2b SDSPR guidance

Scholarships for Disadvantaged Students Application Program Specific Form

OPCSDSPR Guidance FY 2012-13 11-1-2013

Scholarships for Disadvantaged Students Performance Report Form

OMB: 0915-0149

Document [doc]
Download: doc | pdf

Scholarships for Disadvantaged Students (SDS)

Performance Report (PR)


Guidance


FY 20XX-XX


Note: All disciplines/programs and relevant dates are pre-populated.


Enter data for the current reporting period: 20XX through 20XX unless otherwise specified.



SDSPR 1: Funding Information


Item 1.A: Total Federal Funds Authorized for this Funding Period: This amount is automatically inputted based on the Notice of Award.


Item 1.B: Total Amount of item 1A Disbursed: Enter the total amount of money drawn down from PMS and disbursed to students for this funding period.


Item 1.C: Unused Balance of Federal Funds: item 1.A. minus item 1.B. This amount is automatically calculated by the system.


Item 1.D: Check to indicate zero disbursements: Please select the check box if none of the amount indicated in item 1.B. was disbursed.



SDSPR 2: Graduate Information

Item 2.A: Enter the total number of full-time graduates at your discipline/program during the curruent reporting period.

Item 2.B: Enter the total number of full-time underrepresented minorities (URM) graduates at your discipline/program during the current reporting period.

Item 2.C: Enter the total number of full-time graduates discipline/program from rural backgrounds during the current reporting period.

Item 2.D: Enter the total number of full-time students that received SDS funds who graduated during 20XX –20XX (allopathic medicine and osteopathic medicine only)





or

Item 2.D: Enter the total number of full-time students that received SDS funds who graduated during 20XX –20XX (other than allopathic medicine and osteopathic medicine)

3. Medcially Underserved Communities (MUC) Details

Item 3.A: Enter the number of SDS recipients during this reporting period that indicate an intention to serve in a medically underserved community.

Item 3.B: Of the graduates in item 2.D, enter the total number of full-time students that received SDS funds and served in a medically underserved community during the current reporting period.

4. Primary Care (PC) Details

Item 4.A: Enter the number of SDS recipients during this reporting period that indicate an intention to practice in a primary care.

Item 4.B: Of the graduates in item 2.D, enter the total number of full-time students that received SDS funds and practiced in primary care during the current reporting period.

5. Graduates That Entered Field of Study

Enter the of SDS recipients who graduated during 20XX – 20XX that subsequently entered the field for which they received their degree (allopathic medicine and osteopathic medicine only)

or

Enter the of SDS recipients who graduated during 20XX – 20XX that subsequently entered the field for which they received their degree (other than allopathic medicine and osteopathic medicine only)



SDSPR 3: Trainee Information

6. Enrollment and Attrition

Item 6.A: Enter the total full-time enrollment at your school during the current reporting period.

Item 6.B: Of those students in item 6.A, enter the number of students that dropped out during the current reporting period.

Item 6.C: Of those students in item 6.B, enter the number of how many received SDS funds.





7. SDS Receipients Receving Pipeline Training from Other HRSA Diviersity Pipeline Programs

Are there SDS recipients during this reporting period who received or are receiving pipeline training from other HRSA diversity/pipeline programs? Answer Yes or No.

Enter the number of SDS recipients during the current reporting period who received or are receiving pipline training from other HRSA diversity/pipeline programs.

  1. Area Health Education Center (AHEC)

  2. Center of Excellence (COE)

  3. Health Careers Opportunity Program

  4. Nursing Workforce Diversity

  5. Other (specify)

8. Community College Question

Check if your school is a community college.

9. Scholarship Usage

Check box(s) that reflect(s) how the SDS scholarships were used:

Tuition

Fees and other reasonable educational expenses

Reasonable living expenses



SDSPR 4: Recruitment Activities

Check all that apply.



SDSPR 5: Retention Activities

Check all that apply.

