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pdfAppendix C: Program Mapping Document
OMB No. 0915-0061, Exp. Date 03/31/2025
Direct Financial Support Programs
Activity
Code
Name
A22
Nurse Anesthetist Traineeship
A22
Nurse Anesthetist Traineeship
Training
Program
Setup
PC-1
A22
Nurse Anesthetist Traineeship
IND-GEN
A22
Nurse Anesthetist Traineeship
A22
A22
Nurse Anesthetist Traineeship
Nurse Anesthetist Traineeship
Form
INDGENPY
EXP-1
EXP-2
Columns List
1,2
1,2,3,4,5a,5b,5c,7,8,9,10,11,12,13
1,2,2a,3,4,5,5a,7,8,9,10,11,12,14,21b,22,
26,26a,26b,26c,26d,27d,27e,27f,28,29,30,
31,32,32a,33,34,34aa,36,37,38,39,56,56a,
56b,57,58,59,60,61
13,14,16,17,18,18a,18b,18c
1,2,3,4,5a,5b,5c,7,7a,7b,8,9,10,11,13,14
1,2,3,3a,4,5,6,7
Appendix C: Program Mapping Document
OMB No. 0915-0061, Exp. Date 03/31/2025
Activity
Code
Name
Form
Columns List
D87
Dental Faculty Loan Repayment
Faculty
Development
Setup
n/a
IND-GEN
2,2a,3,4,5a,6a,7,8,9,10,11,12,18,21b,22,
22a,23,23a,26,26b,26c,26d,27d,36,37,40,
41,42,43,44,45,45a,50,56,56a,56b,57,58,
59,60,61
D87
Dental Faculty Loan Repayment
D87
Dental Faculty Loan Repayment
D87
D87
D87
D87
D87
D87
D87
Dental Faculty Loan Repayment
Dental Faculty Loan Repayment
Dental Faculty Loan Repayment
Dental Faculty Loan Repayment
Dental Faculty Loan Repayment
Dental Faculty Loan Repayment
Dental Faculty Loan Repayment
INDGENPY
FD-1a
FD-1b
FD-2a
FD-2b
FD-4a
FD-4b
FD-5
13,14,16,17,18,18a,18b,18c
1,1a,2,3,4,5,6,7,8,9,10,11
1,2,2a,3
1,2,3,4,5,6,7
1,2,2a,3
1,1a,2,3,4,5
1,2,2a,3
n/a
Appendix C: Program Mapping Document
OMB No. 0915-0061, Exp. Date 03/31/2025
Activity
Code
Name
E01
Nurse Faculty Loan Program
E01
Nurse Faculty Loan Program
E01
Nurse Faculty Loan Program
PC-1
1,2,3,4,5a,5b,5c,7,8,9,10,11,12,13
E01
Nurse Faculty Loan Program
IND-GEN
1,2,3,4,5a,6a,7,8,9,10,11,12,16,21b,22,
26a,26b,26c,26d,27aa,27d,36,37,38,38c,
39,56,56a,56b,57,58,59,60,61
E01
Nurse Faculty Loan Program
E01
E01
E01
E01
Nurse Faculty Loan Program
Nurse Faculty Loan Program
Nurse Faculty Loan Program
Nurse Faculty Loan Program
Form
Grant
Purpose
Setup
Training
Program
Setup
INDGENPY
NFLP 1
NFLP 2
NFLP 3
NFLP 4
Columns List
See performance measures document,
grant purpose section
1,2
13,14,15,16,17,18,18a,18b,18c
n/a
n/a
n/a
n/a
Appendix C: Program Mapping Document
OMB No. 0915-0061, Exp. Date 03/31/2025
Activity
Code
Name
Form
H56
National Health Service Corps - State
Loan Repayment Program
IND-GEN
H56
National Health Service Corps - State
Loan Repayment Program
EXP-1
Columns List
2,2a,5a,6a,7,8,9,10,11,12,21d,21e,21h,
22a,26d,27aa,34ac,37,80,81,82,84,85,86,
88,89,91,92
1,2,3,4,5a,5b,5c,7,7a,7b,8,9,10,11,13,14,
15,16,17,18
Appendix C: Program Mapping Document
OMB No. 0915-0061, Exp. Date 03/31/2025
Activity
Code
Name
Form
Columns List
K01
Geriatric Academic Career Awards
Faculty
Development
Setup
n/a
K01
Geriatric Academic Career Awards
IND-GEN
K01
K01
K01
K01
K01
K01
K01
K01
Geriatric Academic Career Awards
Geriatric Academic Career Awards
Geriatric Academic Career Awards
Geriatric Academic Career Awards
Geriatric Academic Career Awards
Geriatric Academic Career Awards
Geriatric Academic Career Awards
Geriatric Academic Career Awards
CDE-1
CDE-2
FD-1a
FD-1b
FD-2a
FD-2b
FD-4a
FD-4b
1,2,2a,3,4,5a,6a,7,8,9,10,11,12,17,21b,22,
26,26b,26c,26d,27aa,27d,27e,28,29,31,32
,33,34,36,37,39,40,41,42,43,44,45,46,47,
48,49,56,56a,56b,57,58,59,60,61
1,2,3,4,8,11,12
1,2,2a,3
1,1a,2,3,4,5,6,7,8,9,10,11
1,2,2a,3
1,2,3,4,5,6,7
1,2,2a,3
1,1a,2,3,4,5
1,2,2a,3
Appendix C: Program Mapping Document
OMB No. 0915-0061, Exp. Date 03/31/2025
Activity
Code
Name
Form
Columns List
K02
Primary Care Medicine and Dentistry Clinician Educator Career Development
Awards
Faculty
Development
Setup
n/a
K02
Primary Care Medicine and Dentistry Clinician Educator Career Development
Awards
IND-GEN
2,2a,3,4,5a,6a,7,8,9,10,11,12,20a,21b,22,
26,26b,26c,26d,27d,27e,27f,28,29,30,31,
32,33,34,36,37,38,39,40,41,42,43,44,45,
46,47,48,49,56,56a,56b,57,58,59,60,61
CDE-1
1,2,3,4,8,11,12
CDE-2
1,2,2a,3,5,7,8,9
FD-1a
1,1a,2,3,4,5,6,7,8,9,11
FD-1b
1,2,2a,3
FD-2a
1,2,3,4,5,6,7
FD-2b
1,2,2a,3
FD-4a
1,1a,2,3,4,5
FD-4b
1,2,2a,3
K02
K02
K02
K02
K02
K02
K02
K02
Primary Care Medicine and Dentistry Clinician Educator Career Development
Awards
Primary Care Medicine and Dentistry Clinician Educator Career Development
Awards
Primary Care Medicine and Dentistry Clinician Educator Career Development
Awards
Primary Care Medicine and Dentistry Clinician Educator Career Development
Awards
Primary Care Medicine and Dentistry Clinician Educator Career Development
Awards
Primary Care Medicine and Dentistry Clinician Educator Career Development
Awards
Primary Care Medicine and Dentistry Clinician Educator Career Development
Awards
Primary Care Medicine and Dentistry Clinician Educator Career Development
Awards
Appendix C: Program Mapping Document
OMB No. 0915-0061, Exp. Date 03/31/2025
Activity
Code
Name
T08
Scholarships for Disadvantaged Students
T08
Scholarships for Disadvantaged Students
Training
Program
Setup
PC-1
T08
Scholarships for Disadvantaged Students
IND-GEN
T08
Scholarships for Disadvantaged Students
T08
T08
Scholarships for Disadvantaged Students
Scholarships for Disadvantaged Students
Form
INDGENPY
EXP-1
EXP-2
Columns List
1,2
1,2,3,4,5a,5b,5c,7,8,10,11,12,13
1,2,2a,3,4,5a,6a,7,8,9,10,11,12,15,21b,22,
26,26b,26c,26d,27d,27e,28,29,31,33,34,
34a,34b,36,36a,37,38,39,56,56a,56b,57,
58,59,60,61
13,14,16,17,18,18a,18b,18c
1,2,3,4,5a,5b,5c,7,7a,7b,8,9,10,11,13,14
1,2,3,3a,4,6,7
Appendix C: Program Mapping Document
OMB No. 0915-0061, Exp. Date 03/31/2025
Activity
Code
Name
Form
Columns List
T23
Children's Hospitals Graduate Medical
Education
Training
Program
Setup
1,2
PC-6
1,2,2a,2b,3c
PC-8
1,2,3a,3b,3c,12
PC-10
1,2,3a,3b,3c,4,5,6,7,8,9
PC-9
1,2,3,4,5,7
IND-GEN
1,2,2a,3,4,5a,6a,7,8,9,10,11,12,22,25,26,
26b,26c,26d,27a,27d,27e,27f,28,29,30,31,
32,33,34,36,37,39,56,56a,56b,57,58,59,
60,61
INDGENPY
13,14,16,17,18,18a,18b,18c,19,20
EXP-1
1,2,3,4,5a,5b,5c,7,7a,7b,8,9,10,11,12,13,
14
EXP-2
1,2,3,3a,4,6,7
PCC
1,2,3,4,5,6,7,8
CHD-1
1,2,3,4
CHD-2
1,2,3,4,5
CHD-3
1,2,3,4
T23
T23
T23
T23
T23
T23
T23
T23
T23
T23
T23
T23
Children's Hospitals Graduate Medical
Education
Children's Hospitals Graduate Medical
Education
Children's Hospitals Graduate Medical
Education
Children's Hospitals Graduate Medical
Education
Children's Hospitals Graduate Medical
Education
Children's Hospitals Graduate Medical
Education
Children's Hospitals Graduate Medical
Education
Children's Hospitals Graduate Medical
Education
Children's Hospitals Graduate Medical
Education
Children's Hospitals Graduate Medical
Education
Children's Hospitals Graduate Medical
Education
Children's Hospitals Graduate Medical
Education
Appendix C: Program Mapping Document
OMB No. 0915-0061, Exp. Date 03/31/2025
Activity
Code
Name
T25
Addiction Medicine Fellowship
T25
Addiction Medicine Fellowship
T25
Addiction Medicine Fellowship
PC-6
1,2,2a,2b,2c,4,5,6,7,8,9,10
T25
Addiction Medicine Fellowship
PC-9
T25
Addiction Medicine Fellowship
IND-GEN
1,2,3,4,5,6
1,2,2a,3,4,5a,6a,7,8,9,10,11,12,13,21b,22,
26,26b,26c,26d,27d,27e,27f,28,29,30,31,
32,32a,33,34,34aa,34ab,34ac,36,37,38b,
38f,39,56,56a,56b,57,58,59,60,61
T25
Addiction Medicine Fellowship
T25
T25
T25
T25
T25
T25
T25
T25
Addiction Medicine Fellowship
Addiction Medicine Fellowship
Addiction Medicine Fellowship
Addiction Medicine Fellowship
Addiction Medicine Fellowship
Addiction Medicine Fellowship
Addiction Medicine Fellowship
Addiction Medicine Fellowship
Form
Training
Program
Setup
Faculty
Development
Setup
INDGENPY
CDE-1
CDE-2
EXP-1
EXP-2
FD-1a
FD-1b
FD-2a
FD-2b
Columns List
1,2
n/a
13,14,16,17,18,18a,18b,18c
1,2,3,4,8,11,12
1,2,2a,3,4,5,7,8,9
1,2,3,4,5a,5b,5c,7,7a,7b,8,9,10,11,13,14
1,2,3,3a,4,5,6,7
1,1a,2,3,4,5,6,7,8,9,10,11
1,2,2a,3
1,2,3,4,5,6,7
1,2,2a,3
Appendix C: Program Mapping Document
OMB No. 0915-0061, Exp. Date 03/31/2025
Activity
Code
Name
Form
Columns List
T32
National Research Service Award in
Primary Care
Faculty
Development
Setup
n/a
T32
National Research Service Award in
Primary Care
IND-GEN
2,2a,3,3a,3b,4,5a,6a,7,8,9,10,11,12,13,
13a,21b,22,26,26b,26c,26d,27d,28,31,33,
36,37,39,40,41,42,43,44,45,46,47,48,49,
56,56a,56b,57,58,59,60,61
INDGENPY
13,14,16,17,18,18a,18b,18c
CDE-1
1,2,3,4,8,11,12
CDE-2
1,2,2a,3,4,5,7,8,9
FD-1a
1,1a,2,3,4,5,6,7,8,9,10,11
FD-1b
1,2,2a,3
FD-2a
1,2,3,4,5,6,7
FD-2b
1,2,2a,3
FD-4a
1,1a,2,3,4,5
FD-4b
1,2,2a,3
T32
T32
T32
T32
T32
T32
T32
T32
T32
National Research Service Award in
Primary Care
National Research Service Award in
Primary Care
National Research Service Award in
Primary Care
National Research Service Award in
Primary Care
National Research Service Award in
Primary Care
National Research Service Award in
Primary Care
National Research Service Award in
Primary Care
National Research Service Award in
Primary Care
National Research Service Award in
Primary Care
Appendix C: Program Mapping Document
OMB No. 0915-0061, Exp. Date 03/31/2025
Activity
Code
Name
T52
Public Health Scholarship Program
T52
Public Health Scholarship Program
Training
Program
Setup
PC-1
T52
Public Health Scholarship Program
IND-GEN
T52
Public Health Scholarship Program
T52
T52
T52
T52
Public Health Scholarship Program
Public Health Scholarship Program
Public Health Scholarship Program
Public Health Scholarship Program
Form
INDGENPY
CDE-1
CDE-2
EXP-1
EXP-2
Columns List
1,2
1,2,3,4,5a,5b,5c,7,8,9,10,11,12,13
1,2,3,4,5a,6a,7,8,9,10,11,12,15,21b,22,26,
26b,26c,26d,27d,27e,28,29,31,32,33,34,
35,36,37,38,39,56,56a,56b,57,58,59,60,
61,62,63
13,14,15,16,17,18,18a,18b,18c,21,22
1,2,3,4,7a,8,11,12
1,2,2a,3,4,5,6,7,8,9
