Community Services Block Grant (CSBG) Annual Report

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
CSBG State_Accountability Aeasures_10022015.pdf	Supplementary Document	Uploaded 2016-10-31	Available
General Comments Cost_FY16.docx	Supplementary Document	Uploaded 2016-10-31	Available
General Comment Burden_FY16.docx	Supplementary Document	Uploaded 2016-10-31	Available
CSBG Act Citation_FY16.docx	Supplementary Document	Uploaded 2016-10-31	Available
Module 4 Comments_FY16.docx	Supplementary Document	Uploaded 2016-10-27	Available
Module 3 Comments_FY16.docx	Supplementary Document	Uploaded 2016-10-27	Repair queued
Module 2 Comments_FY16.docx	Supplementary Document	Uploaded 2016-10-27	Available
Module 1 Comments_FY16.docx	Supplementary Document	Uploaded 2016-10-27	Available
IM_150_CSBG Use of the ACSI_08222016.pdf	Supplementary Document	Uploaded 2016-10-27	Available
IM_144_state_and_federal_accountability_measures_data_collection.pdf	Supplementary Document	Uploaded 2016-10-27	Available
CSBG Federal Accountability Aeasures_10022015.pdf	Supplementary Document	Uploaded 2016-10-27	Available
ACSI Planning Reporting Cycle.pdf	Supplementary Document	Uploaded 2016-10-27	Available
Accountability Measure Crosswalk_FY2016.pdf	Supplementary Document	Uploaded 2016-10-27	Available
Use of ACSI Accountability Measures_10022015.pdf	Supplementary Document	Uploaded 2016-10-27	Available
OCS-0375 Supporting Statement CSBG AR_FY16.docx	Supporting Statement A	Uploaded 2016-10-27	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
224195	Sub-Grantees	Instruction	New
224194	Grantees	Instruction	New

ICR Details

OMB Control No: 0970-0492	ICR Reference No: 201610-0970-014
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/ACF	Agency Tracking No: OCS
Title: Community Services Block Grant (CSBG) Annual Report
Type of Information Collection: Existing collection in use without an OMB Control Number	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 01/12/2017
	Date Received in OIRA: 11/02/2016
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2020	36 Months From Approved
Responses	1,087	0	0
Time Burden (Hours)	793,016	0	0
Cost Burden (Dollars)	16,607,471	0	0

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Abstract: This request will support an automated Community Services Block Grant (CSBG) Annual Report that will allow HHS to collect data necessary to meet CSBG Act Section 678E(b)(2)requirement for HHS to submit a report to Congress and Section 678E(a)(2) which requires States annually prepare and submit to HHS a report on the measured performance of the State and the eligible entities in the State. Under authority granted to HHS to collect information necessary to administer CSBG, HHS proposes collecting information on organizational standards for local CSBG eligible entities, accountability measures for States, and Results Oriented Management and Accountability (ROMA) information on results achieved. The information collected in this Annual Report will allow HHS to determine how States actually performed as compared to planned actions set out in the CSBG State Plan. The CSBG State Plan was awarded a clearance (OMB Number 0970-0382) in August 2015.

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Authorizing Statute(s): US Code: 42 USC 9901 Name of Law: Community Services Block Grant 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:
	81 FR 39267	06/16/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 75824	11/01/2016
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
Sub-Grantees
Grantees

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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	1,087	0	0	1,087	0	0
Annual Time Burden (Hours)	793,016	0	0	793,016	0	0
Annual Cost Burden (Dollars)	16,607,471	0	0	16,607,471	0	0

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: New ICR

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Annual Cost to Federal Government: $1,241,170

Does this IC contain surveys, censuses, or employ statistical methods? No

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: 11/02/2016

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