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

Forms and Documents

Document Name	Status
Form 8 PS LRP Employment Verification Form Form and Instruction	Modified
Form 7 PS LRP Privacy Act Release Authorization Form Form and Instruction	Modified
Form 6 Pediatric Specialty LRP Authorization for Disclosure of Loan Information Form Form and Instruction	Modified
Form 5 Pediatric Specialty LRP Application Form and Instruction	Modified
Form 4 Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program (LRP) Employment Verification Form Form and Instruction	Modified
Form 3 Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program (LRP) Privacy Act Release Authorization Form Form and Instruction	Modified
Form 2 Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program (LRP) Authorization for Disclosure of Loan Information Form and Instruction	Modified
Form 1 Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program (LRP) Program Application Form and Instruction	Modified
SS-A - 0906-0058_BHW_ STAR LRP + Ped Spec LRP_12182025.docx Supporting Statement A	2025-12-19

IC Document Collections

IC ID	Document Title	Status
260337	PS LRP Employment Verification Form Form and Instruction	Modified
260336	PS LRP Privacy Act Release Authorization Form Form and Instruction	Modified
260334	Pediatric Specialty LRP Authorization for Disclosure of Loan Information Form Form and Instruction	Modified
260333	Pediatric Specialty LRP Application Form and Instruction	Modified
243487	Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program (LRP) Employment Verification Form Form and Instruction	Modified
243486	Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program (LRP) Privacy Act Release Authorization Form Form and Instruction	Modified
243485	Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program (LRP) Authorization for Disclosure of Loan Information Form and Instruction	Modified
243484	Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program (LRP) Program Application Form and Instruction	Modified

ICR Details

OMB Control No: 0906-0058	ICR Reference No: 202512-0906-006
Status: Received in OIRA	Previous ICR Reference No: 202307-0906-003
Agency/Subagency: HHS/HRSA	Agency Tracking No:
Title: Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program (LRP) and the Pediatric Specialty Loan Repayment Program
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 12/23/2025

	Requested	Previously Approved
Expiration Date	36 Months From Approved	07/31/2026
Responses	8,800	14,800
Time Burden (Hours)	4,400	7,400
Cost Burden (Dollars)	0	0

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

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

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 38983	08/13/2025
30-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 59841	12/22/2025
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 8

IC Title	Form No.	Form Name
PS LRP Privacy Act Release Authorization Form	7	PS LRP Privacy Act Release Authorization Form
Pediatric Specialty LRP Authorization for Disclosure of Loan Information Form	6	PS LRP Auth for Disc of Loan Info Form
PS LRP Employment Verification Form	8	PS LRP Employment Verification Form
Pediatric Specialty LRP Application	5	PS LRP Application
Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program (LRP) Authorization for Disclosure of Loan Information	2	STAR LRP Authorization for Disclosure of Loan Information Form
Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program (LRP) Employment Verification Form	4	STAR LRP Employment Verification Form
Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program (LRP) Privacy Act Release Authorization Form	3	STAR LRP Privacy Act Release Authorization Form
Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program (LRP) Program Application	1	STAR LRP Program Application

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ICR Summary of Burden

	Total Request	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	8,800	14,800	0	-6,000	0	0
Annual Time Burden (Hours)	4,400	7,400	0	-3,000	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to: Miscellaneous Actions

Short Statement: The total estimated annualized burden hours have decreased for the STAR LRP due to a fewer number of respondents for this program.

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Annual Cost to Federal Government: $1,144,563

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 12/23/2025

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