Health Workforce Connector Supporting Statement A_Clean

Health Resources and Services Administration

Health Workforce Connector

OMB Control No. 0906-0031

Extension

Supporting Statement A

A. Justification

1. Circumstances Making the Collection of Information Necessary

This is an extension request for Office of Management and Budget (OMB) continued approval of the Health Resources and Services Administration’s (HRSA) Health Workforce Connector. The legislative authorities that support this information collection request are Section 333(d), Section 336(f), and Section 336A(6) of the Public Health Service (PHS) Act (Attachments A, B, and C respectively). Specifically, continued approval is requested for the Account Creation form and the Profile Completion form.

HRSA is the primary Federal agency for improving access to health care by strengthening the health care workforce, building healthy communities and achieving health equity. HRSA’s Bureau of Health Workforce (BHW) improves the health of underserved and vulnerable populations by strengthening the health workforce and connecting skilled professionals to communities in need. BHW supports the health care workforce across the entire training continuum – from academic to clinical training of nurses, physicians, and other clinicians – and expands the primary care workforce of clinicians who provide health care in underserved and rural communities across the United States. More information about BHW’s programs is available on the BHW website: http://bhw.hrsa.gov/. In particular, BHW manages two programs that aim to support primary care providers in exchange for service in underserved communities: the National Health Service Corps (NHSC) Program and the NURSE Corps Program.

• National Health Service Corps: The National Health Service Corps (NHSC) builds healthy communities by supporting qualified health care providers dedicated to working in areas of the United States with limited access to care (Sec. 331-338H of PHS Act). The NHSC seeks clinicians who demonstrate a commitment to serve the nation’s medically underserved populations at NHSC-approved sites located in Health Professional Shortage Areas (HPSAs). The NHSC, through its providers and sites, plays an important role in helping to address the country’s primary care provider shortages. More information about the NHSC can be found on the NHSC website (http://nhsc.hrsa.gov/).

There are four programs that fall under the National Health Service Corps umbrella:

• The NHSC Scholarship Program

• The NHSC Loan Repayment Programs

  • The NHSC Loan Repayment Program (2-year)

  • The NHSC Substance Use Disorder Workforce Loan Repayment Program

  • The NHSC Rural Community Loan Repayment Program

• The NHSC Students to Service Loan Repayment Program

• The State Loan Repayment Program

NHSC-approved sites are health care facilities that provide outpatient, ambulatory, primary health services in HPSAs and provide care to individuals regardless of ability to pay. Eligible site types include:

• Federally Qualified Health Centers (FQHCs)

• FQHC Look-Alikes

• American Indian and Native Alaska Health Clinics

• Certified Rural Health Clinics (RHCs)

• Critical Access Hospitals (CAHs)

• School-Based Clinics

• Mobile Units

• Free clinics

• Community Mental Health Centers

• State or Local Health Departments

• Correctional or Detention Facilities

• Community Outpatient Facilities and Private Practices

• Substance Use Disorder Treatment Facilities

Facilities must apply to become NHSC-approved sites. Once approved, NHSC-approved sites gain access to desperately-needed primary care providers. NHSC providers often continue to work at their sites after they complete their NHSC service commitments.¹ All four NHSC programs are designed as recruitment and retention incentives; NHSC-approved sites must still pay salaries to clinicians, and clinicians must choose to work at specific NHSC-approved sites.

• Nurse Corps: The Nurse Corps Program builds healthy communities across the country by supporting qualified nurses, nursing students, and nurse faculty dedicated to working in health care facilities with a critical shortage of nurses (Sec. 846 of PHS Act). The Nurse Corps supports nursing education and training by ensuring a sufficient distribution of nursing graduates and professionals and providing recruitment and retention incentives to nurses committed to a career in underserved communities. These incentives take the form of either a scholarship or loan repayment award in exchange for service in a Critical Shortage Facility (CSF), a health care facility with a critical shortage of nurses that is located in a HPSA. The Nurse Corps is also authorized to extend loan repayments to nurse faculty serving in accredited schools of nursing. Additional information can be found at the following website: http://bhw.hrsa.gov/loansscholarships/nursecorps.

