2011 Opioid Treatment Program (OTP) Survey

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 2011 OTP Questionn OTP	Form and Instruction	New	Available
OTP OMB supporting statement rev 23feb11 clean.docx	Supporting Statement B	Uploaded 2011-02-28	Available
Attachment J Thank You Letter.docx	Supplementary Document	Uploaded 2010-12-23	Repair queued
Attachment I OTP RemindLtr.docx	Supplementary Document	Uploaded 2010-12-23	Available
Attachment H OTP Reminder Postcard.docx	Supplementary Document	Uploaded 2010-12-23	Available
Attachment G OTP FAQS.docx	Supplementary Document	Uploaded 2010-12-23	Available
Attachment F OTP ONLINE INSTRUCTIONS.docx	Supplementary Document	Uploaded 2010-12-23	Available
Attachment E OTP-AATOD letter of support.docx	Supplementary Document	Uploaded 2010-12-23	Available
Attachment D OTP-SOTA letter of support.docx	Supplementary Document	Uploaded 2010-12-23	Available
Attachment C OTP CoverLtr.docx	Supplementary Document	Uploaded 2010-12-23	Available
Attachment B OTP Alert Letter.docx	Supplementary Document	Uploaded 2010-12-23	Available
Attachment A cover page.doc	Supplementary Document	Uploaded 2010-12-23	Available
OTP OMB supporting statement rev 23feb11 clean.docx	Supporting Statement A	Uploaded 2011-02-28	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
195867	OTP	Form and Instruction	New

ICR Details

OMB Control No: 0930-0319	ICR Reference No: 201101-0930-001
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/SAMHSA	Agency Tracking No:
Title: 2011 Opioid Treatment Program (OTP) Survey
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 with change	Conclusion Date: 03/01/2011
	Date Received in OIRA: 01/03/2011
Terms of Clearance: The next approval of this collection is contingent upon the agency having a well-developed sampling plan, based on what it learns from this collection round, that minimizes the burdens of the collection.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2014	36 Months From Approved
Responses	1,200	0	0
Time Burden (Hours)	996	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The data collected in the OTP survey will be used to establish a database of information about the services provided at OTPs across the country. The data will be use to develop national-, regional- and state-level aggregate reports describing operating procedures at OTPs as well as the full spectrum of services offered to opiate-addicted patients. The data collection will include up-to-date detailed information on services and treatments available, staffing credentials and patient characteristics.

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Authorizing Statute(s): US Code: 5 USC 303 Name of Law: Control Substances Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 60758	10/01/2010
30-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 12345	12/23/2010
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
OTP	2011 OTP Questionnaire	2011 OTP Questionnaire

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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	1,200	0	0	1,200	0	0
Annual Time Burden (Hours)	996	0	0	996	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: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: This is a new data collection.

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Annual Cost to Federal Government: $390,000

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

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]? 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? 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: 01/03/2011

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