Final Notice Regarding Updates and Clarifications of the Implementation of the Scholarships for Disadvantaged Students Program, 30536-30540 [2012-12568]
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Federal Register / Vol. 77, No. 100 / Wednesday, May 23, 2012 / Notices
obesity, after a brief screening process to
obtain the respondent’s consent and to
determine eligibility. A separate sample
will be drawn for each community. CDC
plans to obtain a total of 6,000 complete
responses for each cycle of data
collection. Interview questions will
assess: (1) Awareness (aided and
unaided) of the local community media
efforts/campaigns about obesity; (2)
beliefs about and attitudes toward the
issue of obesity in their communities;
and (3) behaviors and behavioral
insights to be gained from this
information collection will be valuable
to assessing the impact that CPPW has
achieved in taking on the obesity
epidemic and may be used to inform the
design and delivery of future media
campaigns.
OMB approval is requested for one
year. Participation in the telephone
interviews is voluntary and there are no
costs to respondents other than their
time.
intentions that encourage active living
and healthy eating. The evaluation plan
specifically seeks to identify and
describe changes in beliefs and
behaviors as a function of exposure to
the media campaign.
The long-term goals of CPPW are to
modify the environmental determinants
of risk factors for chronic diseases;
prevent or delay chronic diseases;
promote wellness in children and
adults; and provide positive, sustainable
health change in communities. The
ESTIMATED ANNUALIZED BURDEN HOURS
Average
burden per
response
(in hr)
Number of
responses per
respondent
Number of
respondents
Total burden
(in hr)
Type of respondent
Form name
Adult General Public .........................
Screener for the Community Telephone Interview.
Community Telephone Interview (incomplete).
Community Telephone Interview
(complete).
22,400
1
5/60
187
400
1
5/60
33
12,000
1
10/60
2,000
...........................................................
........................
........................
........................
2,220
Total ...........................................
Kimberly S. Lane,
Deputy Director, Office of Scientific Integrity,
Office of the Associate Director for Science,
Office of the Director, Centers for Disease
Control and Prevention.
[FR Doc. 2012–12479 Filed 5–22–12; 8:45 am]
BILLING CODE 4163–18–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Health Resources and Services
Administration
Final Notice Regarding Updates and
Clarifications of the Implementation of
the Scholarships for Disadvantaged
Students Program
Health Resources and Services
Administration, Department of Health
and Human Services.
ACTION: Notice.
AGENCY:
The Health Resources and
Services Administration (HRSA)
announces updates and clarifications for
the implementation of the Scholarships
for Disadvantaged Students (SDS)
program under authority of Section 737
of the Public Health Service Act (PHS
Act). This notice supersedes all
previous notices regarding the SDS
program.
A notice which proposed updates and
clarified implementation of the SDS
program was published in the Federal
Register on March 20, 2012 (77 FR
16244). A period of 30 days was
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SUMMARY:
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established to allow public comment
concerning the proposed updates and
implementation. Twenty-two letters
were received, each with multiple
comments. This notice discusses the
comments and sets forth the final
updates and implementation to the SDS
program.
DATES: Effective Date: The program
clarifications described in this notice
will be implemented in fiscal year (FY)
2012 and beyond and will become
effective for SDS funds awarded to
schools in FY 2012 and beyond.
Purpose: HRSA is updating the SDS
program to increase the impact of the
program in the areas addressed in the
program’s authorizing statute.
Specifically, the authorizing statute
allows the Secretary to make grants to
eligible entities that are carrying out a
program for recruiting and retaining
students from disadvantaged
backgrounds, including students who
are members of racial and ethnic
minority groups (PHS Act, Sec.
737(d)(1)(B)). In addition, grantees
provide scholarships to individuals who
meet the following requirements: (1) Are
from disadvantaged backgrounds; (2)
have a financial need for a scholarship;
and (3) are enrolled (or accepted for
enrollment) at an eligible health
professions or nursing school as a fulltime student in a program leading to a
degree in nursing or a health profession
(PHS Act, Sec. 737(d)(2)(A–C)). Under
the statute, priority is given to eligible
entities based on the proportion of
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graduating students going into primary
care, the proportion of underrepresented
minority students, and the proportion of
graduates working in medically
underserved communities (PHS Act,
Sec. 737(c)). There is also a requirement
to award at least 16 percent of the
available funds to schools of nursing
(PHS Act, Sec. 740(a)).
The SDS Program required updating,
because the program grantee population
had grown from 401 schools in FY 2000
to almost 700 health profession schools
in FY 2011. Since all SDS eligible
schools received grant awards, the
funding had been divided into ever
decreasing amounts per school over the
years. Many of the schools, in an effort
to provide funding to each of their
disadvantaged students, spread the
award equally among the disadvantaged
students and the smaller school award
amounts resulted in smaller student
scholarship amounts. While the student
scholarship amounts decreased, the
tuition rates increased. For many
students with insufficient financial
resources, the small award size was
unlikely to provide enough funding to
continue in school. Also, the primary
care and underrepresented minority
student priority weights used were too
small to adequately incentivize and
reward schools that were successful in
graduating primary care
underrepresented minority students or
who had excellent plans to improve
their programs to recruit and retain
students from disadvantaged
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backgrounds, including students who
are members of racial and ethnic
minority groups. The primary care
weights were also not enough to
incentivize schools to increase the
proportion of graduating students going
into primary care. Additionally, the
practice of awarding grants for 1 year at
a time did not allow the schools to
select financially disadvantaged
applicants with greater assurance that a
student would receive SDS financial aid
for the entire time the student is
enrolled.
Changes: To provide larger award
amounts to schools and to increase the
retention and graduation of
disadvantaged students, including
students who are members of racial and
ethnic minority groups, HRSA’s Bureau
of Health Professions (BHPr) announces
the following changes to the SDS
program:
(1) Convert the formula-based SDS
program to a competitive peer-reviewed
grant program.
Comments: Four comments were
received regarding the use of peer
review in the grant award process. The
first ‘‘welcomed’’ the change to a peer
review process. The second comment
was concerned that the peer review
process did not include peer review of
priority points. The third commenter
believed that the application process for
peer review would be a burden, and the
fourth commenter gave no readily
discernible reason for not supporting
peer review.
