Fellowship Management System (EIS - Subset)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
FMS Application Module for Science Ambassadors	Form and Instruction	Unchanged	Available
Host Site Module	Form and Instruction	Modified	Available
Host Site Module- screenshots of changes	Form and Instruction	Modified	Available
FMS Alumni Directory - EPI Alumni Directory Example	Form and Instruction	Unchanged	Available
FMS Application Module	Form and Instruction	Modified	Available
FMS Application Module-screenshots of changes	Form and Instruction	Modified	Available
FMS Application Module - screenshots of changes	Form and Instruction	Modified	Available
FMS Application Module - EIS Application Example	Form and Instruction	Modified	Available
OMB_Change_Request_PMRF_4_2019_v.2.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2019-05-02	Available
Attachment 1 -PHAP Change Request Screen Shots_Final.docx	Supplementary Document	Uploaded 2019-03-22	Available
OMB_Change_Request_PHAP_12_2018_Final.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2019-03-22	Available
Estimated Annualized Burden Costs.docx	Supplementary Document	Uploaded 2018-08-23	Available
OMB_Change_Request_EIS_08-2018_ih.docx	Supplementary Document	Uploaded 2018-08-23	Available
Attachment _1-OMB_Change_Request_EIS_Screen Shots_3-2018.docx	Supplementary Document	Uploaded 2018-03-15	Repair queued
OMB_Change_Request_EIS_3-2018.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2018-03-15	Available
Supporting_Statement_A-FMS_Clean_version.docx	Supporting Statement A	Uploaded 2017-11-27	Available
Comment 2_1k1-8yof-13gk.pdf	Supplementary Document	Uploaded 2017-11-08	Available
Comment 1_1k1-8yik-1gek.pdf	Supplementary Document	Uploaded 2017-11-08	Available
Supporting_Statement_B-FMS.DOCX	Supporting Statement B	Uploaded 2017-11-08	Available
Attachment_7_Research_Determination_Memo_FMS.pdf	Supplementary Document	Uploaded 2017-11-08	Available
Attachment_2_60day_FRN.docx	Supplementary Document	Uploaded 2017-11-08	Available
Attachment_1_Authorizing_Legislation-PH_Service_Act.docx	Supplementary Document	Uploaded 2017-11-08	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
232804	FMS Application (Subset Applicants)	Other-Screenshots	Unchanged
226159	PMR/F Fellowship Applicants	Form and Instruction	Unchanged	FMS Application Module for Science Ambassadors
214088	FMS Host Site Module - PHAP Host Site Example	Form and Instruction	Modified	Host Site Module
214088	FMS Host Site Module - PHAP Host Site Example	Form and Instruction	Modified	Host Site Module- screenshots of changes
214087	FMS Alumni Directory - EIS Alumni Directory Example	Form and Instruction	Unchanged	FMS Alumni Directory - EPI Alumni Directory Example
214086	FMS Application Module - EIS Application Example	Form and Instruction	Modified	FMS Application Module
214086	FMS Application Module - EIS Application Example	Form and Instruction	Modified	FMS Application Module-screenshots of changes
214086	FMS Application Module - EIS Application Example	Form and Instruction	Modified	FMS Application Module - screenshots of changes
214086	FMS Application Module - EIS Application Example	Form and Instruction	Modified	FMS Application Module - EIS Application Example

ICR Details

OMB Control No: 0920-0765	ICR Reference No: 201905-0920-002
Status: Historical Active	Previous ICR Reference No: 201903-0920-006
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-0765-19ASE
Title: Fellowship Management System (EIS - Subset)
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 05/31/2019
Retrieve Notice of Action (NOA)	Date Received in OIRA: 05/02/2019
Terms of Clearance: OMB is approving this information collection request; the agency will request approval to extend or revise the collection if the agency seeks to continue the information collection activity beyond the period approved under this action.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2021	01/31/2021	01/31/2021
Responses	4,131	0	4,131
Time Burden (Hours)	4,656	0	4,656
Cost Burden (Dollars)	0	0	0

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Abstract: The FMS application module is a streamlined application for CDC training programs where interested applicants can submit an application online. The purpose of this Change Request is for OMB approval of proposed modifications to data elements to accommodate the changing needs of the fellowship program. Specifically, this change request is to address feedback received on the FMS application module from applicants and STLT health partners. Changes support the efficiency and effectiveness of CDC’s PHAP training program. The proposed changes do not impact burden. Modifications will support a streamlined, standard application and selection process.

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Authorizing Statute(s): US Code: 42 USC 301 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:
	82 FR 41963	09/05/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 58605	12/13/2017
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 5

table that charts list of burden

IC Title	Form No.	Form Name
FMS Alumni Directory - EIS Alumni Directory Example	none	FMS Alumni Directory - EPI Alumni Directory Example
FMS Application (Subset Applicants)
FMS Application Module - EIS Application Example	none, none, none, none	FMS Application Module - EIS Application Example ,   FMS Application Module - screenshots of changes ,   FMS Application Module-screenshots of changes ,   FMS Application Module
FMS Host Site Module - PHAP Host Site Example	none, none	Host Site Module- screenshots of changes ,   Host Site Module
PMR/F Fellowship Applicants	none	FMS Application Module for Science Ambassadors

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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	4,131	4,131	0	0	0	0
Annual Time Burden (Hours)	4,656	4,656	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $850,000

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.     Yes

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

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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: 05/02/2019

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