Data Collection for CDC Fellowship Programs

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 0920-1163 Assessment Instrument Web version	Form and Instruction	New	Available
PHAP Host Site Supervisor Survey - word	Form	New	Available
PHAP Host Site Supervisor Survey	Form	New	Available
Comment_2.pdf	Supplementary Document	Uploaded 2016-08-30	Available
Comment_1.pdf	Supplementary Document	Uploaded 2016-08-30	Available
Research Determination Memorandum.pdf	Supplementary Document	Uploaded 2016-08-30	Available
8_Att 5 - SORN 09-20-0161.pdf	Supplementary Document	Uploaded 2016-08-30	Available
6_Att 3 - GenIC Template.docx	Supplementary Document	Uploaded 2016-08-30	Available
60d FRN - published.pdf	Supplementary Document	Uploaded 2016-08-30	Available
5_Att 2 - List of Fellowships.docx	Supplementary Document	Uploaded 2016-08-30	Available
4_Att 1 - Authorizing Legislation.pdf	Supplementary Document	Uploaded 2016-08-30	Available
2_Fellowship__Supporting Statement_B.docx	Supporting Statement B	Uploaded 2016-08-30	Available
CDC Fellowship Program_Supporting Statement_A 02FEB2017.docx	Supporting Statement A	Uploaded 2017-02-02	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
236778	National Environmental Public Health Internship Program (NEPHIP) Outcome Assessment	Form and Instruction	New	Assessment Instrument Web version
226566	Division of Scientific Education and Professional Development (DSEPD) Pan-Fellowship Stakeholder Survey	Other-WEB	New
226164	PHAP Host Site Supervisor Survey	Form	New	PHAP Host Site Supervisor Survey - word
226164	PHAP Host Site Supervisor Survey	Form	New	PHAP Host Site Supervisor Survey

ICR Details

OMB Control No: 0920-1163	ICR Reference No: 201608-0920-018
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No: 16ARO
Title: Data Collection for CDC Fellowship Programs
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: 02/06/2017
Retrieve Notice of Action (NOA)	Date Received in OIRA: 08/31/2016
Terms of Clearance: Approved consistent with the understanding that outcomes from the genICs submitted under this OMB control number will not be generalizable to broader populations and are intended to inform internal fellowship program development. No incentives will be offered to respondents. All genICs submitted will include the instruments, any consent forms/recruitment letters, a supporting statement part A, and a supporting statement Part B where necessary.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/29/2020	36 Months From Approved
Responses	17,742	0	0
Time Burden (Hours)	8,871	0	0
Cost Burden (Dollars)	251,455	0	0

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Abstract: The intended use of data collected is to inform planning, implementation, and continuous quality improvement of CDC fellowship programs. Data collection methods include focus groups, interviews, and surveys, using both purposive and probabilistic samples. Respondent populations include potential applicants, fellows, alumni, supervisors, mentors, and employers of alumni. Data will be analyzed relative to the data collection methods and purpose.

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Authorizing Statute(s): US Code: 42 USC 241 Name of Law: U.S. 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:
	81 FR 41305	06/24/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 59627	08/30/2016
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 3

table that charts list of burden

IC Title	Form No.	Form Name
Division of Scientific Education and Professional Development (DSEPD) Pan-Fellowship Stakeholder Survey
National Environmental Public Health Internship Program (NEPHIP) Outcome Assessment	0920-1163	Assessment Instrument Web version
PHAP Host Site Supervisor Survey	none, none	PHAP Host Site Supervisor Survey ,   PHAP Host Site Supervisor Survey - word

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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	17,742	0	0	17,742	0	0
Annual Time Burden (Hours)	8,871	0	0	8,871	0	0
Annual Cost Burden (Dollars)	251,455	0	0	251,455	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: Submission of 0920-16ARO is New (Generic) ICR.

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Annual Cost to Federal Government: $121,007

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: 08/31/2016

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