In response, HRSA points out that the
base score totals 100 points and is
determined by the results of the peer
review. The additional priority points
are calculated based on set numeric
standards. Therefore, the majority of an
applicant’s score (100 out of 111 points
total) will be derived from peer
reviewers. The priority points (a
maximum of 11 points, in addition to
the maximum of 100 base points) will
be based on an applicant’s successful
past performance and points will be
designated using data provided by the
applicant (percent of graduates entering
service in medically underserved
communities or primary care and the
percent of students that are
underrepresented minorities). The
calculation of set numeric standards for
the awarding of priority points does not
require the judgment of a peer reviewer.
The priority point evaluation process
described is, in HRSA’s consideration,
the most objective means of evaluating
applicants for the SDS program.
Regarding the third comment about the
application being burdensome, narrative
grant applications are commonly used
by HRSA health professions programs.
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The narrative grant application allows
peer reviewers and HRSA to understand
the applicant’s approach and proposal
more fully. The overall grant application
format has been reviewed and approved
for general use. In addition, since the
grants will be awarded for multiple
years, applicants will only apply once
every four years instead of annually.
(2) Convert the grant award from a
current 1-year project period to a project
period of 4-years. A successful
institutional applicant would be
awarded a 4-year project period with
funding provided annually subject to
appropriations, the availability of funds
and successful progress.
Comments: Eight comments were
received on the project period. Two
comments support the 4-year project
period. One of them said, ‘‘The 4-year
commitment will be key in
incentivizing students to enter one of
these much needed professions and
allow the student to have a firm
financial plan in tackling the cost of the
education.’’ Other comments included
two that were concerned that Congress
might not fund the full 4-year project
period; another was interested in
knowing how a 2-year school would fare
in funding with a 4-year cycle; another
worried that a student’s economic status
might change over the 4-year period,
and another provided no readily
discernible reason for not supporting
the change.
In response, the multi-year project
period has historically been used by
many HRSA health profession training
programs. There is no concern that the
SDS program would encounter any
special difficulties. Grants are awarded
with a multiyear project period which
allows grantees the opportunity to plan
for long-term activities. Regarding the
remaining comments on the project
period, there appears to be a
misunderstanding regarding the school
award project period and the student
award. The SDS school 4-year project
period assures the school of SDS
funding each year, pending availability
of funding and dependent upon the
school’s performance. The school has
the responsibility to select the SDS
students each year and the school must
ensure recipients comply with all
eligibility requirements each year.
Schools may not provide a student with
all four years of funding in the first year,
however; the school may fund the same
student each year if the school has the
funds and the student meets the
eligibility requirements. Having a 2-, 3or 4-year curriculum should not be an
issue.
(3) Add a new requirement that
individual student awards must be at
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least 50 percent of the student’s annual
tuition costs, for tuition $30,000 or less,
but no student can be awarded over
$15,000 SDS funds per year. Individual
student awards must be $15,000 for
students whose tuitions are over
$30,000 per year. The use of funds have
not changed and the amount of the
scholarship still may not exceed a
recipient’s cost of tuition expenses,
other reasonable educational expenses,
and reasonable living expenses incurred
in attendance at the SDS eligible health
professions school. As before, the
scholarship may be expended by the
student only for such allowable costs.
Comments: There were 11 comments
on the tuition award amounts. Three
comments supported the change. Six
comments said they prefer to provide
scholarships to more students rather
than increase scholarship amounts to
fewer students and there was concern
that they would not be able to fund as
many students as they usually do. One
of the six said her preference was to
leave the scholarship amount entirely
up to the grantee. Another comment
suggested lowering the minimum
scholarship amount and another
suggested having a minimum per
semester rather than per year.
In response, HRSA maintains that
providing small amounts to more
students is unlikely to affect student
outcomes in a way consistent with the
statutory aims. The requirement of 50
percent of the tuition up to $15,000 per
year will provide a significant award
amount to allow disadvantaged students
with financial need to better complete
their health profession education. A 50
percent tuition per year award
minimum provides more flexibility than
a per semester minimum. Regarding the
concern that a school may have to select
fewer SDS students due to the changes
being made, HRSA points out that the
total grant award to a school will be
based on the disadvantaged students’
need up to $650,000 rather than basing
it on a formula that determines the
portion of shared available funds.
(4) Increase the weight and provide a
range of points for primary care and
underrepresented minority priorities.
Comments: There were 4 comments
regarding the weights for the priority
points. Two comments supported the
priority point weights. One comment
that supported the weights also said
attaining high percentages of graduates
entering primary care service would be
difficult. One commenter did not like
the high weight on primary care and the
other did not like the high weight given
for applicants with high percentages of
underrepresented minority students, or
for graduates serving in primary care.
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Both said that this would increase
primary care at the expense of other
disciplines.
In response, service in primary care
and having high percentages of students
from underrepresented minority
backgrounds are two of the priorities
required by the authorizing statute.
Increasing primary care practitioners
and increasing the diversity of the
health professions are emphasized in
the statute. They are also both initiatives
of HRSA and the priority points are
weighted to meet these initiatives.
(5) Expand the disciplines eligible for
the primary care priority (currently
allopathic and osteopathic medicine,
dentistry, graduate nurse practitioners,
and physician assistants) to also include
dental hygiene and behavioral and
mental health discipline (clinical
psychology, clinical social work,
professional counseling, marriage and
family therapy).
Comments: There were six comments
regarding the primary care priority
disciplines. Two supported the
expansion. Another comment said they
did not support the expansion, because
it would decrease funds to those already
receiving the primary care priority.
Three additional commentors wanted
HRSA to also add pharmacy as a
primary care discipline, because in
‘‘three states,’’ there is ‘‘* * * a second
level of pharmacist licensure known as
the pharmacist clinician (Ph.C.). Under
protocol with a physician, a Ph.C. acts
as a mid-level provider with similar
rights and responsibilities to that of a
Nurse Practitioner or Physician
Assistant.’’
