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

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
PHAP Alumni Assessment	Form and Instruction	Modified	Repair queued
PHAP Alumni Survey	Form and Instruction	Modified	Repair queued
PHAP Host Site Supervisor Survey	Form and Instruction	Modified	Repair queued
PHAP Host Site Supervisor Survey	Form and Instruction	Modified	Repair queued
Attachment N_PHAP Alumni Survey Reminder Email 2-FINAL.docx	Supplementary Document	Uploaded 2020-12-01	Repair queued
Attachment M_PHAP Alumni Survey Reminder Email-FINAL.docx	Supplementary Document	Uploaded 2020-12-01	Repair queued
Attachment K_PHAP Alumni Survey Email Invitation_FINAL.docx	Supplementary Document	Uploaded 2020-12-01	Repair queued
Attachment J_PHAP Host Site Supervisor Survey Final Reminder_FINAL.docx	Supplementary Document	Uploaded 2020-12-01	Repair queued
Attachment I_PHAP Host Site Supervisor Survey Second Reminder Email_FINAL.docx	Supplementary Document	Uploaded 2020-12-01	Repair queued
Attachment H_PHAP Host Site Supervisor Survey Reminder Email_FINAL.docx	Supplementary Document	Uploaded 2020-12-01	Repair queued
Attachment G_PHAP Host Site Supervisor Survey Invitation Email_FINAL.docx	Supplementary Document	Uploaded 2020-12-01	Available
Attachment E_PHAP Host Site Supervisor Survey Respondent Information_FINAL.docx	Supplementary Document	Uploaded 2020-12-01	Repair queued
Attachment D_Published 60 day_11022020.pdf	Supplementary Document	Uploaded 2020-12-01	Repair queued
Attachment A_Public Health Service Act_FINAL.docx	Supplementary Document	Uploaded 2020-12-01	Available
PHAP ICR- Statement B Extension-FINAL.docx	Supporting Statement B	Uploaded 2020-12-01	Repair queued
PHAP ICR- Statement A Extension_11052020.docx	Supporting Statement A	Uploaded 2020-12-01	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
229893	PHAP Alumni Survey	Form and Instruction	Modified	PHAP Alumni Assessment
229893	PHAP Alumni Survey	Form and Instruction	Modified
229893	PHAP Alumni Survey	Other-WORD version of survey to facilitate review of content	Modified
229891	PHAP Host Site Supervisor Survey	Form and Instruction	Modified	PHAP Host Site Supervisor Survey
229891	PHAP Host Site Supervisor Survey	Form and Instruction	Modified
229891	PHAP Host Site Supervisor Survey	Other-WORD version of survey to facilitate review of content	Modified

ICR Details

OMB Control No: 0920-1078	ICR Reference No: 202010-0920-018
Status: Historical Active	Previous ICR Reference No: 201801-0920-003
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-1078
Title: Public Health Associate Program (PHAP) Assessment of Quality and Value
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 02/04/2021
Retrieve Notice of Action (NOA)	Date Received in OIRA: 12/02/2020
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/29/2024	36 Months From Approved	03/31/2021
Responses	1,000	0	1,000
Time Burden (Hours)	213	0	213
Cost Burden (Dollars)	7,474	0	0

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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). The subpopulations to be studied are the PHAP Host Site Supervisors and PHAP Alumni. Information will be collected through online surveys. Findings will be used to assess the quality and value of the PHAP.

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Authorizing Statute(s): US Code: 42 USC 241 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:
	85 FR 45434	07/28/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 77215	12/01/2020
Did the Agency receive public comments on this ICR? No

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

table that charts list of burden

IC Title	Form No.	Form Name
PHAP Alumni Survey	n/a	PHAP Alumni Assessment
PHAP Host Site Supervisor Survey	n/a	PHAP Host Site Supervisor Survey

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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	1,000	1,000	0	0	0	0
Annual Time Burden (Hours)	213	213	0	0	0	0
Annual Cost Burden (Dollars)	7,474	0	0	7,474	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: $7,839

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? No

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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: 12/02/2020

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