State Opioid Response (SOR) and Tribal Opioid Response (TOR) Program Data Collection and Performance Measurement

ICR 202110-0930-002

OMB: 0930-0384

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Modified
Supporting Statement A
2021-10-08
IC Document Collections
IC ID
Document
Title
Status
234465 Modified
ICR Details
0930-0384 202110-0930-002
Received in OIRA 201812-0930-001
HHS/SAMHSA
State Opioid Response (SOR) and Tribal Opioid Response (TOR) Program Data Collection and Performance Measurement
Revision of a currently approved collection   No
Regular 10/12/2021
  Requested Previously Approved
36 Months From Approved 06/30/2022
636 1,436
191 244
0 0

There will be up to 359 award recipients (states, territories, and tribal entities) in these grant programs. Grantee-level data will include information related to naloxone purchases and distribution. This grantee-level information will be collected quarterly. All funded states/territories and tribal entities will also be required to collect and report client-level data on individuals who are receiving opioid treatment services to ensure program goals and objectives are being met. Client-level data will include information such as: demographic information, services planned/received, mental health/substance use disorder diagnoses, medical status, employment status, substance use, legal status, and psychiatric status/symptoms. Client level data will be collected at intake/baseline, three months post intake, six months post intake, and at discharge.

US Code: 42 USC 1105 Name of Law: GPRA
  
None

Not associated with rulemaking

  86 FR 41495 08/02/2021
86 FR 55853 10/07/2021
No

1
IC Title Form No. Form Name
Program-Level Instrument SOR_TOR Program Level Tool SOR_TOR Program Level Tool

  Total Request 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 636 1,436 0 -800 0 0
Annual Time Burden (Hours) 191 244 0 -53 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
Yes
Miscellaneous Actions
A decrease in respondents created a decrease in total burden hours. There remains a 53.20 hour decrease in burden, despite addition of new items to the instrument.

$108,837
No
    No
    No
No
No
No
No
Carlos Graham 204 276-0361 [email protected]

  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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
10/12/2021


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