There are two programs that fall under the Nurse Corps umbrella:

• The Nurse Corps Scholarship Program

• The Nurse Corps Loan Repayment Program

Previously utilized, the NHSC Jobs Center was a quick and easy way to advertise open clinical job positions at NHSC-approved sites. Created in 2012, the NHSC Jobs Center was a searchable database of vacant positions at NHSC-approved sites and updated daily. It reached thousands of NHSC participants who were actively seeking employment in underserved communities. NHSC-approved sites could update their Site Profile (0915-0127) on the NHSC Jobs Center through the NHSC Customer Service Portal (0915-0127, 0915-0146), and NHSC participants interested in a position located on the NHSC Jobs Center would contact the listed NHSC Site Recruitment Contact directly to apply. There was no database of vacant positions at Nurse Corps CSFs.

Since the creation of the NHSC Jobs Center, Site Administrators and Points of Contact (POCs) at NHSC- and Nurse Corps-approved sites expressed the need for a bi-directional search to allow them to search and find candidates to fill their open needs/job positions in underserved areas.

The Health Workforce Connector expanded on the NHSC Jobs Center. The Health Workforce Connector provides a central platform to connect participants in both the NHSC and Nurse Corps programs with facilities that are approved for performance of their NHSC or Nurse Corps service obligation. The Health Workforce Connector has 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 be searchable by Site POCs. Individuals can use the Health Workforce Connector’s search capability with Google Maps.

2. Purpose and Use of Information Collection

The respondents for this information collection will include individuals searching for a health care job or training opportunity or a NHSC or Nurse Corps health care facility, and health care facilities searching for potential candidates to fill open health care opportunities at their sites.

Information will be collected from users in the following two ways:

• Account Creation: Creating an account will not be mandatory in order to use the website, but instead will be an option provided to users in an effort to personalize their experience (Attachment D). The only required information that will be collected in order to create an account and user profile will be a user’s first name, last name, and email address. The collection of the first name, last name, and email address during the account creation process will be necessary to ensure there are no duplicate accounts created. Once this information has been provided, an automated email will be sent to allow the user to validate their login credentials. This information will also be used to validate any users who already exist within the Bureau of Health Workforce Management Information System Solution (BMISS) database and allow existing BMISS account users to request an initial import of existing data in order to avoid re-entering shared information. BMISS is the official system of record for all applications, awards, and monitoring of participants, sites, and alumni in the NHSC, Nurse Corps, Faculty Loan Repayment Program (FLRP), and Native Hawaiian Health Scholarship Program (NHHSP). BMISS is covered under OMB No. 0915-0127, 0915-0146, 0915-0140, and 0915-0301 (as this the platform used to create applications for the NHSC and Nurse Corps programs and manage the participant’s service obligations).

• Profile Completion: The purpose of the user profile will be to allow Site Administrators and POCs to search for potential participants to fill open needs/ job positions at their NHSC and/or Nurse Corps approved site(s) (Attachment E) and connect with other clinicians interested in serving in medically underserved areas. User profiles will include fields such as location, discipline, specialty, languages spoken, and BHW programs. Users will have the option to fill out a profile to their desired degree of completion, and users will have full privileges to hide their user profile in its entirety or hide their email address and/or phone number if they choose. If a user elects to hide their email address and/or phone number, they will not be able to be contacted. The system provides text to clearly explain this concept to the user. Alternatively, a user will have the ability to “publish” their profile and make it visible to Site POCs and other HWC users. The information collected, if “published” by the user, will allow for the ability to be searched upon and contacted. Users may log into the Health Workforce Connector to access the search dashboard to conduct a search. If a user conducts a search and finds a match, they will have the ability to reach out to the potential candidate via their contact information, if available e.g., email address and/or phone number.

All information collected will be stored within the existing secure BMISS database and information may be used for report generation per the existing BMISS SORN.

In terms of this information collection request, the general forms include the Account Creation functionality and the Profile Completion functionality. The user will have the option to complete all forms. Users will be able to create and complete profiles on the website at any time.