In response to the comment that
disciplines eligible for the primary care
priority should not be expanded,
because the change might decrease the
amount of funds to current primary care
priority recipients, HRSA points out
that the identified primary care priority
disciplines can rationally and
consistently be defined as primary care
across the states following the IOM
definition. Possible funding scenarios
should not be a criterion for deciding
whether a discipline is primary care. In
response to those commentors who
wanted to expand the primary care
definition to include disciplines that
had a primary care role in three states,
HRSA points out that the expanded list
of disciplines proposed were those with
fairly consistent licensure and duties
nationally. Seven states offer prescribing
privileges and many other states support
collaborative drug therapy management,
thereby expanding scope of practice and
allowing pharmacists to work in a team
environment to initiate, modify or
continue drug therapy for a specific
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patient. HRSA will continue to assess
the pharmacist clinician occupation for
possible inclusion in the primary care
discipline category in the future.
(6) Use the Institute of Medicine’s
primary care definition to identify
primary care service for the primary
care priority within the eligible primary
care disciplines:
Primary Care is the provision of integrated,
accessible health care services by clinicians
who are accountable for addressing a large
majority of personal health care needs,
developing a sustained partnership with
patients, and practicing in the context of
family and community. (Institute of
Medicine. Primary Care: America’s Health in
a New Era. Washington, DC: National
Academy Press, 1996).
Comments: There were three
comments regarding the use of the IOM
definition. Two supported the use of the
definition. Another comment did not
support the use of the IOM definition
unless there would be full disclosure
that other health professions, authorized
to participate in the SDS program, were
also included in the primary care
priority.
In response, the primary care
definition as written does not mention
specific disciplines but describes tasks
to better define primary care activities.
(7) Increase the school eligibility
requirement for disadvantaged students
enrolled and disadvantaged students
graduated to 20 percent each.
Comments: There were six comments
regarding the increase in the eligibility
requirements. One comment said that
the change ‘‘seems reasonable’’ though
it may be difficult to maintain. Another
said that its school would likely be able
to attain the 20 percent levels but
worried about what would happen if
after receiving the grant, the school fell
below 20 percent for one of the years.
Four other comments said that raising
the eligibility to 20 percent would
eliminate the school from the program
and two of those who said they would
be eliminated, went on to say that the
discipline itself as a whole didn’t have
near the 20 percent level of
disadvantaged students or practitioners.
In response, the proposed increase in
eligibility that will occur in FY 2012
was designed in order to focus funds on
schools that have a strong commitment
to educating and graduating
disadvantaged students. Based on an
analysis of FY 2010 grantees, over 400
programs met the 20 percent eligibility
criteria. The SDS program eligibility
criteria could help drive improvement
in disciplines with low percentages of
disadvantaged enrollees and graduates.
Prior to the FY 2012 increase, the level
had not been increased since 1999.
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Eligibility Requirements: Eligible
entities are: schools of allopathic and
osteopathic medicine; dentistry;
optometry; pharmacy; podiatric
medicine; veterinary medicine; nursing
(associate, diploma, baccalaureate, and
graduate degree); public health;
chiropractic; allied health
(baccalaureate and graduate degree
programs of dental hygiene, medical
laboratory technology, radiology
technology, speech pathology,
audiology, registered dieticians, and
occupational therapy and physical
therapy); mental and behavioral health
(graduate degree programs in clinical
psychology, clinical social work,
professional counseling, marriage and
family therapy); and entities providing
physician assistant training programs.
(PHS Act, Sec. 737(d)(1)(A)).
There are five requirements a school
must meet in order to be eligible for the
SDS grant program. The requirements,
starting in FY 2012, are as follows:
(1) Twenty (20) percent of enrolled
students must be disadvantaged;
(2) Twenty (20) percent of graduates
must be disadvantaged;
(3) Schools must have a recruitment
program for disadvantaged students;
(4) Schools must have a retention
program for disadvantaged students;
and
(5) Student award must be at least 50
percent of the annual tuition cost with
a $15,000 maximum award per year,
when annual tuition is $30,000 or
below—above $30,000 annual tuition
equals $15,000 award.
Student Eligibility Requirements: To
qualify for the SDS program, a student
must:
(1) Meet the following definition of an
individual from a disadvantaged
background. For the purposes of the
SDS program, an individual from a
disadvantaged background is defined as
one who: (a) Comes from an
environment that has inhibited the
individual from obtaining the
knowledge, skills, and abilities required
to enroll in and graduate from a health
profession or nursing school, or from a
program providing education or training
in allied health professions; or (b) comes
from a family with an annual income
below the established Census Bureau
low-income thresholds, adjusted by the
Secretary for health professions and
nursing programs eligibility;
(2) Have a financial need for a
scholarship, in accordance with a need
analysis procedure approved by the
Department of Education (20 U.S.C.
1087kk–1087vv). In addition, any
student who is enrolled (or accepted for
enrollment) in a health profession
school or program must provide
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information on his or her parents’
financial situation or his or her own
depending upon the tax status of the
student; and
(3) Be enrolled (or accepted for
enrollment), as a full-time student, at an
eligible health professions or nursing
school in a program leading to a degree
in nursing or a heath profession (PHS
Act, Sec. 737).
Comments: There was one comment
regarding financial information required
on graduate students. That comment
requested that HRSA change its policy
requesting that graduate students
provide parental financial information
to determine financial need, because it
may be burdensome to the students. The
commenter noted that some Department
of Education loan programs do not
require parental information.
In response, HRSA points out that
SDS is a scholarship program, and
strong documentation is needed for the
student scholarship selection process.
The consequence of providing a
scholarship to a non-eligible student is
the loss of funds, whereas with loans,
students repay the funds with interest.
During technical assistance meetings,
many grantees were very favorable to
the SDS financial-need documentation
policy and said that the information was
needed to both make appropriate
student selections and the policy
helpful when explaining financial
document requests to students. SDS
policy is for the parental income to be
used to determine a student’s eligibility
for economically disadvantaged status
in all cases except in those cases where
the student is considered independent
by being at least 24 years old and has
not been listed as a dependent on his or
her parents’ income tax for 3 or more
years. In those cases, the student’s
family income will be used instead of
parental family income.
