Environmental Health Workforce Current and Emerging Challenges Assessment

Information Collections to Advance State, Tribal, Local and Territorial (STLT) Governmental Agency System Performance, Capacity, and Program Delivery

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0879 can be found here:

Documents and Forms

Document Name Document Type
Form 0920-0879 Environmental Health Workforce Current and Emerging Challenges Assessment Form and Instruction
0920-0879 Recruitment Instrument - State Health Department EH Prof Attachment C. Recruitment Instrument-Web Version.docx Form and Instruction
0920-0879 Recruitment Instrument - Tribal Health Department EH Pro Attachment C. Recruitment Instrument-Web Version.docx Form and Instruction
0920-0879 Recruitment Instrument - Local Health Department EH Prof Attachment C. Recruitment Instrument-Web Version.docx Form and Instruction
0920-0879 Recruitment Instrument - Territorial Health Department E Attachment C. Recruitment Instrument-Web Version.docx Form and Instruction
0920-0879 Focus Group Facilitation Guide - STLT EH Professionals Attachment D. Facilitation Guide_REVISED.docx Form and Instruction
Attachment A. Respondent Breakdown.docx Respondent Breakdown IC Document
Attachment E. Assessment Topics.docx Assessment Topics IC Document
Attachment F. Information Collection Crosswalk.docx Information Collection Crosswalk IC Document
Attachment G. Notification Email.docx Notification Email IC Document
Attachment H. Reminder Email.docx Reminder Email IC Document
Attachment I. Confirmation Email.docx Confirmation Email IC Document
Attachment J. Confirmation Call.docx Confirmation Call IC Document
UNCOVER-EH-SSA.docx Supporting Statement A IC Document
UNCOVER-EH-SSB_REVISED.docx Supporting Statement B 31MAY2018 IC Document

Information Collection (IC) Details

IC Title:	Environmental Health Workforce Current and Emerging Challenges Assessment	Agency IC Tracking Number:	0920-0879-18AGJ

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	0920-0879	Recruitment Instrument - State Health Department EH Professional	Attachment C. Recruitment Instrument-Web Version.docx	NA	Yes	Yes	Fillable Fileable
Form and Instruction	0920-0879	Recruitment Instrument - Tribal Health Department EH Professional	Attachment C. Recruitment Instrument-Web Version.docx	NA	Yes	Yes	Fillable Fileable
Form and Instruction	0920-0879	Recruitment Instrument - Local Health Department EH Professional	Attachment C. Recruitment Instrument-Web Version.docx	NA	Yes	Yes	Fillable Fileable
Form and Instruction	0920-0879	Recruitment Instrument - Territorial Health Department EH Professional	Attachment C. Recruitment Instrument-Web Version.docx	NA	Yes	Yes	Fillable Fileable
Form and Instruction	0920-0879	Focus Group Facilitation Guide - STLT EH Professionals	Attachment D. Facilitation Guide_REVISED.docx	NA	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,036	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,036	1,036
Annual IC Time Burden (Hours)	177	177
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Respondent Breakdown	Attachment A. Respondent Breakdown.docx	05/31/2018
Assessment Topics	Attachment E. Assessment Topics.docx	05/31/2018
Information Collection Crosswalk	Attachment F. Information Collection Crosswalk.docx	05/31/2018
Notification Email	Attachment G. Notification Email.docx	05/31/2018
Reminder Email	Attachment H. Reminder Email.docx	05/31/2018
Confirmation Email	Attachment I. Confirmation Email.docx	05/31/2018
Confirmation Call	Attachment J. Confirmation Call.docx	05/31/2018
Supporting Statement A	UNCOVER-EH-SSA.docx	05/31/2018
Supporting Statement B 31MAY2018	UNCOVER-EH-SSB_REVISED.docx	05/31/2018

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.