Practice Patterns related to Opioid Use during Pregnancy and Lactation

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
ACOG - Short Introduction and Survey	Form and Instruction	New	Available
ACOG Full Online/Paper Survey	Form and Instruction	New	Available
SS Part A ACOG survey 08MAR2017.docx	Supporting Statement A	Uploaded 2017-03-08	Available
SS Part B ACOG survey 08MAR2017.docx	Supporting Statement B	Uploaded 2017-03-08	Available
10 Att5_Email Reminders.docx	Supplementary Document	Uploaded 2016-09-06	Available
7 Att3b_Introductory Cover Letter-Paper.docx	Supplementary Document	Uploaded 2016-09-06	Repair queued
6 Att3a_ Introductory Cover Letter-Online.docx	Supplementary Document	Uploaded 2016-09-06	Available
15 ACOG IRB determination.pdf	Supplementary Document	Uploaded 2016-09-06	Available
5 Att2b Public Comment Received.docx	Supplementary Document	Uploaded 2016-09-06	Repair queued
4 Att2a 60-day FRN.PDF	Supplementary Document	Uploaded 2016-09-06	Available
3 Att1_Section 301 of Public Health Service Act (42 U.S.C. 241).docx	Supplementary Document	Uploaded 2016-09-06	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
223395	ACOG - Short Introduction and Survey	Form and Instruction	New
223394	ACOG Full Online/Paper Survey	Form and Instruction	New

ICR Details

OMB Control No: 0920-1168	ICR Reference No: 201609-0920-001
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No: 16XD
Title: Practice Patterns related to Opioid Use during Pregnancy and Lactation
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: 03/09/2017
	Date Received in OIRA: 09/09/2016
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2018	12 Months From Approved
Responses	600	0	0
Time Burden (Hours)	120	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: In collaboration with the American College of Obstetricians and Gynecologists, CDC plans to conduct a survey to understand Obstetricians and Gynecologists' knowledge, attitudes, and practices regarding maternal opioid use, which has increased over the last decade and leads to neonatal abstinence syndrome. Information will inform public health prevention efforts.

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Authorizing Statute(s): US Code: 42 USC 241 Name of Law: U.S. Public Health Service 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:
	81 FR 18630	03/31/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 61218	09/06/2016
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
ACOG Full Online/Paper Survey	NA, NA	ACOG Practice Patterns related to Opioid Use during Pregnancy and Lactation - FULL ONLINE ,   ACOG Practice Patterns related to Opioid Use during Pregnancy and Lactation - FULL PAPER
ACOG - Short Introduction and Survey	NA	ACOG Practice Patterns related to Opioid Use during Pregnancy and Lactation - SHORT INTRODUCTION and SURVEY

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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	600	0	0	600	0	0
Annual Time Burden (Hours)	120	0	0	120	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: 0920-16XD is a New ICR submitted for OMB approval.

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Annual Cost to Federal Government: $51,105

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: 09/09/2016

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