Information Collection

[NCIPC] Overdose prevention strategies for individuals experiencing homelessness

IC 270564 under ICR 202408-0920-013 · OMB 0920-1419.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-1419924II) [NCIPC] Overdose prevention strategies for individuals experiencing homelessness	Form and Instruction
Attachment_F1_ConsentSurvey (Online) screenshots.pdf	Other-Screenshots
0920-1419924II) Focus group script Attachment D_ Focus group_8_16_24.docx	Form and Instruction
0920-1419(24II) Focus group script Attachment D_ Semi-structured interview_8_16_24.docx	Form and Instruction
0920-1419(24II) Law Enforcement Perspectives on Homelessness and Overdos Attachment_F_ConsentSurvey (Online).pdf	Form and Instruction
Attachment A_Request letter_CDC ORS v2.pdf Request Letter (24II)	IC Document
Attachment B_Exempt Research Approval.pdf Determination of Non-applicability (24II)	IC Document
Attachment C_Privacy Act-Determination.pdf Privacy Act Determination	IC Document
Attachment_G_Email_Invitation.docx Email Invitation (24II)	IC Document
Overdose preventionhomelessness_ Request Protocol_PHPS GenIC.tfs45_ka8.22.24.docx Request for Approval Under the Generic Clearance (0920-1419) for Overdose prevention strategies for individuals experiencing hom	IC Document

IC Title:

Agency IC Tracking Number:

0920-1419-24II

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	0920-1419924II)	Focus group script	Attachment D_ Focus group_8_16_24.docx	No		Printable Only
Form and Instruction	0920-1419(24II)	Focus group script	Attachment D_ Semi-structured interview_8_16_24.docx	No		Printable Only
Form and Instruction	0920-1419(24II)	Law Enforcement Perspectives on Homelessness and Overdose Survey	Attachment_F_ConsentSurvey (Online).pdf	Yes	Yes	Fillable Fileable
Other-Screenshots			Attachment_F1_ConsentSurvey (Online) screenshots.pdf	No		Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,000

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,000	1,000
Annual IC Time Burden (Hours)	286	286
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Request Letter (24II)	Attachment A_Request letter_CDC ORS v2.pdf	08/30/2024
Determination of Non-applicability (24II)	Attachment B_Exempt Research Approval.pdf	08/30/2024
Privacy Act Determination	Attachment C_Privacy Act-Determination.pdf	08/30/2024
Email Invitation (24II)	Attachment_G_Email_Invitation.docx	08/30/2024
Request for Approval Under the Generic Clearance (0920-1419) for Overdose prevention strategies for individuals experiencing homelessness(0920-24II)	Overdose preventionhomelessness_ Request Protocol_PHPS GenIC.tfs45_ka8.22.24.docx	08/30/2024

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.