Fellowship Management System (EIS - Subset)

Forms and Documents

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

IC Document Collections

IC ID	Document Title	Status
232804	FMS Application (Subset Applicants) Other-Screenshots	Unchanged
226159	PMR/F Fellowship Applicants Form and Instruction	Unchanged
214088	FMS Host Site Module - PHAP Host Site Example Form and Instruction	Modified
214087	FMS Alumni Directory - EIS Alumni Directory Example Form and Instruction	Unchanged
214086	FMS Application Module - EIS Application Example Form and Instruction	Modified

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
	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.

	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

IC Title	Form No.	Form Name
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
FMS Alumni Directory - EIS Alumni Directory Example	none	FMS Alumni Directory - EPI Alumni Directory Example
PMR/F Fellowship Applicants	none	FMS Application Module for Science Ambassadors

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ICR Summary 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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