B. Provide a detailed description of your current recruitment and retention activities for students of disadvantaged backgrounds, including minority student who enter into the health professions. Also, if your school has plans to improve the performance of those recruitment and retention programs, please describe the plans.

C. Please share any success stories for SDS recipients.



Definitions:

Underrepresented Minorities (URM)


  • American Indian or Alaska Native

  • Black or African American

  • Native Hawaiian or Other Pacific Islander

  • Hispanic/Latino

  • More than One Race - except for 2 race combinations of White and Asian



Race:

American Indian or Alaska Native: A person having origins in any of the original peoples of

North America, and who maintains cultural identification through tribal affiliation or community recognition.

Black or African American: A person having origins in any of the Black racial groups of Africa.

Asian: A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand and Vietnam.

Native Hawaiian or Other Pacific Islander: A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.

White: A person having origins in any of the original peoples of Europe, North America, theMiddle East or North Africa.

More than one Race: A person having origins from more than one race.

Race Not Reported:  Race unknown



Ethnicity:

Hispanic or Latino: A person of Mexican, Puerto Rican, Cuban, Central or South American or other Spanish culture or origin, regardless of race.

Non-Hispanic/Non-Latino:  A person not having origins of Mexican, Puerto Rican, Cuban, Central or South American or other Spanish culture or origin, regardless of race.

MEDICALLY UNDERSERVED COMMUNITIES (MUC)

Definition of Medically Underserved Community:

The term Medically Underserved Community means an urban or rural area or population that:

(A) is eligible for designation under Section 332 of the PHS Act as a health professional shortage area (HPSA);

(B) is eligible to be served by a migrant health center under Section 329 [now 330(g)] of the PHS Act, a community health center under Section 330 of the PHS Act, a grantee under Section 330(h) of the PHS Act, (relating to homeless individuals), or a grantee under Section 340A [now 330(i)] of the PHS Act (relating to residents of public housing);

(C) has a shortage of personal health services, as determined under criteria issued by the Secretary under Section 1861(aa)(2) of the Social Security Act (relating to rural health clinics); or

(D) is designated by a State Governor (in consultation with the medical community) as a shortage area or medically underserved community.

In keeping with the Congressional intent that eligible entities should not be limited to formally designated Health Professional Shortage Areas (HPSAs) and populations serviced by CHCs, MHCs, or homeless health centers, the list of types of practice sites that can be claimed under this provision includes the following:

•       Community Health Centers (CHC) (section 330 of the PHS Act)

•       Migrant Health Centers (MHC) (section 330(g) of the PHS Act)

•       Health Care for the Homeless Grantees (section 330(h) of the PHS Act)

•       Public Housing Primary Care Grantees (section 330(i) of the PHS Act)

•       Rural Health Clinics, federally designated (section 1861(aa)(2) of the Social Security

Act)

•       National Health Service Corps (NHSC) Sites (section 333 of the PHS Act)

•       An outpatient health program or facility operated by a tribe or tribal organization under the Indian Self-Determination Act or by an urban Indian organization receivingfunds under Title V of the Indian Health Care Improvement Act (25 U.S.C. § 450 et seq. and 25 U.S.C. § 1601 et seq.)

•       Federally Qualified Health Centers (section 1861(aa)(2) of the Social Security Act)

•       Primary Medical Care Health Professional Shortage Areas (HPSAs) (section 332 of the PHS Act)

•       Mental Health HPSA

•       Dental HPSAs (section 332 of the PHS Act)

•       Nurse Shortage Areas (section 846 of the PHS Act)

•       State or Local Health Departments (regardless of sponsor - for example, local health departments who are funded by the state would qualify)

•       Practice sites designated by State Governors as serving medically underserved communities



Primary Care:

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: Americas Health in a New Era. Washington, D.C.: National Academy Press, 1996).









File Typeapplication/msword
File TitleScholarships for Disadvantaged Students (SDS) Performance Report Guidance
AuthorSutton, Virginia (HRSA)
Last Modified ByWinXPUniv
File Modified2013-11-14
File Created2013-11-14

© 2024 OMB.report | Privacy Policy