TO: Reports Clearance Officer, HHS
THROUGH: Project Clearance Officer, NIH________________________________
FROM: Director, NIH Undergraduate Scholarship Program, OITE, OD, NIH
SUBJECT: National Institutes of Health Undergraduate Scholarship Program for Individuals from Disadvantaged Backgrounds
This is a request for the Office of Management and Budget (OMB) to approve data collection for the Undergraduate Scholarship Program for Individuals from Disadvantaged Backgrounds (UGSP). This program is designed to make available scholarship awards to students from disadvantaged backgrounds that are committed to careers in biomedical research. In return, the recipient is obligated to serve as a full-time paid employee in an NIH research laboratory. The data collected on each application form will be used to determine eligibility and to support the selection process. Approximately 300 applicants are expected to complete the application forms.
The UGSP has an existing data collection with an OMB control number [OMB No. 0925-0438], expiration date December 31, 2007.
Darryl M. Murray, Ph.D.
National Institutes of Health
Undergraduate Scholarship Program for Individuals
from Disadvantaged Backgrounds
OMB No. 0925-0438
Darryl M. Murray, Ph.D.
Director
NIH Undergraduate Scholarship Program
National Institutes of Health
2 Center Drive, Room 2E28 (MSC 0230)
Bethesda, Maryland 20892-0230
Telephone: (301) 594-2222
Fax: (301) 480-5481
E-mail: murrayda@mail.nih.gov
Contents
Abstract of the Supporting Statement
Supporting Statement
A.1. Circumstances Making the Collection of Data Necessary 3
A.2. Purpose and Use of the Information Collection 4
A.3. Use of Information Technology and Burden Reduction 5
A.4. Efforts to Identify Duplication and Use of Similar Information 5
A.5. Impact on Small Businesses or Other Small Entities 5
A.6. Consequences of Collecting the Information Less Frequently 6
A.7. Special Circumstances Relating to the Guidelines of 5 CFR 1320.5 6
A.9. Explanation of Any Payment or Gift to Respondents 7
A.10. Assurance of Confidentiality Provided to Respondents 7
A.11. Justification for Sensitive Questions 8
A.12. Estimates of Hour Burden Including Annualized Hourly Costs 9
A.13. Estimate of Other Total Annual Cost Burden to Respondents or Record Keepers 11
A.14. Annualized Cost to the Federal Government 11
A.15. Explanation for Program Changes or Adjustments 11
A.16. Plans for Tabulation and Publication and Project Time Schedule 12
A.17. Reason(s) Display of OMB Expiration Date Is Inappropriate 12
A.18. Exceptions to the Paperwork Reduction Act Submissions 12
Attachments
Attachment 1: Data Collection Instruments
Attachment 2: Instructions to Respondents
Attachment 3: Privacy Act System of Records Notice
Attachment 4: Contractor Security Procedures
Supporting Statement
The Undergraduate Scholarship Program for Individuals from Disadvantaged Backgrounds (UGSP) is authorized by Section 487D of the Public Health Service (PHS) Act (42 USC 103-43). The purpose of the UGSP is to offer scholarship awards to students from disadvantaged backgrounds in return for service as paid employees in NIH research laboratories during the summer and after graduation.
The UGSP is required by statute to obtain applications to determine the eligibility of applicants as part of the selection process. The UGSP is an existing data collection with an OMB control number (OMB No. 0925-0438), expiration date December 31, 2007. This request for clearance involves data collected using the following forms:
Applicant Information Form (NIH 2762-1). The applicant uses this form to provide demographic information, such as name, mailing address, and Social Security number, and to describe his or her interests and abilities. The applicant also certifies that he or she has no delinquent Federal loans.
Recommendation Form (NIH 2762-2). Recommenders (professors, teachers, etc.) use this form to assess the applicant=s aptitude, achievement, interests, and potential in biomedical research.
