View Information Collection Request (ICR) Package
Skip to main content
An official website of the United States government
The .gov means it's official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.
The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.
Search:
Agenda
Reg Review
ICR
This script is used to control the display of information in this page.
Display additional information by clicking on the following:
All
Brief and OIRA conclusion
Abstract/Justification
Legal Statutes
Rulemaking
FR Notices/Comments
IC List
Burden
Misc.
Common Form Info.
Certification
View Information Collection (IC) List
View Supporting Statement and Other Documents
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:
0930-0234
ICR Reference No:
202105-0930-001
Status:
Historical Active
Previous ICR Reference No:
201911-0930-001
Agency/Subagency:
HHS/SAMHSA
Agency Tracking No:
Title:
Notification of Intent to Use Schedule III, IV, or V Opioid Drugs for the Maintenance and Detoxification Treatment of Opiate Addiction
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:
05/27/2021
Retrieve Notice of Action (NOA)
Date Received in OIRA:
05/27/2021
Terms of Clearance:
SAMHSA shall upload screenshots of the actual electronic from completed by practitioners as a nonsubstantive change to this collection within 30 days of issuance of an NOA.
Inventory as of this Action
Requested
Previously Approved
Expiration Date
01/31/2023
01/31/2023
01/31/2023
Responses
8,163
0
8,163
Time Burden (Hours)
4,893
0
4,893
Cost Burden (Dollars)
0
0
0
Abstract:
The Drug Addiction Treatment Act of 2000 establishes conditions for physicians to obtain waivers to permit them to prescribe certain approved narcotic treatment medications for the maintenance or detoxification treatment of opioid addiction. Under the SUPPORT Act, this data collection will include other practitioners who meet the statutory requirements: nurse practitioners, physician assistants, nurse specialist, nurse-midwives, and registered nurse anesthetists. SAMHSA will adding three additional forms from OMB No. 0930-0369.
Authorizing Statute(s):
US Code:
21 USC 823
Name of Law: Drug Addiction Treatment Act of 2000
Citations for New Statutory Requirements:
US Code: 21 USC 823 Name of Law: Drug Addiction Treatment Act of 2000
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:
84 FR 52521
10/02/2019
30-day Notice:
Federal Register Citation:
Citation Date:
84 FR 66211
12/03/2019
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
9
IC Title
Form No.
Form Name
Notice to Treat up to 100 Patients
Waiver Form 100 patients
Waiver Form 100 patients
Notice to Treat up to 275 Patients
Waiver Form 275 patients
Waiver Form 275 patients
Notification of Intent
Notification to Prescribe Immediately
Practitioner Reporting Form - 8.635
Practitioner Reporting Form
Practitioner Reporting Form
Qualifying Other Practitioner
Qualifying Other Pratitioner
Qualifying Other Pratitioner
Renewal Request for a Patient Limit Increase - 8.64
Request for Patient Limit - 8.620
Request for a Temporary Patient Increase Patient Increase for an Emergency - 8.655
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
8,163
8,163
0
0
0
0
Annual Time Burden (Hours)
4,893
4,893
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:
Currently there are 4,751 burden hours in the OMB inventory. SAMHSA is requesting 5,519 hours. The increase of 768 hours are due to a program change of the following: 1) the 117 hours are for the addition of three nurse specialty occupations and 2) the 651 hours are because of the expansion of the patient limit to 275 for all practitioners.
Annual Cost to Federal Government:
$821,237
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.
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
Agency Contact:
Carlos Graham 204 276-0361 carlos.graham@samhsa.hhs.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:
05/27/2021
An official website of the United States government
The .gov means it's official.
The site is secure.
