[PHIC] Fellowship Management System

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
FMS Activity Tracking Module draft	Form and Instruction	Modified	Available
Activity Tracking	Form and Instruction	Modified	Repair queued
Form 0920-0765 Reference Letter	Form and Instruction	Modified	Available
Form 0920-0765 Reference Letters for Fellowship Applicants	Form and Instruction	Modified	Repair queued
FMS Application Module	Form and Instruction	Modified	Available
FMS Application Writing Samples (Subset Applicants)	Form and Instruction	Modified	Repair queued
Form 0920-0765 FMS Host Site Module	Form and Instruction	Modified	Available
Form 0920-0765 Host Site Module	Form and Instruction	Modified	Repair queued
FMS Alumni Tracking Module Draft	Form and Instruction	Modified	Available
FMS Alumni Directory	Form and Instruction	Modified	Repair queued
Form 0920-0765 FMS Application Module	Form and Instruction	Modified	Available
Form 0920-0765 Fellowship Applications	Form and Instruction	Modified	Repair queued
Change Request EO 14168 14151_2025.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-04-10	Available
Change Request EO 14168 14151_2025.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-04-10	Repair queued
Change Request_0920-0765 Dec24.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2024-12-18	Available
Change Request_0920-0765 Dec24.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2024-12-18	Repair queued
0920-0765 Sept 2024 FMS Change Request.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2024-09-24	Available
0920-0765 Sept 2024 FMS Change Request.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2024-09-24	Repair queued
0920-0765 July 2024 FMS Change Request.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2024-08-05	Available
0920-0765 July 2024 FMS Change Request.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2024-08-05	Repair queued
Change Request Memo OMB No 0920-0765 December 2023.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2024-01-03	Available
Change Request Memo OMB No 0920-0765 December 2023.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2024-01-03	Repair queued
Change Request Memo 0920-0765_11082023.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2023-11-08	Available
Change Request Memo 0920-0765_11082023.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2023-11-08	Repair queued
Change Request Memo OMB No 0920-0765 July 2023.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2023-08-01	Available
Change Request Memo OMB No 0920-0765 July 2023.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2023-08-01	Repair queued
Attachment 8_Privacy Impact Assessment (PIA).pdf	Supplementary Document	Uploaded 2022-07-11	Available
Attachment 8_Privacy Impact Assessment (PIA).pdf	Supplementary Document	Uploaded 2022-07-11	Repair queued
Attachment 7_IRB Determination Letter FMS 2022.docx	Supplementary Document	Uploaded 2022-07-11	Available
Attachment 7_IRB Determination Letter FMS 2022.docx	Supplementary Document	Uploaded 2022-07-11	Repair queued
Attachment 2 Published 60-Day FRN.pdf	Supplementary Document	Uploaded 2022-07-11	Available
Attachment 2 Published 60-Day FRN.pdf	Supplementary Document	Uploaded 2022-07-11	Repair queued
Attachment 1_Authorizing Legislation Public Health Service Act.docx	Supplementary Document	Uploaded 2022-07-11	Available
Attachment 1_Authorizing Legislation Public Health Service Act.docx	Supplementary Document	Uploaded 2022-07-11	Repair queued
SUPPORTING STATEMENT B Revision #0920-0765.docx	Supporting Statement B	Uploaded 2022-07-11	Available
SUPPORTING STATEMENT B Revision #0920-0765.docx	Supporting Statement B	Uploaded 2022-07-11	Repair queued
SUPPORTING STATEMENT A Revision_06242022.docx	Supporting Statement A	Uploaded 2022-07-11	Available
SUPPORTING STATEMENT A Revision_06242022.docx	Supporting Statement A	Uploaded 2022-07-11	Repair queued

IC Document Collections

Information collection document groups

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

ICR Details

OMB Control No: 0920-0765	ICR Reference No: 202503-0920-016
Status: Historical Active	Previous ICR Reference No: 202412-0920-013
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-25-0045
Title: [PHIC] 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
OIRA Conclusion Action: Approved without change	Conclusion Date: 05/09/2025
Retrieve Notice of Action (NOA)	Date Received in OIRA: 05/02/2025
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2026	03/31/2026	03/31/2026
Responses	18,212	0	18,212
Time Burden (Hours)	13,477	0	13,477
Cost Burden (Dollars)	1,531,249	0	1,531,249

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Abstract: The Centers for Disease Control and Prevention (CDC) uses Fellowship Management System (FMS) to collect, process, and manage data from nonfederal applicants seeking training or public health support services through CDC fellowships. FMS is used to electronically submit fellowship applications, submit fellowship host site proposals, track fellows’ activities during their fellowships, and maintain fellowship alumni directories online. FMS is a key tool in CDC’s efforts to maintain and develop a robust public health workforce. This Change Request aims to follow recent executive orders.

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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:
	87 FR 14271	03/14/2022
30-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 41320	07/12/2022
Did the Agency receive public comments on this ICR? No

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

table that charts list of burden

IC Title	Form No.	Form Name
Activity Tracking	None	FMS Activity Tracking Module draft
FMS Alumni Directory	None	FMS Alumni Tracking Module Draft
FMS Application Writing Samples (Subset Applicants)	None	FMS Application Module
Fellowship Applications	0920-0765	FMS Application Module
Host Site Module	0920-0765	FMS Host Site Module
Reference Letters for Fellowship Applicants	0920-0765	Reference Letter

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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	18,212	18,212	0	0	0	0
Annual Time Burden (Hours)	13,477	13,477	0	0	0	0
Annual Cost Burden (Dollars)	1,531,249	1,531,249	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: $1,269,105

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: 05/02/2025

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