Fellowship Management System

Forms and Documents

Document Name	Status
Form 0920-0765 Activity Tracking Form and Instruction	Modified
Form 0920-0765 Reference Letters for Fellowship Applicants Form and Instruction	Unchanged
Form 0920-0765 FMS Application Writing Samples (Subset Applicants) Form and Instruction	Modified
Form 0920-0765 FMS Host Site Module Form and Instruction	Modified
Form 0920-0765 FMS Alumni Directory Form and Instruction	Modified
Form 0920-0765 Fellowship Applications Form and Instruction	Modified
Change Request Memo OMB No. 0920-0765 Feb 2022.docx Justification for No Material/Nonsubstantive Change	2022-02-28
eFMS 2.0 Change Request for EWB_Dec 2021_final.docx Justification for No Material/Nonsubstantive Change	2022-01-10
eFMS Change Request 0920-0765 - Nov 2021.docx Justification for No Material/Nonsubstantive Change	2021-11-16
eFMS Change Request 0920-0765-Nov 2021 Attachment C Host Site Module Screenshots.docx Supplementary Document	2021-11-16
eFMS Change Request 0920-0765-Nov 2021 Attachment B Application Module Screenshots.docx Supplementary Document	2021-11-16
Attachment D_Screenshots for Host Site Module-June 2021.docx Supplementary Document	2021-06-08
Attachment C_ Screenshots for Application Module-June 2021.docx Supplementary Document	2021-06-08
OMB Change Request - 0920-0765 - June 2021 R1.docx Justification for No Material/Nonsubstantive Change	2021-06-08
OMB Change Request - 0920-0765 - Spring 2021_passback 2.docx Justification for No Material/Nonsubstantive Change	2021-03-16
SSB_01312020.docx Supporting Statement B	2020-01-31
0920-0765 Supporting Statement A_revised 3-31-2020.docx Supporting Statement A	2020-03-31
Attachment_8_PIA.pdf Supplementary Document	2020-01-28
Attachment_7_Research_Determination_Memo_FMS.pdf Supplementary Document	2020-01-28
Attachment_2_60 Day FRN.pdf Supplementary Document	2020-01-28
Attachment 1_Public Health Service Act.docx Supplementary Document	2020-01-28

IC Document Collections

IC ID	Document Title	Status
239669	Activity Tracking Form and Instruction	Modified
239668	Reference Letters for Fellowship Applicants Form and Instruction	Unchanged
232804	FMS Application Writing Samples (Subset Applicants) Form and Instruction	Modified
214088	FMS Host Site Module Form and Instruction	Modified
214087	FMS Alumni Directory Form and Instruction	Modified
214086	Fellowship Applications Form and Instruction	Modified

ICR Details

OMB Control No: 0920-0765	ICR Reference No: 202202-0920-012
Status: Received in OIRA	Previous ICR Reference No: 202201-0920-004
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-0765-22CU
Title: Fellowship Management System
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 03/07/2022

	Requested	Previously Approved
Expiration Date	03/31/2023	03/31/2023
Responses	9,708	9,708
Time Burden (Hours)	6,484	5,983
Cost Burden (Dollars)	586,324	586,324

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Abstract: CDC uses the Fellowship Management System (FMS) to collect, process, and manage data from non-federal applicants seeking training or public health support services through CDC fellowships. FMS is used to electronically submit fellowship applications and fellowship host site proposals, and to maintain fellowship alumni directories on-line. This Change Request consist of enhancements to various areas of the ICR and slightly modifies the overall burden.

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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:
	84 FR 44313	08/23/2019
30-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 5664	01/31/2020
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 6

IC Title	Form No.	Form Name
Activity Tracking	0920-0765	FMS 2.0 Activity Tracking Module (revised Jan 2022)
FMS Alumni Directory	0920-0765	FMS 2.0 Alumni Tracking Module (2020)
FMS Application Writing Samples (Subset Applicants)	0920-0765	FMS 2.0 Application Module - 13.6 with Prompt Options for EIS Writing Samples
FMS Host Site Module	0920-0765	FMS Host Site Module (revised Jan 2022)
Fellowship Applications	0920-0765	FMS Application Module (revised Jan 2022)
Reference Letters for Fellowship Applicants	0920-0765	FMS Application Module 2020 (sections 12.2 - 12.3.3)

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ICR Summary of Burden

	Total Request	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	9,708	9,708	0	0	0	0
Annual Time Burden (Hours)	6,484	5,983	0	501	0	0
Annual Cost Burden (Dollars)	586,324	586,324	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: No

Burden Reduction Due to:

Short Statement: This Change Request, CDC seeks OMB approval to accommodate specific changes to all fellowship programs’ modules. The proposed changes will contribute enhancements and provide the CDC with a more efficient and effective mechanism for collecting and monitoring fellowship information and ongoing fellowship activities, and compliance with fellowship requirements. These changes will also help us better understand the reach of our promotional recruitment efforts and the demographics of the resulting applicant population, and our Educational Loan Repayment Program for Health Professionals (ELRPHP) recruitment efforts, and the demographics of the applicant population.

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Annual Cost to Federal Government: $465,133

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.     Yes

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: 03/07/2022

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