1,2,3,4,5a,5b,5c,6,7,7a,7b,8,9,10,11,13,14
1,2,3,3a,4,5,6,7
Appendix C: Program Mapping Document
OMB No. 0915-0061, Exp. Date 03/31/2025
Activity
Code
Name
T91
Teaching Health Center Graduate
Medical Education
T91
Teaching Health Center Graduate
Medical Education
T91
T91
T91
T91
T91
T91
T91
T91
T91
T91
T91
T91
T91
Teaching Health Center Graduate
Medical Education
Teaching Health Center Graduate
Medical Education
Teaching Health Center Graduate
Medical Education
Teaching Health Center Graduate
Medical Education
Teaching Health Center Graduate
Medical Education
Teaching Health Center Graduate
Medical Education
Teaching Health Center Graduate
Medical Education
Teaching Health Center Graduate
Medical Education
Teaching Health Center Graduate
Medical Education
Teaching Health Center Graduate
Medical Education
Teaching Health Center Graduate
Medical Education
Teaching Health Center Graduate
Medical Education
Teaching Health Center Graduate
Medical Education
Form
Training
Program
Setup
Faculty
Development
Setup
Columns List
1,2
n/a
PC-6
1,2,2a,2b,2c,3a,4,5,6,7,8,9,10
PC-8
1,2,3a,3b,3c,4a,5,6,7,8,9,10,11
PC-9
1,2,3,4,5,6
IND-GEN
1,2,2a,2b,3,3a,4,5a,6a,7,8,9,10,11,12,13,
14,20,21b,22,25,26,26b,26c,26d,27c,27d,
27e,27f,28,29,30,31,32,32a,33,34,34aa,
34ab,36,36a,37,39,52,53,56,56a,56b,57,
58,59,60,61
INDGENPY
13,14,16,17,18,18a,18b,18c,19,20
CDE-1
1,2,3,4,8,11,12,13
CDE-2
1,2,2a,3,4,5,7,8,9
EXP-1
1,2,3,4,5a,5b,5c,7,7a,7b,8,9,10,11,12,13,
14
EXP-2
1,2,3,3a,4,5,6,7
FD-1a
1,1a,2,3,4,5,6,7,8,9,10,11,12
FD-1b
1,2,2a,3
FD-2a
1,2,3,4,5,6,7,8
FD-2b
1,2,2a,3
Appendix C: Program Mapping Document
OMB No. 0915-0061, Exp. Date 03/31/2025
Activity
Code
Name
Form
Columns List
T96
Advanced Nursing Education – Sexual
Assault Nurse Examiners
Training
Program
Setup
1,2
PC-1
1,2,3,4,5a,5b,5c
PC-3
1,2,3,4,8a,8b,8c,10
PC-5
1,2,3a,3b,3c
PC-7
1,2,2a,2b,2c
IND-GEN
1,2,3,3b,4,5a,6a,7,8,9,10,11,12,20a,21b,
22,26,26a,26b,26c,26d,27a,27d,28,31,33,
34ab,34ac,34a,35,36,36a,37,38,38a,38b,
39,56,56a,56b,57,58,59,60,61,62,63
INDGENPY
13,14,18,18a,18b,18c
CDE-1
1,2,3,4,8,11,12
CDE-2
1,2,2a,3,4,5,7,8,9
EXP-1
1,2,3,4,5a,5b,5c,7,7a,7b,8,9,10,11,13,14
EXP-2
1,2,3,3a,4,6,7
T96
T96
T96
T96
T96
T96
T96
T96
T96
T96
Advanced Nursing Education – Sexual
Assault Nurse Examiners
Advanced Nursing Education – Sexual
Assault Nurse Examiners
Advanced Nursing Education – Sexual
Assault Nurse Examiners
Advanced Nursing Education – Sexual
Assault Nurse Examiners
Advanced Nursing Education – Sexual
Assault Nurse Examiners
Advanced Nursing Education – Sexual
Assault Nurse Examiners
Advanced Nursing Education – Sexual
Assault Nurse Examiners
Advanced Nursing Education – Sexual
Assault Nurse Examiners
Advanced Nursing Education – Sexual
Assault Nurse Examiners
Advanced Nursing Education – Sexual
Assault Nurse Examiners
Appendix C: Program Mapping Document
OMB No. 0915-0061, Exp. Date 03/31/2025
Activity
Code
T9C
T9C
T9C
T9C
T9C
T9C
T9C
T9C
T9C
T9C
T9C
T9C
T9C
T9C
T9C
Name
Form
Teaching Health Center
Graduate Medical Education
Program
Teaching Health Center
Graduate Medical Education
Program
Teaching Health Center
Graduate Medical Education
Program
Teaching Health Center
Graduate Medical Education
Program
Teaching Health Center
Graduate Medical Education
Program
Training
Program
Setup
Faculty
Development
Setup
Teaching Health Center
Graduate Medical Education
Program
Teaching Health Center
Graduate Medical Education
Program
Teaching Health Center
Graduate Medical Education
Program
Teaching Health Center
Graduate Medical Education
Program
Teaching Health Center
Graduate Medical Education
Program
Teaching Health Center
Graduate Medical Education
Program
Teaching Health Center
Graduate Medical Education
Program
Teaching Health Center
Graduate Medical Education
Program
Teaching Health Center
Graduate Medical Education
Program
Teaching Health Center
Graduate Medical Education
Program
Columns List
1,2
n/a
PC-6
1,2,2a,2b,2c,3a,4,5,6,7,8,9,10
PC-8
1,2,3a,3b,3c,4a,5,6,7,8,9,10,11
PC-9
1,2,3,4,5,6
IND-GEN
1,2,2a,3,3a,4,5a,6a,7,8,9,10,11,12,13,14,20,21b,22,25,
26,26b,26c,26d,27c,27d,27e,27f,28,29,30,31,32,32a,33
,34,34aa,34ab,36,36a,37,39,52,53,56,56a,56b,57,58,59,
60,61
INDGENPY
13,14,16,17,18,18a,18b,18c,19,20
CDE-1
1,2,3,4,8,11,12,13
CDE-2
1,2,2a,3,4,5,7,8,9
EXP-1
1,2,3,4,5a,5b,5c,7,7a,7b,8,9,10,11,12,13,14
EXP-2
1,2,3,3a,4,5,6,7
FD-1a
1,1a,2,3,4,5,6,7,8,9,10,11
FD-1b
1,2,2a,3
FD-2a
1,2,3,4,5,6,7
FD-2b
1,2,2a,3
Appendix C: Program Mapping Document
OMB No. 0915-0061, Exp. Date 03/31/2025
Infrastructure Programs
Activity
Code
P13
P13
P13
P13
P13
P13
P13
P13
P13
P13
P13
P13
P13
Name
Form
Rural Residency Planning and Development Training
Program
Program Setup
Faculty
Rural Residency Planning and Development
Development
Program
Setup
Rural Residency Planning and Development
PC-8
Program
Rural Residency Planning and Development
PC-9
Program
Rural Residency Planning and Development
IND-GEN
Program
Rural Residency Planning and Development
CDE-1
Program
Rural Residency Planning and Development
CDE-2
Program
Rural Residency Planning and Development
EXP-1
Program
Rural Residency Planning and Development
EXP-2
Program
Rural Residency Planning and Development
FD-1a
Program
Rural Residency Planning and Development
FD-1b
Program
Rural Residency Planning and Development
FD-2a
Program
Rural Residency Planning and Development
FD-2b
Program
Columns List
1,2
n/a
1,2,3a,3b,3c,4a,5,6,7,8,9,10,11
1,2,3,4,5
1,2,2a,3,3a,4,5,5a,6a,7,8,9,10,11,26,26b,
26c,26d,27d,28,30,31,33,36,37,39,52,53,
56,56a,56b,57,58,59,60,61
1,2,3,4,8,11,12
1,2,2a,3,4,5,7,8,9
1,2,3,4,5a,5b,5c,7,7a,7b,8,9,10,11,13,14
1,2,3,3a,4,5,6,7
1,1a,2,3,4,5,6,7,8,9,10
1,2,2a,3
1,2,3,4,5,6,7
1,2,2a,3
Appendix C: Program Mapping Document
OMB No. 0915-0061, Exp. Date 03/31/2025
Activity
Code
Name
T9B
Teaching Health Center Planning and
Development
T9B
Teaching Health Center Planning and
Development
T9B
T9B
T9B
T9B
T9B
T9B
T9B
T9B
T9B
T9B
T9B
T9B
T9B
Teaching Health Center Planning and
Development
Teaching Health Center Planning and
Development
Teaching Health Center Planning and
Development
Teaching Health Center Planning and
Development
Teaching Health Center Planning and
Development
Teaching Health Center Planning and
Development
Teaching Health Center Planning and
Development
Teaching Health Center Planning and
Development
Teaching Health Center Planning and
Development
Teaching Health Center Planning and
Development
Teaching Health Center Planning and
Development
Teaching Health Center Planning and
Development
Teaching Health Center Planning and
Development
Form
Training
Program
Setup
Faculty
Development
Setup
Columns List
1,2
n/a
PC-6
1,2,2a,2b,2c,3a
PC-8
1,2,3a,3b,3c,4a
PC-9
1,2,3,4,5,6
IND-GEN
1,2,2a,3,3a,4,5a,6a,7,8,9,10,11,12,13,14,
20,21b,22,26,26b,26c,26d,27c,27d,27e,
27f,28,29,30,31,32,32a,33,34,34aa,34ab,
36,36a,37,39,56,56a,56b,57,58,59,60,61
INDGENPY
13,14,16,17,18,18a,18b,18c
CDE-1
1,2,3,4,8,11,12
CDE-2
1,2,2a,3,4,5,7,8,9
EXP-1
1,2,3,4,5a,5b,5c,7,7a,7b,8,9,10,11,12,13,
14
EXP-2
1,2,3,3a,4,5,6,7
FD-1a
1,1a,2,3,4,5,6,7,8,9,10,11
FD-1b
1,2,2a,3
FD-2a
1,2,3,4,5,6,7
FD-2b
1,2,2a,3
Appendix C: Program Mapping Document
OMB No. 0915-0061, Exp. Date 03/31/2025
Activity
Code
U3M
U3M
U3M
U3M
U3M
U3M
U3M
U3M
U3M
U3M
U3M
U3M
U3M
U3M
Name
Form
Columns List
Promoting Resilience and Mental Health
Among the Health Professional
Workforce
Promoting Resilience and Mental Health
Among the Health Professional
Workforce
Promoting Resilience and Mental Health
Among the Health Professional
Workforce
Promoting Resilience and Mental Health
Among the Health Professional
Workforce
Promoting Resilience and Mental Health
Among the Health Professional
Workforce
Promoting Resilience and Mental Health
Among the Health Professional
Workforce
Promoting Resilience and Mental Health
Among the Health Professional
Workforce
Promoting Resilience and Mental Health
Among the Health Professional
Workforce
Promoting Resilience and Mental Health
Among the Health Professional
Workforce
Promoting Resilience and Mental Health
Among the Health Professional
Workforce
Promoting Resilience and Mental Health
Among the Health Professional
Workforce
Promoting Resilience and Mental Health
Among the Health Professional
Workforce
Promoting Resilience and Mental Health
Among the Health Professional
Workforce
Promoting Resilience and Mental Health
Among the Health Professional
Workforce
Training
Program
Setup
1,2
PC-3
1,2,3,4,5,8a,8b,8c,10
LR-1a
1,2,6,7,8
LR-2
1,2,3,7,8,12,13,17,19a,19f
DV-1
1,2,3,7,8,12,13,17
DV-2
1,2,3,10,11
DV-3
1,2,6,7
CDE-1
1,2,3,4,8,11,12
CDE-2
1,2,2a,3,4,5,7,8,9
EXP-1
1,2,3,4,5a,5b,5c,7,7a,7b,8,9,10,11,12,14
EXP-2
1,2,3,3a,4,6,7
FD-5
n/a
CE-1
1,2,3,4,5,8,9,10,11,12,14
CE-2
1,2,2a,3,4
Appendix C: Program Mapping Document
OMB No. 0915-0061, Exp. Date 03/31/2025
Activity
Code
Name
U3N
Health and Public Safety Workforce
Resiliency Training Program
U3N
Health and Public Safety Workforce
Resiliency Training Program
U3N
U3N
U3N
U3N
U3N
U3N
U3N
U3N
U3N
U3N
U3N
U3N
U3N
U3N
U3N
U3N
Health and Public Safety Workforce
Resiliency Training Program
Health and Public Safety Workforce
Resiliency Training Program
Health and Public Safety Workforce
Resiliency Training Program
Health and Public Safety Workforce
Resiliency Training Program
Health and Public Safety Workforce
Resiliency Training Program
Health and Public Safety Workforce
Resiliency Training Program
Health and Public Safety Workforce
Resiliency Training Program
Health and Public Safety Workforce
Resiliency Training Program
Health and Public Safety Workforce
Resiliency Training Program
Health and Public Safety Workforce
Resiliency Training Program
Health and Public Safety Workforce
