View Information Collection Request (ICR) Package
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Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
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
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.
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
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
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
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
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:
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 elizabeth.appel@bia.gov
Common Form ICR:
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:
(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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