[Federal Register Volume 75, Number 162 (Monday, August 23, 2010)]
[Notices]
[Pages 51821-51822]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2010-20763]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration
Agency Information Collection Activities: Submission for OMB
Review; Comment Request
Periodically, the Health Resources and Services Administration
(HRSA) publishes abstracts of information collection requests under
review by the Office of Management and Budget (OMB), in compliance with
the Paperwork Reduction Act of 1995 (44 U.S.C. Chapter 35). To request
a copy of the clearance requests submitted to OMB for review, e-mail
[email protected] or call the HRSA Reports Clearance Office on (301)
443-1129.
The following request has been submitted to the Office of
Management and Budget for review under the Paperwork Reduction Act of
1995:
Proposed Project: The National Health Service Corps Loan Repayment
Program (OMB No. 0915-0127)--Extension
The National Health Service Corps (NHSC) Loan Repayment Program
(LRP) was established to assure an adequate supply of trained primary
care health care professionals to provide services in the neediest
Health Professional Shortage Areas (HPSAs) of the United States. Under
this program, the Department of Health and Human Services agrees to
repay the educational loans of the primary care health
[[Page 51822]]
professionals. In return, the health professionals agree to serve for a
specified period of time in a federally designated HPSA approved by the
Secretary for LRP participants. The NHSC LRP forms collect information
that is needed for selecting participants and repaying qualifying loans
for education. The LRP forms include the following: The NHSC LRP
Application, the Loan Information and Verification form, the Employment
Verification and Community Site Information form, the Payment
Information Form, the Authorization to Release Information form and the
Self-Certification Form. Once health professionals complete NHSC
service basic contact information such as name, phone number, e-mail
address, State (of residence and/or employment), discipline and
specialty will be collected and maintained in a database to enable HRSA
to communicate with NHSC alumni.
The annual estimate of burden is as follows:
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Number of Responses per Total Hours per Total burden
Instrument respondents respondent responses response hours
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NHSC LRP Application............ 5,175 1 5,175 .30 1,553
Payment Information Form........ 5,175 1 5,175 .20 1,035
Employment Verification and 5,175 1 5,175 .75 3,881
Community Site Information Form
Loan Information and 5,175 3 15,525 .30 4,658
Verification Form..............
Authorization to Release 5,175 1 5,175 .10 518
Information....................
Self-Certification Form......... 5,175 1 5,175 .10 518
NHSC Alumni Database............ 5,000 1 5,000 .20 1,000
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Total....................... .............. .............. 46,400 .............. 13,163
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Written comments and recommendations concerning the proposed
information collection should be sent within 30 days of this notice to
the OMB desk officer for HRSA, either by e-mail to [email protected] or by fax to 202-395-6974. Please direct all
correspondence to the ``attention of the OMB desk officer for HRSA.''
Dated: August 16, 2010.
Sahira Rafiullah,
Director, Division of Policy and Information Coordination.
[FR Doc. 2010-20763 Filed 8-20-10; 8:45 am]
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