Student Award Selection: The law
requires that in providing SDS
scholarships, the school or program
must give ‘‘preference to students for
whom the cost of attending an SDS
school or program would constitute a
severe financial hardship.’’ Severe
financial hardship is to be determined
by the school or program in accordance
with standard need analysis procedures
prescribed by the Department of
Education for its Federal student aid
programs. The school or program has
discretion in deciding how to determine
which students have ‘‘severe financial
hardship,’’ as long as the standard is
applied consistently to all eligible
students.
The law also requires that schools
give awards to students who were
former recipients of scholarships under
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PHS Act sections 736 (Exceptional
Financial Need Scholarships) and
740(d)(2)(B) (Financial Assistance for
Disadvantaged Health Professions
Students Scholarships), as such sections
existed on November 13, 1998, if such
recipients are still students in financial
need.
Elements of Peer Review: Peer
reviewers will assess a school’s
allocations based on accomplishment of,
or commitment to, the following
criteria:
(1) Degree to which applicant
demonstrates its commitment to the
education of disadvantaged students,
including underrepresented minorities
(10 points);
(2) Degree to which applicant
demonstrates its commitment to
increasing primary care practitioners (10
points);
(3) Degree to which applicant
demonstrates its commitment to
increasing graduates working in
medically underserved communities
(MUCs) (10 points);
(4) Level of achievements and
successes in educating disadvantaged
students, including underrepresented
minorities, in a way that eliminates
barriers along the educational pipeline
for disadvantaged students and assures
graduates practice in primary care and
serve in MUCs (30 points); and
(5) Level of adequacy of proposed
plan to increase and educate
disadvantaged students, including
underrepresented minorities, and retain
students in their academic programs,
and encourage them to enter primary
care and serve in MUCs (40 points).
Comments: There were 17 different
comments regarding the review criteria.
One comment said that the school liked
the focus on recruitment and retention
programs. Three comments indicated
that they would prefer that HRSA
provide administrative costs to acquire
the data needed to apply and report on
students. Eight comments requested that
the changes not be implemented this
year for the following reasons: in order
to complete a study of the likely
outcomes of these changes, to provide
time for institutions to gather
information to write better applications,
and to assure the SDS scholarship funds
can be provided to students this year
and be a recruitment tool despite the
later than normal grantee award date
this year. Two comments said that the
MUC service review criterion was
problematic since service was a student
decision and beyond the school’s
control. One comment said that the goal
of increasing disadvantaged students in
primary care would destroy the SDS
program as it currently exists. Two
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30539
comments were that the school
disagreed with the focus on primary
care.
In response, HRSA is unable to fund
administrative costs for this program at
this time. Regarding the request for an
impact study, HRSA will base the
programmatic changes on information it
has gathered from grantees about
program operations and analysis of
grantee data. HRSA will assess the
impact of these changes after they are
implemented to determine if they had
the intended effect. In regard to the
additional application burden, HRSA
points out that the applications for the
SDS will include much of the same
information requested in the past, but
will have additional opportunities for
applicants to describe their programs in
narrative and check-box format.
Program has determined that the time
allocated to complete the application
will be appropriate to satisfy any new
requirements. Regarding timing of the
awards in FY 2012, HRSA grantees (in
meetings with HRSA) said that schools
will be able to award the funds
requested for FY 2012 even if the
awards come out in September. In
response to the comments regarding the
MUC review criteria, the SDS program
already awards funds to schools that
have programs and activities to support
and encourage students to provide
service in MUCs and grantees have been
tracking students’ service in MUCs for
years. The mission of the SDS program
is to provide funding to disadvantaged
students, including students from racial
and ethnic minority backgrounds in
financial need, so they may study at and
graduate from a health professions
school and enter a health profession,
preferably in primary care in a
medically underserved community, as
per the statutory preferences. The
review criteria focus on program
activities that will produce those
results.
Priority Scoring: Additional points
ranging from two through four will be
given for having a high percentage of the
following priorities: (1)
Underrepresented minority students
and (2) graduates entering primary care
service. Additional points ranging from
one through three will be given for
having a high percentage of graduates
serving in medically underserved
communities. The number of points
awarded to each applicant for meeting
the priorities will be determined by the
applicant’s percentage in meeting these
priorities. A higher number of points
will be assigned to applicants with
higher percentages of meeting these
priorities. There will be no institutional
or discipline preferences.
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Additional Letters: There were three
additional letters that did not contain
comments. They asked questions that
were answered in the text of this Notice
or required very detailed responses that
were more appropriate for response in
technical assistance meetings.
Dated: May 17, 2012.
Mary K. Wakefield,
Administrator.
[FR Doc. 2012–12568 Filed 5–22–12; 8:45 am]
BILLING CODE 4165–15–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
National Institutes of Health
Proposed Collection; Comment
Request; Cognitive Testing of
Instrumentation and Materials for the
Population Assessment of Tobacco
and Health (PATH) Study
In compliance with the
requirement of Section 3506(c)(2)(A) of
the Paperwork Reduction Act of 1995,
SUMMARY:
for opportunity for public comment on
proposed data collection projects, the
National Institute on Drug Abuse
(NIDA), the National Institutes of Health
(NIH) will publish periodic summaries
of proposed projects to be submitted to
the Office of Management and Budget
(OMB) for review and approval.
Proposed Collection: Title: Cognitive
Testing of Instrumentation and
Materials for Population Assessment of
Tobacco and Health (PATH) Study.
