0920-24IL Reporting Tool

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Overview

START HERE
HE_Activities
HR_Encounters
HR_Naloxone
LTC_Navigator_Hours
LTC_Referrals
HS_Training
HS_SUD_Protocols

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Sheet 1: START HERE

V2.1	OD2A: LOCAL Performance Measures Reporting Tool				Form approved: OMB Control Number: 0920-1282 Expiration date: 06/30/2026
	Instructions
	Note: This tool is best viewed in the desktop version of Microsoft Excel. This reporting tool was designed for OD2A: LOCAL programs to support data collection, as well as reporting on required performance measures for evaluation to CDC. The tool is organized into 8 distinct tabs that are named by the performance measure labels provided in the Indicator Reference Sheets. Specifically, these tabs will capture data on the primary unit of measure and disaggregates. Within this tool some cells will appear gray to indicate that no additional data entry is needed. Any contextual questions/data quality questions that align to each performance measure will be entered into Partner's Portal. After completing each required tab of this tool, please save your file using the following naming convention before uploading the Excel file to the Performance Measures section of Partners Portal: OD2ALOCAL Reporting Template_Jurisdiction_Submission Date Partner's Portal Any contextual questions/data qualtiy questions that align to each performance measure will be entered into Partner's Portal. Due to the qualitative nature of the HE_Impact measure, this measure will be reported in Partner's Portal. Technical Guidance Please see the Indicator Reference Sheets and glossary of the technical guidance for definitions that have been developed to help operationalize each performance measure. For additional details about the reporting process, refer to the technical guidance. Feel free to reach out to your Evaluation Science Officer, if you have additional questions about using this tool.
		Select your jurisdiction
		Select reporting period
	Data Entry Instructions
		Variable/Disaggregate	Reporting Specifications
		Jurisdiction	This field will be prepopulated for all rows of data based on the selection made in the drop-down above from 'Select your jurisdiction' from the Start Here tab. The cells will appear gray to indicate that no additional data entry is needed.
		Reporting_Period	This field will be prepopulated for all rows of data based on the selection made above in the drop-down for 'Select reporting period' from the Start Here tab (See technical guidance for reporting timeline table.) The cells will appear gray to indicate that no additional data entry is needed.
		HE_Activities
		Total_HE_Activities	This is a formula field that will generate a total count of health equity focused overdose prevention activities that occurred in a clinical, harm reduction, public safety, or other settings during the designated reporting period once the disaggregates below are entered into the appropriate fields.
		HE_Clinical_Settings	Enter a whole number for the health equity focused overdose prevention activities that occurred in a health/clinical setting.
		HE_HR_Settings	Enter a whole number for the health equity focused overdose prevention activities that occurred in a harm reduction setting.
		HE_Public_Safety_Settings	Enter a whole number for the health equity focused overdose prevention activities that occurred in a public safety setting.
		HE_Other_Settings	Enter a whole number that reflects the health equity focused overdose prevention activities that occurred in any setting outside of clinical, harm reduction, and public safety.
		HR_Encounters
		Total_HR_Encounters	This is a formula field that will generate a total count of harm reduction service encounters (e.g., in-person, mail, telephone, online) that occurred at OD2A: LOCAL funded organizations during the designated reporting period once the data are entered by zip code into the appropriate fields. Note the total is calculated from the data entered by zip code, not the encounters with drug checking disaggregates.
		Encounters_with_Drug_Checking	Enter a whole number for service encounters where drug checking occurred.
		Encounters_with_People_High_Risk	This disaggregate is optional. If chosen, enter a whole number for service encounters with people at highest risk of overdose and/or with populations disproportionately affected by overdose.
		ZipCode_By_HR_Service_Site	Enter the five-digit zip code for each site where harm reduction services (e.g., in-person, mail, telephone, online) were provided. For any service site where services are provided in person, use the brick-and-mortar location zip code. For services provided via phone or mail, use the address of the brick-and-mortar location. For mobile-based outreach services, use the zip code of where the outreach encounter happened. For any service sites where zip codes are unknown, provide the total number of encounters that occurred across locations with unknown zip codes in the designated cell for “unknown” within the reporting tool.
		Num_Encounters_ZipCode	Enter a whole number for total number of service encounters for each zip code provided. When the zip code is "unknown" total the remaining encounters and enter a whole number.
		HR_Naloxone