Undergraduate Institution Certification Form (NIH 2762-3). The financial aid staff of the educational institution use this form to certify that the applicant is a currently enrolled student in good standing with exceptional financial need (EFN) and to calculate the applicant=s current educational and living expenses.
Applicant Contract Form (NIH 2762-4). By reading and signing the contract form, the applicant agrees to carry out his or her obligations if awarded a scholarship.
Academic Enrollment Certification and Service Obligation Deferment Request Form (NIH 2762-5). If a UGSP participant wishes to defer his or her service obligation, then the registrar of the participant’s academic institution completes this form to certify that the participant is enrolled in an approved undergraduate, graduate, or medical training program.
The UGSP is designed to provide undergraduate scholarships of up to $20,000 per year for tuition and reasonable living expenses to undergraduate students who are committed to careers in biomedical research. Currently, the data collected on each application form is used to review and evaluate applicants’ eligibility for UGSP participation or a participant’s eligibility for deferment in a consistent and equitable manner. UGSP staff will continue to use the information requested in the application to determine the eligibility of the applicants and as part of the information used to select the successful applicants. The questions asked of the applicant, the educational institution, and the recommenders are the minimum required by the NIH to determine eligibility.
The application materials will be used by the review board, which comprises scientists and educators from within the NIH, as well as invited non-NIH professionals from selected scientific fields. The collected information will also be used by authorized Federal contractors, only as needed, to carry out contractual obligations in support of the UGSP. Copies of the application forms are contained in Attachment 1: Data Collection Instruments. Instructions on completing the forms are included in the information packet, which is included in Attachment 3: Instructions to Respondents.
During fiscal year 2007, there were 13 new UGSP Scholars selected and 8 renewal Scholars. Also, 6 Scholars returned to the NIH to complete the service payback; 5 UGSP scholars successfully completed their service obligations and are currently enrolled in a graduate or medical program that include the Johns Hopkins University, Harvard University, Syracuse University and the University of Texas Southwestern Medical Center.
During the past three years, this application package has proven to be a very successful tool for the selection of high caliber students to become UGSP Scholars. We have noticed that a higher percentage of students prefer to submit their applications via the UGSP Internet web site. However, since we are targeting students from financially disadvantaged backgrounds, the hard copy version of the application remains important for applicants who may not have direct access to the Internet.
Applications and informational materials are available electronically to potential applicants, recommenders, financial aid staff, and registrars through the UGSP Web site at http://ugsp.info.nih.gov. Applicants can also request forms and information using a toll-free line (800-528-7689). As requested, information can be either mailed or faxed to applicants.
Information may be submitted electronically through the UGSP Web site, which has been developed to ensure data confidentiality. Information submitted electronically is saved to a database file, and the server on which the database is stored is locked in a secured server room. Information residing in the database can be accessed remotely only through the secured UGSP management pages, which are password-protected using operating system-level security. Approximately 80 percent of applicants submit their applications to the UGSP through the Web site.
All electronic submissions are confirmed with the sender at the time of receipt.
The information collected on the UGSP application forms cannot be obtained from any other sources.
This data collection will have a minimal impact on colleges and universities. These entities will be asked to certify that the applicant either is accepted as an entering student or is in good standing if already enrolled. Verification of EFN is also required, together with an estimate of educational (tuition, books, laboratory fees, etc.) and living expenses at the institution. For all respondents, the information being requested has been held to the minimum for the required use.
A funding period of 1 year is the maximum allowable under the enabling statute; therefore, the UGSP must require an annual application for award or renewal of the UGSP scholarship. Annual progress reports from research mentors and academic advisors will allow assessment of participants= academic achievement and demonstrated progress in the field of biomedical research. Annual verification of tuition and educational and living expenses is also necessary for accurate payments to academic institutions.
Similarly, the period of service for which an individual is obligated to serve as an employee of the NIH is 1 year for each academic year for which the scholarship is provided. Therefore, the UGSP must also require at least an annual application for deferment of the service obligation.
This project is in compliance with all provisions of 5 CFR 1320.5.