Type of Information Collection Request:
Generic Clearance. Need and Use of
Information Collection: The PATH
study will establish a population-based
framework for monitoring and
evaluating the behavioral and health
impacts of regulatory provisions
implemented as part of the Family
Smoking Prevention and Tobacco
Control Act (FSPTCA) by the Food and
Drug Administration (FDA). NIDA is
requesting generic approval from OMB
for cognitive testing of the PATH study’s
instrumentation, materials to support
data collection (e.g., advance mailings,
reminder letters, etc.), consent forms,
and methods of administration (e.g.,
computer assisted personal interviews
[CAPI], audio computer assisted selfinterviews [ACASI], web-based
interviews). Cognitive testing of these
materials and methods will help to
ensure that their design and content are
valid and meet the PATH study’s
objectives. Additionally, results from
cognitive testing will inform the
feasibility (scientific robustness),
acceptability (burden to participants
and study logistics) and cost of the
information collection to help minimize
its estimated cost and public burden.
Frequency of Response: Annual [As
needed on an on-going and concurrent
basis]. Affected Public: Members of the
public. Type of Respondents: Youth
(ages 12–17) and Adults (ages 18+).
Annual Reporting Burden: See Table 1.
The annualized cost to respondents is
estimated at: $11,861. There are no
Capital Costs to report. There are no
Operating or Maintenance Costs to
report.
TABLE 1—ESTIMATED ANNUAL REPORTING BURDEN SUMMARY—COGNITIVE TESTING OF INSTRUMENTATION AND
MATERIALS FOR THE PATH STUDY
Estimated
number of respondents
Instruments/Documents to be tested
Type of
respondent
Materials to Support Data Collection ................
Assent Forms ....................................................
Consent Forms .................................................
PATH Study Questionnaires .............................
Total ..................................................................
Estimated total
annual burden
hours requested
1
1
1
1
1
130⁄60
2
2
2
2
150
196
196
80
260
466
...........................
Average burden
hours per
response*
100
98
98
40
130
Adult .................
Youth ................
Adult .................
Youth ................
Adult .................
Estimated number of responses
per respondent
............................
............................
882
mstockstill on DSK4VPTVN1PROD with NOTICES
* Calculations include one hour of travel time per respondent.
Request for Comments: Written
comments and/or suggestions from the
public and affected agencies are invited
on one or more of the following points:
(1) Whether the proposed collection of
information is necessary for the proper
performance of the function of the
agency, including whether the
information will have practical utility;
(2) The accuracy of the agency’s
estimate of the burden of the proposed
collection of information, including the
validity of the methodology and
assumptions used; (3) Ways to enhance
the quality, utility, and clarity of the
information to be collected; and
(4) Ways to minimize the burden of the
collection of information on those who
are to respond, including the use of
appropriate automated, electronic,
mechanical, or other technological
collection techniques or other forms of
information technology.
VerDate Mar<15>2010
17:00 May 22, 2012
Jkt 226001
To
request more information on the
proposed project or to obtain a copy of
the data collection plans contact Kevin
P. Conway, Ph.D., Deputy Director,
Division of Epidemiology, Services, and
Prevention Research, National Institute
on Drug Abuse, 6001 Executive Blvd.,
Room 5185, Rockville, MD 20852, or
call non-toll free number 301–443–8755
or Email your request, including your
address to:
PATHprojectofficer@mail.nih.gov.
Comments Due Date: Comments
regarding this information collection are
best assured of having their full effect if
received within 60-days of the date of
this publication.
FOR FURTHER INFORMATION CONTACT:
Dated: May 17, 2012.
David Shurtleff,
Acting Deputy Director, NIDA.
[FR Doc. 2012–12489 Filed 5–22–12; 8:45 am]
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DEPARTMENT OF HEALTH AND
HUMAN SERVICES
National Institutes of Health
Center for Scientific Review Notice of
Closed Meetings
Pursuant to section 10(d) of the
Federal Advisory Committee Act, as
amended (5 U.S.C. App.), notice is
hereby given of the following meetings.
The meetings will be closed to the
public in accordance with the
provisions set forth in sections
552b(c)(4) and 552b(c)(6), Title 5 U.S.C.,
as amended. The grant applications and
the discussions could disclose
confidential trade secrets or commercial
property such as patentable material,
and personal information concerning
individuals associated with the grant
applications, the disclosure of which
would constitute a clearly unwarranted
invasion of personal privacy.
E:\FR\FM\23MYN1.SGM
23MYN1
]]>Agencies
[Federal Register Volume 77, Number 100 (Wednesday, May 23, 2012)]
[Notices]
[Pages 30536-30540]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2012-12568]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration
Final Notice Regarding Updates and Clarifications of the
Implementation of the Scholarships for Disadvantaged Students Program
AGENCY: Health Resources and Services Administration, Department of
Health and Human Services.
ACTION: Notice.
-----------------------------------------------------------------------
SUMMARY: The Health Resources and Services Administration (HRSA)
announces updates and clarifications for the implementation of the
Scholarships for Disadvantaged Students (SDS) program under authority
of Section 737 of the Public Health Service Act (PHS Act). This notice
supersedes all previous notices regarding the SDS program.
A notice which proposed updates and clarified implementation of the
SDS program was published in the Federal Register on March 20, 2012 (77
FR 16244). A period of 30 days was established to allow public comment
concerning the proposed updates and implementation. Twenty-two letters
were received, each with multiple comments. This notice discusses the
comments and sets forth the final updates and implementation to the SDS
program.
DATES: Effective Date: The program clarifications described in this
notice will be implemented in fiscal year (FY) 2012 and beyond and will
become effective for SDS funds awarded to schools in FY 2012 and
beyond.
Purpose: HRSA is updating the SDS program to increase the impact of
the program in the areas addressed in the program's authorizing
statute. Specifically, the authorizing statute allows the Secretary to
make grants to eligible entities that are carrying out a program for
recruiting and retaining students from disadvantaged backgrounds,
including students who are members of racial and ethnic minority groups
(PHS Act, Sec. 737(d)(1)(B)). In addition, grantees provide
scholarships to individuals who meet the following requirements: (1)
Are from disadvantaged backgrounds; (2) have a financial need for a
scholarship; and (3) are enrolled (or accepted for enrollment) at an
eligible health professions or nursing school as a full-time student in
a program leading to a degree in nursing or a health profession (PHS
Act, Sec. 737(d)(2)(A-C)). Under the statute, priority is given to
eligible entities based on the proportion of graduating students going
into primary care, the proportion of underrepresented minority
students, and the proportion of graduates working in medically
underserved communities (PHS Act, Sec. 737(c)). There is also a
requirement to award at least 16 percent of the available funds to
schools of nursing (PHS Act, Sec. 740(a)).
