[NCIPC] Monitoring and Reporting for the Overdose Data to Action Cooperative Agreement

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 0920-n/a OD2A-LOCALData Management Plan Template	Form and Instruction	Unchanged	Available
Form 0920-n/a OD2A-LOCAL Evaluation and Performance Measuring Plan Template	Form and Instruction	Unchanged	Repair queued
Form 0920-1283 OD2A-S Data Management Plan Template	Form and Instruction	Unchanged	Available
Form 0920-1283 OD2A-S Annual Performance Report and Work Plan	Form and Instruction	Unchanged	Available
Form 0920-1283 Activity Progress Report and Work Plan Tool	Form and Instruction	Unchanged	Available
Form 0920-25-0159 OD2A-LOCAL Annual Performance Report and Work Plan_08.2025	Form	Modified	Available
Form 0920-1283 Organizational Capacity Assessment - Annual Reporting	Form and Instruction	Unchanged	Available
Form 0920-25-0159 OD2A-S Annual Performance Report and Work Plan_08.2025	Form	Modified	Available
Form 0920-1283 Evaluation and Performance Measuring Plan Template - Annual Reporting	Form and Instruction	Unchanged	Available
Change Request Memo - 0920-1283.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-08-21	Repair queued
Attachment 4_List of Data Collection Instrument Requests.docx	Supplementary Document	Uploaded 2023-01-11	Available
Att 7 Crosswalk of the four required reporting.docx	Supplementary Document	Uploaded 2019-10-16	Available
Attachment 7_Research Determination.pdf	Supplementary Document	Uploaded 2023-01-11	Available
Attachment 5_PIA.pdf	Supplementary Document	Uploaded 2023-01-05	Available
Attachment B_Published 60dy FRN.pdf	Supplementary Document	Uploaded 2023-01-05	Available
Attachment 2 List of Funded Jurisdictions.docx	Supplementary Document	Uploaded 2023-01-05	Available
Att 1 Authorizing Legislation.doc	Supplementary Document	Uploaded 2019-10-16	Source copy available
SSB_1283 OD2A Progress Reporting_final.docx	Supporting Statement B	Uploaded 2023-01-11	Available
SSA_1283_OD2A Progress Reporting_011123.docx	Supporting Statement A	Uploaded 2023-01-11	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
257750	OD2A-LOCAL Data Management Plan Template	Form and Instruction	Unchanged	OD2A-LOCALData Management Plan Template
257748	OD2A-LOCAL Evaluation & Performance Measurement Plan Template	Form and Instruction	Unchanged	OD2A-LOCAL Evaluation and Performance Measuring Plan Template
238174	OD2A-S Data Management Plan Template	Form and Instruction	Unchanged	OD2A-S Data Management Plan Template
238173	(OD2A-S) Annual Performance Report and Work Plan	Form and Instruction	Unchanged	OD2A-S Annual Performance Report and Work Plan
238172	Activity Progress Report and Work Plan Tool - Annual Performance Report	Form and Instruction	Unchanged	Activity Progress Report and Work Plan Tool
238171	OD2A-LOCAL Annual Performance Report and Work Plan	Form	Modified	OD2A-LOCAL Annual Performance Report and Work Plan_08.2025
238170	Organization Capacity Assessment - Annual Reporting	Form and Instruction	Unchanged	Organizational Capacity Assessment - Annual Reporting
238169	[OD2A] S-Annual Performance Report and Work Plan	Form	Modified	OD2A-S Annual Performance Report and Work Plan_08.2025
238168	Evaluation and Performance Measuring Plan Template	Form and Instruction	Unchanged	Evaluation and Performance Measuring Plan Template - Annual Reporting

ICR Details

OMB Control No: 0920-1283	ICR Reference No: 202508-0920-007
Status: Active	Previous ICR Reference No: 202301-0920-001
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-25-0159
Title: [NCIPC] Monitoring and Reporting for the Overdose Data to Action Cooperative Agreement
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/22/2025
Retrieve Notice of Action (NOA)	Date Received in OIRA: 08/21/2025
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2026	05/31/2026	05/31/2026
Responses	471	0	471
Time Burden (Hours)	1,343	0	1,343
Cost Burden (Dollars)	0	0	0

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Abstract: This is a revision request for the previously approved ICR to continue collecting program monitoring and reporting information from jurisdictions (which include states, Washington, D.C., U.S. Territories, cities, and counties) currently funded under the Overdose Data to Action (CDC-RFA-CE19-1904) notice of funding opportunity (OD2A NOFO). Reporting requirements have been carefully designed to align with and support the specific goals and outcomes outlined in the OD2A NOFO. This revision request is to initiate data collection activities for two new Overdose Data to Action NOFOs, the Overdose Data to Action in States (OD2A-S) will collect program monitoring and reporting information from states and Washington, D.C. The Overdose Data to Action-Limiting Overdose through Collaborative Actions in Localities (OD2A-LOCAL) will collect program monitoring and reporting information from U.S. Territories, cities, and counties. This non substantive change request updates questions used in OMB 0920-1283 Monitoring and Reporting for the Overdose Data to Action Cooperative Agreement to be in accordance with E.O. 14168 & E.O. 14151.

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Authorizing Statute(s): US Code: 42 USC 241 Name of Law: Public Health Service Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 54694	09/07/2022
30-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 3990	01/23/2023
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 9

table that charts list of burden

IC Title	Form No.	Form Name
(OD2A-S) Annual Performance Report and Work Plan	0920-1283	OD2A-S Annual Performance Report and Work Plan
Activity Progress Report and Work Plan Tool - Annual Performance Report	0920-1283	Activity Progress Report and Work Plan Tool
Evaluation and Performance Measuring Plan Template	0920-1283	Evaluation and Performance Measuring Plan Template - Annual Reporting
OD2A-LOCAL Annual Performance Report and Work Plan	0920-25-0159	OD2A-LOCAL Annual Performance Report and Work Plan_08.2025
OD2A-LOCAL Data Management Plan Template	0920-n/a	OD2A-LOCALData Management Plan Template
OD2A-LOCAL Evaluation & Performance Measurement Plan Template	0920-n/a	OD2A-LOCAL Evaluation and Performance Measuring Plan Template
OD2A-S Data Management Plan Template	0920-1283	OD2A-S Data Management Plan Template
Organization Capacity Assessment - Annual Reporting	0920-1283	Organizational Capacity Assessment - Annual Reporting
[OD2A] S-Annual Performance Report and Work Plan	0920-25-0159	OD2A-S Annual Performance Report and Work Plan_08.2025

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ICR Summary of Burden

table that charts list of burden

	Total Approved	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	471	471	0	0	0	0
Annual Time Burden (Hours)	1,343	1,343	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $622,976

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 08/21/2025

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