Public Health Associate Program (PHAP) Assessment of Quality and Value.

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 0920-1078 PHAP Alumni Survey	Form and Instruction	New	Repair queued
Form 0920-1078 PHAP Host Site Supervisor Survey	Form and Instruction	New	Available
Public Health Associate Program (PHAP) Alumni Assessment	Form and Instruction	Removed	Available
Statement A PHAP ICR 0920-1078.docx	Supporting Statement A	Uploaded 2018-01-30	Available
PH Research Non Research Determination Form 0920-1078.pdf	Supplementary Document	Uploaded 2018-01-30	Available
Attachment M_PHAP Alumni Survey Reminder Email 2.docx	Supplementary Document	Uploaded 2018-01-30	Repair queued
Attachment L_PHAP Alumni Survey Reminder Email.docx	Supplementary Document	Uploaded 2018-01-30	Available
Attachment J_PHAP Alumni Survey Email Invitation.docx	Supplementary Document	Uploaded 2018-01-30	Available
Attachment I_PHAP Host Site Supervisor Survey Final Reminder.docx	Supplementary Document	Uploaded 2018-01-30	Repair queued
Attachment H_PHAP Host Site Supervisor Survey Reminder Email 2.docx	Supplementary Document	Uploaded 2018-01-30	Available
Attachment G_PHAP Host Site Supervisor Survey Reminder Email.docx	Supplementary Document	Uploaded 2018-01-30	Available
Attachment F_PHAP Host Site Supervisor Survey Invitation Email.docx	Supplementary Document	Uploaded 2018-01-30	Repair queued
Attachment D_PHAP Host Site Supervisor Survey Respondent Information.docx	Supplementary Document	Uploaded 2018-01-30	Available
60 day FRN.pdf	Supplementary Document	Uploaded 2018-01-30	Available
Statement B PHAP ICR 0920-1078.docx	Supporting Statement B	Uploaded 2018-01-30	Repair queued
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
229893	PHAP Alumni Survey	Form and Instruction	New
229891	PHAP Host Site Supervisor Survey	Form and Instruction	New
216295	Public Health Associate Program (PHAP) Alumni Assessment	Form and Instruction	Removed

ICR Details

OMB Control No: 0920-1078	ICR Reference No: 201801-0920-003
Status: Active	Previous ICR Reference No: 201503-0920-010
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-1078
Title: Public Health Associate Program (PHAP) Assessment of Quality and Value.
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/12/2018
	Date Received in OIRA: 01/31/2018
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2021	36 Months From Approved	08/31/2018
Responses	1,000	0	160
Time Burden (Hours)	213	0	21
Cost Burden (Dollars)	0	0	0

---

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 to inform program improvements and document evidence of outcomes and impact to inform future decision making. The method that will be used to collect data will be through an online assessment. The subpopulation to be studied is PHAP Host Site Supervisors and PHAP Alumni. The revision includes the following adjustments: 1) Expansion from one data collection instrument to two, both of which will inform improvements to the Public Health Associate Program (PHAP) and document evidence of quality and value. 2) Name change to reflect this adjustment from “Public Health Associate Program (PHAP) Alumni Assessment” to “Public Health Associate Program (PHAP): Assessment of Quality and Value.”

---

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

Citations for New Statutory Requirements: None

---

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

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 46991	10/10/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 4058	01/29/2018
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
PHAP Alumni Survey	0920-1078	PHAP Alumni Survey
PHAP Host Site Supervisor Survey	0920-1078	PHAP Host Site Supervisor Survey
Public Health Associate Program (PHAP) Alumni Assessment	None	Public Health Associate Program (PHAP) Alumni Assessment

---

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	1,000	160	0	840	0	0
Annual Time Burden (Hours)	213	21	0	192	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: Yes

Burden Reduction Due to: Changing Forms

Short Statement: Revision of PHAP 0920-1078 results in an increase in Burden Hours as a result of removal of previous PHAP Alumni Assessment information collection instrument and replacement with two surveys that collect information from PHAP Host Site Supervisors and PHAP Alumni.

---

Annual Cost to Federal Government: $13,422

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

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     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

---

Common Form ICR:  No

---

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: 01/31/2018

---