The SDS Program required updating, because the program grantee
population had grown from 401 schools in FY 2000 to almost 700 health
profession schools in FY 2011. Since all SDS eligible schools received
grant awards, the funding had been divided into ever decreasing amounts
per school over the years. Many of the schools, in an effort to provide
funding to each of their disadvantaged students, spread the award
equally among the disadvantaged students and the smaller school award
amounts resulted in smaller student scholarship amounts. While the
student scholarship amounts decreased, the tuition rates increased. For
many students with insufficient financial resources, the small award
size was unlikely to provide enough funding to continue in school.
Also, the primary care and underrepresented minority student priority
weights used were too small to adequately incentivize and reward
schools that were successful in graduating primary care
underrepresented minority students or who had excellent plans to
improve their programs to recruit and retain students from
disadvantaged
[[Page 30537]]
backgrounds, including students who are members of racial and ethnic
minority groups. The primary care weights were also not enough to
incentivize schools to increase the proportion of graduating students
going into primary care. Additionally, the practice of awarding grants
for 1 year at a time did not allow the schools to select financially
disadvantaged applicants with greater assurance that a student would
receive SDS financial aid for the entire time the student is enrolled.
Changes: To provide larger award amounts to schools and to increase
the retention and graduation of disadvantaged students, including
students who are members of racial and ethnic minority groups, HRSA's
Bureau of Health Professions (BHPr) announces the following changes to
the SDS program:
(1) Convert the formula-based SDS program to a competitive peer-
reviewed grant program.
Comments: Four comments were received regarding the use of peer
review in the grant award process. The first ``welcomed'' the change to
a peer review process. The second comment was concerned that the peer
review process did not include peer review of priority points. The
third commenter believed that the application process for peer review
would be a burden, and the fourth commenter gave no readily discernible
reason for not supporting peer review.
In response, HRSA points out that the base score totals 100 points
and is determined by the results of the peer review. The additional
priority points are calculated based on set numeric standards.
Therefore, the majority of an applicant's score (100 out of 111 points
total) will be derived from peer reviewers. The priority points (a
maximum of 11 points, in addition to the maximum of 100 base points)
will be based on an applicant's successful past performance and points
will be designated using data provided by the applicant (percent of
graduates entering service in medically underserved communities or
primary care and the percent of students that are underrepresented
minorities). The calculation of set numeric standards for the awarding
of priority points does not require the judgment of a peer reviewer.
The priority point evaluation process described is, in HRSA's
consideration, the most objective means of evaluating applicants for
the SDS program. Regarding the third comment about the application
being burdensome, narrative grant applications are commonly used by
HRSA health professions programs. The narrative grant application
allows peer reviewers and HRSA to understand the applicant's approach
and proposal more fully. The overall grant application format has been
reviewed and approved for general use. In addition, since the grants
will be awarded for multiple years, applicants will only apply once
every four years instead of annually.
(2) Convert the grant award from a current 1-year project period to
a project period of 4-years. A successful institutional applicant would
be awarded a 4-year project period with funding provided annually
subject to appropriations, the availability of funds and successful
progress.
Comments: Eight comments were received on the project period. Two
comments support the 4-year project period. One of them said, ``The 4-
year commitment will be key in incentivizing students to enter one of
these much needed professions and allow the student to have a firm
financial plan in tackling the cost of the education.'' Other comments
included two that were concerned that Congress might not fund the full
4-year project period; another was interested in knowing how a 2-year
school would fare in funding with a 4-year cycle; another worried that
a student's economic status might change over the 4-year period, and
another provided no readily discernible reason for not supporting the
change.
In response, the multi-year project period has historically been
used by many HRSA health profession training programs. There is no
concern that the SDS program would encounter any special difficulties.
Grants are awarded with a multiyear project period which allows
grantees the opportunity to plan for long-term activities. Regarding
the remaining comments on the project period, there appears to be a
misunderstanding regarding the school award project period and the
student award. The SDS school 4-year project period assures the school
of SDS funding each year, pending availability of funding and dependent
upon the school's performance. The school has the responsibility to
select the SDS students each year and the school must ensure recipients
comply with all eligibility requirements each year. Schools may not
provide a student with all four years of funding in the first year,
however; the school may fund the same student each year if the school
has the funds and the student meets the eligibility requirements.
Having a 2-, 3- or 4-year curriculum should not be an issue.
(3) Add a new requirement that individual student awards must be at
least 50 percent of the student's annual tuition costs, for tuition
$30,000 or less, but no student can be awarded over $15,000 SDS funds
per year. Individual student awards must be $15,000 for students whose
tuitions are over $30,000 per year. The use of funds have not changed
and the amount of the scholarship still may not exceed a recipient's
cost of tuition expenses, other reasonable educational expenses, and
reasonable living expenses incurred in attendance at the SDS eligible
health professions school. As before, the scholarship may be expended
by the student only for such allowable costs.
Comments: There were 11 comments on the tuition award amounts.
Three comments supported the change. Six comments said they prefer to
provide scholarships to more students rather than increase scholarship
amounts to fewer students and there was concern that they would not be
able to fund as many students as they usually do. One of the six said
her preference was to leave the scholarship amount entirely up to the
grantee. Another comment suggested lowering the minimum scholarship
amount and another suggested having a minimum per semester rather than
per year.
In response, HRSA maintains that providing small amounts to more
students is unlikely to affect student outcomes in a way consistent
with the statutory aims. The requirement of 50 percent of the tuition
up to $15,000 per year will provide a significant award amount to allow
disadvantaged students with financial need to better complete their
health profession education. A 50 percent tuition per year award
minimum provides more flexibility than a per semester minimum.
Regarding the concern that a school may have to select fewer SDS
students due to the changes being made, HRSA points out that the total
grant award to a school will be based on the disadvantaged students'
need up to $650,000 rather than basing it on a formula that determines
the portion of shared available funds.
