Community Services Block Grant (CSBG) Annual Report

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 4 CSBG Disaster Supplemental Annual Report Module 4	Form and Instruction	New	Available
Form 2 CSBG Disaster Supplemental Annual Report Module 2	Form and Instruction	New	Available
Form 1 CSBG Disaster Supplemental Annual Report Module 1	Form and Instruction	New	Available
Form 4 CSBG Disaster Supplemental Annual Report Module 4	Form and Instruction	New	Available
Form 2 CSBG Disaster Supplemental Annual Report Module 2	Form and Instruction	New	Available
Form 1 CSBG Disaster Supplemental Annual Report Module 1	Form and Instruction	New	Available
Form 4 CSBG CARES Supplemental Annual Report Module 4	Form and Instruction	New	Available
Form 2 CSBG CARES Supplemental Annual Report Module 2	Form and Instruction	New	Available
Form 1 CSBG CARES Supplemental Annual Report Module 1	Form and Instruction	New	Available
Form 4 CSBG CARES Supplemental Annual Report Module 4	Form and Instruction	New	Available
Form 2 CSBG CARES Supplemental Annual Report Module 2	Form and Instruction	New	Available
Form 1 CSBG CARES Supplemental Annual Report Module 1	Form and Instruction	New	Available
Form 4 CSBG Module 4	Form and Instruction	Modified	Available
Form 3 CSBG Annual Report Module 3	Form and Instruction	Modified	Available
Form 2 CSBG Module 2	Form and Instruction	Modified	Available
Form 1 CSBG Module 1	Form and Instruction	Modified	Available
Form 4 CSBG Module 4	Form and Instruction	Modified	Available
Form 3 CSBG Annual Report Module 3	Form and Instruction	Modified	Available
Form 2 CSBG Module 2	Form and Instruction	Modified	Available
Form 1 CSBG Module 1	Form and Instruction	Modified	Available
GDL_CSBG_AR M2-4 Form Revision Summary.docx	Supplementary Document	Uploaded 2020-01-22	Available
GDL_CSBG_AR M1 Revision Summary.docx	Supplementary Document	Uploaded 2020-01-22	Available
CSBG State Accountability Measures.pdf	Supplementary Document	Uploaded 2020-01-22	Available
CSBG Federal Accountability Measures.pdf	Supplementary Document	Uploaded 2020-01-22	Available
CSBG_AR OMB Supporting Statement_011620.docx	Supporting Statement A	Uploaded 2020-01-16	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
244534	CSBG Disaster Annual Report: Sub-Grantees	Form and Instruction	New	CSBG Disaster Supplemental Annual Report Module 4
244534	CSBG Disaster Annual Report: Sub-Grantees	Form and Instruction	New	CSBG Disaster Supplemental Annual Report Module 2
244534	CSBG Disaster Annual Report: Sub-Grantees	Form and Instruction	New	CSBG Disaster Supplemental Annual Report Module 1
244533	CSBG Disaster Annual Report: Grantees	Form and Instruction	New	CSBG Disaster Supplemental Annual Report Module 4
244533	CSBG Disaster Annual Report: Grantees	Form and Instruction	New	CSBG Disaster Supplemental Annual Report Module 2
244533	CSBG Disaster Annual Report: Grantees	Form and Instruction	New	CSBG Disaster Supplemental Annual Report Module 1
244532	CSBG CARES Annual Report: Sub-grantees	Form and Instruction	New	CSBG CARES Supplemental Annual Report Module 4
244532	CSBG CARES Annual Report: Sub-grantees	Form and Instruction	New	CSBG CARES Supplemental Annual Report Module 2
244532	CSBG CARES Annual Report: Sub-grantees	Form and Instruction	New	CSBG CARES Supplemental Annual Report Module 1
244531	CSBG CARES Annual Report: Grantees	Form and Instruction	New	CSBG CARES Supplemental Annual Report Module 4
244531	CSBG CARES Annual Report: Grantees	Form and Instruction	New	CSBG CARES Supplemental Annual Report Module 2
244531	CSBG CARES Annual Report: Grantees	Form and Instruction	New	CSBG CARES Supplemental Annual Report Module 1
224195	CSBG Annual Report: Sub-Grantees	Form and Instruction	Modified	CSBG Module 4
224195	CSBG Annual Report: Sub-Grantees	Form and Instruction	Modified	CSBG Annual Report Module 3
224195	CSBG Annual Report: Sub-Grantees	Form and Instruction	Modified	CSBG Module 2
224195	CSBG Annual Report: Sub-Grantees	Form and Instruction	Modified	CSBG Module 1
224194	CSBG Annual Report: Grantees	Form and Instruction	Modified	CSBG Module 4
224194	CSBG Annual Report: Grantees	Form and Instruction	Modified	CSBG Annual Report Module 3
224194	CSBG Annual Report: Grantees	Form and Instruction	Modified	CSBG Module 2
224194	CSBG Annual Report: Grantees	Form and Instruction	Modified	CSBG Module 1

ICR Details

OMB Control No: 0970-0492	ICR Reference No: 202011-0970-005
Status: Historical Active	Previous ICR Reference No: 202001-0970-004
Agency/Subagency: HHS/ACF	Agency Tracking No: OCS
Title: Community Services Block Grant (CSBG) Annual Report
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Emergency	Approval Requested By: 11/19/2020
OIRA Conclusion Action: Approved without change	Conclusion Date: 11/23/2020
Retrieve Notice of Action (NOA)	Date Received in OIRA: 11/19/2020
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2021	6 Months From Approved	02/28/2023
Responses	2,187	0	1,061
Time Burden (Hours)	1,241,795	0	713,569
Cost Burden (Dollars)	0	0	0

