Senior Community Service Employment Program (SCSEP) Performance Measurement System

Forms and Documents

Document Name	Status
Form ETA-9120 SCSEP Participant Data Form (State) Form	Modified
Form ETA-9123 SCSEP Exit Form (National) Form	Modified
Form ETA-9123 SCSEP Exit Form (State) Form	Modified
Form ETA-9122 SCSEP Unsubsidized Employment Form (National) Form	Modified
Form ETA-9122 SCSEP Unsubsidized Employment Form (State) Form	Modified
Form ETA-9121 SCSEP Community Service Assignment Form (National) Form	Modified
Form ETA 9121 SCSEP Community Service Assignment Form (State) Form	Modified
Form ETA-9120 SCSEP Participant Data Form (National) Form	Modified
Form ETA 8705 SCSEP Equitable Distribution Report Form	Modified
1205-0040FRN30Day(20101026.1745).doc Supplementary Document	2010-10-28
QPR Handbook_Rev 5_5 19 10.pdf Supplementary Document	2010-10-21
Data Collection Handbook Rev 6_4 19 10 Final.pdf Supplementary Document	2010-10-21
1205-0040_SupportPartA_final(20110119).doc Supporting Statement A	2011-01-19
BLS cover sheet signed by Eltinge 10 1 2010.pdf Supplementary Document	2010-10-20
SCSEP Privacy Statement09.doc Supplementary Document	2010-10-19
1205-0040 SupportPartB_9_30_10.pdf Supporting Statement B	2010-10-19

IC Document Collections

IC ID	Document Title	Status
43785	SCSEP Participant Data Form (State) Form	Modified
185407	SCSEP Four-Year State Strategy Instruction	Modified
181013	SCSEP Exit Form (National) Form	Modified
181011	SCSEP Exit Form (State) Form	Modified
181010	SCSEP Unsubsidized Employment Form (National) Form	Modified
181009	SCSEP Unsubsidized Employment Form (State) Form	Modified
181008	SCSEP Community Service Assignment Form (National) Form	Modified
181007	SCSEP Community Service Assignment Form (State) Form	Modified
180574	SCSEP Participant Data Form (National) Form	Modified
180499	SCSEP Equitable Distribution Report Form	Modified
180161	SCSEP Participant Customer Satisfaction Survey Other-survey	Modified
180160	SCSEP Employer and Host Agency Customer Satisfaction Surveys Other-survey	Modified

ICR Details

OMB Control No: 1205-0040	ICR Reference No: 201010-1205-008
Status: Historical Inactive	Previous ICR Reference No: 200806-1205-007
Agency/Subagency: DOL/ETA	Agency Tracking No:
Title: Senior Community Service Employment Program (SCSEP) Performance Measurement System
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Withdrawn	Conclusion Date: 03/15/2011
	Date Received in OIRA: 10/29/2010
Terms of Clearance: DOL requests to withdraw the current package. DOL will resubmit separate packages for the existing and proposed requirements.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date		36 Months From Approved	03/31/2011
Responses	0	0	324,474
Time Burden (Hours)	0	0	46,146
Cost Burden (Dollars)	0	0	0

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Abstract: This information collection contains program performance reports for the Senior Community Service Employment Program (SCSEP).

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Authorizing Statute(s): PL: Pub.L. 109 - 365 501-518 Name of Law: Older Americans Act Amendments of 2006
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
1205-AB60	Proposed rulemaking	75 FR 71514	11/23/2010

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 27001	05/13/2010
30-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 27001	10/29/2010
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 12

IC Title	Form No.	Form Name
SCSEP Four-Year State Strategy
SCSEP Unsubsidized Employment Form (State)	ETA-9122	SPARQ Unsubsidized Employment Form
SCSEP Exit Form (National)	ETA-9123	SPARQ Exit Form
SCSEP Unsubsidized Employment Form (National)	ETA-9122	SCSEP Unsubsidized Employment Form
SCSEP Participant Customer Satisfaction Survey
SCSEP Participant Data Form (National)	ETA-9120	SPARQ Participant Data Form
SCSEP Community Service Assignment Form (State)	ETA 9121	SPARQ Community Service Assignment Form
SCSEP Community Service Assignment Form (National)	ETA-9121	SPARQ Community Service Assignment Form
SCSEP Exit Form (State)	ETA-9123	SPARQ Exit Form
SCSEP Participant Data Form (State)	ETA-9120	SPARQ Participant Form
SCSEP Equitable Distribution Report	ETA 8705	Equitable Distribution Form
SCSEP Employer and Host Agency Customer Satisfaction Surveys

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Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: The overall burden has incresed from the previously approved 46,146 hours to the current request for 53,546 hours due to added ARRA funding, which gave opportunities for additional participants to be included in the program, and to estimated burden for a volunteer form, ETA 9156, to contain a few added questions in response to comments submitted during a previous regulatory proceeding. A significantly higher number of customer satisfaction surveys to the three identified groups must be distributed and accounted for in burden hours. Also a computation error was corrected in ROCIS for the suvey burden. The reason this increase is not larger is that 1) the response data for the SPARQ (specifically, ETA-9122, which measures unsubsidized employment achievement in the program)and Customer Satisfaction Forms have been adjusted downward based on PY 2008 usage statistics, 2)the SPARQ forms ETA 9121 and ETA 9122 in the previously approved submission were inadvertently pegged at 11 minutes per form instead of 6 minutes per form, which is the stated estimated public burden for completing the form, and 3) the hour burden for biennial grant plans was recalculated at an annualized 203 hour burden rather than the biennial estimation of 406 burden hours. Lastly, the federal cost burden increased to $83,434 due in part to federal wage updates and because of the added program participants. In addition, note that ROCIS now also reflects $2,900,000 in annual contractor costs (not included in ROCIS in the previous submission), for a total of $2,983,434.

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Annual Cost to Federal Government: $2,983,434

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

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? 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? Uncollected

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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: 10/29/2010

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