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

Forms and Documents

Document Name	Status
Form 2 Nurse Faculty Loan Program- Annual Performance Report Financial Data Form Form and Instruction	New
Form 1 Nurse Faculty Loan Program- Program Specific Data Form Form and Instruction	Modified
ATTACHMENT 2 - NFLP Legislation.docx Supplementary Document	2020-05-12
ATTACHMENT1 60-day frn 0314 BHW NFLP REV.pdf Supplementary Document	2020-05-12
FINAL Supporting Statement 5-8-2020.docx Supporting Statement A	2020-05-12

IC Document Collections

IC ID	Document Title	Status
241796	Nurse Faculty Loan Program- Annual Performance Report Financial Data Form Form and Instruction	New
182194	Nurse Faculty Loan Program- Program Specific Data Form Form and Instruction	Modified

ICR Details

OMB Control No: 0915-0314	ICR Reference No: 202005-0915-002
Status: Active	Previous ICR Reference No: 201704-0915-004
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 with change	Conclusion Date: 08/04/2020
	Date Received in OIRA: 05/12/2020
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2023	36 Months From Approved	08/31/2020
Responses	350	0	260
Time Burden (Hours)	2,280	0	1,560
Cost Burden (Dollars)	0	0	0

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Abstract: This clearance request is for approval of both the Nurse Faculty Loan Program (NFLP) Program Specific Data Form and the Annual Performance Report (APR) Financial Data Form under the OMB Approval No. 0915-0314. The Program Specific Data Form is currently approved under OMB Approval No.: 0915-0378 with an expiration date of 7/31/2020 and the APR Financial Data Form is currently approved under OMB Approval No: 0915-0314 with an expiration date of 7/31/2020. The APR Form was previously titled as the Nurse Faculty Loan Program, Annual Operating Report.

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Authorizing Statute(s): US Code: 42 USC 297n-1, Section 846A Name of Law: Title VIII, PHSA
  

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:
	85 FR 7315	02/07/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 28017	05/12/2020
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
Nurse Faculty Loan Program- Program Specific Data Form	1	NFLP Program Specific Data Form_7-30-2020 CLEAN.docx
Nurse Faculty Loan Program- Annual Performance Report Financial Data Form	2	NFLP APR Financial Data Form_7-30-2020 CLEAN.pdf

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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	350	260	0	90	0	0
Annual Time Burden (Hours)	2,280	1,560	0	720	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

Burden Increase Due to: Miscellaneous Actions

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

Burden Reduction Due to: Miscellaneous Actions

Short Statement: Burden increase is due to the inclusion of a form previously in 0915-0378, which will be discontinued upon approval of this ICR to avoid redundancy. Burden decrease is due to the decrease in respondents for the Specific Data Form, from 260 to 90 respondents.

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Annual Cost to Federal Government: $8,888

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]? 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? 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: 05/12/2020

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