(4) Increase the weight and provide a range of points for primary
care and underrepresented minority priorities.
Comments: There were 4 comments regarding the weights for the
priority points. Two comments supported the priority point weights. One
comment that supported the weights also said attaining high percentages
of graduates entering primary care service would be difficult. One
commenter did not like the high weight on primary care and the other
did not like the high weight given for applicants with high percentages
of underrepresented minority students, or for graduates serving in
primary care.
[[Page 30538]]
Both said that this would increase primary care at the expense of other
disciplines.
In response, service in primary care and having high percentages of
students from underrepresented minority backgrounds are two of the
priorities required by the authorizing statute. Increasing primary care
practitioners and increasing the diversity of the health professions
are emphasized in the statute. They are also both initiatives of HRSA
and the priority points are weighted to meet these initiatives.
(5) Expand the disciplines eligible for the primary care priority
(currently allopathic and osteopathic medicine, dentistry, graduate
nurse practitioners, and physician assistants) to also include dental
hygiene and behavioral and mental health discipline (clinical
psychology, clinical social work, professional counseling, marriage and
family therapy).
Comments: There were six comments regarding the primary care
priority disciplines. Two supported the expansion. Another comment said
they did not support the expansion, because it would decrease funds to
those already receiving the primary care priority. Three additional
commentors wanted HRSA to also add pharmacy as a primary care
discipline, because in ``three states,'' there is ``* * * a second
level of pharmacist licensure known as the pharmacist clinician
(Ph.C.). Under protocol with a physician, a Ph.C. acts as a mid-level
provider with similar rights and responsibilities to that of a Nurse
Practitioner or Physician Assistant.''
In response to the comment that disciplines eligible for the
primary care priority should not be expanded, because the change might
decrease the amount of funds to current primary care priority
recipients, HRSA points out that the identified primary care priority
disciplines can rationally and consistently be defined as primary care
across the states following the IOM definition. Possible funding
scenarios should not be a criterion for deciding whether a discipline
is primary care. In response to those commentors who wanted to expand
the primary care definition to include disciplines that had a primary
care role in three states, HRSA points out that the expanded list of
disciplines proposed were those with fairly consistent licensure and
duties nationally. Seven states offer prescribing privileges and many
other states support collaborative drug therapy management, thereby
expanding scope of practice and allowing pharmacists to work in a team
environment to initiate, modify or continue drug therapy for a specific
patient. HRSA will continue to assess the pharmacist clinician
occupation for possible inclusion in the primary care discipline
category in the future.
(6) Use the Institute of Medicine's primary care definition to
identify primary care service for the primary care priority within the
eligible primary care disciplines:
Primary Care is the provision of integrated, accessible health
care services by clinicians who are accountable for addressing a
large majority of personal health care needs, developing a sustained
partnership with patients, and practicing in the context of family
and community. (Institute of Medicine. Primary Care: America's
Health in a New Era. Washington, DC: National Academy Press, 1996).
Comments: There were three comments regarding the use of the IOM
definition. Two supported the use of the definition. Another comment
did not support the use of the IOM definition unless there would be
full disclosure that other health professions, authorized to
participate in the SDS program, were also included in the primary care
priority.
In response, the primary care definition as written does not
mention specific disciplines but describes tasks to better define
primary care activities.
(7) Increase the school eligibility requirement for disadvantaged
students enrolled and disadvantaged students graduated to 20 percent
each.
Comments: There were six comments regarding the increase in the
eligibility requirements. One comment said that the change ``seems
reasonable'' though it may be difficult to maintain. Another said that
its school would likely be able to attain the 20 percent levels but
worried about what would happen if after receiving the grant, the
school fell below 20 percent for one of the years. Four other comments
said that raising the eligibility to 20 percent would eliminate the
school from the program and two of those who said they would be
eliminated, went on to say that the discipline itself as a whole didn't
have near the 20 percent level of disadvantaged students or
practitioners.
In response, the proposed increase in eligibility that will occur
in FY 2012 was designed in order to focus funds on schools that have a
strong commitment to educating and graduating disadvantaged students.
Based on an analysis of FY 2010 grantees, over 400 programs met the 20
percent eligibility criteria. The SDS program eligibility criteria
could help drive improvement in disciplines with low percentages of
disadvantaged enrollees and graduates. Prior to the FY 2012 increase,
the level had not been increased since 1999.
Eligibility Requirements: Eligible entities are: schools of
allopathic and osteopathic medicine; dentistry; optometry; pharmacy;
podiatric medicine; veterinary medicine; nursing (associate, diploma,
baccalaureate, and graduate degree); public health; chiropractic;
allied health (baccalaureate and graduate degree programs of dental
hygiene, medical laboratory technology, radiology technology, speech
pathology, audiology, registered dieticians, and occupational therapy
and physical therapy); mental and behavioral health (graduate degree
programs in clinical psychology, clinical social work, professional
counseling, marriage and family therapy); and entities providing
physician assistant training programs. (PHS Act, Sec. 737(d)(1)(A)).
There are five requirements a school must meet in order to be
eligible for the SDS grant program. The requirements, starting in FY
2012, are as follows:
(1) Twenty (20) percent of enrolled students must be disadvantaged;
(2) Twenty (20) percent of graduates must be disadvantaged;
(3) Schools must have a recruitment program for disadvantaged
students;
(4) Schools must have a retention program for disadvantaged
students; and
(5) Student award must be at least 50 percent of the annual tuition
cost with a $15,000 maximum award per year, when annual tuition is
$30,000 or below--above $30,000 annual tuition equals $15,000 award.