		Total_Naloxone_Distributed	This is a formula field that will generate a total count of doses of naloxone that were distributed by OD2A-funded organizations during the designated reporting period once the disaggregates below are entered into the appropriate fields.
		Type_of_Organization	This variable has been pre-selected. If data are not available for a particular type of organization, enter 0 in the adjacent row.
		Num_Doses_Distributed	Enter a whole number for the count of all pre-measured naloxone doses distributed for each type of organization.
		ZipCode_By_Nal_Distribution_Site	Enter the five-digit zip code where the funded organization distributed their doses of naloxone. For any distribution site where the zip code is unknown, provide the total in the adjacent cell. For any distribution site where zip codes are unknown, provide the total number of doses distributed across locations with unknown zip codes in the designated cell for “unknown” within the reporting tool.
		Num_Doses_Distributed_ZipCode	Enter a whole number for the count of pre-measured naloxone doses distributed for each zip code. When the zip code is "unknown" total the remaining doses distributed and enter a whole number.
		LTC_Navigator_Hours
		Total_Navigator_Hours	This is a formula field that will generate a total count of hours navigators spent linking PWUD to care and/or harm reduction services via warm handoffs once the disaggregates below are entered into the appropriate fields.
		Navigator_Hours_Clinical	Enter a whole number for the total hours navigators have spent on linkage to care or referral efforts in health/clinical settings.
		Navigator_Hours_HR	Enter a whole number for the total hours navigators have spent on linkage to care or referral efforts in harm reduction settings.
		Navigator_Hours_Public_Safety	Enter a whole number for the total hours navigators have spent on linkage to care or referral efforts in public safety settings.
		Navigator_Hours_Other	Enter a whole number for the total hours navigators have spent on linkage to care or referral efforts in any other settings.
		LTC_Referrals
		Total_Referrals	This is a formula field that will generate a total count for all referrals to MOUD, behavioral health treatment only (without MOUD), and harm reduction services.
		Race_Ethnicity	This variable has been pre-selected. If data are not available for a particular race and ethnicity, enter 0 for all variables in the adjacent row. Note: when the race_ethnicity is marked unknown, this also includes if an individual preferred not to answer.
		Ref_MOUD	Enter a whole number for all referrals to MOUD for each race and ethnicity with available data.
		Ref_Behavioral_Trt	Enter a whole number for all referrals to behavioral health treatment only (without MOUD) for each race and ethnicity with available data.
		Ref_to_HR	Enter a whole number for all referrals to harm reduction services for each race and ethnicity with available data.
		Total_Ref_Race_Ethnicity	This is a formula field that will generate a total count for all referrals to MOUD, behavioral treatment only (without MOUD), and harm reduction services by each race and ethnicity.
		HS_Training
		Total_Percentage_Trained	This is a formula field that will generate a percentage of clinicians trained on implementing the 2022 CDC Clinical Practice Guidelines for Prescribing Opioids for Pain once the numerator and denominator are entered into the appropriate fields for each specialty.
		Specialty	This variable has been pre-selected. If data are not available for a particular specialty, enter 0 for all variables in the adjacent row.
		Num_Trained	Enter a numerator for the unique clinicians trained on implementing the 2022 CDC Clinical Practice Guidelines for Prescribing Opioids for Pain for each specialty.
		Num_Eligible	Enter a denominator for all eligible individuals who could be trained on implementing the 2022 CDC Clinical Practice Guidelines for Prescribing Opioids for Pain for each specialty.
		Percent_Clinician_Trained	This is a formula field that will generate a percentage of clinicians trained for each specialty once the numerator (Num_Trained) and denominator (Num_Eligible) are entered into the appropriate fields.
		HS_SUD_Protocols
		Total_Health_Settings	Enter the total count of health settings where protocols and/or policies have been implemented/improved for evidence-based SUD treatment and/or referrals. Note this will be the number of unique health settings, regardless of whether they have just one or both types of protocols/policies.
		Num_Settings_SUD_Treatment	Enter a whole number for the health settings where protocols or policies have been implemented/improved for evidence-based SUD treatment.
		Num_Settings_SUD_Referrals	Enter a whole number for the health settings where protocols or policies have been implemented/improved for evidence-based SUD referrals.
	CDC estimates the average public reporting burden for this collection of information as 35 hours annually per response from each recipient, including the time for reviewing instructions, searching existing data/information sources, gathering and maintaining the data/information needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Information Collection Review Office, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-1282)