3. Use of Improved Information Technology and Burden Reduction

This information collection activity will be fully web-based. The link to the current website is available at https://connector.hrsa.gov/. Currently, NHSC and Nurse Corps applicants, program participants, and sites need to register for a user account within the BMISS system to submit an application to the program and to fulfill program requirements while fulfilling their obligation to the program. To avoid having multiple account credentials, the Health Workforce Connector will allow an existing BMISS account user to validate their BMISS credentials to create an account. In addition, since there is overlap in information collected for both BMISS and the Health Workforce Connector, the Health Workforce Connector has the functionality to allow a user to import their data/information from the BMISS system into their Health Workforce Connector user account to avoid re-entering the shared information.

4. Efforts to Identify Duplication and Use of Similar Information

The Health Workforce Connector is similar to other job search websites (e.g. Monster), but the information collected will be specific and unique to NHSC and NURSE Corps program participants and approved sites.

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

The Health Workforce Connector is an optional, free recruitment and retention tool for NHSC and Nurse Corps participants and approved sites. There will be no requirement to create or complete a profile as a condition of participating in the NHSC and Nurse Corps programs, and it will be up to each user to determine what information they would like to include in a profile and if they would like to make this information visible to other users.

There are no legal obstacles to reduce the burden.

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

The request fully complies with the regulation.

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

Section 8A

A 60-day Federal Register Notice was published on August 12, 2020, vol. 85, no. 156, pp. 48708-48709. No public comments were received.

Section 8B

HRSA conducted internal pretesting with eight federal staff to create an account and complete a profile on an internal testing website to get an estimate of the approximate time (in hours) that it would take users to create and complete a profile.

9. Explanation of any Payment/Gift to Respondents

Respondents will not receive any payment or gifts for participation in this website.

10. Assurance of Confidentiality Provided to Respondents

Data will be kept private to the extent allowed by law.

Applicability of the Privacy Act

The Health Workforce Connector will allow a user to import data from the BMISS system and/or look up the National Provider Identifier (NPI) number from the CMS National Plan and Provider Enumeration System (NPPES). See Federal data sources below:

• CMS National Plan and Provider Enumeration System (NPPES) – provides publically available National Provider Identifier (NPI) records for individual U.S. medical professionals;

• Bureau of Health Workforce Management Information System Solution (BMISS) – provides information for applicants, participants, alumni, and health facilities affiliated with four BHW programs: the NHSC, the Nurse Corps, the FLRP, and the NHHSP. BMISS is the official system of record for all participants, sites, and alumni in these programs.

For existing BMISS users, the Health Workforce Connector will allow for a one-time optional import of the same information captured in both BMISS and the Health Workforce Connector. The Health Workforce Connector will use the above data sources as part of the user profile creation process so users can avoid re-entering the same information already captured in the BMISS system.

SORN

The Health Workforce Connector is a subsystem to BMISS. The SORN for BMISS can be found at this link: http://www.hrsa.gov/about/privacyact/09150037.html

Privacy Impact Assessment

As the Health Workforce Connector is a subsystem to BMISS, BHW has a BMISS PIA (Attachment F).

11. Justification for Sensitive Questions

There are no questions of a sensitive nature.

12. Estimates of Annualized Hour and Cost Burden

Section 12A - Estimated Annualized Burden Hours

Burden Estimate:

Type of Respondent	Form Name	No. of Respondents	No. Responses per Respondent	Total Responses	Average Burden per Response (in hours)	Total Burden Hours
User	Account Creation	5,008	1	5,008	.08	400.64
User	Complete Profile	4,164	1	4,164	1	4,164
Total		5,008*	--	5,008	--	4,564.64

*The 4,164 respondents who complete their profiles are a subset of the 5,008 respondents who create accounts.

This number reflects the actual number of accounts over the last year. Upon initial release of the Health Workforce Connector, the estimations were calculated based off of assumptions relating to the total number of active participants for both NHSC and Nurse Corps programs (originally 10,658 plus an anticipated 5,000 additional logins for non-participants). However, since the HWC is live, the new estimate is based on actual numbers over the last year. It is anticipated that the estimates will be very similar over the next year since the HWC is in a steady state.

