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
2900-AQ74	Proposed rulemaking	85 FR 45135	07/27/2020

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Federal Register Notices & Comments

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
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 10-0491d, 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 10-0491m	HPSP Academic Verification ,   HPSP Addendum to Application ,   HPSP Annual VA Employment or Deferment Verification ,   HPSP Education Program Completion Notice_Service Obligation Placement ,   HPSP Evaluation Recommendation Form ,   HPSP Agreement ,   HPSP Application ,   HPSP Notice of Approaching Graduation ,   HPSP Notice of Change and/or Annual Academic Status Report ,   HPSP Request for Deferment for Advanced Education ,   HPSP VA Scholarship Offer Response ,   HPSP Mobility Agreement

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ICR Summary of Burden

table that charts list of burden

	Total Request	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	1,800	0	-1,700	0	0
Annual Time Burden (Hours)	413	6,996	0	-6,583	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: Changing Regulations

Short Statement: The EACFMAF program is newly established and will be included in the currently approved collection under OMB Control Number 2900-0793. In order to efficiently respond to the described recent legislation, VHA is utilizing these existing forms (with modifications to the burden) to administer the EACFMAF program.

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Annual Cost to Federal Government: $27,689,000

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? No

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Common Form ICR:  Yes

Description/Changes for Common Form Usage: 

Approved RCFs using this ICR

table that charts list of RCF

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: 08/06/2020

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