Nurse Faculty Loan Program (NFLP) Annual Performance Report Financial Data Form

Forms and Documents

Document Name	Status
Form 1 Nurse Faculty Loan Program (NFLP) Annual Performance Report Financial Data Form Form and Instruction	Modified
Supporting Statement 0314_Final.doc Supporting Statement A	2017-04-10

IC Document Collections

IC ID	Document Title	Status
182194	Nurse Faculty Loan Program (NFLP) Annual Performance Report Financial Data Form Form and Instruction	Modified

ICR Details

OMB Control No: 0915-0314	ICR Reference No: 201704-0915-004
Status: Historical Active	Previous ICR Reference No: 201402-0915-001
Agency/Subagency: HHS/HSA	Agency Tracking No: 21370
Title: Nurse Faculty Loan Program (NFLP) Annual Performance Report Financial Data Form
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 07/19/2017
	Date Received in OIRA: 04/26/2017
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2020	36 Months From Approved	07/31/2017
Responses	260	0	250
Time Burden (Hours)	1,560	0	2,000
Cost Burden (Dollars)	0	0	0

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Abstract: The school of nursing must keep records of all NFLP loan fund transactions. The NFLP-Annual Performance Report (APR) Financial Data Form is used to monitor grantee performance by collecting information relating to the NFLP loan fund operations and financial activities for a specified reporting period (July 1 through June 30 of the academic year). Participating schools are required to complete and submit the NFLP-APR financial data form semi-annually. The data provided in the form are essential for HRSA to effectively monitor the school’s use of NFLP funds in accordance with program guidelines. Approval of the revised NFLP-APR financial data form will facilitate our current effort to determine future awards to the school. The electronic data collection capability will streamline the report submission process, enable an efficient annual performance review process and serve as a data repository to facilitate reporting on the use of funds and analysis of program outcomes.

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Authorizing Statute(s): US Code: 42 USC 297n-1, Section 846A Name of Law: Title VIII, PHSA
   PL: Pub.L. 111 - 148 846A, Section 5311 Name of Law: Patient Protection and Affordable Care Act
  

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:
	82 FR 11228	02/21/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 19068	04/25/2017
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Nurse Faculty Loan Program (NFLP) Annual Performance Report Financial Data Form	1	Blank NFLP Performance Report Financial Data Form 0314.doc

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	260	250	0	10	0	0
Annual Time Burden (Hours)	1,560	2,000	0	-440	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: Using Information Technology

Short Statement: Burden decreased because the data form will collect less data that is limited to financial data, and will not include nursing degree program data and student enrollee data. Additionally, electronic submission of the NFLP-Annual Performance Report Financial Data Form reduces the burden for participating NFLP schools required to complete the report.

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Annual Cost to Federal Government: $6,149

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

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Yes

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? Uncollected

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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: 04/26/2017

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