Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 0920-1050)

Drug Overdose Surveillance and Epidemiology (DOSE)

(OMB# 0920-1268, exp. date 09/30/2025)

Proposed Changes: Justification and Overview

Date of Submission: 03/01/2023

Justification

This non-substantial change request is related to the ICR entitled “Drug Overdose Surveillance and Epidemiology (DOSE),” OMB control number 0920-1268.

This non-substantial change request is for the following changes: 1) Remove quarterly data collection for emergency department (ED)/hospitalization discharge overdose data, 2) Increase the number of states submitting ED/hospitalization discharge overdose data from 28 to 35, 3) Request line-level ED/hospitalization discharge overdose data instead of aggregate counts. These changes will not alter the purpose of DOSE, the methods, or interpretation of DOSE data.

This non-substantial change request will result in an overall reduction in the currently approved total annual burden and costs for respondents, from 975 hours ($29,123) to 657.5 hours ($19,640), due to the elimination of the aggregation process which takes time to complete and removing quarterly data submissions. Changes will also allow CDC the ability to have access to complete line-level data making the data more actionable and granular (e.g., drug combinations can now be analyzed).

Brief Project Description

The declaration of the opioid overdose epidemic as a national public health emergency on October 26, 2017ⁱ highlighted the urgent need to enhance timely surveillance of drug overdoses. The Drug Overdose Surveillance and Epidemiology (DOSE) system (OMB# 0920-1268) currently captures data from 47 states and the District of Columbia funded through the Overdose Data to Action (OD2A) cooperative agreement. DOSE provides data critical to inform timely regional response, especially to acute and/or widespread multi-state outbreaks. DOSE captures and rapidly shares existing emergency department (ED) data on counts of ED visits and inpatient hospitalizations involving suspected drug, opioid, heroin, fentanyl, stimulant, cocaine, methamphetamine, benzodiazepine, and other emerging drug overdoses using standard CDC case definitions and two standard data forms: 1) the Rapid ED overdose data form, and 2) the ED/Hospitalization discharge overdose data form.

Proposed Changes and Justification

The purpose of this request is to highlight three minor changes being proposed for DOSE data collected using the ED/Hospitalization discharge overdose data form (Att. E). Specifically, we are proposing the following changes:

1. Data using the ED/Hospitalization discharge overdose data form will only be collected annually (minimum 6-month lag from discharge date to report date), instead of both annually and quarterly. CDC analyzes these data annually and will update the publicly available DOSE Dashboard annually. In addition, annual data collection with a 6-month lag will increase data completeness compared to quarterly submissions with a 3-month lag, as many states have a 3-6+ month lag receiving data from their state hospital associations.

2. The number of states that will be submitting data using the ED/Hospitalization discharge overdose data form is estimated to increase from 28 to 35 states. We anticipate the number of states submitting data to increase, as more states can meet an annual (vs. quarterly) data submission timeline, resulting in improved data collection and reporting.

3. Data using the ED/Hospitalization discharge overdose data form will now be line-level (e.g., one ED visit per overdose observation) instead of aggregate. Please note the data will not contain PII. Currently, states maintain these data in a line-level format and use CDC programs to process the data and aggregate it before submission to CDC. Changing to requiring line-level data will eliminate the need to process line-level data into the aggregate form for drug overdose counts; therefore, we anticipate that there will be a decrease in burden to the health department staff. Moreover, it will make the data more actionable by allowing for analyses of drug overdoses involving multiple substances and novel combinations. Please see the Crosswalk of Changes for the details on specific changes to the ED/Hospitalization discharge overdose data form. The currently approved ED/Hospitalization discharge overdose data form (Att E) includes eight tabs. The revised form will include seven total tabs. Two metadata tabs will be unchanged, four tabs will reduce the number of columns from 11 to 8, two tabs will be removed, and one new tab will be included (the line level tab).

Change to Burden or Cost

The proposed changes will result in an overall reduction in the currently approved total annual burden and costs for respondents, from 975 hours ($29,123) to 657.5 hours ($19,640). See the revised burden and cost tables below.

Table 1. Estimates of annualized respondent burden hours

Type of respondent	Form name	No. of respondents	Total no. of responses per respondent	Average burden per response (hours)	Total annual burden (hours)
Participating health departments sharing aggregate data from local syndromic or hospital discharge file	Rapid ED overdose data form (Att. D)	10	12	3	360
Participating health departments sharing case-level ED data with CDC through the NSSP BioSense (OMB #0920-0824)*	Rapid ED overdose data form (Att. D)	35	12	30/60	210
Participating health department sharing finalized ED/hospital discharge data on a yearly basis	ED discharge overdose data form (Att. E)	35	1	2.5	87.5
Total					657.5

* The reporting burden for jurisdictions sharing case-level ED data with CDC is substantially lower because CDC completes most of the form for the jurisdiction and only needs to consult with the jurisdiction on completing the metadata.

Table 2. Estimates of annualized respondent burden costs

Type of respondent	No. of respondents	No. of responses per respondent	Total burden (hours)	Hourly wage rate	Total respondent cost
Participating health departments sharing aggregate data from local syndromic or hospital discharge file	10	12	360	$29.87	$10,753
Participating health departments sharing case-level ED data with CDC through the NSSP BioSense (OMB #0920-0824)*	35	12	210	$29.87	$6,273
Participating health department sharing finalized ED/hospital discharge data on a yearly basis	35	1	87.5	$29.87	$2,614
Total					$19,640

* The reporting burden for jurisdictions sharing case-level ED data with CDC is substantially lower because CDC completes most of the form for the jurisdiction and only needs to consult with the jurisdiction on completing the metadata.

i Additional information on President Trump’s Initiative to Stop Opioid Abuse, https://www.whitehouse.gov/opioids/.