Senior Community Service Employment Program (SCSEP)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form ETA 9124A Participant Survey	Form	New	Available
Form ETA 9124A Participant Customer Satisfaction – ETA-9124A	Form	New	Repair queued
Form ETA 5140 SCSEP Quarterly Progress Report	Form and Instruction	Removed	Available
Form ETA 9191 GPMS Data Collection Instrument	Form and Instruction	Removed	Available
Form ETA 9120, ETA 9121 SPARQ Data Collection Forms	Form and Instruction	Removed	Available
Form ETA 9120, ETA 9121 ETA 5140 and ETA 9191	Form and Instruction	Removed	Repair queued
Form ETA 8705B Equitable Distribution Report	Form	Removed	Repair queued
Form ETA 8705B Grantee Equitable Distribution Report	Form	Removed	Repair queued
Form ETA 9124C2 Employer Survey	Form	Modified	Available
Form ETA 9124C2 Employer Customer Satisfaction – ETA-9124C2	Form	Modified	Repair queued
Form ETA 9124C2 Employer Survey	Form	Modified	Repair queued
Form ETA 9124C2 Non-Host Agency Employer Survey Pilot Project -- ETA-9124C2	Form	Modified	Repair queued
Form ETA 9124A Participant Survey	Form	Modified	Available
Form ETA 9124B Host Agency Survey	Form	Modified	Available
Form ETA 9124B Host Agency Customer Satisfaction – ETA-9124B	Form	Modified	Repair queued
Form ETA 9124C1 Employer Survey	Form and Instruction	Modified	Available
Form ETA 9124C1 Employer Customer Satisfaction – ETA-9124C1	Form and Instruction	Modified	Repair queued
SCSEP CSS 1205-0040 Supporting Statement Part B_ clean.docx	Supporting Statement B	Uploaded 2024-03-13	Repair queued
signed_PRA Signature Form_SCSEP_(2024_0206).pdf	Supplementary Document	Uploaded 2024-03-13	Repair queued
Additional Context for ICR Changes 10.18.21.docx	Supplementary Document	Uploaded 2021-10-18	Repair queued
signed_PRA Signature Form_SCSEP_(2021_1001).pdf	Supplementary Document	Uploaded 2021-10-04	Repair queued
1205-0040 Supporting Statement - clean.docx	Supporting Statement A	Uploaded 2024-03-14	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
264386	Participant Customer Satisfaction – ETA-9124A	Form	New	Participant Survey
264386	Participant Customer Satisfaction – ETA-9124A	Form	New
249068	ETA 5140 and ETA 9191	Form and Instruction	Removed	SCSEP Quarterly Progress Report
249068	ETA 5140 and ETA 9191	Form and Instruction	Removed	GPMS Data Collection Instrument
249068	ETA 5140 and ETA 9191	Form and Instruction	Removed	SPARQ Data Collection Forms
249068	ETA 5140 and ETA 9191	Form and Instruction	Removed
232731	Grantee Equitable Distribution Report	Form	Removed	Equitable Distribution Report
232731	Grantee Equitable Distribution Report	Form	Removed
232730	Employer Customer Satisfaction – ETA-9124C2	Form	Modified	Employer Survey
232730	Employer Customer Satisfaction – ETA-9124C2	Form	Modified
232726	Non-Host Agency Employer Survey Pilot Project -- ETA-9124C2	Form	Modified	Employer Survey
232726	Non-Host Agency Employer Survey Pilot Project -- ETA-9124C2	Form	Modified
215838	Participant Survey Pilot Project -- ETA-9124A	Form	Modified	Participant Survey
215838	Participant Survey Pilot Project -- ETA-9124A	Instruction	Modified
185407	Host Agency Customer Satisfaction – ETA-9124B	Form	Modified	Host Agency Survey
185407	Host Agency Customer Satisfaction – ETA-9124B	Form	Modified
180160	Employer Customer Satisfaction – ETA-9124C1	Form and Instruction	Modified	Employer Survey
180160	Employer Customer Satisfaction – ETA-9124C1	Form and Instruction	Modified

