Evaluation of Public Health AmeriCorps

OMB Control No: 3045-0199	ICR Reference No: 202503-3045-005
Status: Active	Previous ICR Reference No: 202406-3045-001
Agency/Subagency: CNCS	Agency Tracking No:
Title: Evaluation of Public Health AmeriCorps
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: 03/27/2025
Retrieve Notice of Action (NOA)	Date Received in OIRA: 03/26/2025
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2027	04/30/2027	04/30/2027
Responses	2,198	0	2,198
Time Burden (Hours)	2,097	0	2,097
Cost Burden (Dollars)	99,267	0	99,267

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Abstract: This information collection includes a survey of Public Health AmeriCorps (PHA) members, a survey of PHA grantees and a PHA grantee training and technical assistance form, and questions for PHA grantees who choose to participate in focus groups, to allow AmeriCorps to evaluate the success of PHA in meeting its goals of addressing public health needs and developing the next generation of public health leaders.

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Authorizing Statute(s): EO: EO 13996 Name/Subject of EO: Establishing the COVID-19 Pandemic Testing Board and Ensuring a Sustainable Public Health Workforce    US Code: 42 USC 12639 Name of Law: National and Community Service Act, as amended

Citations for New Statutory Requirements: EO: EO 13996 Name/Subject of EO: Establishing the COVID-19 Pandemic Testing Board and Ensuring a Sustainable Public Health Workforce

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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:
	88 FR 61575	09/07/2023
30-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 8184	02/06/2024
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 7

IC Title Form No. Form Name Early Exit Interview Early Exit Survey 01 Member Alumni Survey and Early Exit Survey Grantee Focus Group Grantee Survey 02 Grantee Survey Member Alumni Survey 01 Revised Member Alumni Survey and Early Exit Survey Partner Interview Training and TA Form 06 Grantee Technical Assistance and Training Form

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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	2,198	2,198	0	0	0	0
Annual Time Burden (Hours)	2,097	2,097	0	0	0	0
Annual Cost Burden (Dollars)	99,267	99,267	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: $120,522

Does this IC contain surveys, censuses, or employ statistical methods? No

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? Yes

Agency Contact: Elizabeth Appel 202 273-4680 [email protected]

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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: 03/26/2025

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