Resiliency Training Program
Health and Public Safety Workforce
Resiliency Training Program
Health and Public Safety Workforce
Resiliency Training Program
Health and Public Safety Workforce
Resiliency Training Program
Health and Public Safety Workforce
Resiliency Training Program
Health and Public Safety Workforce
Resiliency Training Program
Form
Training
Program
Setup
Faculty
Development
Setup
Columns List
1,2
n/a
PC-3
1,2,3,4,5,8a,8b,8c,10
LR-1a
1,2,6,7,8,16
LR-2
1,2,3,7,8,12,13,17,19a,19f,20
DV-1
1,2,3,7,8,12,13,17,18
DV-2
1,2,3,10,11,12
DV-3
1,2,6,7
CDE-1
1,2,3,4,8,11,12
CDE-2
1,2,2a,3,4,5,7,8,9
EXP-1
1,2,3,4,5a,5b,5c,7,7a,7b,8,9,10,11,12,13,
14
EXP-2
1,2,3,3a,4,5,6,7
FD-1a
FD-1b
FD-2a
FD-2b
1,1a,2,3,4,5,6,7,8,9,10,11
1,2,2a,3
1,2,3,4,5,6,7
1,2,2a,3
CE-1
1,2,3,4,5,6,8,9,10,11,12,14
CE-2
1,2,2a,3,4
Appendix C: Program Mapping Document
OMB No. 0915-0061, Exp. Date 03/31/2025
Activity
Code
Name
U4E
Nurse Education, Practice, Quality and
Retention: Simulation Education Training
U4E
Nurse Education, Practice, Quality and
Retention: Simulation Education Training
U4E
U4E
U4E
U4E
U4E
U4E
U4E
U4E
U4E
U4E
U4E
U4E
U4E
Nurse Education, Practice, Quality and
Retention: Simulation Education Training
Nurse Education, Practice, Quality and
Retention: Simulation Education Training
Nurse Education, Practice, Quality and
Retention: Simulation Education Training
Nurse Education, Practice, Quality and
Retention: Simulation Education Training
Nurse Education, Practice, Quality and
Retention: Simulation Education Training
Nurse Education, Practice, Quality and
Retention: Simulation Education Training
Nurse Education, Practice, Quality and
Retention: Simulation Education Training
Nurse Education, Practice, Quality and
Retention: Simulation Education Training
Nurse Education, Practice, Quality and
Retention: Simulation Education Training
Nurse Education, Practice, Quality and
Retention: Simulation Education Training
Nurse Education, Practice, Quality and
Retention: Simulation Education Training
Nurse Education, Practice, Quality and
Retention: Simulation Education Training
Nurse Education, Practice, Quality and
Retention: Simulation Education Training
Form
Training
Program
Setup
Faculty
Development
Setup
Columns List
1,2
n/a
PC-3
1,2,4,8a,8b,8c,10
PC-7
1,2,2a,2b,2c,3a,3b
LR-1a
1,1a,6a,7,8,16
LR-2
1,2,2a,6a,7a,11a,12a,16a,20
DV-1
1,2,2a,6a,7a,11a,18
DV-2
1,13,14,15,16,12
DV-3
1,8,9,7
CDE-1
1,2,3,4,8,11,12
CDE-2
1,2,2a,3,4,5,7,8,9
EXP-1
1,2,3,4,5a,5b,5c,7,7a,7b,8,9,10,11,13,14
EXP-2
1,2,3,3a,4,5,6,7
FD-2a
1,2,3,4,5,6,7
FD-2b
1,2,2a,3
Appendix C: Program Mapping Document
OMB No. 0915-0061, Exp. Date 03/31/2025
Activity
Code
Name
U77
Area Health Education Centers
U77
Area Health Education Centers
U77
Area Health Education Centers
Grant
Purpose
Setup
Training
Program
Setup
PC-1
U77
Area Health Education Centers
PC-2
1,2,3,4,5,5a,5b,5c,6a,7
U77
Area Health Education Centers
PC-3
1,2,3,4,5,6,7,8,8a,8b,8c,9a,10
U77
Area Health Education Centers
PC-7
1,2,2a,2b,2c,3a,3b
U77
Area Health Education Centers
PC-8
1,2,3a,3b,3c,4a,5,6,7,8,9,10,11
U77
Area Health Education Centers
LR-1a
1,1a,6a,7,8,16
U77
Area Health Education Centers
LR-2
1,2,2a,6a,7a,11a,12a,16a,19,19e,20
U77
Area Health Education Centers
DV-1
1,2,2a,6a,7a,11a,12a,16a,18
U77
Area Health Education Centers
DV-2
1,13,14,15,16,12
U77
Area Health Education Centers
DV-3
U77
Area Health Education Centers
IND-GEN
1,8,9,7
1,2,3,4,5a,6a,7,8,9,10,11,12,20a,21b,22,
26,26a,26b,26c,26d,27a,27b,27d,27e,28,
29,31,32,33,34,34a,34b,36,36a,37,38,39,
56,56a,56b,57,58,59,60,61
U77
Area Health Education Centers
U77
Area Health Education Centers
INDGENPY
CDE-1
U77
Area Health Education Centers
CDE-2
1,2,2a,3,4,5,7,8,9
U77
Area Health Education Centers
EXP-1
1,2,3,4,5a,5b,5c,7,7a,7b,8,9,10,11,13,14
U77
Area Health Education Centers
EXP-2
1,2,3,3a,4,5,6,7
U77
Area Health Education Centers
CE-1
1,2,3,4,5,6,8,9,10,11,12,13,16
U77
Area Health Education Centers
CE-2
1,2,2a,3,4
Form
Columns List
See performance measures document,
grant purpose section
1,2
1,2,3,5a,5b,5c
13,14,16,17,18,18a,18b,18c
1,2,3,4,8,11,12,13
Appendix C: Program Mapping Document
OMB No. 0915-0061, Exp. Date 03/31/2025
Activity
Code
UK1
UK1
UK1
UK1
UK1
UK1
UK1
UK1
UK1
UK1
UK1
UK1
UK1
UK1
UK1
UK1
Name
Form
Nurse Education, Practice, Quality and
Retention: Mobile Health Training
Program
Nurse Education, Practice, Quality and
Retention: Mobile Health Training
Program
Nurse Education, Practice, Quality and
Retention: Mobile Health Training
Program
Nurse Education, Practice, Quality and
Retention: Mobile Health Training
Program
Nurse Education, Practice, Quality and
Retention: Mobile Health Training
Program
Nurse Education, Practice, Quality and
Retention: Mobile Health Training
Program
Training
Program
Setup
Faculty
Development
Setup
Nurse Education, Practice, Quality and
Retention: Mobile Health Training
Program
Nurse Education, Practice, Quality and
Retention: Mobile Health Training
Program
Nurse Education, Practice, Quality and
Retention: Mobile Health Training
Program
Nurse Education, Practice, Quality and
Retention: Mobile Health Training
Program
Nurse Education, Practice, Quality and
Retention: Mobile Health Training
Program
Nurse Education, Practice, Quality and
Retention: Mobile Health Training
Program
Nurse Education, Practice, Quality and
Retention: Mobile Health Training
Program
Nurse Education, Practice, Quality and
Retention: Mobile Health Training
Program
Nurse Education, Practice, Quality and
Retention: Mobile Health Training
Program
Nurse Education, Practice, Quality and
Retention: Mobile Health Training
Program
Columns List
1,2
n/a
PC-1
1,2,3,4,5a,5b,5c,6d
PC-3
1,2,3,4,8a,8b,8c,10
PC-7
1,2,2a,2b,2c
PC-8
1,2,3a,3b,3c
IND-GEN
1,2,3,3b,4,5a,6a,7,8,9,10,11,12,13,13a,
20a,21b,22,26,26b,26c,26d,27aa,27a,27d,
27e,27f,28,29,30,31,32,32a,33,34,34aa,
34ab,34ac,36,36a,37,38,38b,39,56,56a,
56b,57,58,59,60,61
INDGENPY
13,14,18,18a,18b,18c
CDE-1
1,2,3,4,8,11,12,13
CDE-2
1,2,2a,3,4,5,7,8,9
EXP-1
1,2,3,4,5a,5b,5c,7,7a,7b,8,9,10,11,13,14
EXP-2
1,2,3,3a,4,5,6,7
FD-1a
1,1a,1b,2,3,4,5,6,7,8,9,10,11,12
FD-1b
1,2,2a,3
FD-2a
1,2,3,4,5,6,7,8
FD-2b
1,2,2a,3
Appendix C: Program Mapping Document
OMB No. 0915-0061, Exp. Date 03/31/2025
Multipurpose or Hybrid Programs
Activity
Code
Name
D18
Health Careers Opportunity Program
D18
Health Careers Opportunity Program
Training
Program
Setup
PC-2
D18
Health Careers Opportunity Program
PC-3
1,2,3,4,5,8,8a,8b,8c,10
D18
Health Careers Opportunity Program
LR-1a
1,2,6,7,8,16
D18
Health Careers Opportunity Program
LR-2
1,2,3,7,8,12,13,17,19a,19f,20
D18
Health Careers Opportunity Program
DV-1
1,2,3,7,8,12,13,17,18
D18
Health Careers Opportunity Program
DV-2
1,2,3,10,11,12
D18
Health Careers Opportunity Program
DV-3
D18
Health Careers Opportunity Program
IND-GEN
1,2,6,7
1,2,3,4,5a,6a,7,8,9,10,11,12,13,15,21b,22,
26,26b,26c,26d,27d,27e,28,29,31,32,33,
34,34a,34b,36,36a,37,38,38a,38b,39,56,
56a,56b,57,58,59,60,61
D18
Health Careers Opportunity Program
D18
Health Careers Opportunity Program
INDGENPY
EXP-1
D18
Health Careers Opportunity Program
EXP-2
Form
Columns List
1,2
1,2,3,4,5,5a,5b,5c,7
13,14,16,17,18,18a,18b,18c
1,2,3,4,5a,5b,5c,7,7a,7b,8,9,10,11,13,14
1,2,3,3a,4,6,7
Appendix C: Program Mapping Document
OMB No. 0915-0061, Exp. Date 03/31/2025
Activity
Code
Name
D19
Nurse Workforce Diversity
D19
Nurse Workforce Diversity
D19
Nurse Workforce Diversity
Training
Program
Setup
Faculty
Development
Setup
PC-1
D19
Nurse Workforce Diversity
PC-2
1,2,3,4,5,5a,5b,5c,7
D19
Nurse Workforce Diversity
PC-3
D19
Nurse Workforce Diversity
IND-GEN
1,2,3,4,5,7,8,8a,8b,8c,10
1,2,3,4,5a,6a,7,8,9,10,11,12,13,15,21b,22,
26,26b,26c,26d,27aa,27d,27e,28,29,31,32
,33,34,34a,34b,36,37,38,38b,39,56,56a,
56b,57,58,59,60,61
D19
Nurse Workforce Diversity
D19
Nurse Workforce Diversity
INDGENPY
CDE-1
D19
Nurse Workforce Diversity
CDE-2
1,2,2a,3,4,5,7,8,9
D19
Nurse Workforce Diversity
EXP-1
1,2,3,4,5a,5b,5c,7,7a,7b,8,9,10,11,13,14
D19
Nurse Workforce Diversity
EXP-2
1,2,3,3a,4,5,6,7
D19
Nurse Workforce Diversity
FD-1a
1,1a,1b,2,3,5,6,7,8,9,10,11
D19
Nurse Workforce Diversity
FD-1b
1,2,2a,3
D19
Nurse Workforce Diversity
FD-2a
1,2,3,4,5,6,7
D19
Nurse Workforce Diversity
FD-2b
1,2,2a,3
Form
Columns List
1,2
n/a
1,2,3,4,5a,5b,5c,7,8,9,10,11,12,13
13,14,16,17,18,18a,18b,18c
1,2,3,4,8,11,12
Appendix C: Program Mapping Document
OMB No. 0915-0061, Exp. Date 03/31/2025
Activity
Code
Name
D33
Preventive Medicine Residency
D33
Preventive Medicine Residency
D33
Preventive Medicine Residency
D33
Preventive Medicine Residency
Grant
Purpose
Setup
Training
Program
Setup
Faculty
Development
Setup
PC-8
D33
Preventive Medicine Residency
PC-9
D33
Preventive Medicine Residency
IND-GEN
D33
Preventive Medicine Residency
D33
Preventive Medicine Residency
INDGENPY
CDE-1
D33
Preventive Medicine Residency
CDE-2
1,2,2a,3,4,5,7,8,9
D33
Preventive Medicine Residency
EXP-1
1,2,3,4,5a,5b,5c,7,7b,8,9,10,11,13,14
D33
Preventive Medicine Residency
EXP-2
1,2,3,3a,4,5,6,7
D33
Preventive Medicine Residency
FD-1a
1,1a,2,3,4,5,6,7,8,9,10,11
D33
Preventive Medicine Residency
FD-1b
1,2,2a,3
D33
Preventive Medicine Residency
FD-2a
1,2,3,4,5,6,7
D33
Preventive Medicine Residency
FD-2b
1,2,2a,3
Form
Columns List
See performance measures document,
grant purpose section
1,2
n/a
1,2,3a,3b,3c,5,6,7,8,9,10,11
1,2,3,5
1,2,2a,3,4,5a,6a,7,8,9,10,11,12,13,13a,
20a,21b,22,26,26b,26c,27d,27e,27f,28,29,
30,31,32,32a,33,34,34aa,34ab,36,37,39,
56,57,58,59,60,61
13,14,16,17,18,18a,18b,18c
1,2,3,4,8,11,12
Appendix C: Program Mapping Document
OMB No. 0915-0061, Exp. Date 03/31/2025
Activity
Code
Name
D34
Centers of Excellence