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Abstract: The Office of Community Services designed the CSBG Annual Report to support a multi-level Performance Management Framework. The data provided in the CSBG Annual Report is used at the local, state, and national levels to improve performance and track results from year-to-year and to assure accountability for critical activities and outcomes at each level of the CSBG Network. ACF encourages the use of principals outlined in the Government Performance and Results (GPRA) and Modernization Act to use the data collected in the CSBG Annual Report for improvement to achieve breakthrough results for people with low-incomes and the communities in which they live. At the local eligible entity level, the information in the CSBG Annual Report supports agency efforts to set and measure progress on targets for individual, family, and community outcomes resulting from locally determined services and strategies to address locally-identified community needs. At the state level, the CSBG Annual Report supports oversight and technical assistance, and promotes accountability for critical state functions such as State Plan development, monitoring, grant administration, training and technical assistance, and state-level communications and linkages. At the federal level, receipt and review of CSBG Annual Reports will permit necessary oversight and accountability for CSBG grant funds and provide necessary information for the Secretary’s Accountability and Performance Requirements as outlined in Section 678E(b) of the CSBG Act. Combined with information from the CSBG State Plan and other information from federal monitoring and oversight, the Annual Reports from States will provide necessary information to report to Congress as required under Section 678E(b)(2) regarding: • how funds were actually spent by the state and eligible entities in the state, including a breakdown of funds spent on administrative costs and on the direct delivery of local services by eligible entities; • information on the number of entities eligible receiving CSBG funds, the number of low-income persons served, and necessary demographic data on the low-income populations served by eligible entities as is determined by the Secretary to be feasible; • a summary of each state’s performance results, and the results for the eligible entities, • other information necessary for grant administration, accountability, and transparency purposes consistent with the CSBG performance management framework; and • use of CSBG funds to provide training and technical assistance to eligible entities. The purposes and uses of information from the CARES Act and the Disaster Supplemental reports are consistent with the purposes and uses described above. The supplemental reports are modified versions of modules collected through the regular CSBG Annual Report. The supplemental reports collect substantially less information than the comparable modules in the regular annual report and only request information on services and outcomes supported by the supplemental funds.

Emergency Justfication: OCS received disaster appropriation and CARES Act supplemental money through the CSBG program in federal fiscal year (FFY) 2019 and FFY 2020, respectively. CSBG grantees are required to submit a report accounting of the expenditure of supplemental funds received by the state through these funding sources. OCS currently does not have reporting mechanisms in place for CSBG grantees to report on their use of these supplemental funds. The CSBG CARES and Disaster Supplemental Reports will allow all states and agencies to appropriately use funding, update their systems as needed, and collect the required data related to the CARES and Disaster Supplemental funding.

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Authorizing Statute(s): PL: Pub.L. 105 - 285 678E(a)(1)(A) and 678E(a)(2) Name of Law: CSBG Act
  

Citations for New Statutory Requirements: US Code: 42 USC 9902(2) Name of Law: Community Services Block Grant Program

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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:
	85 FR 73724	11/19/2020
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 6

table that charts list of burden

IC Title	Form No.	Form Name
CSBG Annual Report: Grantees	1, 2, 3, 4	CSBG Module 1 ,   CSBG Module 2 ,   CSBG Annual Report Module 3 ,   CSBG Module 4
CSBG Annual Report: Sub-Grantees	1, 2, 3, 4	CSBG Module 1 ,   CSBG Module 2 ,   CSBG Annual Report Module 3 ,   CSBG Module 4
CSBG CARES Annual Report: Grantees	1, 2, 4	CSBG CARES Supplemental Annual Report Module 1 ,   CSBG CARES Supplemental Annual Report Module 2 ,   CSBG CARES Supplemental Annual Report Module 4
CSBG CARES Annual Report: Sub-grantees	4, 1, 2	CSBG CARES Supplemental Annual Report Module 1 ,   CSBG CARES Supplemental Annual Report Module 2 ,   CSBG CARES Supplemental Annual Report Module 4
CSBG Disaster Annual Report: Grantees	1, 2, 4	CSBG Disaster Supplemental Annual Report Module 1 ,   CSBG Disaster Supplemental Annual Report Module 2 ,   CSBG Disaster Supplemental Annual Report Module 4
CSBG Disaster Annual Report: Sub-Grantees	1, 2, 4	CSBG Disaster Supplemental Annual Report Module 1 ,   CSBG Disaster Supplemental Annual Report Module 2 ,   CSBG Disaster Supplemental Annual Report Module 4

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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	2,187	1,061	1,126	0	0	0
Annual Time Burden (Hours)	1,241,795	713,569	528,226	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement: OCS received disaster appropriation and CARES Act supplemental money through the CSBG program in federal fiscal year (FFY) 2019 and FFY 2020, respectively. CSBG grantees are required to submit a report accounting of the expenditure of supplemental funds received by the state through these funding sources. OCS currently does not have reporting mechanisms in place for CSBG grantees to report on their use of these supplemental funds. This request is for the addition of CSBG CARES and Disaster Supplemental reports, which increases the burden estimates under this OMB number.

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Annual Cost to Federal Government: $413,723

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

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     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? Yes

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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: 11/19/2020

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