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:
0920-1283
ICR Reference No:
202108-0920-016
Status:
Historical Inactive
Previous ICR Reference No:
201910-0920-003
Agency/Subagency:
HHS/CDC
Agency Tracking No:
0920-1283-21HW
Title:
Monitoring and Reporting for the Overdose Data to Action Cooperative Agreement
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:
Improperly submitted and continue
Conclusion Date:
12/06/2021
Retrieve Notice of Action (NOA)
Date Received in OIRA:
09/14/2021
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
01/31/2023
01/31/2023
05/31/2023
Responses
286
0
286
Time Burden (Hours)
1,342
0
1,342
Cost Burden (Dollars)
44,740
0
44,740
Abstract:
The goal of this data collection is to gather program monitoring and reporting information from jurisdictions (which include states, Washington D.C., U.S. Territories, cities and counties) funded under the Overdose Data to Action (CDC-RFA-CE19-1904) notice of funding opportunity (OD2A NOFO). Reporting requirements have been carefully designed to align with and support the specific goals and outcomes outlined in the OD2A NOFO. The Change Request proposes edits to three of the instruments but no burden change.
Authorizing Statute(s):
US Code:
42 USC 241
Name of Law: Public Health Service Act
Citations for New Statutory Requirements:
None
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 35865
07/25/2019
30-day Notice:
Federal Register Citation:
Citation Date:
84 FR 59377
11/04/2019
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
7
IC Title
Form No.
Form Name
Activity Progress Report and Work Plan Tool – Annual Reporting
n/a
Activity Progress Report and Work Plan Tool
Activity Progress Report and Work Plan Tool – Initial Population
n/a
Activity Progress Report and Work Plan Tool
Evaluation and Performance Measuring Plan Template - Annual Reporting
n/a
Evaluation and Performance Measuring Plan Template
Evaluation and Performance Measuring Plan Template – Initial Population
n/a
Evaluation and Performance Measuring Plan Template
Organizational Capacity Assessment - Annual Reporting
n/a
Overdose Prevention Capacity Assessment Tool
Organizational Capacity Assessment - Initial Population
n/a
Overdose Prevention Capacity Assessment Tool
Surveillance Data Dissemination Plan
n/a
Surveillance Data Dissemination Plan
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 is a new information collection to support administration of the Overdose Data to Action cooperative agreement program, which went into effect October 2019.
Annual Cost to Federal Government:
$1,939,659
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
Agency Contact:
Kevin Joyce 404 639-1944 kdj7@cdc.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:
09/14/2021
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