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Rural Communities Opioid Response Program-Implementation/Neonatal Abstinence Syndrome/MAT Expansion
Rural Communities Opioid Response Program (RCORP) Grantee Data
OMB: 0906-0044
IC ID: 237084
OMB.report
HHS/HRSA
OMB 0906-0044
ICR 202306-0906-002
IC 237084
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0906-0044 can be found here:
2024-07-15 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form 1a
Rural Communities Opioid Response Program-Implementation/Neonatal Abstinence Syndrome/MAT Expansion
Form and Instruction
1a Implementation Measures
Implementation Measures to Share 63023.pdf
Form and Instruction
1a Implementation Measures
Implementation Measures to Share 63023.pdf
Form and Instruction
1b MAT Expansion Measures
MAT Expansion Measures to Share 63023.pdf
Form and Instruction
1b MAT Expansion Measures
MAT Expansion Measures to Share 63023.pdf
Form and Instruction
1c NAS Measures
NAS Measures to Share 63023.pdf
Form and Instruction
1c NAS Measures
NAS Measures to Share 63023.pdf
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Rural Communities Opioid Response Program-Implementation/Neonatal Abstinence Syndrome/MAT Expansion
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
1a
Implementation Measures
Implementation Measures to Share 63023.pdf
Yes
Yes
Fillable Fileable
Form and Instruction
1b
MAT Expansion Measures
MAT Expansion Measures to Share 63023.pdf
Yes
Yes
Fillable Fileable
Form and Instruction
1c
NAS Measures
NAS Measures to Share 63023.pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
290
Number of Respondents for Small Entity:
290
Affected Public:
Private Sector
Private Sector:
Not-for-profit institutions
Percentage of Respondents Reporting Electronically:
100 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
580
0
0
0
0
580
Annual IC Time Burden (Hours)
719
0
0
0
0
719
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.