D34
Centers of Excellence
D34
Centers of Excellence
D34
Centers of Excellence
Grant
Purpose
Setup
Training
Program
Setup
Faculty
Development
Setup
PC-3
D34
Centers of Excellence
LR-1a
1,2,6,7,8,16
D34
Centers of Excellence
LR-2
1,2,3,7,8,12,13,17,19a,19f,20
D34
Centers of Excellence
DV-1
1,2,3,7,8,12,13,17,18
D34
Centers of Excellence
DV-2
1,2,3,10,11,12
D34
Centers of Excellence
DV-3
D34
Centers of Excellence
IND-GEN
1,2,6,7
1,2,3,4,5a,6a,7,8,9,10,11,12,13,21b,22,26,
26b,26c,26d,27d,27e,28,29,31,32,33,34,
34a,34b,36,36a,37,38,38a,38b,39,56,56a,
56b,57,58,59,60,61
D34
Centers of Excellence
D34
Centers of Excellence
INDGENPY
CDE-1
D34
Centers of Excellence
CDE-2
1,2,2a,3,4,5,7,8,9
D34
Centers of Excellence
EXP-1
1,2,3,4,5a,5b,5c,7,7a,7b,8,9,10,11,13,14
D34
Centers of Excellence
EXP-2
1,2,3,3a,4,5,6,7
D34
Centers of Excellence
FD-1a
1,1a,2,3,4,5,6,7,8,9,10,11,12
D34
Centers of Excellence
FD-1b
1,2,2a,3
D34
Centers of Excellence
FD-2a
1,2,3,4,5,6,7,8
D34
Centers of Excellence
FD-2b
1,2,2a,3
D34
Centers of Excellence
FD-3
1,1a,2,3,4,5,6,7,8,9,10
Form
Columns List
See performance measures document,
grant purpose section
1,2
n/a
1,2,3,4,5,7,8,8a,8b,8c,10
13,14,16,17,18,18a,18b,18c
1,2,3,4,8,11,12,13
Appendix C: Program Mapping Document
OMB No. 0915-0061, Exp. Date 03/31/2025
Activity
Code
Name
D40
Graduate Psychology Education
D40
Graduate Psychology Education
D40
Graduate Psychology Education
D40
Graduate Psychology Education
Grant
Purpose
Setup
Training
Program
Setup
Faculty
Development
Setup
PC-4
D40
Graduate Psychology Education
PC-6
1,2,2a,2b,2c,4,5,6,7,8,9,10
D40
Graduate Psychology Education
PC-7
1,2,2a,2b,2c,4,5,6,7,8,9,10
D40
Graduate Psychology Education
PC-9
D40
Graduate Psychology Education
IND-GEN
1,2,5,6
1,2,2a,3,4,5a,6,7,8,9,10,11,12,13,21b,22,
26,26b,26c,26d,27d,27e,28,29,31,32,33,
34,34ac,36,37,39,56,56a,56b,57,58,59,60,
61
D40
Graduate Psychology Education
D40
Graduate Psychology Education
INDGENPY
CDE-1
D40
Graduate Psychology Education
CDE-2
1,2,2a,3,4,5,7,8,9
D40
Graduate Psychology Education
EXP-1
1,2,3,4,5a,5b,5c,7,7a,7b,8,9,10,11,13,14
D40
Graduate Psychology Education
EXP-2
1,2,3,3a,4,5,6,7
D40
Graduate Psychology Education
FD-1a
1,1a,2,3,4,5,6,7,8,9,10,11
D40
Graduate Psychology Education
FD-1b
1,2,2a,3
D40
Graduate Psychology Education
FD-2a
1,2,3,4,5,6,7
D40
Graduate Psychology Education
FD-2b
1,2,2a,3
D40
Graduate Psychology Education
CE-1
1,2,3,4,5,6,8,9,10,11,12
D40
Graduate Psychology Education
CE-2
1,2,2a,3,4
Form
Columns List
See performance measures document,
grant purpose section
1,2
n/a
1,2,3a,3b,3c,4,5,6,7,8,9,10
13,14,16,17,18,18a,18b,18c
1,2,3,4,8,11,12
Appendix C: Program Mapping Document
OMB No. 0915-0061, Exp. Date 03/31/2025
Activity
Code
Name
D57
Physician Assistant Training in Primary
Care
D57
Physician Assistant Training in Primary
Care
D57
D57
D57
D57
D57
D57
D57
D57
D57
D57
D57
D57
D57
D57
Physician Assistant Training in Primary
Care
Physician Assistant Training in Primary
Care
Physician Assistant Training in Primary
Care
Physician Assistant Training in Primary
Care
Physician Assistant Training in Primary
Care
Physician Assistant Training in Primary
Care
Physician Assistant Training in Primary
Care
Physician Assistant Training in Primary
Care
Physician Assistant Training in Primary
Care
Physician Assistant Training in Primary
Care
Physician Assistant Training in Primary
Care
Physician Assistant Training in Primary
Care
Physician Assistant Training in Primary
Care
Physician Assistant Training in Primary
Care
Form
Training
Program
Setup
Faculty
Development
Setup
Columns List
1,2
n/a
PC-1
1,2,4,5a,5b,5c,7,8,9,10,11,12,13
PC-9
1,2,3,4,5
IND-GEN
1,2,2a,3,4,5a,6a,7,8,9,10,11,12,13,14,15,
20,21b,22,26,26b,26c,26d,27d,27e,27f,28
,29,30,31,32,33,34,36,37,38,39,56,56a,
56b,57,58,59,60,61
INDGENPY
13,14,16,17,18,18a,18b,18c
CDE-1
1,2,3,4,8,11,12
CDE-2
1,2,2a,3,4,5,7,8,9
EXP-1
1,2,3,4,5a,5b,5c,7,7a,7b,8,9,10,11,13,14
EXP-2
1,2,3,3a,4,5,6,7
FD-1a
1,1a,2,3,4,5,6,7,8,9,10,11
FD-1b
1,2,2a,3
FD-2a
1,2,3,4,5,6,7
FD-2b
1,2,2a,3
CE-1
1,2,3,4,5,6,8,9,10,11,12
CE-2
1,2,2a,3,4
Appendix C: Program Mapping Document
OMB No. 0915-0061, Exp. Date 03/31/2025
Activity
Code
Name
D58
Residency Training in Primary Care
D58
Residency Training in Primary Care
D58
Residency Training in Primary Care
Training
Program
Setup
Faculty
Development
Setup
PC-8
D58
Residency Training in Primary Care
PC-9
D58
Residency Training in Primary Care
IND-GEN
D58
Residency Training in Primary Care
D58
Residency Training in Primary Care
INDGENPY
CDE-1
D58
Residency Training in Primary Care
CDE-2
1,2,2a,3,4,5,6,7,8,9
D58
Residency Training in Primary Care
EXP-1
1,2,3,4,5a,5b,5c,7,7a,7b,8,9,10,11,13,14
D58
Residency Training in Primary Care
EXP-2
1,2,3,3a,4,5,6,7
D58
Residency Training in Primary Care
FD-1a
1,1a,5,6,7,8,9,10,11
D58
Residency Training in Primary Care
FD-1b
1,2,2a,3
D58
Residency Training in Primary Care
FD-2a
1,2,3,4,5,6,7
D58
Residency Training in Primary Care
FD-2b
1,2,2a,3
Form
Columns List
1,2
n/a
1,2,3a,3b,3c,4a,5,6,7,8,9,10,11
1,2,3,4,5
1,2,2a,3,4,5a,6a,7,8,9,10,11,12,13,13a,
20a,21b,22,26,26a,26b,26c,26d,27d,27e,
28,29,31,32,33,34,34ab,36,37,39,56,56a,
56b,57,58,59,60,61
13,14,16,17,18,18a,18b,18c
1,2,3,4,8,11,12
Appendix C: Program Mapping Document
OMB No. 0915-0061, Exp. Date 03/31/2025
Activity
Code
D85
D85
D85
D85
D85
D85
D85
D85
D85
D85
D85
D85
D85
Name
Form
Predoctoral Training in General
Dentistry, Pediatric Dentistry, and Dental
Public Health and Dental Hygiene
Predoctoral Training in General
Dentistry, Pediatric Dentistry, and Dental
Public Health and Dental Hygiene
Predoctoral Training in General
Dentistry, Pediatric Dentistry, and Dental
Public Health and Dental Hygiene
Predoctoral Training in General
Dentistry, Pediatric Dentistry, and Dental
Public Health and Dental Hygiene
Predoctoral Training in General
Dentistry, Pediatric Dentistry, and Dental
Public Health and Dental Hygiene
Grant
Purpose
Setup
Training
Program
Setup
Faculty
Development
Setup
Predoctoral Training in General
Dentistry, Pediatric Dentistry, and Dental
Public Health and Dental Hygiene
Predoctoral Training in General
Dentistry, Pediatric Dentistry, and Dental
Public Health and Dental Hygiene
Predoctoral Training in General
Dentistry, Pediatric Dentistry, and Dental
Public Health and Dental Hygiene
Predoctoral Training in General
Dentistry, Pediatric Dentistry, and Dental
Public Health and Dental Hygiene
Predoctoral Training in General
Dentistry, Pediatric Dentistry, and Dental
Public Health and Dental Hygiene
Predoctoral Training in General
Dentistry, Pediatric Dentistry, and Dental
Public Health and Dental Hygiene
Predoctoral Training in General
Dentistry, Pediatric Dentistry, and Dental
Public Health and Dental Hygiene
Predoctoral Training in General
Dentistry, Pediatric Dentistry, and Dental
Public Health and Dental Hygiene
Columns List
See performance measures document,
grant purpose section
1,2
n/a
PC-1
1,2,3,4,5a,5b,5c,7,8,9,10,11,12,13
PC-9
1,2,5
IND-GEN
1,2,2a,3,4,5a,6a,7,8,9,10,11,12,13,14,15,
20,21b,22,26,26b,26c,26d,27d,27e,27f,28
,29,30,31,32,32a,33,34,34aa,36,37,38,39,
56,56a,56b,57,58,59,60,61
INDGENPY
13,14,16,17,18,18a,18b,18c
CDE-1
1,2,3,4,8,11,12
CDE-2
1,2,2a,3,4,5,7,8,9
EXP-1
1,2,3,4,5a,5b,5c,7,7a,7b,8,9,10,11,13,14
EXP-2
1,2,3,3a,4,5,6,7
FD-2a
1,2,3,4,5,6,7
FD-2b
1,2,2a,3
Appendix C: Program Mapping Document
OMB No. 0915-0061, Exp. Date 03/31/2025
Activity
Code
Name
D88
Postdoctoral Training in General,
Pediatric, and Public Health Dentistry
D88
Postdoctoral Training in General,
Pediatric, and Public Health Dentistry
D88
D88
D88
D88
D88
D88
D88
D88
D88
D88
D88
D88
D88
Postdoctoral Training in General,
Pediatric, and Public Health Dentistry
Postdoctoral Training in General,
Pediatric, and Public Health Dentistry
Postdoctoral Training in General,
Pediatric, and Public Health Dentistry
Postdoctoral Training in General,
Pediatric, and Public Health Dentistry
Postdoctoral Training in General,
Pediatric, and Public Health Dentistry
Postdoctoral Training in General,
Pediatric, and Public Health Dentistry
Postdoctoral Training in General,
Pediatric, and Public Health Dentistry
Postdoctoral Training in General,
Pediatric, and Public Health Dentistry
Postdoctoral Training in General,
Pediatric, and Public Health Dentistry
Postdoctoral Training in General,
Pediatric, and Public Health Dentistry
Postdoctoral Training in General,
Pediatric, and Public Health Dentistry
Postdoctoral Training in General,
Pediatric, and Public Health Dentistry
Postdoctoral Training in General,
Pediatric, and Public Health Dentistry
Form
Training
Program
Setup
Faculty
Development
Setup
Columns List
1,2
n/a
PC-6
1,2,2a,2b,2c,4,5,6,7,8,9,10
PC-8
1,2,3,3a,3b,3c,5,6,7,8,9,10,11
PC-9
1,2,4,5,6
IND-GEN
1,2,2a,3,4,5a,6a,7,8,9,10,11,12,13,14,15,
20,21b,22,26,26b,26c,26d,27d,27e,27f,28
,29,30,31,32,32a,33,34,34aa,36,37,38,39,
56,56a,56b,57,58,59,60,61
INDGENPY
13,14,16,17,18,18a,18b,18c
CDE-1
1,2,3,4,8,11,12
CDE-2
1,2,2a,3,4,5,7,8,9
EXP-1
1,2,3,4,5a,5b,5c,7,7a,7b,8,9,10,11,13,14
EXP-2
1,2,3,3a,4,5,6,7
FD-1a
1,1a,2,3,4,5,6,7,8,9,10,11
FD-1b
1,2,2a,3
FD-2a
1,2,3,4,5,6,7
FD-2b
1,2,2a,3
Appendix C: Program Mapping Document
OMB No. 0915-0061, Exp. Date 03/31/2025
Activity
Code
Name
M01
Behavioral Health Workforce Education
and Training
M01
Behavioral Health Workforce Education
and Training
M01
Behavioral Health Workforce Education
and Training
M01
M01
M01
M01
M01
M01
M01
M01
M01
M01
M01
M01
Behavioral Health Workforce Education
and Training
Behavioral Health Workforce Education
and Training
Behavioral Health Workforce Education
and Training
Behavioral Health Workforce Education
