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:
0920-1268
ICR Reference No:
202504-0920-022
Status:
Active
Previous ICR Reference No:
202303-0920-004
Agency/Subagency:
HHS/CDC
Agency Tracking No:
0920-1268
Title:
[NCIPC] Drug Overdose Surveillance and Epidemiology (DOSE)
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
09/09/2025
Retrieve Notice of Action (NOA)
Date Received in OIRA:
06/26/2025
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
09/30/2028
36 Months From Approved
09/30/2025
Responses
646
0
575
Time Burden (Hours)
655
0
658
Cost Burden (Dollars)
0
0
20,162
Abstract:
The purpose of the Drug Overdose Surveillance and Epidemiology (DOSE) system (OMB Control No. 0920-1268) is to rapidly identify outbreaks and provide situational awareness of changes in emergency department (ED) visits involving suspected drug overdoses at the local, state, and regional level. This goal will be accomplished by standardizing and enhancing sharing of existing ED data locally collected by health departments with CDC. Data will be used to improve local, state, and regional situational awareness of all drug, all opioid, heroin, fentanyl, all stimulant, cocaine, methamphetamine, and benzodiazepine, overdose trends and response to acute local and multi-state drug outbreaks. This Revision aims to revise the number of eligible states, change the data collection template (see Attachment D-2), and revise burden. Based on current data sharing from states we have decreased our burden estimate to 655 from 975 hours.
Authorizing Statute(s):
US Code:
42 USC 241
Name of Law: PHSA
US Code:
42 USC 280
Name of Law: Subtitle Q of the Substance Use-Disorder Prevention 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:
89 FR 88774
11/08/2024
30-day Notice:
Federal Register Citation:
Citation Date:
90 FR 24625
06/11/2025
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
5
IC Title
Form No.
Form Name
ED Discharge Overdose data (annual reporting)
0920-1268
ED Annual Discharge Overdose Data Form
ED and hospitalization discharge overdose data form - Health Department ED and inpatient hospital metadata - yearly
0920-1268
ED and Hospitalization Discharge Overdose Data Form
Inpatient hospitalization discharge overdose data form - Health Department Line-level ED and Inpatient Hospitalization Discharge Data - Yearly
0920-1268
Inpatient Hospitalization Discharge Overdose Data Form
Inpatient hospitalization discharge overdose data form - Health Department Total Inpatient Hospitalization Visits and Metadata - Yearly
0920-1268
Inpatient Hospitalization Discharge Overdose Data Form
Rapid ED Overdose Data - Case-level Data Shared through NSSP Biosense
None
Rapid ED Data Submission Template
Rapid ED Overdose Data Form - Health Departments sharing data from Local Syndromic Data File
0920-1268
Rapid ED Overdose Death Form
Rapid ED Overdose Data from Local Syndromic or Hospital Discharge File
None
Rapid ED Data Submission Template
Rapid ED overdose Data Form - Health Departments sharing from NSSP BioSense
0920-1268
Rapid ED Overdose Death 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
646
575
0
71
0
0
Annual Time Burden (Hours)
655
658
0
-3
0
0
Annual Cost Burden (Dollars)
0
20,162
0
-20,162
0
0
Burden increases because of Program Change due to Agency Discretion:
Yes
Burden Increase Due to:
Miscellaneous Actions
Burden decreases because of Program Change due to Agency Discretion:
Yes
Burden Reduction Due to:
Miscellaneous Actions
Short Statement:
Revision for 0920-1268 aims to revise the number of eligible states, change the data collection template and revise burden. resulting in a decreased burden estimate of 655 hours.
Annual Cost to Federal Government:
$2,046,636
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:
Jeffrey Zirger 404 639-7118 wtj5@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:
06/26/2025
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