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HRSA Response to Questions from OMB on the Chiropractic and Pharmacy Loan
Repayment Program Surveys

1. Regarding the response #4f, can HRSA clarify whether they will use administrative data
to adjust for non-response?
We will use administrative data maintained by the community health centers and clinics to
adjust for non-response. These data will provide some basic demographic information about the
patients that visited the center or clinic for care during the survey field period.
2. Regarding the response #4g: if this study is trying to evaluate the change (e.g. in access,
quality of care, etc.) that results from being able to recruit chiropractors/pharmacists to
work in underserved areas through the NHSC award, isn’t it a problem if some clinicians
are already employed at the clinics for a year or more before applying for an NHSC
award?
We are only able to evaluate the change in the volume of services overall and per clinician
that community health centers and clinics realize as a result of hiring an NHSC chiropractor or
pharmacist. For these measures, it does not matter that the clinician was employed at the health
center or clinic prior to applying for an NHSC award. We will use Uniform Data System (UDS)
data from the year prior to the clinician’s employment at the NHSC site to measure the center’s
or clinic’s baseline volume of services overall and per clinician. These baseline measures will be
compared to the same data from the years when the clinicians were serving their NHSC
obligations. We will obtain UDS data from the same years for the comparison sites, which will
allow us to evaluate the change in these measures to the change in the same measures at
comparison sites.

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3. Race and ethnicity questions: the response categories do not seem to be in keeping
with OMB guidelines on reporting race/ethnicity information (for example, the “other”
response category). Can HRSA please revise these questions so that they are in keeping
with OMB guidelines?
The response category “other” has been removed from the question asking about race,
leaving only the five minimum, along with the instruction to “Please mark one or more answers”.
The question on ethnicity is asked separately and prior to the question on race, as specified in the
OMB guidelines.
4. Whenever HRSA says it will “protect and keep private” the respondents information,
the phrase, “to the full extent permitted by law” should be added (e.g. “All individual
responses to the survey will be protected and kept private to the full extent permitted by
law”).
This phrase will be added wherever the protection of respondent information is referenced
so that the privacy protections will clearly mention that privacy will be protected to the full
extent permitted by law. Attached are the three revised cover letters sent previously with the
response to questions with this phrase added regarding respondent information.

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