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Request for Public Comment: 60-Day Proposed Information Collection: Application for Participation in the IHS Scholarship Program

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Indian Health Service.




In compliance with Section 3506 (c)(2)(A) of the Paperwork Reduction Act of 1995 which requires 60-days advance opportunity for public comment on proposed information collection projects, the Indian Health Service (IHS) is publishing for comment a summary of a proposed information collection to be submitted to the Office of Management and Budget (OMB) for review.

Proposed Collection: Title: 0917-0006, “Application for Participation in the IHS Scholarship Program.” Type of Information Collection Request: Three year extension of the currently approved information collection, 0917-0006, “Application for Participation in the IHS Scholarship Program.” Form Number(s): IHS-856-3, IHS-856-5 through 856-19, IHS-856-21 through 856-24, IHS-817, and IHS-818 are retained for use by the IHS Scholarship Program (IHSSP) as part of this current Information Collection Request. Reporting forms are found on the IHS Web site at​scholarship. Form Numbers: IHS-856, IHS-856-2, IHS-856-4, IHS-856-20, IHS-815, and IHS-816 have been deleted from the previous Information Collection Request in an effort to comply with the Paperwork Reduction Act (44 U.S.C. 3501 et seq.).

Need and Use of Information Collection: The IHS Scholarship Branch needs this information for program administration and uses the information to: solicit, process, and award IHS Pre-graduate, Preparatory, and/or Health Professions Scholarship recipients; monitor the academic performance of recipients; and to place recipients at payback sites. The IHS Scholarship Program streamlined the application process by converting the IHS-856 to an electronic tool and reduced the number of required supplemental application and reporting forms to minimize the time needed by applicants and recipients to complete the application process and provide required information after receiving a scholarship from the IHSSP. The IHSSP application is electronically available on the internet at the IHS Web site at:​scholarship/​apply_​now.cfm.

Affected Public: Individuals, not-for-profit institutions and State, local or Tribal Governments.

Type of Respondents: Students pursuing health care professions.

The table below provides: Types of data collection instruments, Estimated number of respondents, Number of responses per respondent, Annual number of responses, Average burden hour per response, and Total annual burden hours.

Data collection instrument(s)Number of respondentsResponses per respondentTotal annual responseBurden hour per response*Annual burden hours
Faculty/Employer Evaluation (IHS-856-3)1500230000.42 (25 min)1250
Delinquent Federal Debt (IHS-856-5)1500115000.13 ( 8 min)200
Course Curriculum Verification (IHS-856-6)1500115000.70 (42 min)1050
Verification of Acceptance or Decline of Award (IHS-856-7)50015000.13 ( 8 min)67
Recipient's Initial Program Progress Report (IHS-856-8)1200112000.13 ( 8 min)160
Notification of Academic Problem (IHS-856-9)501500.13 ( 8 min)7
Change of Status (IHS-856-10)50150.045 (25 min)21
Request for Approval of Deferment (IHS-856-11)201200.13 ( 8 min)3
Preferred Placement (IHS-856-12)15011500.50 (30 min)75
Notice of Impending Graduation (IHS-856-13)17011700.17 (10 min)28
Notification of Deferment Program (IHS-856-14)201200.13 (8 min)3
Placement Update (IHS-856-15)17011700.18 (11 min)31
Annual Status Report (IHS-856-16)20012000.25 (15 min)50
Extern Site Preference Request (IHS-856-17)30013000.13 ( 8 min)40
Request for Extern Travel Reimbursement (IHS-856-18)15011500.10 ( 6 min)15
Lost Stipend Payment (IHS-856-19)501500.13 ( 8 min)7
Summer School Request (IHS-856-21)10011000.10 ( 6 min)10
Change of Name or Address (IHS-856-22)201200.13 (8 min)3
Request for Credit Validation (IHS-856-23)301300.10 (6 min)3
Faculty/Advisor Evaluation (IHS-856-24)1500230000.42 (25 min)1250
Scholarship Program Agreement (IHS-817)17511750.16 (10 min)29
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Health Professions Contract (IHS-818)22512250.16 (10min)38
* For ease of understanding, burden hours are also provided in actual minutes.

There are no direct costs to respondents other than their time to voluntarily complete the forms and submit them for consideration. The estimated cost in time to respondents, as a group, is $45,396 [4340 burden hours X $10.46 per hour (2013 GS-3 hourly base pay rate)]. This total dollar amount is based upon the number of burden hours per data collection instrument, rounded to the nearest dollar. Request for Comments: Your written comments and/or suggestions are invited on one or more of the following points: (a) Whether the information collection activity is necessary to carry out an agency function; (b) whether the agency processes the information collected in a useful and timely fashion; (c) the accuracy of public burden estimate (the estimated amount of time needed for individual respondents to provide the requested information); (d) whether the methodology and assumptions used to determine the estimate are logical; (e) ways to enhance the quality, utility, and clarity of the information being collected; and (f) ways to minimize the public burden through the use of automated, electronic, mechanical, or other technological collection techniques or other forms of information technology.

Send Comments and Requests for Further Information: Send your written comments and requests for more information on the proposed collection or requests to obtain a copy of the data collection instrument(s) and instructions to: Dr. Dawn Kelly, Chief, Scholarship Program, 801 Thompson Avenue, TMP Suite 450A, Rockville, MD 20852, call non-toll free (301) 443-6622, send via facsimile to (301) 443-6048, or send your email requests, comments, and return address to:

Comment Due Date: Comments regarding this information collection are best assured of having full effect if received within 60 days of the date of this publication.

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Dated: June 10, 2013.

Yvette Roubideaux,

Acting Director, Indian Health Service.

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[FR Doc. 2013-14291 Filed 6-14-13; 8:45 am]