Notice2024-17142
Agency Information Collection Activities Comment Request
Primary source
Metadata and text below are from the Federal Register, a public-domain U.S. government work. Always verify the official published version before relying on it for any legal matter.
Published
August 5, 2024
Issuing agencies
Health and Human Services DepartmentSubstance Abuse and Mental Health Services Administration
Full Text
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<title>Federal Register, Volume 89 Issue 150 (Monday, August 5, 2024)</title>
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[Federal Register Volume 89, Number 150 (Monday, August 5, 2024)]
[Notices]
[Pages 63438-63439]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2024-17142]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Substance Abuse and Mental Health Services Administration
Agency Information Collection Activities Comment Request
Periodically, the Substance Abuse and Mental Health Services
Administration (SAMHSA) will publish a summary of information
collection requests under OMB review, in compliance with the Paperwork
Reduction Act (44 U.S.C. Chapter 35). To request a copy of these
documents, call the SAMHSA Reports Clearance Officer on (240) 276-0361.
Proposed Project: Drug and Alcohol Warning Network (DAWN) (OMB No.
0930-0078)--Reinstatement With Change
Under the Public Health Service Act (42 U.S.C. 290aa-4), SAMHSA is
authorized to collect data on the number of individuals admitted to the
emergency rooms of hospitals as a result of the abuse of alcohol or
other drugs. DAWN is a nationwide public health surveillance system to
improve hospital emergency department (ED) monitoring of substance use-
related visits. It captures data on ED visits related to recent
substance use and misuse directly from the electronic health records
(EHR) of participating hospitals. The new DAWN helps SAMHSA and public
health professionals, clinicians, and policymakers respond effectively
to the opioid and substance misuse crisis in the United States.
SAMHSA is requesting OMB approval of reinstatement with change of
the DAWN data collections, to include following changes:
<bullet> Revise the data collection title to ``Drug and Alcohol
Warning Network'', replacing existing `abuse' term and including
``alcohol'' in the title.
<bullet> Remove drug-related death investigation records review
component administered by state medical examiners (MEs) and individual
medical examiners/coroners (ME/Cs).
<bullet> Revise data collection procedures where participating
hospitals can choose the direct chart review option (at the
contractor's operation center, home-based abstraction or on site at the
hospital). Hospitals will also have the opportunity to select the
machine learning with natural language processing (ML with NLP) option.
The option for hospitals to use their own staff to abstract DAWN data
as they did in the legacy DAWN is no longer offered.
<bullet> Revise the hospital selection design of the ED component
to a hybrid system that combines sentinel hospitals and probability-
based selection of hospitals from high priority suburban/rural areas
and from the remaining areas in the United States.
<bullet> Change the reporting and publication schedule to further
increase the timeliness of the new DAWN data availability and delivery
to SAMHSA. The new DAWN data are collected on an ongoing basis and
could be available to SAMHSA on demand. The new DAWN data are delivered
to SAMHSA and available for analysis at a more frequent intervals than
the legacy DAWN.
<bullet> Propose following changes to the ED Case Report Form:
[cir] Add ``Center for Behavioral Health Statistics and Quality''
to specify the center responsible for DAWN data collection.
[cir] Revise the data collection title to ``Drug and Alcohol
Warning Network'' from ``Drug Abuse Warning Network.''
[cir] Replace prior ``Facility'' data field title with ``Hospital
Emergency Department ID'' to provide more precise description and ID
number of the DAWN participating hospitals.
[cir] Q3 ``Age'': replace prior option of ``less than 1 year'' with
two detailed options of ``4 weeks (28 days) or younger'' and ``Between
4 weeks and one year old (>4 weeks, <1 year)'' to enable new
identification of neonatal substance issues.
[cir] Q4 ``County of Residence'': revise data field title from
prior ``patient's home zip code'' and add more accurate description on
what data to be collected and clarify the purpose of data collection.