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Sheet 2: HE_Activities

Number of health equity focused overdose prevention activities implemented with OD2A funding
Data Entry Instructions
Total_HE_Activities: This is a formula field that will generate a total count of health equity focused overdose prevention activities that occurred in a clinical, harm reduction, public safety, or other settings during the designated reporting period once the disaggregates below are entered into the appropriate fields. HE_Clinical_Settings: Enter a whole number that reflects the health equity focused overdose prevention activities that occurred in a clinical setting. HE_HR_Settings: Enter a whole number that reflects the health equity focused overdose prevention activities that occurred in a harm reduction setting. HE_Public_Safety_Settings: Enter a whole number that reflects the health equity focused overdose prevention activities that occurred in a public safety setting. HE_Other_Settings: Enter a whole number that reflects the health equity focused overdose prevention activities that occurred in any setting outside of clinical, harm reduction, and public safety. Please note that CDC is requesting that jurisdictions enter all counts—please do not suppress small numbers. If the count is zero, please enter “0”—please do not leave these cells null or blank to ensure these cells are not mischaracterized as missing data.
		Total_HE_Activities		0
			DISAGGREGATES
			Required	Required	Required	Required
	Jurisdiction	Reporting_Period	HE_Clinical_Settings	HE_HR_Settings	HE_Public_Safety_Settings	HE_Other_Settings
	0	0

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Sheet 3: HR_Encounters

Number of harm reduction service encounters at organizations funded or supported by OD2A
Data Entry Instructions
Total_HR_Encounters: This is a formula field that will generate a total count of harm reduction service encounters (e.g., in-person, mail, telephone, online) that occurred at OD2A: LOCAL funded organizations during the designated reporting period once the data are entered by zip code into the appropriate fields. Note the total is calculated from the data entered by zip code, not the encounters with drug checking disaggregates. Encounters_with_Drug_Checking: Enter a whole number for service encounters where drug checking occurred. Encounters_with_People_High_Risk: This disaggregate is optional. If chosen, enter a whole number for service encounters with people at highest risk of overdose and/or with populations disproportionately affected by overdose. ZipCode_By_HR_Service_Site: Enter the five-digit zip code for each site where harm reduction services (e.g., in-person, mail, telephone, online) were provided. For any service site where services are provided in person, use the brick-and-mortar location zip code. For services provided via phone or mail, use the address of the brick-and-mortar location. For mobile-based outreach services, use the zip code of where the outreach encounter happened. For any service sites where zip codes are unknown, provide the total number of encounters that occurred across locations with unknown zip codes in the designated cell for “unknown” within the reporting tool. Num_Encounters_ZipCode: Enter a whole number for service encounters for each zip code provided. When the zip code is "unknown" total the remaining encounters and enter a whole number. Please note that CDC is requesting that jurisdictions enter all counts—please do not suppress small numbers. If the count is zero, please enter “0”—please do not leave these cells null or blank to ensure these cells are not mischaracterized as missing data.
		Total_HR_Encounters		0
				DISAGGREGATES
				Required	Optional
		Jurisdiction	Reporting_Period	Encounters_with_Drug_Checking	Encounters_with_People_High_Risk
		0	0
		Required	Required
		ZipCode_By_HR_Service_Site	Num_Encounters_ZipCode
		Subtotal	0
		unknown

