Public Health Associate Program (PHAP) Alumni Assessment

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Public Health Associate Program (PHAP) Alumni Assessment	Form and Instruction	New	Available
PHAP ICR- Statement A_Revised 7 15 15.docx	Supporting Statement A	Uploaded 2015-07-27	Available
Att B PHAP Alumni Assessment_Word Version.docx	Supplementary Document	Uploaded 2015-04-27	Repair queued
Att E Email Reminder.docx	Supplementary Document	Uploaded 2015-04-27	Available
Att D Email Invite.docx	Supplementary Document	Uploaded 2015-04-27	Available
PHAP ICR- Statement B_Revised_7 15 15.docx	Supporting Statement B	Uploaded 2015-07-27	Available
PHAP Generic ICR 60 Day FRN.pdf	Supplementary Document	Uploaded 2015-03-26	Available
IRB Non_Research Determination.pdf	Supplementary Document	Uploaded 2015-03-26	Available
Att A Public Health Service Act.doc	Supplementary Document	Uploaded 2015-03-26	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
216295	Public Health Associate Program (PHAP) Alumni Assessment	Form and Instruction	New

ICR Details

OMB Control No: 0920-1078	ICR Reference No: 201503-0920-010
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No: 15IG
Title: Public Health Associate Program (PHAP) Alumni Assessment
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 08/03/2015
	Date Received in OIRA: 05/07/2015
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2018	36 Months From Approved
Responses	160	0	0
Time Burden (Hours)	21	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: This information collection request (ICR) is to gain three-year approval to follow alumni career progression following participation in the Public Health Associate Program (PHAP). Information will be used to answer key program assessment questions, specifically: "Is PHAP a quality program?", "Is PHAP an effective program?", and "What is the impact of PHAP?". The method that will be used to collect data will be through an online assessment. The subpopulation to be studied is PHAP Alumni.

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Authorizing Statute(s): US Code: 42 USC 241 Name of Law: Public Health Service Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 77006	12/23/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 24931	05/01/2015
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Public Health Associate Program (PHAP) Alumni Assessment	None	Public Health Associate Program (PHAP) Alumni Assessment

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	160	0	0	160	0	0
Annual Time Burden (Hours)	21	0	0	21	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: 0920-15IG is a New ICR.

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Annual Cost to Federal Government: $11,387

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 05/07/2015

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