Health Workforce Connector

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 1 Account Creation and Profile Completion	Form and Instruction	Modified	Available
BMISS PIA_Privacy_Impact_Assessment - Attachment F.pdf	Supplementary Document	Uploaded 2020-10-01	Available
Section 336A(6) of the PHS Act - Attachment C.pdf	Supplementary Document	Uploaded 2020-10-01	Available
Section 336(f) of the PHS Act - Attachment B.pdf	Supplementary Document	Uploaded 2020-10-01	Available
Section 333(d) of the PHS Act - Attachment A.pdf	Supplementary Document	Uploaded 2020-10-01	Available
Health Workforce Connector Supporting Statement A_Clean.docx	Supporting Statement A	Uploaded 2020-10-01	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
226284	Account Creation and Profile Completion	Form and Instruction	Modified

ICR Details

OMB Control No: 0906-0031	ICR Reference No: 202010-0906-001
Status: Active	Previous ICR Reference No: 201704-0906-001
Agency/Subagency: HHS/HRSA	Agency Tracking No:
Title: Health Workforce Connector
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 12/16/2020
	Date Received in OIRA: 10/06/2020
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	12/31/2020
Responses	5,008	0	15,600
Time Burden (Hours)	4,565	0	10,648
Cost Burden (Dollars)	0	0	0

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Abstract: The Health Workforce Connector is requesting to collect information to provide a central platform to connect participants in both the NHSC and Nurse Corps programs and facilities that are approved for performance of their NHSC or Nurse Corps service obligation. The Health Workforce Connector will become a resource that engages any health care professional or student interested in providing primary care services in underserved communities with facilities in need of health care providers. The Health Workforce Connector also allows users to create a profile, search for NHSC and Nurse Corps sites, find job and training opportunities, search for other clinicians who are similarly interested in working with underserved populations, and is searchable by Site POCs. Individuals can use the Health Workforce Connector’s search capability with Google Maps.

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Authorizing Statute(s): None

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 48708	08/12/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 63118	10/06/2020
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
Account Creation and Profile Completion	2, 1	Account Creation Instructions and Screenshots ,   Account Creation Instructions and Screenshots

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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	5,008	15,600	0	-10,592	0	0
Annual Time Burden (Hours)	4,565	10,648	0	-6,083	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: There is no legal basis for the collection of information and it is not mandated by law. All information collected is optional. The burden decrease is due to a decrease in the number of respondents.

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Annual Cost to Federal Government: $802,400

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: 10/06/2020

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