and Training
Behavioral Health Workforce Education
and Training
Behavioral Health Workforce Education
and Training
Behavioral Health Workforce Education
and Training
Behavioral Health Workforce Education
and Training
Behavioral Health Workforce Education
and Training
Behavioral Health Workforce Education
and Training
Behavioral Health Workforce Education
and Training
Behavioral Health Workforce Education
and Training
Form
Grant
Purpose
Setup
Training
Program
Setup
Faculty
Development
Setup
Columns List
See performance measures document,
grant purpose section
1,2
n/a
PC-1
1,2,3,4,5a,5b,5c,7,8,9,10,11,12,13
PC-4
1,2,3a,3b,3c,4,5,6,7,8,9,10
PC-6
1,2,2a,2b,2c,4,5,6,7,8,9,10
PC-7
1,2,2a,2b,2c,4,5,6,7,8,9,10
IND-GEN
1,2,2a,3,4,5a,7,8,9,10,11,12,13,13a,21b,
22,26,26b,27aa,27d,27e,28,29,31,32,33,
34,36,37,38,39,56,56a,56b,57,58,59,60,
61,93,94,95,96,107
INDGENPY
13,14,16,17,18,18a,18b,18c
CDE-1
1,2,3,4,8,11,12
CDE-2
1,2,2a,3,4,5,7,8,9
EXP-1
1,2,3,4,5a,5b,5c,7,7a,7b,8,9,10,11,13,14
EXP-2
1,2,3,3a,4,5,6,7
FD-2a
1,2,3,4,5,6,7
FD-2b
1,2,3
Appendix C: Program Mapping Document
OMB No. 0915-0061, Exp. Date 03/31/2025
Activity
Code
Name
MC1
Behavioral Health Workforce Education
and Training - American Rescue Plan
MC1
Behavioral Health Workforce Education
and Training - American Rescue Plan
MC1
MC1
MC1
MC1
MC1
MC1
MC1
MC1
MC1
MC1
Behavioral Health Workforce Education
and Training - American Rescue Plan
Behavioral Health Workforce Education
and Training - American Rescue Plan
Behavioral Health Workforce Education
and Training - American Rescue Plan
Behavioral Health Workforce Education
and Training - American Rescue Plan
Behavioral Health Workforce Education
and Training - American Rescue Plan
Behavioral Health Workforce Education
and Training - American Rescue Plan
Behavioral Health Workforce Education
and Training - American Rescue Plan
Behavioral Health Workforce Education
and Training - American Rescue Plan
Behavioral Health Workforce Education
and Training - American Rescue Plan
Behavioral Health Workforce Education
and Training - American Rescue Plan
Form
Training
Program
Setup
Faculty
Development
Setup
Columns List
1,2
n/a
PC-4
1,2,3a,3b,3c,4,5,6,7,8,9,10
PC-7
1,2,2a,2b,2c,4,5,6,7,8,9,10
IND-GEN
1,2,2a,3,4,5a,6,7,8,9,10,11,12,13,21b,22,
26,26b,26c,26d,27aa,27d,27e,28,29,31,32
,33,34,36,37,38,39,56,56a,56b,57,58,59,
60,61,93,94,95,96,107
INDGENPY
13,14,16,17,18,18a,18b,18c
CDE-1
1,2,3,4,8,11,12
CDE-2
1,2,2a,3,4,5,7,8,9
EXP-1
1,2,3,4,5a,5b,5c,7,7a,7b,8,9,10,11,13,14
EXP-2
1,2,3,3a,4,5,6,7
FD-2a
1,2,3,4,5,6,7
FD-2b
1,2,2a,3
Appendix C: Program Mapping Document
OMB No. 0915-0061, Exp. Date 03/31/2025
Activity
Code
T0B
T0B
T0B
T0B
T0B
T0B
T0B
T0B
T0B
T0B
T0B
T0B
T0B
T0B
T0B
T0B
T0B
Name
Form
Primary Care Training Enhancement
Program – Integrating Behavioral Health
in Primary Care
Primary Care Training Enhancement
Program – Integrating Behavioral Health
in Primary Care
Primary Care Training Enhancement
Program – Integrating Behavioral Health
in Primary Care
Primary Care Training Enhancement
Program – Integrating Behavioral Health
in Primary Care
Primary Care Training Enhancement
Program – Integrating Behavioral Health
in Primary Care
Primary Care Training Enhancement
Program – Integrating Behavioral Health
in Primary Care
Primary Care Training Enhancement
Program – Integrating Behavioral Health
in Primary Care
Primary Care Training Enhancement
Program – Integrating Behavioral Health
in Primary Care
Primary Care Training Enhancement
Program – Integrating Behavioral Health
in Primary Care
Primary Care Training Enhancement
Program – Integrating Behavioral Health
in Primary Care
Primary Care Training Enhancement
Program – Integrating Behavioral Health
in Primary Care
Primary Care Training Enhancement
Program – Integrating Behavioral Health
in Primary Care
Grant
Purpose
Setup
Training
Program
Setup
Faculty
Development
Setup
Primary Care Training Enhancement
Program – Integrating Behavioral Health
in Primary Care
Primary Care Training Enhancement
Program – Integrating Behavioral Health
in Primary Care
Primary Care Training Enhancement
Program – Integrating Behavioral Health
in Primary Care
Primary Care Training Enhancement
Program – Integrating Behavioral Health
in Primary Care
Primary Care Training Enhancement
Program – Integrating Behavioral Health
in Primary Care
Columns List
See performance measures document,
grant purpose section
1,2
n/a
PC-1
1,2,3,4,5a,5b,5c,6b,6c,7,8,9,10,11,12,13
PC-6
1,2,2a,2b,2c,3a,3b,4,5,6,7,8,9,10
PC-8
1,3a,3b,3c,4a,4b,5,6,7,8,9,10,11
PC-9
1,2,3,5
LR-1a
1,1a,6a,7,8
LR-2
1,2,2a,6a,7a,11a,12a,16a
DV-1
1,2,2a,6a,7a,11a,12a,16a
DV-2
1,13,14,15,16
DV-3
1,8,9
IND-GEN
1,2,2a,3,4,5,6a,7,8,9,10,11,12,20a,21b,22,
26,26b,26c,26d,27d,27e,27f,28,29,30,31,
32,32a,33,34,34aa,36,37,38,39,44,45,56,
56a,56b,57,58,59,60,61
INDGENPY
13,14,16,17,18,18a,18b,18c
CDE-1
1,2,3,4,8,11,12
CDE-2
1,2,2a,3,4,5,7,8,9
EXP-1
1,2,3,4,5a,5b,5c,7,7a,7b,8,9,10,11,12,13,
14
Appendix C: Program Mapping Document
OMB No. 0915-0061, Exp. Date 03/31/2025
T0B
T0B
T0B
T0B
T0B
T0B
T0B
T0B
T0B
Primary Care Training Enhancement
Program – Integrating Behavioral Health
in Primary Care
Primary Care Training Enhancement
Program – Integrating Behavioral Health
in Primary Care
Primary Care Training Enhancement
Program – Integrating Behavioral Health
in Primary Care
Primary Care Training Enhancement
Program – Integrating Behavioral Health
in Primary Care
Primary Care Training Enhancement
Program – Integrating Behavioral Health
in Primary Care
Primary Care Training Enhancement
Program – Integrating Behavioral Health
in Primary Care
Primary Care Training Enhancement
Program – Integrating Behavioral Health
in Primary Care
Primary Care Training Enhancement
Program – Integrating Behavioral Health
in Primary Care
Primary Care Training Enhancement
Program – Integrating Behavioral Health
in Primary Care
EXP-2
1,2,3,3a,4,5,6,7
FD-1a
1,2,3,4,5,6,7,8,9,10,11
FD-1b
1,2,2a,3
FD-2a
1,2,3,4,5,6,7
FD-2b
1,2,2a,3
FD-4a
1,1a,2,3,4,5
FD-4b
1,2,2a,3
CE-1
1,2,3,4,5,6,8,9,10,11,12
CE-2
1,2,2a,3,4
Appendix C: Program Mapping Document
OMB No. 0915-0061, Exp. Date 03/31/2025
Activity
Code
Name
T12
State Oral Health Workforce Program
T12
State Oral Health Workforce Program
T12
State Oral Health Workforce Program
T12
State Oral Health Workforce Program
Grant
Purpose
Setup
Training
Program
Setup
Faculty
Development
Setup
PC-1
T12
State Oral Health Workforce Program
PC-6
1,2,2a,2b,2c,4,5,6,7,8,9,10
T12
State Oral Health Workforce Program
PC-8
1,2,3,3a,3b,3c,5,6,7,8,9,10,11
T12
State Oral Health Workforce Program
PC-9
1,2,4,5,6
T12
State Oral Health Workforce Program
LR-1a
1,4,6,7,8
T12
State Oral Health Workforce Program
LR-2
1,2,5,7,10,12,15,17,19c,19f
T12
State Oral Health Workforce Program
DV-1
1,2,5,7,10,12
T12
State Oral Health Workforce Program
DV-2
1,6,7,10,11
T12
State Oral Health Workforce Program
DV-3
T12
State Oral Health Workforce Program
IND-GEN
1,4,6
1,2,3,4,5a,6a,7,8,9,10,11,12,13,14,15,16,
17,18,19,20,21b,22,23,24,26,26b,26c,26d
,27d,27e,27f,28,29,30,31,32,32a,33,34,
34aa,36,37,38,39,50,51,52,53,54,55
T12
State Oral Health Workforce Program
T12
State Oral Health Workforce Program
INDGENPY
CDE-1
T12
State Oral Health Workforce Program
CDE-2
1,2,2a,3,4,5,7,8,9
T12
State Oral Health Workforce Program
EXP-1
1,2,3,4,5a,5b,5c,7,7a,7b,8,9,10,11,13,14
T12
State Oral Health Workforce Program
EXP-2
1,2,3,3a,4,5,6,7
T12
State Oral Health Workforce Program
FD-5
n/a
T12
State Oral Health Workforce Program
RET
5,6,7
T12
State Oral Health Workforce Program
CE-1
1,2,3,4,5,6,8,9,10,11,12
T12
State Oral Health Workforce Program
CE-2
1,2,2a,3,4
T12
State Oral Health Workforce Program
SOHWP-A
1,2,3,4,5
T12
State Oral Health Workforce Program
SOHWP-B
1,2,3,4,5,6,7
T12
State Oral Health Workforce Program
SOHWP-C
3,4,5
T12
State Oral Health Workforce Program
SOHWP-D
6,7,8,9,10,11,12,13,14,15
T12
State Oral Health Workforce Program
SOHWP-E
1,2,3,4,5
T12
State Oral Health Workforce Program
SOHWP-F
1,2,3,4,5,6,7,8,9,10,11,12,13,14
T12
State Oral Health Workforce Program
SOHWP-G
22
Form
Columns List
See performance measures document,
grant purpose section
1,2
n/a
1,2,2a,2b,2c,4,5,6,7,8,9,10
13,14,16,17
1,2,3,4,8,11,12
Appendix C: Program Mapping Document
OMB No. 0915-0061, Exp. Date 03/31/2025
Activity
Code
Name
Form
Columns List
T13
Primary Care Training Enhancement –
Training Primary Care Champions
Faculty
Development
Setup
n/a
T13
Primary Care Training Enhancement –
Training Primary Care Champions
IND-GEN
2,2a,3,4,5a,6a,7,8,9,10,11,12,20a,21b,22,
26,26b,26c,26d,27d,27e,27f,28,29,30,31,
32,32a,33,34,34aa,36,37,39,44,45,46,47,
48,49,56,56a,56b,57,58,59,60,61
INDGENPY
13,14,18,18a,18b,18c
CDE-1
1,2,3,4,8,11,12
CDE-2
1,2,2a,3,4,5,7,8,9
FD-1a
1,1a,2,3,4,5,6,7,8,9,11
FD-1b
1,2,2a,3
FD-2a
1,2,3,4,5,6,7
FD-2b
1,2,2a,3
FD-3
1,1a,2,3,8,9
FD-4a
1,1a,2,3,4,5
FD-4b
1,2,2a,3
T13
T13
T13
T13
T13
T13
T13
T13
T13
T13
Primary Care Training Enhancement –
Training Primary Care Champions
Primary Care Training Enhancement –
Training Primary Care Champions
Primary Care Training Enhancement –
Training Primary Care Champions
Primary Care Training Enhancement –
Training Primary Care Champions
Primary Care Training Enhancement –
Training Primary Care Champions
Primary Care Training Enhancement –
Training Primary Care Champions
Primary Care Training Enhancement –
Training Primary Care Champions
Primary Care Training Enhancement –
Training Primary Care Champions
Primary Care Training Enhancement –
Training Primary Care Champions
Primary Care Training Enhancement –
Training Primary Care Champions
Appendix C: Program Mapping Document
OMB No. 0915-0061, Exp. Date 03/31/2025
