OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Monitoring and Reporting for the Overdose Data to Action Cooperative Agreement

ICR 201910-0920-003 · OMB 0920-1283 · Active

Forms and Documents
DocumentTypeStatusAvailability
Surveillance Data Dissemination Plan Form and Instruction New Available
Activity Progress Report and Work Plan Tool – Annual Reporting Form and Instruction New Available
Activity Progress Report and Work Plan Tool – Initial Population Form and Instruction New Available
Organizational Capacity Assessment - Annual Reporting Form and Instruction New Available
Organizational Capacity Assessment - Initial Population Form and Instruction New Available
Evaluation and Performance Measuring Plan Template - Annual Reporting Form and Instruction New Available
Evaluation and Performance Measuring Plan Template – Initial Population Form and Instruction New Repair queued
Att 7 Crosswalk of the four required reporting.docx Supplementary Document Uploaded 2019-10-16 Repair queued
Att 6 Research Determination.pdf Supplementary Document Uploaded 2019-10-16 Available
Att 5b PIA _ Overdose Data to Action.pdf Supplementary Document Uploaded 2019-10-16 Repair queued
Att 5a PIA_Partner's Portal.pdf Supplementary Document Uploaded 2019-10-16 Available
Att 4 60 Dy FRN OD2A Progress Reporting.pdf Supplementary Document Uploaded 2019-10-16 Available
Att 2 List of Funded Jurisdictions.docx Supplementary Document Uploaded 2019-10-16 Available
Att 1 Authorizing Legislation.doc Supplementary Document Uploaded 2019-10-16 Available
SSB_OD2A_10162019.docx Supporting Statement B Uploaded 2019-10-16 Available
SSA_OD2A_10162019.docx Supporting Statement A Uploaded 2019-10-16 Available
IC Document Collections
IC IDCollectionTypeStatusForm
238174 Surveillance Data Dissemination Plan Form and Instruction New
238173 Activity Progress Report and Work Plan Tool – Annual Reporting Form and Instruction New
238172 Activity Progress Report and Work Plan Tool – Initial Population Form and Instruction New
238171 Organizational Capacity Assessment - Annual Reporting Form and Instruction New
238170 Organizational Capacity Assessment - Initial Population Form and Instruction New
238169 Evaluation and Performance Measuring Plan Template - Annual Reporting Form and Instruction New
238168 Evaluation and Performance Measuring Plan Template – Initial Population Form and Instruction New
ICR Details
0920-1283 201910-0920-003
Active
HHS/CDC 0920-19BJD
Monitoring and Reporting for the Overdose Data to Action Cooperative Agreement
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 01/29/2020
Retrieve Notice of Action (NOA) 11/05/2019
OMB approves this package for three years consistent with the understanding that data collected for this purpose will not produce generalizable knowledge or allow for causal attribution. When communicating findings from this collection, all publications, both internal reports and external summaries, will clearly describe the scope and limitations of the study findings.
  Inventory as of this Action Requested Previously Approved
01/31/2023 36 Months From Approved
286 0 0
1,342 0 0
44,740 0 0
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.
US Code: 42 USC 241 Name of Law: Public Health Service Act
  
None
Not associated with rulemaking
  84 FR 35865 07/25/2019
84 FR 59377 11/04/2019
No
  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 286 0 0 286 0 0
Annual Time Burden (Hours) 1,342 0 0 1,342 0 0
Annual Cost Burden (Dollars) 44,740 0 0 44,740 0 0
Yes
Miscellaneous Actions
No
This is a new information collection to support administration of the Overdose Data to Action cooperative agreement program, which went into effect October 2019.
$1,939,659
Yes Part B of Supporting Statement
    No
    No
No
No
No
Uncollected
Renita Macaluso 770 488-6458 [email protected]
  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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
11/05/2019