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Sheet 4: HR_Naloxone

Number of naloxone doses distributed by OD2A-funded or supported organizations
Data Entry Instructions
Total_Naloxone_Distributed: This is a formula field that will generate a total count of doses of naloxone that were distributed by OD2A-funded or supported organizations during the designated reporting period once the disaggregates below are entered into the appropriate fields. Type_of_Organization: This variable has been pre-selected. If data are not available for a particular type of organization, enter 0 in the adjacent row. Num_Doses_Distributed: Enter a whole number for the count of all pre-measured naloxone doses distributed for each type of organization. ZipCode_By_Distribution_Site: Enter the five-digit zip code where the funded organization distributed their doses of naloxone. For any distribution site where the zip code is unknown, provide the total in the adjacent cell. For any distribution site where zip codes are unknown, provide the total number of doses distributed across locations with unknown zip codes in the designated cell for “unknown” within the reporting tool. Num_Doses_Distributed_ZipCode: Enter a whole number for the count of pre-measured naloxone doses distributed to each zip code. When the zip code is "unknown" total the remaining encounters and enter a whole number. Please note that CDC is requesting that jurisdictions enter all counts—please do not suppress small numbers. If the count is zero, please enter “0”—please do not leave these cells null or blank to ensure these cells are not mischaracterized as missing data.
		Total_Naloxone_Distributed		0
			DISAGGREGATES
			Required	Required
	Jurisdiction	Reporting_Period	Type_of_Organization	Num_Doses_Distributed
	0	0	Syringe Service Programs
	0	0	Community-based organizations
	0	0	Senior care organizations
	0	0	Faith-based organizations
	0	0	Emergency Department/Urgent Care
	0	0	Other healthcare organizations
	0	0	Police departments
	0	0	Jails/Prisons
	0	0	Colleges/Universities
	0	0	Secondary education
	0	0	Health Department
	0	0	Other
	Subtotal			0
			DISAGGREGATES
			Required	Required
			ZipCode_By_Nal_Distribution_Site	Num_Doses_Distributed_ZipCode
			Subtotal	0
			unknown

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Sheet 5: LTC_Navigator_Hours

Number of hours navigators spent on linkage to care and harm reduction services via warm handoffs
Data Entry Instructions
Total_Navigator_Hours: This is a formula field that will generate a total count of hours navigators spent linking PWUD to care and/or harm reduction services via warm handoffs once the disaggregates below are entered into the appropriate fields. Navigator_Hours_Clinical: Enter a whole number for the total hours navigators have spent on linkage to care or referral efforts in health/clinical settings. Navigator_Hours_HR: Enter a whole number for the total hours navigators have spent on linkage to care or referral efforts in harm reduction settings. Navigator_Hours_Public_Safety: Enter a whole number for the total hours navigators have spent on linkage to care or referral efforts in public safety settings. Navigator_Hours_Other: Enter a whole number for the total hours navigators have spent on linkage to care or referral efforts in any other settings. Please note that CDC is requesting that jurisdictions enter all counts—please do not suppress small numbers. If the count is zero, please enter “0”—please do not leave these cells null or blank to ensure these cells are not mischaracterized as missing data.
		Total_Navigator_Hours		0
			DISAGGREGATES
			Required	Required	Required	Required
	Jurisdiction	Reporting_Period	Navigator_Hours_Clinical	Navigator_Hours_HR	Navigator_Hours_Public_Safety	Navigator_Hours_Other
	0	0