Activity
Code
Name
Form
Columns List
T1Q
Nurse Education, Practice, Quality and
Retention: Clinical Faculty and Preceptor
Academies Program
Faculty
Development
Setup
n/a
T1Q
Nurse Education, Practice, Quality and
Retention: Clinical Faculty and Preceptor
Academies Program
IND-GEN
2,2a,3,3b,4,5a,6a,7,8,9,10,11,12,13,13a,
21b,22,26,26b,26c,26d,27aa,27a,27d,28,
31,33,34a,34b,36,36a,37,38b,39,40,41,42,
43,45a,45b,56,56a,56b,57,58,59,60,61
INDGENPY
14,15,16,17,18,18a,18b,18c
CDE-1
1,2,3,4,8,11,12
CDE-2
1,2,2a,3,4,5,7,8,9
EXP-1
1,2,3,4,5a,5b,5c,7,7a,7b,8,9,10,11,13,14
EXP-2
2,3,3a,4,5,6,7
FD-1a
1,1a,1b,6,7,8,9,10,11
FD-1b
1,2,2a,3
FD-2a
1,2,3,4,5,6,7
FD-2b
1,2,2a,3
FD-4a
1,1a,2,3,4,5
FD-4b
1,2,2a,3
T1Q
T1Q
T1Q
T1Q
T1Q
T1Q
T1Q
T1Q
T1Q
T1Q
T1Q
Nurse Education, Practice, Quality and
Retention: Clinical Faculty and Preceptor
Academies Program
Nurse Education, Practice, Quality and
Retention: Clinical Faculty and Preceptor
Academies Program
Nurse Education, Practice, Quality and
Retention: Clinical Faculty and Preceptor
Academies Program
Nurse Education, Practice, Quality and
Retention: Clinical Faculty and Preceptor
Academies Program
Nurse Education, Practice, Quality and
Retention: Clinical Faculty and Preceptor
Academies Program
Nurse Education, Practice, Quality and
Retention: Clinical Faculty and Preceptor
Academies Program
Nurse Education, Practice, Quality and
Retention: Clinical Faculty and Preceptor
Academies Program
Nurse Education, Practice, Quality and
Retention: Clinical Faculty and Preceptor
Academies Program
Nurse Education, Practice, Quality and
Retention: Clinical Faculty and Preceptor
Academies Program
Nurse Education, Practice, Quality and
Retention: Clinical Faculty and Preceptor
Academies Program
Nurse Education, Practice, Quality and
Retention: Clinical Faculty and Preceptor
Academies Program
Appendix C: Program Mapping Document
OMB No. 0915-0061, Exp. Date 03/31/2025
Activity
Code
Name
Form
Columns List
T26
Opioid-Impacted Family Support
Program
Training
Program
Setup
1,2
T26
Opioid-Impacted Family Support
Program
PC-1
1,2,3,4,5a,5b,5c,7,8,9,10,11,12,13
IND-GEN
1,2,3,4,5a,6a,7,8,9,10,11,12,13,13a,21b,
22,26,26b,26c,26d,27d,27e,28,29,31,32,
33,34,34ac,36,36a,37,38,38b,38f,39,56,
56a,56b,56c,57,58,59,60,61, 93,94, 95,96,
107
INDGENPY
13,14,16,17,18a,18b,18c,19
CDE-1
1,2,3,4,8,11,12
CDE-2
1,2,2a,3,4,5,7,8,9
EXP-1
1,2,3,4,5a,5b,5c,7a,7b,8,9,10,11,13,14
EXP-2
1,2,3,3a,4,5,6,7
T26
T26
T26
T26
T26
T26
Opioid-Impacted Family Support
Program
Opioid-Impacted Family Support
Program
Opioid-Impacted Family Support
Program
Opioid-Impacted Family Support
Program
Opioid-Impacted Family Support
Program
Opioid-Impacted Family Support
Program
Appendix C: Program Mapping Document
OMB No. 0915-0061, Exp. Date 03/31/2025
Activity
Code
Name
Form
Columns List
T29
Community Health Worker Training
Program
Training
Program
Setup
1,2
T29
Community Health Worker Training
Program
PC-1
1,2,3,4,5a,5b,5c,7,8,9,10,11,12,13
IND-GEN
1,2,3,4,5a,6a,7,8,9,10,11,12,13,13a,21b,
22,26,26b,26c,26d,27d,27e,27f,28,29,30,
31,32,32a,33,34,34aa,34ab,34ac,34c,36,
37,38,39,39a,39b,56,56a,56b,56c,56d,57,
58,59,60,61,62,63,64,93,94,95,96,97,98,9
9,100,101,102,103,104,105,106,107,108
INDGENPY
13,14,16,17,18,18a,18b,18c,21,22
CDE-1
1,2,3,4,8,11,12
CDE-2
1,2,2a,3
EXP-1
1,2,3,4,5a,5b,5c,7,7a,7b,8,9,10,11,13,14
EXP-2
1,2,3,3a,4,5
T29
T29
T29
T29
T29
T29
Community Health Worker Training
Program
Community Health Worker Training
Program
Community Health Worker Training
Program
Community Health Worker Training
Program
Community Health Worker Training
Program
Community Health Worker Training
Program
Appendix C: Program Mapping Document
OMB No. 0915-0061, Exp. Date 03/31/2025
Activity
Code
T34
T34
T34
T34
T34
T34
T34
T34
T34
T34
T34
T34
T34
T34
T34
Name
Form
Primary Care Training Enhancement –
Community Prevention and Maternal
Health
Primary Care Training Enhancement –
Community Prevention and Maternal
Health
Primary Care Training Enhancement –
Community Prevention and Maternal
Health
Primary Care Training Enhancement –
Community Prevention and Maternal
Health
Primary Care Training Enhancement –
Community Prevention and Maternal
Health
Faculty
Development
Setup
Training
Program
Setup
Primary Care Training Enhancement –
Community Prevention and Maternal
Health
Primary Care Training Enhancement –
Community Prevention and Maternal
Health
Primary Care Training Enhancement –
Community Prevention and Maternal
Health
Primary Care Training Enhancement –
Community Prevention and Maternal
Health
Primary Care Training Enhancement –
Community Prevention and Maternal
Health
Primary Care Training Enhancement –
Community Prevention and Maternal
Health
Primary Care Training Enhancement –
Community Prevention and Maternal
Health
Primary Care Training Enhancement –
Community Prevention and Maternal
Health
Primary Care Training Enhancement –
Community Prevention and Maternal
Health
Primary Care Training Enhancement –
Community Prevention and Maternal
Health
Columns List
n/a
1,2
PC-6
1,2,2a,2b,2c,3a,4,5,6,7,8,9,10
PC-8
1,2,3a,3b,3c,4a,5,6,7,8,9,10,11
PC-9
1,2,3,4,5,6
IND-GEN
1,2,2a,3,3a,4,5a,6a,7,8,9,10,11,12,13,14,
20,21b,22,26,26a,26b,26c,26d,27c,27d,
27e,27f,28,29,30,31,32,32a,33,34,34aa,
34ab,36,37,39,56,56a,56b,57,58,59,60,61
INDGENPY
13,14,16,17,18,18a,18b,18c
CDE-1
1,2,3,4,8,11,12
CDE-2
1,2,2a,3,4,5,7,8,9
EXP-1
1,2,3,4,5a,5b,5c,7,7a,7b,8,9,10,11,13,14
EXP-2
1,2,3,3a,4,5,6,7
FD-1a
1,1a,5,6,7,8,9,10,11
FD-1b
1,2,2a,3
FD-2a
1,2,3,4,5,6,7
FD-2b
1,2,2a,3
Appendix C: Program Mapping Document
OMB No. 0915-0061, Exp. Date 03/31/2025
Activity
Code
T59
T59
T59
T59
T59
T59
Name
Form
Advanced Nursing Education – Nurse
Practitioner Residency and Fellowship
Program
Advanced Nursing Education – Nurse
Practitioner Residency and Fellowship
Program
Advanced Nursing Education – Nurse
Practitioner Residency and Fellowship
Program
Advanced Nursing Education – Nurse
Practitioner Residency and Fellowship
Program
Advanced Nursing Education – Nurse
Practitioner Residency and Fellowship
Program
Training
Program
Setup
Faculty
Development
Setup
Advanced Nursing Education – Nurse
Practitioner Residency and Fellowship
Program
Columns List
1,2
n/a
PC-6
1,2,2a,2b,2c,3a,4,5,6,7,8,9,10
PC-8
1,2,3a,3b,3c,5,6,7,8,9,10,11
PC-9
1,2,3,4,5
IND-GEN
1,2,2a,3,3b,4,5a,6a,7,8,9,10,11,12,13,21b,22
,26,26b,26c,26d,27aa,27a,27b,27c,27d,27e,2
7f,28,29,30,31,32,32a,33,34,34aa,34ab,34ac
,36,36a,37,38,39,56,56a,56b,57,58,59,60,61
Advanced Nursing Education – Nurse
Practitioner Residency and Fellowship INDGEN-PY 13,14,16,17,18,18a,18b,18c
Program
Advanced Nursing Education – Nurse
T59
Practitioner Residency and Fellowship CDE-1
1,2,3,4,8,11,12
Program
Advanced Nursing Education – Nurse
T59
Practitioner Residency and Fellowship CDE-2
1,2,2a,3,4,5,7,8,9
Program
Advanced Nursing Education – Nurse
T59
Practitioner Residency and Fellowship EXP-1
1,2,3,4,5a,5b,5c,7,7a,7b,8,9,10,11,13,14
Program
Advanced Nursing Education – Nurse
T59
Practitioner Residency and Fellowship EXP-2
1,2,3,3a,4,5,6,7
Program
Advanced Nursing Education – Nurse
T59
Practitioner Residency and Fellowship FD-1a
1,1a,1b,5,6,7,8,9,10,11
Program
Advanced Nursing Education – Nurse
T59
Practitioner Residency and Fellowship FD-1b
1,2,2a,3
Program
Advanced Nursing Education – Nurse
T59
Practitioner Residency and Fellowship FD-2a
1,2,3,4,5,6,7
Program
Advanced Nursing Education – Nurse
T59
Practitioner Residency and Fellowship FD-2b
1,2,2a,3
Program
Advanced Nursing Education – Nurse
T59
Practitioner Residency and Fellowship CE-1
1,2,3,4,5,6,8,9,10,11,12
Program
Advanced Nursing Education – Nurse
T59
Practitioner Residency and Fellowship CE-2
1,2,3,4
Program
Note: This upcoming program will start collecting data in AY 2023-2024. Forms and columns listed are based on
expected reporting requirements, but they may vary slightly from what is listed above.
T59
Appendix C: Program Mapping Document
OMB No. 0915-0061, Exp. Date 03/31/2025
Activity
Code
Name
T5C
Primary Care Training and Enhancement
- Language and Disability Access
T5C
Primary Care Training and Enhancement
- Language and Disability Access
T5C
Primary Care Training and Enhancement
- Language and Disability Access
T5C
Primary Care Training and Enhancement
- Language and Disability Access
Form
Training
Program
Setup
Faculty
Development
Setup
Columns List
1,2
n/a
PC-7
1,2,2a,2b,2c,4,5,6,7,8,9,10
IND-GEN
1,2,2a,3,4,5a,6a,7,8,9,10,11,12,13,20a,21
b,22,26,26b,26c,26d,27d,27e,27f,28,29,3
0,31,32,32a,33,34,34a,34b,34aa,36,37,
39,56,56a,56b,57,58,59,60,61
Primary Care Training and Enhancement
INDGEN13,14,16,17,18,18a,18b,18c
- Language and Disability Access
PY
Primary Care Training and Enhancement
T5C
CDE-1
1,2,3,4,8,11,12
- Language and Disability Access
Primary Care Training and Enhancement
T5C
CDE-2
1,2,2a,3,4,5,7,8,9
- Language and Disability Access
Primary Care Training and Enhancement
T5C
EXP-1
1,2,3,4,5a,5b,5c,7,7a,7b,8,9,10,11,13,14
- Language and Disability Access
Primary Care Training and Enhancement
T5C
EXP-2
1,2,3,3a,4,5,6,7
- Language and Disability Access
Primary Care Training and Enhancement
T5C
FD-1a
1,1a,5,6,7,8,9,10
- Language and Disability Access
Primary Care Training and Enhancement
T5C
FD-1b
1,2,2a,3
- Language and Disability Access
Primary Care Training and Enhancement
T5C
FD-2a
1,2,3,4,5,6,7
- Language and Disability Access
Primary Care Training and Enhancement
T5C
FD-2b
1,2,2a,3
- Language and Disability Access
Note: This upcoming program will start collecting data in AY 2023-2024. Forms and columns listed are based on
expected reporting requirements, but they may vary slightly from what is listed above.
