OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

[NCIPC] Monitoring and Reporting for the Overdose Data to Action Cooperative Agreement

ICR 202508-0920-007 · OMB unassigned · Active

Forms and Documents
DocumentTypeStatusAvailability
Form 0920-n/a OD2A-LOCALData Management Plan Template Form and Instruction Unchanged Available
Form 0920-n/a OD2A-LOCAL Evaluation and Performance Measuring Plan Template Form and Instruction Unchanged Repair queued
Form 0920-1283 OD2A-S Data Management Plan Template Form and Instruction Unchanged Available
Form 0920-1283 OD2A-S Annual Performance Report and Work Plan Form and Instruction Unchanged Available
Form 0920-1283 Activity Progress Report and Work Plan Tool Form and Instruction Unchanged Available
Form 0920-25-0159 OD2A-LOCAL Annual Performance Report and Work Plan_08.2025 Form Modified Available
Form 0920-1283 Organizational Capacity Assessment - Annual Reporting Form and Instruction Unchanged Available
Form 0920-25-0159 OD2A-S Annual Performance Report and Work Plan_08.2025 Form Modified Available
Form 0920-1283 Evaluation and Performance Measuring Plan Template - Annual Reporting Form and Instruction Unchanged Available
Change Request Memo - 0920-1283.docx Justification for No Material/Nonsubstantive Change Uploaded 2025-08-21 Repair queued
Attachment 4_List of Data Collection Instrument Requests.docx Supplementary Document Uploaded 2023-01-11 Repair queued
Att 7 Crosswalk of the four required reporting.docx Supplementary Document Uploaded 2019-10-16 Repair queued
Attachment 7_Research Determination.pdf Supplementary Document Uploaded 2023-01-11 Repair queued
Attachment 5_PIA.pdf Supplementary Document Uploaded 2023-01-05 Repair queued
Attachment B_Published 60dy FRN.pdf Supplementary Document Uploaded 2023-01-05 Available
Attachment 2 List of Funded Jurisdictions.docx Supplementary Document Uploaded 2023-01-05 Available
Att 1 Authorizing Legislation.doc Supplementary Document Uploaded 2019-10-16 Repair queued
SSB_1283 OD2A Progress Reporting_final.docx Supporting Statement B Uploaded 2023-01-11 Available
SSA_1283_OD2A Progress Reporting_011123.docx Supporting Statement A Uploaded 2023-01-11 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
257750 OD2A-LOCAL Data Management Plan Template Form and Instruction UnchangedOD2A-LOCALData Management Plan Template
257748 OD2A-LOCAL Evaluation & Performance Measurement Plan Template Form and Instruction UnchangedOD2A-LOCAL Evaluation and Performance Measuring Plan Template
238174 OD2A-S Data Management Plan Template Form and Instruction UnchangedOD2A-S Data Management Plan Template
238173 (OD2A-S) Annual Performance Report and Work Plan Form and Instruction UnchangedOD2A-S Annual Performance Report and Work Plan
238172 Activity Progress Report and Work Plan Tool - Annual Performance Report Form and Instruction UnchangedActivity Progress Report and Work Plan Tool
238171 OD2A-LOCAL Annual Performance Report and Work Plan Form ModifiedOD2A-LOCAL Annual Performance Report and Work Plan_08.2025
238170 Organization Capacity Assessment - Annual Reporting Form and Instruction UnchangedOrganizational Capacity Assessment - Annual Reporting
238169 [OD2A] S-Annual Performance Report and Work Plan Form ModifiedOD2A-S Annual Performance Report and Work Plan_08.2025
238168 Evaluation and Performance Measuring Plan Template Form and Instruction UnchangedEvaluation and Performance Measuring Plan Template - Annual Reporting
ICR Details
0920-1283 202508-0920-007
Active 202301-0920-001
HHS/CDC 0920-25-0159
[NCIPC] Monitoring and Reporting for the Overdose Data to Action Cooperative Agreement
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 08/22/2025
Retrieve Notice of Action (NOA) 08/21/2025
  Inventory as of this Action Requested Previously Approved
05/31/2026 05/31/2026 05/31/2026
471 0 471
1,343 0 1,343
0 0 0
This is a revision request for the previously approved ICR to continue collecting program monitoring and reporting information from jurisdictions (which include states, Washington, D.C., U.S. Territories, cities, and counties) currently 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. This revision request is to initiate data collection activities for two new Overdose Data to Action NOFOs, the Overdose Data to Action in States (OD2A-S) will collect program monitoring and reporting information from states and Washington, D.C. The Overdose Data to Action-Limiting Overdose through Collaborative Actions in Localities (OD2A-LOCAL) will collect program monitoring and reporting information from U.S. Territories, cities, and counties. This non substantive change request updates questions used in OMB 0920-1283 Monitoring and Reporting for the Overdose Data to Action Cooperative Agreement to be in accordance with E.O. 14168 & E.O. 14151.
US Code: 42 USC 241 Name of Law: Public Health Service Act
  
None
Not associated with rulemaking
  87 FR 54694 09/07/2022
88 FR 3990 01/23/2023
Yes
  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 471 471 0 0 0 0
Annual Time Burden (Hours) 1,343 1,343 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$622,976
Yes Part B of Supporting Statement
    No
    No
No
No
No
No
Odion Clunis 770 488-0045 [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.
08/21/2025