Drug Overdose Response Investigation (DORI) Data Collections

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Undetermined Risk Factors for Fentanyl-Related Overdose Deaths - Ohio	Form and Instruction	New	Available
AttaC5 NM_EpiIInstr_14ARR GenDORI.pdf	Supplementary Document	Uploaded 2014-11-25	Available
AttaC4 RI_IntervInstr_14ARR GenDORI.docx	Supplementary Document	Uploaded 2014-11-25	Available
AttaC3 RI_EpiInfoInstr_14ARR GenDORI.pdf	Supplementary Document	Uploaded 2014-11-25	Available
AttaC2_WVA_Instr_14ARR GenDORI.docx	Supplementary Document	Uploaded 2014-11-25	Available
AttaC1_PrevEpiAid_14ARR GenDORI.docx	Supplementary Document	Uploaded 2014-11-25	Available
AttF IRB-14ARR Generic DORI NCIPC Research Determination.pdf	Supplementary Document	Uploaded 2014-11-25	Available
AttaE BurdenMemo_14ARR GenDORI.docx	Supplementary Document	Uploaded 2014-11-25	Available
Attachment D Investigation Protocol Template Generic DORI 11.17.14.docx	Supplementary Document	Uploaded 2014-11-25	Available
AttaB_60dFRN_14ARR GenDORI..pdf	Supplementary Document	Uploaded 2014-11-25	Available
AttaA_AuthLeg_14ARR GenDORI.docx	Supplementary Document	Uploaded 2014-11-25	Available
SSB_Generic DORI FINAL revision for OMB.docx	Supporting Statement B	Uploaded 2015-03-06	Available
SSA_Generic DORI FINAL revision for OMB.docx	Supporting Statement A	Uploaded 2015-03-06	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
218644	Undetermined Risk Factors for Fentanyl-Related Overdose Deaths - Ohio	Form and Instruction	New

ICR Details

OMB Control No: 0920-1054	ICR Reference No: 201411-0920-013
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No: 14ARR
Title: Drug Overdose Response Investigation (DORI) Data Collections
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: 03/10/2015
	Date Received in OIRA: 12/10/2014
Terms of Clearance: For any Gen ICs with statistical methods, a Part B will be submitted for review along with the Gen IC and template.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2018	36 Months From Approved
Responses	8,100	0	0
Time Burden (Hours)	4,050	0	0
Cost Burden (Dollars)	0	0	0

---

Abstract: State and local health authorities frequently call upon CDC's National Center for Injury Prevention and Control (NCIPC) to assist in their response to urgent public health problems resulting from drug use, misuse, abuse, and overdose. When called, NCIPC supports the states and local health authorities by conducting Drug Overdose Response Investigations (DORI), which entails a rapid and flexible epidemiological response. Urgent requests such as DORIs depend on the time and resources available, number of persons involved, and other circumstances unique to the urgent conditions at hand and usually involve the development of procedures, specific data collection instruments, and the collection of critical data. This request is for a new generic approval to conduct information collections during DORIs. A three-year clearance is requested to ensure: (1) rapid deployment data collection tools and (2) timely information collection of vital information. Of particular interest is response to increasing trends in, or changing characteristics of, overdose from prescription drugs (with a special interest in opioid analgesics such as oxycodone or methadone; benzodiazepines such as alprazolam) and/or illicit drugs (e.g., heroin). Specifically, this request covers investigative collections with the following aims: (1) To understand sudden increases in drug use and misuse associated with fatal and nonfatal overdoses; (2) to understand the drivers and risk factors associated with those trends; and (3) to identify the groups most affected. This will allow CDC to effectively advise states on recommended actions to control local epidemics. Thus, the ultimate goals of these collections are to minimize adverse health consequences, provide epidemiological data collection support to the states and, based on the findings from the investigation, appropriately assist with implementation of prevention and control measures.

---

Authorizing Statute(s): US Code: 42 USC 241 Name of Law: Public Heath Service 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:
	79 FR 47640	08/14/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 70189	11/25/2014
Did the Agency receive public comments on this ICR? No

---

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

table that charts list of burden

IC Title	Form No.	Form Name
Undetermined Risk Factors for Fentanyl-Related Overdose Deaths - Ohio	NA, NA	Interview Guide - Opioid Drug Users ,   Interview Guide - Harm Reduction Practitioners

---

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	8,100	0	0	8,100	0	0
Annual Time Burden (Hours)	4,050	0	0	4,050	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: NCIPC submission 0920-14ARR is a NEW Generic ICR.

---

Annual Cost to Federal Government: $70,220

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]? 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

---

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: 12/10/2014

---