T5C
Appendix C: Program Mapping Document
OMB No. 0915-0061, Exp. Date 03/31/2025
Activity
Code
Name
T62
Integrated Substance Use Disorder
Training Program
T62
Integrated Substance Use Disorder
Training Program
T62
Integrated Substance Use Disorder
Training Program
T62
Integrated Substance Use Disorder
Training Program
T62
T62
T62
T62
T62
T62
T62
T62
T62
Integrated Substance Use Disorder
Training Program
Integrated Substance Use Disorder
Training Program
Integrated Substance Use Disorder
Training Program
Integrated Substance Use Disorder
Training Program
Integrated Substance Use Disorder
Training Program
Integrated Substance Use Disorder
Training Program
Integrated Substance Use Disorder
Training Program
Integrated Substance Use Disorder
Training Program
Integrated Substance Use Disorder
Training Program
Form
Training
Program
Setup
Faculty
Development
Setup
Columns List
1,2
n/a
PC-7
1,2,2a,2b,2c,4,5,6,7,8,9,10
IND-GEN
1,2,2a,3,4,5a,6a,7,8,9,10,11,12,13,13a,
21b,22,26,26b,26c,26d,27d,27e,27f,28,29
,30,31,32,32a,33,34,34aa,34ab,34ac,36,37
,39,56,56a,56b,57,58,59,60,61
INDGENPY
13,14,16,17,18,18a,18b,18c
CDE-1
1,2,3,4,8,11,12
CDE-2
1,2,2a,3,4,5,7,8,9
EXP-1
1,2,3,4,5a,5b,5c,7,7a,7b,8,9,10,11,13,14
EXP-2
1,2,3,3a,4,5,6,7
FD-1a
1,1a,5,6,7,8,9,10,11
FD-1b
1,2,2a,3
FD-2a
1,2,3,4,5,6,7
FD-2b
1,2,2a,3
Appendix C: Program Mapping Document
OMB No. 0915-0061, Exp. Date 03/31/2025
Activity
Code
Name
Form
Columns List
T68
Maternity Care Nursing Workforce
Expansion Program
Training
Program
Setup
1,2
T68
Maternity Care Nursing Workforce
Expansion Program
PC-1
1,2,3,4,5a,5b,5c,7,8,9,10,11,12,13
IND-GEN
1,2,2a,3,3b,4,5a,6a,7,8,9,10,11,12,13,15,2
0a,21b,22,26,26b,26c,26d,27d,27e,27f,28,
29,30,31,32,32a,33,34,34a,34b,34aa,36,3
7,38,38b,38f,39,56,56a,56b,57,58,59,60,6
1
T68
Maternity Care Nursing Workforce
Expansion Program
Maternity Care Nursing Workforce
INDGEN13,14,16,17,18,18a,18b,18c
Expansion Program
PY
Maternity Care Nursing Workforce
T68
CDE-1
1,2,3,4,8,11,12
Expansion Program
Maternity Care Nursing Workforce
T68
CDE-2
1,2,2a,3,4,5,7,8,9
Expansion Program
Maternity Care Nursing Workforce
T68
EXP-1
1,2,3,4,5a,5b,5c,7,7a,7b,8,9,10,11,13,14
Expansion Program
Maternity Care Nursing Workforce
T68
EXP-2
1,2,3,3a,4,5,6,7
Expansion Program
Note: This upcoming program will start collecting data in AY 2023-2024. Forms and columns listed are based on
expected reporting requirements, but they may vary slightly from what is listed above.
T68
Appendix C: Program Mapping Document
OMB No. 0915-0061, Exp. Date 03/31/2025
Activity
Code
Name
T94
Advanced Nursing Education Workforce
T94
Advanced Nursing Education Workforce
T94
Advanced Nursing Education Workforce
Training
Program
Setup
Faculty
Development
Setup
PC-1
T94
Advanced Nursing Education Workforce
LR-1a
1,1a,6a,7,8,16
T94
Advanced Nursing Education Workforce
LR-2
1,2,2a,6a,7a,11a,12a,16a,20
T94
Advanced Nursing Education Workforce
DV-1
1,2,2a,6a,7a,11a,18
T94
Advanced Nursing Education Workforce
DV-2
1,13,14,15,16,12
T94
Advanced Nursing Education Workforce
DV-3
T94
Advanced Nursing Education Workforce
IND-GEN
1,8,9,7
1,2,2a,3,3b,4,5a,6a,7,8,9,10,11,12,20a,
21b,22,26,26b,26c,26d,27aa,27d,27e,28,
29,31,32,33,34,34a,34b,36,36a,37,38,38b,
39,56,56b,57,58,59,60,61
T94
Advanced Nursing Education Workforce
T94
Advanced Nursing Education Workforce
INDGENPY
CDE-1
T94
Advanced Nursing Education Workforce
CDE-2
1,2,2a,3,4,5,7,8,9
T94
Advanced Nursing Education Workforce
EXP-1
1,2,3,4,5a,5b,5c,7,7a,7b,8,9,10,11,13,14
T94
Advanced Nursing Education Workforce
EXP-2
1,2,3,3a,4,5,6,7
T94
Advanced Nursing Education Workforce
FD-1a
1,1a,1b,2,3,5,6,7,8,9,10,11
T94
Advanced Nursing Education Workforce
FD-1b
1,2,2a,3
T94
Advanced Nursing Education Workforce
FD-2a
1,2,3,4,5,6,7
T94
Advanced Nursing Education Workforce
FD-2b
1,2,2a,3
T94
Advanced Nursing Education Workforce
FD-4a
1,1a,2,3,4,5
T94
Advanced Nursing Education Workforce
FD-4b
1,2,2a,3
T94
Advanced Nursing Education Workforce
CE-1
1,2,3,4,5,6,8,9,10,11,12
T94
Advanced Nursing Education Workforce
CE-2
1,2,2a,3,4
Form
Columns List
1,2
n/a
1,2,4,5a,5b,5c,6d
13,14,16,17,18,18a,18b,18c
1,2,3,4,8,11,12
Appendix C: Program Mapping Document
OMB No. 0915-0061, Exp. Date 03/31/2025
Activity
Code
Name
T99
Value-Based Medical Student Education
Training
T99
Value-Based Medical Student Education
Training
T99
T99
T99
T99
T99
T99
T99
T99
T99
T99
T99
T99
T99
T99
Value-Based Medical Student Education
Training
Value-Based Medical Student Education
Training
Value-Based Medical Student Education
Training
Value-Based Medical Student Education
Training
Value-Based Medical Student Education
Training
Value-Based Medical Student Education
Training
Value-Based Medical Student Education
Training
Value-Based Medical Student Education
Training
Value-Based Medical Student Education
Training
Value-Based Medical Student Education
Training
Value-Based Medical Student Education
Training
Value-Based Medical Student Education
Training
Value-Based Medical Student Education
Training
Value-Based Medical Student Education
Training
Form
Faculty
Development
Setup
Training
Program
Setup
Columns List
n/a
1,2
PC-1
1,2,4,5a,5b,5c,7,8,9,10,11,12,13
PC-9
1,2,5
IND-GEN
1,2,2a,3,4,5a,7,8,9,10,11,12,20a,21b,22,
26,26b,26c,26d,27d,27e,28,29,31,32,33,
34,36,37,38,38d,38e,39,56,56a,56b,57,58,
59,60,61
INDGENPY
13,14,16,17,18,18a,18b,18c
CDE-1
1,2,3,4,8,11,12
CDE-2
1,2,2a,3,4,5,7,8,9
EXP-1
1,2,3,4,5a,5b,5c,7,7a,7b,8,9,10,11,12,13,
14
EXP-2
1,2,3,3a,4,5,6,7
FD-1a
1,1a,2,3,4,5,6,7,8,9,10,11
FD-1b
1,2,2a,3
FD-2a
1,2,3,4,5,6,7
FD-2b
1,2,2a,3
CE-1
1,2,3,4,5,6,8,9,10,11,12
CE-2
1,2,2a,3,4
Appendix C: Program Mapping Document
OMB No. 0915-0061, Exp. Date 03/31/2025
Activity
Code
T9D
T9D
T9D
T9D
T9D
T9D
T9D
T9D
T9D
T9D
T9D
T9D
T9D
T9D
T9D
T9D
Name
Form
Primary Care Training Enhancement –
Physician Assistant Rural Training
Program
Primary Care Training Enhancement –
Physician Assistant Rural Training
Program
Primary Care Training Enhancement –
Physician Assistant Rural Training
Program
Primary Care Training Enhancement –
Physician Assistant Rural Training
Program
Training
Program
Setup
Faculty
Development
Setup
Primary Care Training Enhancement –
Physician Assistant Rural Training
Program
Primary Care Training Enhancement –
Physician Assistant Rural Training
Program
Primary Care Training Enhancement –
Physician Assistant Rural Training
Program
Primary Care Training Enhancement –
Physician Assistant Rural Training
Program
Primary Care Training Enhancement –
Physician Assistant Rural Training
Program
Primary Care Training Enhancement –
Physician Assistant Rural Training
Program
Primary Care Training Enhancement –
Physician Assistant Rural Training
Program
Primary Care Training Enhancement –
Physician Assistant Rural Training
Program
Primary Care Training Enhancement –
Physician Assistant Rural Training
Program
Primary Care Training Enhancement –
Physician Assistant Rural Training
Program
Primary Care Training Enhancement –
Physician Assistant Rural Training
Program
Primary Care Training Enhancement –
Physician Assistant Rural Training
Program
Columns List
1,2
n/a
PC-1
1,2,4,5a,5b,5c,7,8,9,10,11,12,13
PC-9
1,2,3,4,5
IND-GEN
1,2,2a,3,4,5a,6a,7,8,9,10,11,12,13,21b,22,
26,26b,26c,26d,27d,27e,27f,28,29,30,31,
32,32a,33,34,34aa,36,37,38,39,56,56a,
56b,57,58,59,60,61
INDGENPY
13,14,16,17,18,18a,18b,18c
CDE-1
1,2,3,4,8,11,12
CDE-2
1,2,2a,3,4,5,7,8,9
EXP-1
1,2,3,4,5a,5b,5c,7,7a,7b,8,9,10,11,13,14
EXP-2
1,2,3,3a,4,5,6,7
FD-1a
1,1a,5,6,7,8,9,10
FD-1b
1,2,2a,3
FD-2a
1,2,3,4,5,6,7
FD-2b
1,2,2a,3
CE-1
1,2,3,4,5,6,8,9,10,11
CE-2
1,2,3,4
Appendix C: Program Mapping Document
OMB No. 0915-0061, Exp. Date 03/31/2025
Activity
Code
TA2
TA2
TA2
TA2
TA2
Name
Form
Primary Care Training and Enhancement
- Residency Training in Mental and
Behavioral Health
Primary Care Training and Enhancement
- Residency Training in Mental and
Behavioral Health
Primary Care Training and Enhancement
- Residency Training in Mental and
Behavioral Health
Primary Care Training and Enhancement
- Residency Training in Mental and
Behavioral Health
Primary Care Training and Enhancement
- Residency Training in Mental and
Behavioral Health
Training
Program
Setup
Faculty
Development
Setup
Columns List
1,2
n/a
PC-8
3a,3b,3c,4a,5,6,7,8,9,10,11
PC-9
1,2,3,4,5,6
IND-GEN
1,2,2a,3,4,5a,6a,7,8,9,10,11,12,13,20a,21
b,22,26,26b,26c,26d,27d,27e,27f,28,29,3
0,31,32,32a,33,34, 34aa,36,37,
39,56,56a,56b,57,58,59,60,61
Primary Care Training and Enhancement
INDGEN- Residency Training in Mental and
13,14,16,17,18,18a,18b,18c
PY
Behavioral Health
Primary Care Training and Enhancement
TA2
- Residency Training in Mental and
CDE-1
1,2,3,4,8,11,12
Behavioral Health
Primary Care Training and Enhancement
TA2
- Residency Training in Mental and
CDE-2
1,2,2a,3,4,5,7,8,9
Behavioral Health
Primary Care Training and Enhancement
TA2
- Residency Training in Mental and
EXP-1
1,2,3,4,5a,5b,5c,7,7a,7b,8,9,10,11,13,14
Behavioral Health
Primary Care Training and Enhancement
TA2
- Residency Training in Mental and
EXP-2
1,2,3,3a,4,5,6,7
Behavioral Health
Primary Care Training and Enhancement
TA2
- Residency Training in Mental and
FD-1a
1,1a,5,6,7,8,9,10
Behavioral Health
Primary Care Training and Enhancement
TA2
- Residency Training in Mental and
FD-1b
1,2,2a,3
Behavioral Health
Primary Care Training and Enhancement
TA2
- Residency Training in Mental and
FD-2a
1,2,3,4,5,6,7
Behavioral Health
Primary Care Training and Enhancement
TA2
- Residency Training in Mental and
FD-2b
1,2,2a,3
Behavioral Health
Note: This upcoming program will start collecting data in AY 2023-2024. Forms and columns listed are based on
expected reporting requirements, but they may vary slightly from what is listed above.