Student Eligibility Requirements: To qualify for the SDS program, a
student must:
(1) Meet the following definition of an individual from a
disadvantaged background. For the purposes of the SDS program, an
individual from a disadvantaged background is defined as one who: (a)
Comes from an environment that has inhibited the individual from
obtaining the knowledge, skills, and abilities required to enroll in
and graduate from a health profession or nursing school, or from a
program providing education or training in allied health professions;
or (b) comes from a family with an annual income below the established
Census Bureau low-income thresholds, adjusted by the Secretary for
health professions and nursing programs eligibility;
(2) Have a financial need for a scholarship, in accordance with a
need analysis procedure approved by the Department of Education (20
U.S.C. 1087kk-1087vv). In addition, any student who is enrolled (or
accepted for enrollment) in a health profession school or program must
provide
[[Page 30539]]
information on his or her parents' financial situation or his or her
own depending upon the tax status of the student; and
(3) Be enrolled (or accepted for enrollment), as a full-time
student, at an eligible health professions or nursing school in a
program leading to a degree in nursing or a heath profession (PHS Act,
Sec. 737).
Comments: There was one comment regarding financial information
required on graduate students. That comment requested that HRSA change
its policy requesting that graduate students provide parental financial
information to determine financial need, because it may be burdensome
to the students. The commenter noted that some Department of Education
loan programs do not require parental information.
In response, HRSA points out that SDS is a scholarship program, and
strong documentation is needed for the student scholarship selection
process. The consequence of providing a scholarship to a non-eligible
student is the loss of funds, whereas with loans, students repay the
funds with interest. During technical assistance meetings, many
grantees were very favorable to the SDS financial-need documentation
policy and said that the information was needed to both make
appropriate student selections and the policy helpful when explaining
financial document requests to students. SDS policy is for the parental
income to be used to determine a student's eligibility for economically
disadvantaged status in all cases except in those cases where the
student is considered independent by being at least 24 years old and
has not been listed as a dependent on his or her parents' income tax
for 3 or more years. In those cases, the student's family income will
be used instead of parental family income.
Student Award Selection: The law requires that in providing SDS
scholarships, the school or program must give ``preference to students
for whom the cost of attending an SDS school or program would
constitute a severe financial hardship.'' Severe financial hardship is
to be determined by the school or program in accordance with standard
need analysis procedures prescribed by the Department of Education for
its Federal student aid programs. The school or program has discretion
in deciding how to determine which students have ``severe financial
hardship,'' as long as the standard is applied consistently to all
eligible students.
The law also requires that schools give awards to students who were
former recipients of scholarships under PHS Act sections 736
(Exceptional Financial Need Scholarships) and 740(d)(2)(B) (Financial
Assistance for Disadvantaged Health Professions Students Scholarships),
as such sections existed on November 13, 1998, if such recipients are
still students in financial need.
Elements of Peer Review: Peer reviewers will assess a school's
allocations based on accomplishment of, or commitment to, the following
criteria:
(1) Degree to which applicant demonstrates its commitment to the
education of disadvantaged students, including underrepresented
minorities (10 points);
(2) Degree to which applicant demonstrates its commitment to
increasing primary care practitioners (10 points);
(3) Degree to which applicant demonstrates its commitment to
increasing graduates working in medically underserved communities
(MUCs) (10 points);
(4) Level of achievements and successes in educating disadvantaged
students, including underrepresented minorities, in a way that
eliminates barriers along the educational pipeline for disadvantaged
students and assures graduates practice in primary care and serve in
MUCs (30 points); and
(5) Level of adequacy of proposed plan to increase and educate
disadvantaged students, including underrepresented minorities, and
retain students in their academic programs, and encourage them to enter
primary care and serve in MUCs (40 points).
Comments: There were 17 different comments regarding the review
criteria. One comment said that the school liked the focus on
recruitment and retention programs. Three comments indicated that they
would prefer that HRSA provide administrative costs to acquire the data
needed to apply and report on students. Eight comments requested that
the changes not be implemented this year for the following reasons: in
order to complete a study of the likely outcomes of these changes, to
provide time for institutions to gather information to write better
applications, and to assure the SDS scholarship funds can be provided
to students this year and be a recruitment tool despite the later than
normal grantee award date this year. Two comments said that the MUC
service review criterion was problematic since service was a student
decision and beyond the school's control. One comment said that the
goal of increasing disadvantaged students in primary care would destroy
the SDS program as it currently exists. Two comments were that the
school disagreed with the focus on primary care.
In response, HRSA is unable to fund administrative costs for this
program at this time. Regarding the request for an impact study, HRSA
will base the programmatic changes on information it has gathered from
grantees about program operations and analysis of grantee data. HRSA
will assess the impact of these changes after they are implemented to
determine if they had the intended effect. In regard to the additional
application burden, HRSA points out that the applications for the SDS
will include much of the same information requested in the past, but
will have additional opportunities for applicants to describe their
programs in narrative and check-box format. Program has determined that
the time allocated to complete the application will be appropriate to
satisfy any new requirements. Regarding timing of the awards in FY
2012, HRSA grantees (in meetings with HRSA) said that schools will be
able to award the funds requested for FY 2012 even if the awards come
out in September. In response to the comments regarding the MUC review
criteria, the SDS program already awards funds to schools that have
programs and activities to support and encourage students to provide
service in MUCs and grantees have been tracking students' service in
MUCs for years. The mission of the SDS program is to provide funding to
disadvantaged students, including students from racial and ethnic
minority backgrounds in financial need, so they may study at and
graduate from a health professions school and enter a health
profession, preferably in primary care in a medically underserved
community, as per the statutory preferences. The review criteria focus
on program activities that will produce those results.
Priority Scoring: Additional points ranging from two through four
will be given for having a high percentage of the following priorities:
(1) Underrepresented minority students and (2) graduates entering
primary care service. Additional points ranging from one through three
will be given for having a high percentage of graduates serving in
medically underserved communities. The number of points awarded to each
applicant for meeting the priorities will be determined by the
applicant's percentage in meeting these priorities. A higher number of
points will be assigned to applicants with higher percentages of
meeting these priorities. There will be no institutional or discipline
preferences.
[[Page 30540]]
Additional Letters: There were three additional letters that did
not contain comments. They asked questions that were answered in the
text of this Notice or required very detailed responses that were more
appropriate for response in technical assistance meetings.
Dated: May 17, 2012.
Mary K. Wakefield,
Administrator.
[FR Doc. 2012-12568 Filed 5-22-12; 8:45 am]
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