NIDA QUICK RESPONSE SURVEY - EMERGENCY ROOM SURVEY PROJECT (HEROIN STUDY)

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Information collection document groups

IC ID	Collection	Type	Status	Form
112030	NIDA QUICK RESPONSE SURVEY - EMERGENCY ROOM SURVEY PROJECT (HEROIN STUDY)		Migrated

ICR Details

OMB Control No: 0930-0156	ICR Reference No: 199109-0930-001
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/SAMHSA	Agency Tracking No:
Title: NIDA QUICK RESPONSE SURVEY - EMERGENCY ROOM SURVEY PROJECT (HEROIN STUDY)
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 10/31/1991
	Date Received in OIRA: 09/25/1991
Terms of Clearance: Approved for use through 4/92 under the following conditions: 1) NIDA ensures that dissemination of the survey results characterizes this effort as a preliminary survey of opinions regarding prevalence of heroin abuse, rather than as an expert survey; 2) NIDA performs a stratified sample validation of the survey respons (including review of medical records) no later than three months after the survey is conducted. Responses to questions 17 - 20 should be used, in part, to characterize the limitations of the data from questions 1 - 16. Until the validation is completed, all releases of survey results must speak to the limitations of the data; 3) Results of this survey only will be presented in conjunction with other existing sources of information. These sources of information (e.g. DAWN and NHSDA) should provide a meaningful context for interpretation of this QRS data; 4) NIDA deletes the follow-up parentheses that provide responses for questions 3, 8, 12, and 16. OMB believes that these parentheses would bias responses; 5) NIDA will replace question 20 with a new series of questions regarding the volume of admissions necessitating the provision of care to drug abusers. NIDA should add questions to acquire the following data: average number of admissions per day requiring treatment of dru abusers, average number of such admissions on the (continued)

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/1992	04/30/1992
Responses	189	0	0
Time Burden (Hours)	378	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: THIS PROJECT IS AN INQUIRY DIRECTED AT HOSPITAL IN SIX CITIES THAT ARE PART OF THE DRUG ABUSE WARNING NETWORK (DAWN) FOCUSING ON HEROIN USE. RESULTS WILL BE COMBINED WITH ANALYSIS OF EXISTING DATA EXPERT REPORTS AND USED IN DEVELOPING NATIONAL DRUG POLICY.

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
NIDA QUICK RESPONSE SURVEY - EMERGENCY ROOM SURVEY PROJECT (HEROIN STUDY)

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ICR Summary of Burden

table that charts list 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	189	0	0	189	0	0
Annual Time Burden (Hours)	378	0	0	378	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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: 09/25/1991

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