[PHIC] The Division of Workforce Development (DWD) Fellowship Alumni Assessment

Forms and Documents

Document Name	Status
Form 0920-24IB Presidential Management Fellowship (PMF) Form	Unchanged
Form 0920-1078 SAF Alumni Form and Instruction	Unchanged
Form 0920-1078 PHAP Alumni Form and Instruction	Unchanged
Form 0920-1078 PHIFP Alumni Form and Instruction	Unchanged
Form 0920-1078 PE Fellowship Alumni Form and Instruction	Unchanged
Form 0920-1078 FLIGHT Alumni Form and Instruction	Unchanged
EIS/LLS Alumni Form and Instruction	Modified
Form 0920-1078 EFP Alumni Form and Instruction	Unchanged
Form 0920-1078 EEP Alumni Survey Form and Instruction	Unchanged
0920-1078 July2025 CR Memo.docx Justification for No Material/Nonsubstantive Change	2025-07-24
0920-1078 2025 EO CR Memo.docx Justification for No Material/Nonsubstantive Change	2025-05-05
AttC_July2025_clean.docx Supplementary Document	2025-07-24
Change_Justification_Dec2024.docx Justification for No Material/Nonsubstantive Change	2025-01-15
Att O-1_PMF Alumni Survey Initial Email.docx Supplementary Document	2024-08-28
Att O_PMF_Alum_Surv_Clean.docx Supplementary Document	2024-08-28
0920-1078 Change Request_PMF.docx Justification for No Material/Nonsubstantive Change	2024-08-28
Att N_Acronym List.docx Supplementary Document	2024-02-16
Att M_Privacy Act Checklist.docx Supplementary Document	2024-02-16
Att L-2_SAF Reminder Email.docx Supplementary Document	2024-02-16
Att L-1_SAF Invitation Email.docx Supplementary Document	2024-02-16
Att K-2_PHAP Reminder Email.docx Supplementary Document	2024-02-16
Att K-1_PHAP Initial Email.docx Supplementary Document	2024-02-16
Att J-2_PHIFP Reminder Email.docx Supplementary Document	2024-02-16
Att J-1_PHIFP Initial Email.docx Supplementary Document	2024-02-16
Att I-2_PE Reminder Email.docx Supplementary Document	2024-02-16
Att I-1_PE Initial Email.docx Supplementary Document	2024-02-16
Att H-2_FLIGHT Reminder Email.docx Supplementary Document	2024-02-16
Att H-1_FLIGHT Initial Email.docx Supplementary Document	2024-02-16
Att G-2_EIS-LLS Reminder Email.docx Supplementary Document	2024-02-16
Att G-1_EIS-LLS Initial Email.docx Supplementary Document	2024-02-16
Att F-2_EFP Reminder Email.docx Supplementary Document	2024-02-16
Att F-1_EFP Initial Email.docx Supplementary Document	2024-02-16
Att E-2_EEP Reminder Email.docx Supplementary Document	2024-02-16
Att E-1_EEP Initial Email.docx Supplementary Document	2024-02-16
Att D_Alumni Survey Screen Shots.docx Supplementary Document	2024-02-16
Att A_Public Health Service Act.docx Supplementary Document	2024-02-16
Attachment N_PHAP Alumni Survey Reminder Email 2-FINAL.docx Supplementary Document	2020-12-01
Attachment M_PHAP Alumni Survey Reminder Email-FINAL.docx Supplementary Document	2020-12-01
Attachment K_PHAP Alumni Survey Email Invitation_FINAL.docx Supplementary Document	2020-12-01
Attachment J_PHAP Host Site Supervisor Survey Final Reminder_FINAL.docx Supplementary Document	2020-12-01
Attachment I_PHAP Host Site Supervisor Survey Second Reminder Email_FINAL.docx Supplementary Document	2020-12-01
Attachment H_PHAP Host Site Supervisor Survey Reminder Email_FINAL.docx Supplementary Document	2020-12-01
Attachment G_PHAP Host Site Supervisor Survey Invitation Email_FINAL.docx Supplementary Document	2020-12-01
Attachment E_PHAP Host Site Supervisor Survey Respondent Information_FINAL.docx Supplementary Document	2020-12-01
Attachment D_Published 60 day_11022020.pdf Supplementary Document	2020-12-01
Attachment A_Public Health Service Act_FINAL.docx Supplementary Document	2020-12-01
DWD Alumni Survey ICR- Statement B Revision.docx Supporting Statement B	2024-02-16
DWD Alumni ICR- Statement A Revision.docx Supporting Statement A	2024-02-16

IC Document Collections

IC ID	Document Title	Status
270147	Presidential Management Fellowship (PMF) Form	Unchanged
265458	SAF Alumni Form and Instruction	Unchanged
265457	PHAP Alumni Form and Instruction	Unchanged
265456	PHIFP Alumni Form and Instruction	Unchanged
265455	PE Fellowship Alumni Form and Instruction	Unchanged
265454	FLIGHT Alumni Form and Instruction	Unchanged
265453	EIS/LLS Alumni Form and Instruction	Modified
265452	EFP Alumni Form and Instruction	Unchanged
265415	EEP Alumni Survey Form and Instruction	Unchanged

ICR Details

OMB Control No: 0920-1078	ICR Reference No: 202507-0920-017
Status: Received in OIRA	Previous ICR Reference No: 202505-0920-001
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-25-0144
Title: [PHIC] The Division of Workforce Development (DWD) Fellowship Alumni Assessment
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  Yes
Type of Review Request: Regular	Date Submitted to OIRA: 07/28/2025

	Requested	Previously Approved
Expiration Date	03/31/2027	03/31/2027
Responses	695	695
Time Burden (Hours)	182	182
Cost Burden (Dollars)	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. This change requests minor edits to the core questions and to the EIS and LLS surveys.

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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:
	88 FR 74193	10/30/2023
30-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 9150	02/09/2024
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 9

IC Title	Form No.	Form Name
EEP Alumni Survey	0920-1078	Att E_EEP Alumni Survey
EFP Alumni	0920-1078	Att F_EFP Alumni Survey
EIS/LLS Alumni	n/a, n/a	EIS Alumni Survey ,   LLS Alumni Survey
FLIGHT Alumni	0920-1078	Att H_FLIGHT Alumni Survey
PE Fellowship Alumni	0920-1078	Att I_PE Alumni Survey
PHAP Alumni	0920-1078	Att K_PHAP Alumni Survey
PHIFP Alumni	0920-1078	Att J_PHIFP Alumni Survey
Presidential Management Fellowship (PMF)	0920-24IB	Presidential Management Fellowship (PMF)
SAF Alumni	0920-1078	Att L_SAF Alumni Survey

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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	695	695	0	0	0	0
Annual Time Burden (Hours)	182	182	0	0	0	0
Annual Cost Burden (Dollars)	0	0	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: This request seeks to add the Presidential Management Fellowship (PMF). The PMF is a 2 year training fellowship administered by the US Office of Personnel Management. The addition of the PMF is intended to parallel other fellowship’s use of the DWD Alumni Survey.

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Annual Cost to Federal Government: $60,145

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:  Yes

Description/Changes for Common Form Usage: 

Approved RCFs using this ICR

Agency/Sub Agency	RCF ID	RCF Title	RCF Status	IC Title

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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: 07/28/2025

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