Burden estimates were derived from internal testing with federal staff to create an account and complete a profile on an internal testing website. It is estimated that the Account Creation step will require almost 5 minutes to complete and the burden is displayed as the number of minutes over 60. (5,008 users x (1 responses x 8/60 hours/response per application) = 400 total burden hours).

It is also estimated that full profile completion will require 1 hour to complete. The hour-burden estimates include the time to fill out all fields for full profile completion. (4,164 users x (1 responses x 1 hours/response per application) = 4,164 total burden hours).

Section 12B

Estimated Annualized Burden Costs

Type of Respondent	Total Burden Hours	Hourly Wage Rate	Total Respondent Costs
Dentists	331	$85.16	$28,187.96
Dental Hygienists	331	$34.96	$11,571.76
Physician Assistants	331	$47.73	$15,798.63
Physicians and Surgeons	331	$97.33	$32,216.23
Nurse Midwives	331	$45.01	$14,898.31
Nurse Practitioners	331	$48.68	$16,113.08
Registered Nurses	331	$34.14	$11,300.34
Mental Health and Substance Abuse Social Workers	331	$22.69	$7,510.39
Marriage and Family Therapists	331	$25.73	$8,516.63
Mental Health Counselors	331	$21.67	$7,172.77
Clinical Psychologists	331	$36.56	$12,101.36
Human Resource Specialists	7,007	$30.63	$214,624.41
Total	10,648		$380,011.87

The wage rates were calculated based on the wage rates for the primary care provider types that are supported by the NHSC and Nurse Corps programs in addition to the wage rate for Human Resource Specialists at NHSC- and Nurse Corps-approved sites (https://www.bls.gov/oes/current/oes_nat.htm).

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

Other than their time, there is no cost to respondents.

14. Annualized Cost to Federal Government

The average annual costs to the government for implementing the website are as follows:

Federal Employee Costs:

Instrument	GS-Level/Base Pay Rate	Project Time per FTE	Number of FTEs	Total Annual Cost
Health Workforce Connector Project Management	$141,534 (GS-14, Step 6)	.25	1	$35,383
Health Workforce Connector Program Support	$161,730 (GS-15, Step 5)	.10	1	$16,173
Health Workforce Connector Technical Support	$79,720 (GS-12, Step 1)	.10	4	$31,888
Total				$83,444

Project, program, and technical assistance for the Health Workforce Connector will be provided by approximately six HRSA staff, ranging from a GS-12 to GS-15, who will spend less than 25% of their time on the Health Workforce Connector project. It is estimated that the annualized total cost to the government will be $83,444.

Contractor costs:

Contract costs for the website include operations and maintenance costs, development, modernization, and enhancement costs, and hosting services costs.

Period of Performance	Type	Amount
6/1/2016 to 5/31/2026	Operations & Maintenance (O&M) (includes improvements & production support)	$3.34 million
6/1/2016 to 5/31/2026	Development, Modernization & Enhancement (DME)	$4.2 million
6/1/2016 to 5/31/2026	Hosting Services Represents the total annual hosting charges for the Nextgen Platform; 40% allocated to the Health Workforce Connector	$.384 million

The total estimated cost over the 10-year life of the system is $8.024 million, with an annualized cost to the Federal Government of $802,400.00.

15. Explanation for Program Changes or Adjustments

The current burden inventory is 10,648 with this request being for 4,564 hours. The initial estimates of burden (10,648) were prior to the initial deployment of the Health Workforce Connector.  Those estimates were accurate as brand new users created accounts and published profiles.  However, as the HWC is now in a steady state, HRSA looked at the exact numbers over the last year and can project comparable numbers for the upcoming year.  Now the estimated burden is significantly lower (4564.64) due to the total number of users who are estimated to create accounts and publish profiles. 

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

There are no plans for the tabulation, statistical analysis or publication of the information.

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

No exemption is being requested. The expiration date will be displayed.

18. Exceptions to Certification for Paperwork Reduction Act Submissions

There are no exceptions to the certification.

1 “Evaluating Retention in BCRS Programs” Final Report. March 30, 2012. Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill.