Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program (LRP)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 5 Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program (LRP) Site Application	Form and Instruction	New	Available
Form 4 Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program (LRP) Employment Verification Form	Form and Instruction	New	Available
Form 3 Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program (LRP) Privacy Act Release Authorization Form	Form and Instruction	New	Available
Form 2 Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program (LRP) Authorization for Disclosure of Loan Information	Form and Instruction	New	Available
Form 1 Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program (LRP) Program Application	Form and Instruction	New	Available
Final - STAR LRP Program Supporting Statement 9-4-20.docx	Supporting Statement A	Uploaded 2020-09-04	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
243488	Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program (LRP) Site Application	Form and Instruction	New
243487	Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program (LRP) Employment Verification Form	Form and Instruction	New
243486	Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program (LRP) Privacy Act Release Authorization Form	Form and Instruction	New
243485	Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program (LRP) Authorization for Disclosure of Loan Information	Form and Instruction	New
243484	Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program (LRP) Program Application	Form and Instruction	New

ICR Details

OMB Control No: 0906-0058	ICR Reference No: 202009-0906-001
Status: Active	Previous ICR Reference No:
Agency/Subagency: HHS/HRSA	Agency Tracking No:
Title: Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program (LRP)
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 12/08/2020
	Date Received in OIRA: 09/08/2020
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2023	36 Months From Approved
Responses	1,600	0	0
Time Burden (Hours)	1,000	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: Substance Use–Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act or the ‘‘SUPPORT for Patients and Communities Act 2020 requires an STAR LRP application. The legislative authority stating the need for the information collected in this application is found in Substance Use–Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act or the ‘‘SUPPORT for Patients and Communities Act 2020. The Bureau of Health Workforce (BHW) in the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) will administer the STAR LRP. Under the STAR LRP, HHS will enter into contracts with selected primary care health professionals including behavioral health providers and paraprofessionals. In return, HHS will assist the awardees in their repayment of outstanding qualifying educational loans.

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Authorizing Statute(s): PL: Pub.L. 115 - 271 0 Name of Law: SUPPORT for Patients and Communities Act 2020
  

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:
	85 FR 34454	06/04/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 55465	09/08/2020
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 5

table that charts list of burden

IC Title	Form No.	Form Name
Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program (LRP) Program Application	1	STAR LRP Program - Program Application Content.docx
Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program (LRP) Authorization for Disclosure of Loan Information	2	STAR LRP Program - Authorization for Disclosure of Loan Information Form.docx
Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program (LRP) Privacy Act Release Authorization Form	3	STAR LRP Program - Privacy Act Release Authorization Form.docx
Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program (LRP) Employment Verification Form	4	Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program (LRP) Employment Verification Form
Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program (LRP) Site Application	5	FY 2021 STAR LRP Site Application.docx

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ICR Summary of Burden

table that charts list 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	1,600	0	0	1,600	0	0
Annual Time Burden (Hours)	1,000	0	0	1,000	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a new ICR so the burden is increasing from zero (0).

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Annual Cost to Federal Government: $649,671

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:  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: 09/08/2020

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