ICR Details

OMB Control No: 1205-0040	ICR Reference No: 202401-1205-001
Status: Historical Active	Previous ICR Reference No: 202108-1205-007
Agency/Subagency: DOL/ETA	Agency Tracking No:
Title: Senior Community Service Employment Program (SCSEP)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 07/29/2024
Retrieve Notice of Action (NOA)	Date Received in OIRA: 04/18/2024
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2027	36 Months From Approved	11/30/2024
Responses	18,832	0	70,408
Time Burden (Hours)	2,786	0	157,921
Cost Burden (Dollars)	0	0	0

---

Abstract: The Senior Community Service Employment Program (SCSEP), is a community service and work-based training program for older workers. The program provides subsidized, work-experience training for low-income persons 55 or older who are unemployed and have poor employment prospects. SCSEP national grants are awarded through a competitive process; state and territorial grants are awarded through a formula outlined in the OAA-2016 Section 506 (b-c). The dual goals of the program are to promote useful community service employment activities and to move SCSEP participants into unsubsidized employment, so that they can achieve economic self-sufficiency. The Department is required to collect the information in order to comply with the OAA statutory and regulatory requirements. The information is also necessary for grantee performance accountability and program management.

---

Authorizing Statute(s): PL: Pub.L. 114 - 144 500-518 Name of Law: Older Americans Act Reauthorization Act of 2016
  

Citations for New Statutory Requirements: PL: Pub.L. 116 - 131 401 Name of Law: Supporting Older Americans Act of 2020

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 51858	08/04/2023
30-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 27802	04/18/2024
Did the Agency receive public comments on this ICR? Yes

---

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

table that charts list of burden

IC Title	Form No.	Form Name
ETA 5140 and ETA 9191	ETA 9120, ETA 9121, ETA 9022, ETA 9123, ETA 9191, ETA 5140	SPARQ Data Collection Forms ,   GPMS Data Collection Instrument ,   SCSEP Quarterly Progress Report
Employer Customer Satisfaction – ETA-9124C1	ETA 9124C1	Employer Survey
Employer Customer Satisfaction – ETA-9124C2	ETA 9124C2	Employer Survey
Grantee Equitable Distribution Report	ETA 8705B	Equitable Distribution Report
Host Agency Customer Satisfaction – ETA-9124B	ETA 9124B	Host Agency Survey
Non-Host Agency Employer Survey Pilot Project -- ETA-9124C2	ETA 9124C2	Employer Survey
Participant Customer Satisfaction – ETA-9124A	ETA 9124A	Participant Survey
Participant Survey Pilot Project -- ETA-9124A	ETA 9124A	Participant Survey

---

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	18,832	70,408	0	-651	-50,925	0
Annual Time Burden (Hours)	2,786	157,921	0	-2,360	-152,775	0
Annual Cost Burden (Dollars)	0	0	0	0	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: Yes

Burden Reduction Due to: Changing Forms

Short Statement: SCSEP grantees are required by the OAA to pay the minimum wage within the state or locality where their authorized positions are awarded. The applicable minimum wage determines how many participants the grantees can enroll. Increasing minimum wages at the state and local level have resulted in fewer modified positions each year, which, in turn, means fewer host agencies and employers each year. As a result, the number of potential respondents for each of the surveys has declined. The revision of the employer survey will increase the number of respondents by adding host agency employers and non-host agency employers that did not receive a substantial service, neither group having been surveyed previously. Non-host agency employers that did receive a substantial service have always been surveyed. Their numbers have decreased for the reasons described above. The timeline in this proposal has been adjusted to conform with the approval process in real time; grammatical changes were made to adjust to language to present tense and data has changed based on status of program to date.

---

Annual Cost to Federal Government: $0

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

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.     Yes

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? No

---

Common Form ICR:  No

---

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: 04/18/2024

---