Information Collection Request

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

ICR 202301-0920-001 · OMB 0920-1283 · Received in OIRA

Forms and Documents

Document Name	Status
Form 0920-n/a OD2A-LOCAL Data Management Plan Template Form and Instruction	New
Form 0920-n/a OD2A-LOCAL Evaluation & Performance Measurement Plan Template Form and Instruction	New
Form 0920-1283 OD2A-S Data Management Plan Template Form and Instruction	Modified
Form 0920-1283 (OD2A-S) Annual Performance Report and Work Plan Form and Instruction	Modified
Form 0920-1283 Activity Progress Report and Work Plan Tool - Annual Performance Report Form and Instruction	Modified
OD2A-LOCAL Annual Performance Report and Work Plan Form and Instruction	Modified
Form 0920-1283 Organization Capacity Assessment - Annual Reporting Form and Instruction	Modified
Form 0920-1283 (OD2A-S) Annual Performance Report and Work Plan Form and Instruction	Modified
Form 0920-1283 Evaluation and Performance Measuring Plan Template Form and Instruction	Modified
Attachment 4_List of Data Collection Instrument Requests.docx Supplementary Document	2023-01-11
Att 7 Crosswalk of the four required reporting.docx Supplementary Document	2019-10-16
Attachment 7_Research Determination.pdf Supplementary Document	2023-01-11
Attachment 5_PIA.pdf Supplementary Document	2023-01-05
Attachment B_Published 60dy FRN.pdf Supplementary Document	2023-01-05
Attachment 2 List of Funded Jurisdictions.docx Supplementary Document	2023-01-05
Att 1 Authorizing Legislation.doc Supplementary Document	2019-10-16
SSB_1283 OD2A Progress Reporting_final.docx Supporting Statement B	2023-01-11
SSA_1283_OD2A Progress Reporting_011123.docx Supporting Statement A	2023-01-11

IC Document Collections

IC ID	Document Title	Status
257750	OD2A-LOCAL Data Management Plan Template Form and Instruction	New
257748	OD2A-LOCAL Evaluation & Performance Measurement Plan Template Form and Instruction	New
238174	OD2A-S Data Management Plan Template Form and Instruction	Modified
238173	(OD2A-S) Annual Performance Report and Work Plan Form and Instruction	Modified
238172	Activity Progress Report and Work Plan Tool - Annual Performance Report Form and Instruction	Modified
238171	OD2A-LOCAL Annual Performance Report and Work Plan Form and Instruction	Modified
238170	Organization Capacity Assessment - Annual Reporting Form and Instruction	Modified
238169	(OD2A-S) Annual Performance Report and Work Plan Form and Instruction	Modified
238168	Evaluation and Performance Measuring Plan Template Form and Instruction	Modified

ICR Details

Status	Received in OIRA
Agency/Subagency	HHS/CDC
OMB Control No	0920-1283
Type of Information Collection	Revision of a currently approved collection
Previous ICR Reference No	201910-0920-003
Agency Tracking No	0920-1283
Date Submitted to OIRA	1969-12-31
Requested Expiration Date	1969-12-31