The 60-day Federal Register notice appeared in volume 72, number 214, published November 6, 2007, on pages 62661-62662.
The UGSP has consulted extensively with a broad range of potential applicants, writers of recommendations, and scientists/educators to determine the efficacy and ease of use of the UGSP forms and informational brochures. In addition, the UGSP has consulted with the individuals listed in Table A.8.1.
Table A.8-1. Individuals Consulted Prior to OMB Publication
Name, Title, and Affiliation |
Consultation Date |
Telephone Number |
Joan Reede, M.D., M.P.H., M.S. Dean for Diversity and Community Partnership Harvard Medical School |
July 2007 |
(617) 432-2413 |
Sister John Karen Frei, Ph.D. Dean, School of Natural Sciences Barry University |
July 2007 |
(305) 899-3200
|
Joel Oppenheim, Ph.D. Senior Associate Dean for Biomedical Sciences New York University Medical Center |
July 2007 |
(212) 268-8001 |
No gifts or payments will be made to applicants for completing the application forms.
The data collected for the UGSP is maintained by the Undergraduate Scholarship Program is solely for the purpose of determining an applicant=s eligibility for this program. The data is not used by the NIH for any other purpose.
Each application package includes an Assurance of Confidentiality and Privacy Act Notice. All information collected through the UGSP application forms will be in compliance with the Privacy Act of 1974. Data gathered on the Applicant Information form (NIH 2762-1), the Recommendation form (NIH 2762-2), the Undergraduate Institution Certification form (NIH 2762-3), the Applicant Contract form (NIH 2762-4), and the Academic Enrollment Certification and Service Obligation Deferment Request form (NIH 2762-5) is maintained in a Privacy Act System of Records, DHHS 09-25-0165. An update to this system of records was published in the Federal Register on February 8, 2002. These documents are contained in Attachment 3: Privacy Act System of Records Notice.
Information provided on each applicant and participant is retained and disposed of under the authority of the NIH Records Control Schedule. Participants= records are maintained for 6 years after closeout. This is the minimum retention period for records of a financial nature. Data gathered from program applicants and participants is maintained in file folders and computer storage media. Access is limited to authorized personnel in the performance of their duties. Contractors will be required to maintain the same security standards, as described in Attachment 6. The limited number of employees with access to these materials will be trained in the requirements of the Privacy Act.
As noted earlier, all sensitive information maintained in an electronic database accessible to UGSP or contractor staff is password-protected.
Provisions of 45 CRF 46 concerning the protection of human subjects do not apply.
The questions contained in the application forms for the UGSP program pertain only to information necessary to allow the NIH to determine applicants= eligibility for this program and aptitude for biomedical research.
Social Security numbers of applicants are necessary to make payment on behalf of participants and to make tax payments to the Internal Revenue Service. Further, they are necessary for identification purposes and for processing deferment requests.
Financial information recorded on the Undergraduate Institution Certification form concerning the applicant=s EFN status is the minimum necessary to determine an applicant=s eligibility for the program and level of need.
Recommendations and evaluations by teachers, professors, and mentors are necessary to assess the applicant=s ability, achievements, interests, and aspirations toward a biomedical research career.
Academic enrollment information and expected completion date of program requirements are necessary to determine a UGSP scholar’s eligibility for deferment of the service obligation.
The purposes of the information collection are described to applicants in a section of the information packet entitled AAssurance of Confidentiality and Privacy Act Notice.@ This notice is included in Attachment 2: Instructions to Respondents.
Approximately 300 applicants are expected to complete the application forms. Each applicant is expected to spend 3 hours 10 minutes on assembling the information for the application and completing the forms. In addition, each applicant will require that the financial aid staff of his or her college or university complete the Undergraduate Institution Certification form. These forms are expected to require 25 minutes of clerical time and 5 minutes of professional time. Three recommendations will be required for each applicant. Each person completing a recommendation is expected to require 1 hour to do so. If a UGSP participant requests a service obligation deferment, the registrar of his or her academic institution must certify the participant’s enrollment. This form is expected to take the participant 5 minutes to complete and the registrar 45 minutes to complete. The UGSP anticipates approximately 40 requests for service obligation deferments per year. The projection of these estimates is shown in Table A.12-1.
