Information Collection

[NCIPC] Overdose prevention strategies for individuals experiencing homelessness

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

Documents and Forms

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

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	[NCIPC] Overdose prevention strategies for individuals experiencing homelessness	Agency IC Tracking Number:	0920-1419-24II

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection 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 %

	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

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.