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Sheet 6: LTC_Referrals

Number of referrals to care and harm reduction services
Data Entry Instructions
Total_Referrals: This is a formula field that will generate a total count for all referrals to MOUD, behavioral health treatment only (without MOUD), and harm reduction services. Race_Ethnicity: This variable has been pre-selected. If data are not available for a particular race and ethnicity, enter 0 for all variables in the adjacent row. Note: when the race_ethnicity is marked unknown, this also includes if an individual preferred not to answer. Ref_MOUD: Enter a whole number for all referrals to MOUD for each race and ethnicity with available data. Ref_Behavioral_Trt: Enter a whole number for all referrals to behavioral health treatment only (without MOUD) for each race and ethnicity with available data. Ref_to_HR: Enter a whole number for all referrals to harm reduction services for each race and ethnicity with available data. Total_Ref_Race_Ethnicity: This is a formula field that will generate a total count for all referrals to MOUD, behavioral treatment only (without MOUD), and harm reduction services by all races and ethnicities. Please note that CDC is requesting that jurisdictions enter all counts—please do not suppress small numbers. If the count is zero, please enter “0”—please do not leave these cells null or blank to ensure these cells are not mischaracterized as missing data.
		Total_Referrals		0
				DISAGGREGATES
				Required	Required	Required
	Jurisdiction	Reporting_Period	Race_Ethnicity	Ref_MOUD	Ref_Behavioral_Trt	Ref_to_HR	Total_Ref_Race_Ethnicity
	0	0	American Indian or Alaska Native only				0
	0	0	Asian only				0
	0	0	Black or African American only				0
	0	0	Hispanic or Latino only				0
	0	0	Middle Eastern or North African only				0
	0	0	Native Hawaiian or Other Pacific Islander only				0
	0	0	White only				0
	0	0	American Indian or Alaska Native and Hispanic or Latino				0
	0	0	Asian and Hispanic or Latino				0
	0	0	Black or African American and Hispanic or Latino				0
	0	0	Middle Eastern or North African				0
	0	0	Native Hawaiian or Other Pacific Islander and Hispanic or Latino				0
	0	0	White and Hispanic or Latino				0
	0	0	Multiracial and/or Multiethnic				0
	0	0	Unknown				0
	Subtotal			0	0	0	0

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Sheet 7: HS_Training

Percent of clinicians who received training on implementing the “2022 CDC Clinical Practice Guideline for Prescribing Opioids for Pain”
Data Entry Instructions
Total_Percentage_Trained: This is a formula field that will generate a percentage of clinicians trained on implementing the 2022 CDC Clinical Practice Guidelines for Prescribing Opioids for Pain once the numerator and denominator are entered into the appropriate fields for each specialty. Specialty: This variable has been pre-selected. If data are not available for a particular specialty, enter 0 for all variables in the adjacent row. Num_Trained: Enter a numerator (n) for the unique clinicians trained on implementing the 2022 CDC Clinical Practice Guidelines for Prescribing Opioids for Pain for each specialty. Num_Eligible: Enter a denominator (d) for all eligible individuals who could be trained on implementing the 2022 CDC Clinical Practice Guidelines for Prescribing Opioids for Pain for each specialty. Percent_Clinician_Trained: This is a formula field that will generate a percentage of clinicians trained for each specialty once the numerator (Num_Trained) and denominator (Num_Eligible) are entered into the appropriate fields. Please note that CDC is requesting that jurisdictions enter all counts—please do not suppress small numbers. If the count is zero, please enter “0”—please do not leave these cells null or blank to ensure these cells are not mischaracterized as missing data.
	Total_Percentage_Trained
	Jurisdiction	Reporting_Period	Specialty	Num_Trained	Num_Eligible	Percent_Clinician_Trained
	0	0	Primary Care
	0	0	Emergency medicine
	0	0	Hospitalists
	0	0	Surgeons
	0	0	OB/GYNs
	0	0	Neurologists
	0	0	Dentists
	0	0	Physical medicine and rehabilitation
	0	0	Occupational medicine
	0	0	Pharmacists
	0	0	Nurse practitioners and other advanced-practice registered nurses
	0	0	Physician assistants
	0	0	Other
	Subtotal			0	0

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Sheet 8: HS_SUD_Protocols

Number of health settings implementing or improving protocols and/or policies for evidence-based substance use disorder (SUD) treatment or referrals
Data Entry Instructions
Total_Health_Settings: Enter the total count of health settings where protocols and/or policies have been implemented/improved for evidence-based SUD treatment and/or referrals. Note this will be the number of unique health settings, regardless of whether they have just one or both types of protocols/policies. Num_Settings_SUD_Treatment: Enter a whole number for the health settings where protocols or policies have been implemented/improved for evidence-based SUD treatment. Num_Settings_SUD_Referrals: Enter a whole number for the health settings where protocols or policies have been implemented/improved for evidence-based SUD referrals. Please note that CDC is requesting that jurisdictions enter all counts—please do not suppress small numbers. If the count is zero, please enter “0”—please do not leave these cells null or blank to ensure these cells are not mischaracterized as missing data.
		Total_Health_Settings
			DISAGGREGATES
			Required	Required
	Jurisdiction	Reporting_Period	Num_Settings_SUD_Treatment	Num_Settings_SUD_Referrals
	0	0