OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

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

ICR 201801-0920-003 · OMB 0920-1078 · Active

Forms and Documents
DocumentTypeStatusAvailability
Form 0920-1078 PHAP Alumni Survey Form and Instruction New Repair queued
Form 0920-1078 PHAP Host Site Supervisor Survey Form and Instruction New Available
Public Health Associate Program (PHAP) Alumni Assessment Form and Instruction Removed Available
Statement A PHAP ICR 0920-1078.docx Supporting Statement A Uploaded 2018-01-30 Available
PH Research Non Research Determination Form 0920-1078.pdf Supplementary Document Uploaded 2018-01-30 Available
Attachment M_PHAP Alumni Survey Reminder Email 2.docx Supplementary Document Uploaded 2018-01-30 Repair queued
Attachment L_PHAP Alumni Survey Reminder Email.docx Supplementary Document Uploaded 2018-01-30 Repair queued
Attachment J_PHAP Alumni Survey Email Invitation.docx Supplementary Document Uploaded 2018-01-30 Available
Attachment I_PHAP Host Site Supervisor Survey Final Reminder.docx Supplementary Document Uploaded 2018-01-30 Repair queued
Attachment H_PHAP Host Site Supervisor Survey Reminder Email 2.docx Supplementary Document Uploaded 2018-01-30 Available
Attachment G_PHAP Host Site Supervisor Survey Reminder Email.docx Supplementary Document Uploaded 2018-01-30 Repair queued
Attachment F_PHAP Host Site Supervisor Survey Invitation Email.docx Supplementary Document Uploaded 2018-01-30 Repair queued
Attachment D_PHAP Host Site Supervisor Survey Respondent Information.docx Supplementary Document Uploaded 2018-01-30 Available
60 day FRN.pdf Supplementary Document Uploaded 2018-01-30 Repair queued
Statement B PHAP ICR 0920-1078.docx Supporting Statement B Uploaded 2018-01-30 Repair queued
Att A Public Health Service Act.doc Supplementary Document Uploaded 2015-03-26 Available
IC Document Collections
IC IDCollectionTypeStatusForm
229893 PHAP Alumni Survey Form and Instruction New
229891 PHAP Host Site Supervisor Survey Form and Instruction New
216295 Public Health Associate Program (PHAP) Alumni Assessment Form and Instruction Removed
ICR Details
0920-1078 201801-0920-003
Active 201503-0920-010
HHS/CDC 0920-1078
Public Health Associate Program (PHAP) Assessment of Quality and Value.
Revision of a currently approved collection   No
Regular
Approved without change 03/12/2018
Retrieve Notice of Action (NOA) 01/31/2018
  Inventory as of this Action Requested Previously Approved
03/31/2021 36 Months From Approved 08/31/2018
1,000 0 160
213 0 21
0 0 0
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). Information will be used to answer key program assessment questions, specifically to inform program improvements and document evidence of outcomes and impact to inform future decision making. The method that will be used to collect data will be through an online assessment. The subpopulation to be studied is PHAP Host Site Supervisors and PHAP Alumni. The revision includes the following adjustments: 1) Expansion from one data collection instrument to two, both of which will inform improvements to the Public Health Associate Program (PHAP) and document evidence of quality and value. 2) Name change to reflect this adjustment from “Public Health Associate Program (PHAP) Alumni Assessment” to “Public Health Associate Program (PHAP): Assessment of Quality and Value.”
US Code: 42 USC 241 Name of Law: Public Health Service Act
  
None
Not associated with rulemaking
  82 FR 46991 10/10/2017
83 FR 4058 01/29/2018
No
  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 1,000 160 0 840 0 0
Annual Time Burden (Hours) 213 21 0 192 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
Yes
Changing Forms
Revision of PHAP 0920-1078 results in an increase in Burden Hours as a result of removal of previous PHAP Alumni Assessment information collection instrument and replacement with two surveys that collect information from PHAP Host Site Supervisors and PHAP Alumni.
$13,422
Yes Part B of Supporting Statement
    No
    No
No
No
No
Uncollected
Jeffrey Zirger 404 639-7118 [email protected]
  No
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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
01/31/2018