Table A.12-1. Estimates of Hour Burden
Type of Respondent |
Estimated Number of Respondents |
Estimated Number of Responses per Respondent |
Average Burden Hours per Response |
Estimated Total Annual Burden Hours Requested |
Applicant |
300 |
1.0 |
3.167 |
950.10 |
Recommender |
900 |
1.0 |
1.000 |
900.00 |
Financial Aid Staff |
300 |
1.0 |
.500 |
150.00 |
UGSP Participant |
40 |
1.0 |
.084 |
3.36 |
Registrar |
40 |
1.0 |
.750 |
30.00 |
Totals |
1,580 |
|
2,033.46 |
|
The cost to the applicant for completing the application is based on the average hourly wage that will be paid during the summer internship ($10.75 per hour). The cost for completing the Undergraduate Institution Certification is based on 5 minutes of professional time (at $32 per hour) and 25 minutes of clerical time (at $13 per hour) to retrieve data from the institution=s files. These rates have been combined to yield a prorated hourly rate of approximately $17. Typically, recommenders will be associate professors (or teachers, if the applicant is a graduating high school senior). The cost for an associate professor to complete the recommendation form is based on 1 hour at an average hourly rate of $30 (as confirmed by the annual salary survey of the American Association of University Professors). The cost for completing the Academic Enrollment Certification and Service Obligation Deferment Request Form is based on 5 minutes of the participant’s time (at $10.75 per hour) and 45 minutes of the registrar’s time (at $15 per hour). A projection of these estimates is shown in Table A.12-2.
Table A.12-2. Annualized Cost to Respondents
Type of Respondent |
Estimated Number of Respondents |
Hourly Wage Rate |
Average Time per Response |
Total Burden |
Applicant |
300 |
$10.75 |
3.167 |
$10,213.58 |
Recommender |
900 |
$30.00 |
1.000 |
27,000.00 |
Financial Aid Staff |
300 |
$17.00 |
0.500 |
2,550.00 |
UGSP Participant |
40 |
$10.75 |
0.084 |
36.12 |
Registrar |
40 |
$15.00 |
0.750 |
450.00 |
Total Respondent Cost: $40,249.70 |
||||
There are no additional costs associated with the collection of this information. There are no capital costs, operating costs, or maintenance costs to report.
The annualized cost to the Federal Government for administering the UGSP will be $398,000. The UGSP will provide ongoing administrative support, as well as the following:
Distribution of application forms and program information.
Receipt and processing of completed hard-copy applications.
Review of applications for satisfaction of minimum application requirements.
Meeting support, reimbursement, and honoraria for the review committee.
Preparation of notification materials for successful applicants.
This work by the UGSP will require approximately 70 percent of the UGSP Director=s time, and 450 percent of a clerical employee=s time. The cost of Federal employee salaries will be approximately $387,990.
There is an additional recurring annual cost of $20,000 for the production (under contract) of application packages, including forms, informational materials, and envelopes. The continuing development and maintenance of the UGSP Internet site is being carried out by a contractor under a separate contract at a cost of approximately $135,000 annually. There are no capital costs.
The annualized cost to the Federal Government will be $528,990. Federal employee salaries comprise $373,990, and the support contracts comprise $155,000.
No program changes or adjustments are requested.
No statistical analyses will be published using the data collected in these applications.
The OMB expiration date will be displayed.
There are no exceptions to Item 19, ACertification for Paperwork Reduction Act Submissions,@ of OMB Form 83-1
| File Type | application/msword |
| File Title | (Date) |
| Author | Patty Burgess |
| Last Modified By | curriem |
| File Modified | 2008-02-14 |
| File Created | 2008-02-14 |