Strategic Prevention Framework for Prescription Drugs (SPF-Rx)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form Evaluation Plan Evaluation Plan	Form and Instruction	New	Available
Form Grantee-Level Inte Grantee-Level Interview	Form and Instruction	New	Available
Form Annual Implementat Annual Implementation Instrument	Form and Instruction	New	Available
Form Substitue Data Req Substitue Data Request Form	Form and Instruction	New	Available
Form Community-Level Ou Community-Level Outcomes	Form and Instruction	New	Available
Form Grantee-Level Outc Grantee-Level Outcomes	Form and Instruction	New	Available
SS_B_Rx 6.19.17.docx	Supporting Statement B	Uploaded 2017-06-19	Available
SS_A_Rx 6.15.17.docx	Supporting Statement A	Uploaded 2017-06-19	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
227233	Evaluation Plan	Form and Instruction	New	Evaluation Plan
227232	Grantee-Level Interview	Form and Instruction	New	Grantee-Level Interview
227231	Annual Implementation Instrument	Form and Instruction	New	Annual Implementation Instrument
227230	Substitue Data Request Form	Form and Instruction	New	Substitue Data Request Form
227229	Community-Level Outcomes Module	Form and Instruction	New	Community-Level Outcomes
227224	Grantee-Level Outcomes Module	Form and Instruction	New	Grantee-Level Outcomes

ICR Details

OMB Control No: 0930-0377	ICR Reference No: 201706-0930-003
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/SAMHSA	Agency Tracking No:
Title: Strategic Prevention Framework for Prescription Drugs (SPF-Rx)
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: 08/08/2017
Retrieve Notice of Action (NOA)	Date Received in OIRA: 06/21/2017
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2020	36 Months From Approved
Responses	204	0	0
Time Burden (Hours)	618	0	0
Cost Burden (Dollars)	0	0	0

---

Abstract: The SPF-Rx program is designed to address nonmedical use of prescription drugs as well as opioid overdoses by raising awareness about the dangers of sharing medications and by working with pharmaceutical and medical communities. The SPF-Rx program aims to promote collaboration between states/tribes and pharmaceutical and medical communities to understand the risks of overprescribing to youth age 12–17 and adults 18 years of age and older and enhance capacity for and access to Prescription Drug Monitoring Program (PDMP) data for prevention purposes.

---

Authorizing Statute(s): US Code: 42 USC 516 Name of Law: Healthy Pople 2020 Substance Abuse Yopic Area HP 2020-SA
  

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:
	82 FR 18307	04/18/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 28082	06/20/2017
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 6

table that charts list of burden

IC Title	Form No.	Form Name
Annual Implementation Instrument	Annual Implementation Instrument	Annual Implementation Instrument
Community-Level Outcomes Module	Community-Level Outcomes	Community-Level Outcomes
Evaluation Plan	Evaluation Plan	Evaluation Plan
Grantee-Level Interview	Grantee-Level Interview	Grantee-Level Interview
Grantee-Level Outcomes Module	Grantee-Level Outcomes	Grantee-Level Outcomes
Substitue Data Request Form	Substitue Data Request Form	Substitue Data Request Form

---

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	204	0	0	204	0	0
Annual Time Burden (Hours)	618	0	0	618	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.

---

Annual Cost to Federal Government: $326,660

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: 06/21/2017

---