TA2
Appendix C: Program Mapping Document
OMB No. 0915-0061, Exp. Date 03/31/2025
Activity
Code
Name
U1Q
Geriatrics Workforce Enhancement
Program
U1Q
Geriatrics Workforce Enhancement
Program
U1Q
U1Q
U1Q
U1Q
U1Q
U1Q
U1Q
U1Q
U1Q
U1Q
U1Q
U1Q
U1Q
U1Q
U1Q
U1Q
U1Q
U1Q
U1Q
U1Q
U1Q
U1Q
Geriatrics Workforce Enhancement
Program
Geriatrics Workforce Enhancement
Program
Geriatrics Workforce Enhancement
Program
Geriatrics Workforce Enhancement
Program
Geriatrics Workforce Enhancement
Program
Geriatrics Workforce Enhancement
Program
Geriatrics Workforce Enhancement
Program
Geriatrics Workforce Enhancement
Program
Geriatrics Workforce Enhancement
Program
Geriatrics Workforce Enhancement
Program
Geriatrics Workforce Enhancement
Program
Geriatrics Workforce Enhancement
Program
Geriatrics Workforce Enhancement
Program
Geriatrics Workforce Enhancement
Program
Geriatrics Workforce Enhancement
Program
Geriatrics Workforce Enhancement
Program
Geriatrics Workforce Enhancement
Program
Geriatrics Workforce Enhancement
Program
Geriatrics Workforce Enhancement
Program
Geriatrics Workforce Enhancement
Program
Geriatrics Workforce Enhancement
Program
Geriatrics Workforce Enhancement
Program
Form
Training
Program
Setup
Faculty
Development
Setup
Columns List
1,2
n/a
PC-1
1,2,3,4,5a,5b,5c,6b,7,8,9,10,11,12,13
PC-6
1,2,2a,2b,2c,3a,4,5,6,7,8,9,10
PC-7
1,2,2a,2b,2c,3a,4,5,6,7,8,9,10
LR-1a
1,1a,6a,7,8,16
LR-2
1,2,2a,6a,7a,11a,12a,16a,19,19e,20
DV-1
1,2,2a,6a,7a,11a,12a,16a,18
DV-2
1,13,14,15,16,12
DV-3
1,8,9,7
IND-GEN
1,2,2a,3,4,5a,6a,7,8,9,10,11,12,20a,21b,
22,26,26b,26c,26d,27aa,27d,27e,28,29,
21,32,33,34,36,37,38,39,56,56a,56b,57,
58,59,60,61
INDGENPY
13,14,16,17,18,18a,18b,18c
CDE-1
1,2,3,4,8,11,12,13
CDE-2
1,2,2a,3,4,5,7,8,9
EXP-1
1,2,3,4,5a,5b,5c,7,7a,7b,8,9,10,11,12,13
EXP-2
1,2,3,3a,4,5,6,7
FD-1a
1,2,3,4,5,6,7,8,9,10,11,12
FD-1b
1,2,2a,3
FD-2a
1,2,3,4,5,6,7,8
FD-2b
1,2,2a,3
FD-4a
1,1a,2,3,4,5
FD-4b
1,2,2a,3
CE-1
1,1b,2,3,4,5,6,8,9,10,11,12,15,16
CE-2
1,2,2a,3,4,5
Appendix C: Program Mapping Document
OMB No. 0915-0061, Exp. Date 03/31/2025
Activity
Code
Name
Form
Columns List
U68
State Primary Care Offices
PCO-1
n/a
U68
State Primary Care Offices
PCO-2
1,2,3,4,5,6,7,8
U68
State Primary Care Offices
PCO-3a
1,2,3,4,5,6,7,8
U68
State Primary Care Offices
PCO-3b
1,2,3,4,5,6
Appendix C: Program Mapping Document
OMB No. 0915-0061, Exp. Date 03/31/2025
Activity
Code
Name
UB6
Public Health Training Centers
UB6
Public Health Training Centers
UB6
Public Health Training Centers
Training
Program
Setup
Faculty
Development
Setup
PC-7
UB6
Public Health Training Centers
IND-GEN
UB6
Public Health Training Centers
UB6
Public Health Training Centers
INDGENPY
EXP-1
UB6
Public Health Training Centers
EXP-2
1,2,3,3a,4,5,6,7
UB6
Public Health Training Centers
FD-3
1,1a,2,3,4,5,6,7,8,9
UB6
Public Health Training Centers
CE-1
1,2,3,4,5,6,8,9,10,11,12,13,14
UB6
Public Health Training Centers
CE-2
1,2,2a,3,4
Form
Columns List
1,2
n/a
1,2,2a,2b,2c,4,5,6,7,8,9,10
1,2,3,4,5a,6a,7,8,9,10,11,12,13,21b,22,26,
26b,26c,26d,27aa,27d,27e,28,29,31,32,33
,34,35,36,37,39,56,57,58,59,60,61
13,14,16,17,18,18a,18b,18c
1,2,3,4,5a,5b,5c,6,7,7a,7b,8,9,10,11,13,14
Appendix C: Program Mapping Document
OMB No. 0915-0061, Exp. Date 03/31/2025
Activity
Code
UD7
UD7
UD7
UD7
UD7
UD7
UD7
UD7
UD7
UD7
UD7
UD7
UD7
UD7
UD7
UD7
UD7
Name
Form
Nurse Education, Practice, Quality and
Retention - Pathway to Registered Nurse
Program
Nurse Education, Practice, Quality and
Retention - Pathway to Registered Nurse
Program
Nurse Education, Practice, Quality and
Retention - Pathway to Registered Nurse
Program
Nurse Education, Practice, Quality and
Retention - Pathway to Registered Nurse
Program
Nurse Education, Practice, Quality and
Retention - Pathway to Registered Nurse
Program
Nurse Education, Practice, Quality and
Retention - Pathway to Registered Nurse
Program
Nurse Education, Practice, Quality and
Retention - Pathway to Registered Nurse
Program
Nurse Education, Practice, Quality and
Retention - Pathway to Registered Nurse
Program
Nurse Education, Practice, Quality and
Retention - Pathway to Registered Nurse
Program
Training
Program
Setup
Faculty
Development
Setup
Nurse Education, Practice, Quality and
Retention - Pathway to Registered Nurse
Program
Nurse Education, Practice, Quality and
Retention - Pathway to Registered Nurse
Program
Nurse Education, Practice, Quality and
Retention - Pathway to Registered Nurse
Program
Nurse Education, Practice, Quality and
Retention - Pathway to Registered Nurse
Program
Nurse Education, Practice, Quality and
Retention - Pathway to Registered Nurse
Program
Nurse Education, Practice, Quality and
Retention - Pathway to Registered Nurse
Program
Nurse Education, Practice, Quality and
Retention - Pathway to Registered Nurse
Program
Nurse Education, Practice, Quality and
Retention - Pathway to Registered Nurse
Program
Columns List
1,2
n/a
PC-1
1,2,3,4,5a,5b,5c,7,8,9,10,11,12,13
PC-3
4,5,8a,8b,8c
LR-1a
2,6,7,8
LR-2
3,7,8,12,13,17
DV-1
1,2,3,7,8,12
DV-2
1,2,3,10,11,12
DV-3
1,2,6,7
IND-GEN
1,2,3,4,5a,6a,7,8,9,10,11,12,13,20a,21b,2
2,26,26b,26c,26d,27d,27e,27f,28,29,30,3
1,32,32a,33,34,34aa,34a,34b,36,37,38,39,
39a,56,56a,56b,57,58,59,60,61
INDGENPY
13,14,16,17,18,18a,18b,18c
CDE-1
1,2,3,4,8,11,12
CDE-2
1,2,2a,3,4,5,7,8,9
EXP-1
1,2,3,4,5a,5b,5c,7,7a,7b,8,9,10,11,13,14
EXP-2
1,2,3,3a,4,5,6,7
EXP-3
1,2,3,4,4a,5,6,7
FD-1a
1,1a,5,6,7,8,9,10
Appendix C: Program Mapping Document
OMB No. 0915-0061, Exp. Date 03/31/2025
Nurse Education, Practice, Quality and
Retention - Pathway to Registered Nurse
FD-1b
1,2,2a,3
Program
Nurse Education, Practice, Quality and
UD7
Retention - Pathway to Registered Nurse
FD-2a
1,2,3,4,5,6,7
Program
Nurse Education, Practice, Quality and
UD7
Retention - Pathway to Registered Nurse
FD-2b
1,2,2a,3
Program
Note: This upcoming program will start collecting data in AY 2023-2024. Forms and columns listed are based on
expected reporting requirements, but they may vary slightly from what is listed above.
UD7
Appendix C: Program Mapping Document
OMB No. 0915-0061, Exp. Date 03/31/2025
Activity
Code
US6
US6
US6
US6
US6
US6
US6
US6
US6
US6
US6
US6
US6
US6
US6
Name
Form
Nurse Education, Practice, Quality and
Retention - Registered Nurse Training
Program
Nurse Education, Practice, Quality and
Retention - Registered Nurse Training
Program
Nurse Education, Practice, Quality and
Retention - Registered Nurse Training
Program
Training
Program
Setup
Faculty
Development
Setup
Nurse Education, Practice, Quality and
Retention - Registered Nurse Training
Program
Nurse Education, Practice, Quality and
Retention - Registered Nurse Training
Program
Nurse Education, Practice, Quality and
Retention - Registered Nurse Training
Program
Nurse Education, Practice, Quality and
Retention - Registered Nurse Training
Program
Nurse Education, Practice, Quality and
Retention - Registered Nurse Training
Program
Nurse Education, Practice, Quality and
Retention - Registered Nurse Training
Program
Nurse Education, Practice, Quality and
Retention - Registered Nurse Training
Program
Nurse Education, Practice, Quality and
Retention - Registered Nurse Training
Program
Nurse Education, Practice, Quality and
Retention - Registered Nurse Training
Program
Nurse Education, Practice, Quality and
Retention - Registered Nurse Training
Program
Nurse Education, Practice, Quality and
Retention - Registered Nurse Training
Program
Nurse Education, Practice, Quality and
Retention - Registered Nurse Training
Program
Columns List
1,2
n/a
PC-7
1,2,2a,2b,2c
IND-GEN
1,2,3,4,5a,6a,7,8,9,10,11,12,13,13a,20a,
21b,22,26,26b,26c,26d,27a,27c,27d,27e,
27f,28,29,30,31,32,32a,33,34,34aa,34ab,
34ac,36,36a,37,38b,39,56,56a,56b,57,58,
59,60,61
INDGENPY
13,14,16,17,18,18a,18b,18c
CDE-1
1,2,3,4,8,11,12
CDE-2
1,2,2a,3,4,5,7,8,9
EXP-1
1,2,3,4,5a,5b,5c,7,7a,7b,8,9,10,11,13,14
EXP-2
1,2,3,3a,4,5,6,7
FD-1a
1,1a,1b,2,3,4,5,6,7,8,9,10,11
FD-1b
1,2,2a,3
FD-2a
1,2,3,4,5,6,7
FD-2b
1,2,2a,3
CE-1
1,2,3,4,5,6,8,9,10,11,12
CE-2
1,2,2a,3,4
Public Burden Statement: The BHW Performance Report for Grants and Cooperative Agreements (PRGCA) is an annual performance and progress
report required from each health professions and nursing education grantee that has an approved, funded project with a project period of one year or
more. The report is required to determine the extent to which objectives of the project have been met so that a decision regarding continuation funding
can be made. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently
valid OMB control number. The OMB control number for this information collection is 0915-0061 and it is valid until 03/31/2025. This information
collection is required to obtain or retain a benefit (Government Performance and Results Act (GPRA) of 1993 and the GPRA Modernization Act of
2010). The information will be kept private to the extent permitted by law (see 42 USC 292 et seq). Public reporting burden for this collection of
information is estimated to average 3.2 hours per response to the annual performance report, including the time for reviewing instructions, searching
existing data sources, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of
this collection of information, including suggestions for reducing this burden, to HRSA Reports Clearance Officer, 5600 Fishers Lane, Room 14N39,
Rockville, Maryland, 20857 or [email protected].
| File Type | application/pdf |
| Author | Hays, Cameron (HRSA) |
| File Modified | 2024-03-08 |
| File Created | 2023-12-21 |