Add new ``Unable to determine county'' option to improve data accuracy
and account for geographical variation.
[cir] Q6 ``Gender Identity'' and Q7 ``Sexual Orientation'': added
to provide inclusive measures and to align with SAMHSA's efforts in
enhancing behavioral health equities among diverse populations.
[cir] Q8 ``Ethnicity'' and Q9 ``Race'': revise prior data field
``Race/Ethnicity'' to align with OMB 1997 Standards for Maintaining,
Collecting, And Presenting Federal Data on Race and Ethnicity
(Statistical Policy Directive No. 15) and to improve data accuracy and
comprehensiveness.
[cir] Q10 ``Case Description'': replace the word ``drug(s)'' with
``substance(s)'' to clarify that the DAWN collects data on all
substances including alcohol. Add new instruction language of ``Do not
include information that could identify the patient or hospital'' to
provide clear instruction and specify the
[[Page 63439]]
importance of patient and hospital privacy protection.
[cir] Q11 ``Substance(s) Involved and Route of Administration'':
add two new options of ``transdermal'' and ``vaped'' to improve the
comprehensiveness of the list on how substance is administered by the
patient. Remove ``Mark if confirmed by toxicology test'' and ``alcohol
involved?''
[cir] Q12 ``Diagnosis'': change the question order and move the
data field after Q11. Revise prior instruction of ``list up to 4
diagnoses'' to ``list all diagnoses'' to enhances new DAWN's ability to
identify novel drug, drug trends, and drug outbreaks.
[cir] Q13 ``Type of Case'': remove instruction language of ``using
the decision tree.'' Revise the existing option of ``seeking detox'' to
``seeking detox and/or substance abuse treatment only'' and remove age
restriction for ``Alcohol only'' option to include cases involving
alcohol as the only substance of all ages.
[cir] Q14, Q15, and Q16 ``Was naloxone/buprenorphine/methadone
administered to the patient in the ED'': added to capture new data on
the implementation of medication-assisted treatment for opioid use
disorder in the emergency department setting and understand why
buprenorphine and methadone is administered.
[cir] Q17 ``Disposition'': add new options and re-categorize
disposition to improve data accuracy and comprehensiveness and better
understand where the patient went after their ED visit.
<bullet> Proposes a new Activity Report From to be submitted by the
abstractors to collect information on the date of ED visits the
abstractor has reviewed, counts of ED visits for that date, number of
records reviewed, and number of left without being seen (LWBS) visits
for the ED visit date if participating hospitals choose the direct
chart review option.
The estimated annual burden for the DAWN data collection is as
follows:
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Hours per
Information collection activities Number of Responses per Total response (in Total burden Average hourly Total annual
respondents respondent responses hours) hours wage cost
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Setting Up Activities *
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Initial outreach and recruitment (all 143 1 143 81.50 11,655 $48.72 $567,807
hospitals).............................
ED record provision setting up (direct 58 1 58 5.25 305 26.71 8,133
chart review)..........................
ED record provision setting up (ML with 85 1 85 36.00 3,060 26.71 81,733
NLP)...................................
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Ongoing Maintenance Activities
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Ongoing Maintenance (direct chart 58 1 58 1.50 87 26.71 2,324
review)................................
Ongoing Maintenance (ML with NLP)....... 85 1 85 6.00 510 26.71 13,622
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Totals.............................. .............. .............. .............. .............. 15,616 .............. 673,619
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* Setting up activities will be conducted once.
Written comments and recommendations for the proposed information
collection should be sent within 30 days of publication of this notice
to <a href="http://www.reginfo.gov/public/do/PRAMain">www.reginfo.gov/public/do/PRAMain</a>. Find this particular information
collection by selecting ``Currently under 30-day Review--Open for
Public Comments'' or by using the search function.
Alicia Broadus,
Public Health Advisor.
[FR Doc. 2024-17142 Filed 8-2-24; 8:45 am]
BILLING CODE 4162-20-P
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