Supporting Statement

Health Resources and Services Administration

National Health Service Corps
Site Retention Assessment Questionnaire

SUPPORTING STATEMENT

A. Justification

1. Circumstances of Information Collection

This is a request to conduct a Site Retention Assessment Questionnaire for the National Health Service Corps (NHSC), managed by the Bureau of Clinician Recruitment and Service (BCRS) within the Health Resources and Service Administration (HRSA), and receive approval from the Office of Management and Budget (OMB). The legislative authority supporting the need for the information collected is found in Section 333 [254f] (a) and (d) of the Public Health Service Act.

The NHSC is a network of primary health care professionals that provide medical, dental, and mental and behavioral health services in communities, known as Health Professional Shortage Areas (HPSAs), across the country that have limited access to health care. The NHSC was established by Congress to eliminate designated HPSAs. HPSAs are geographic areas, facilities or population groups determined by the Secretary of Health and Human Services to have a shortage of health professionals. In exchange for their service, the NHSC provides clinicians with financial support in the form of loan repayment and scholarships. Corps members fulfill their service requirement by working at NHSC-approved sites. To date, the NHSC has over 14,000 member sites.

The NHSC’s mission is to improve access to primary care, which is supported by clinicians who remain in their sites well beyond their contracted periods of service. In order to maintain and improve retention, the NHSC determined it would be necessary to conduct a site survey to understand the influence and impact sites have on clinician retention levels. The NHSC Site Retention Assessment Questionnaire is a tool that allows sites to provide information regarding their management practices and retention efforts.

2. Purpose and Use of Information

The purpose of the NHSC Site Retention Assessment Questionnaire is to collect survey information from administrative officials at NHSC sites that will guide NHSC initiatives and assist sites in improving their retention outcomes. The survey will ask site administrators to rate how difficult it is to retain clinicians, their general attitudes about the feasibility of good retention and awareness of its principles, their practices’ current approaches to promoting retention, ratings on various aspects of their practices’ organizational culture and administrative style, and their sites’ interest in and preferred ways of learning how to bolster retention. Survey data will be gathered anonymously and presented in-aggregate, to promote administrators’ participation and full disclosure.

The data obtained through the NHSC Site Retention Assessment Questionnaire facilitates the process of identifying and analyzing sites’ retention efforts. The NHSC Site Retention Assessment Questionnaire specifically identifies the current and long term retention needs of the sites, which facilitates the recruitment of necessary health care professionals; it also indicates the retention levels of NHSC clinicians who have fulfilled their service obligation and remained at the site. The information that is collected by the NHSC is utilized to improve clinician retention within the program and bring awareness to relevant technical assistance issues for sites.

The proposed survey will provide information to the NHSC to optimize the program in terms of recognizing the factors that influenced NHSC clinicians to remain in their service sites; or if they chose to leave, the factors that influence them to relocate to other practices that provide care to the underserved. The NHSC helps bring committed clinicians into underserved settings for their periods of service obligation; the NHSC’ contribution’s to care in these communities is magnified when its alumni remain beyond their obligations to provide, ideally, decades more care. Having invested in covering the costs of its clinicians’ education, the NHSC wishes to determine how optimally to retain them.

The findings of the survey will be used to assess the efforts the Corps has taken, how these efforts have impacted the participants, and the actions the Corps should now take to retain its committed clinicians, and determine how best to strengthen the NHSC.

3. Use of Improved Information Technology

The NHSC Site Retention Assessment Questionnaire is an interactive, online-based survey, which will be made fully accessible through a link provided to site participants by email. The electronic submission of the survey will enable the NHSC to efficiently track each site’s response and facilitate the data analysis process.

4. Efforts to Avoid Duplication

The NHSC Site Retention Assessment Questionnaire does not duplicate any other survey tool. NHSC sites are the only population group that will be surveyed. Although a NHSC retention study was conducted in 2012 (a revision of the former 1998 survey), its primary focus was that of clinician retention within the NHSC. The proposed Assessment Questionnaire will focus on site-specific retention efforts and practices, and does not utilize the same set of retention questions as the previous survey tool.

With regard to duplication of persons to be surveyed, the BCRS maintains a database containing all current and recent NHSC site participants. This database has been searched for duplications by name and site address.

5. Involvement of Small Entities

The information requested does not have a significant or substantial impact on small entities or small businesses.

6. Consequences If Information Collected Less Frequently

Each site administrator and/or site official must respond only once. This survey will be administered on an annual basis.

If the information were collected less frequently, the NHSC could not provide appropriate and timely technical assistance to sites in need. In addition, there would be no method for the program to accurately report on the full scope of retention activities or improve retention after program completion.

7. Consistency with the Guidelines in 5 CFR 1320.6 (d) (2)

The data will be collected in a manner consistent with guidelines contained in 5 CFR 1320.6.

8. Consultation Outside the Agency

The notice required by 5 CFR 1320.8(d) was published in the Federal Register on
November 13, 2012 (Vol. 77, No. 219, pages 67656 - 67657). Only one comment was received regarding the method of distribution and the release date of the survey.

Respondents who reviewed the survey for burden, comprehension, and format, are:

Kristi Carmean, MBA

Three Lower Counties Community Services, Inc.

P.O. Box 1978

Salisbury, MD 21802

(410) 749-1015 (Ext. 1615)

Chrissy Warren

Cross Trails Medical Center

408 S. Broadview

Cape Girardeau, MO  63703

(573) 339-1196

Mark Mancinelli

Delaware Valley Community Health, Inc.

1412-22 Fairmount Avenue

Philadelphia, PA 19130

(215) 684-5343

9. Remuneration of Respondents

Respondents will not be remunerated for completing the survey.

10. Assurance of Confidentiality

No personal identifiers are to be requested of respondents on the survey.

11. Questions of a Sensitive Nature

There are no questions of a sensitive nature.

12. Estimates of Annualized Hour Burden

The following table summarizes the annual estimate of burden for completing the Questionnaire:

Hour and Cost Estimates

Instrument	Number of Respondents	Responses per Respondent	Total Responses	Hours per Response	Total hour Burden	Wage Rate	Total Hour Cost
NHSC Site Retention Assessment Questionnaire	7,000	1	7,000	.507	3,549	$10.00	$35,490

The estimates contained in the table reflect an annual number of 7,000 respondents. The survey information requested takes approximately 30 minutes (.507 hours) to complete by a site administrator or authorized site official, at a wage rate of $10.00 per hour. The estimated total hour cost is $35,490 for this instrument.

13. Estimates of Annualized Cost Burden to Respondents

There are no capital or start-up costs nor are there any operation and maintenance costs.

14. Estimates of Annualized Cost to the Government

An annual survey is planned with the cost for contractor support being $70,000, inclusive of the survey design, sample selection, respondent contact, follow-up, data analysis and assembly.

15. Changes in Burden

Since the survey is a new project, there are no changes to the estimate of burden.

16. Time Schedule, Publication and Analysis Plans

Once official notification is received regarding OMB approval, the survey will be implemented. An email correspondence will be sent to all respondents, including an online link to access the survey instrument. It is anticipated that survey responses will be received within 30 to 45 days from the initial email correspondence. Subsequently, the contractor will conduct a survey analysis and submit a final report to the NHSC.

17. Exemption for Display of Expiration Date

The expiration date will be displayed.

18. Certifications

This information collection fully complies with the guidelines in 5 CFR 1320.9. The required certifications are included in the package.