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OMB Control No: 0970-0382	ICR Reference No: 202302-0970-006
Status: Historical Active	Previous ICR Reference No: 202105-0970-018
Agency/Subagency: HHS/ACF	Agency Tracking No: OCS
Title: Community Services Block Grant (CSBG) Program Model Plan Applications
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 02/27/2023
	Date Received in OIRA: 02/23/2023
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2024	08/31/2024	08/31/2024
Responses	448	0	448
Time Burden (Hours)	1,959	0	1,959
Cost Burden (Dollars)	0	0	0

Abstract: CSBG grantees (states and territories) develop and submit the data in the CSBG State Plan to the OCS Division of Community Assistance (DCA). DCA reviews the CSBG State Plans to determine whether grantees have submitted a complete application to qualify for federal funds in compliance with the CSBG Act. OCS administers the ACSI biennially to CSBG subgrantees (eligible entities) to seek feedback and better understand performance in several areas related to the CSBG grantees administration of CSBG. The results of this survey provide data to the state that can be used in developing future CSBG State Plans and in guiding improvement efforts. The next time OCS will administer this survey is 2023 and participation in the survey is voluntary. This current request includes proposed revisions to the CSBG State Plan to further clarify the current questions; OCS added three additional questions to seek additional information based on congressional inquiries in the recent years – including how CSBG grantees distribute funds and policies that CSBG grantees have in place for monitoring CSBG subgrantees (known as CSBG eligible entities). The revised and automated CSBG State Plan streamlines both the state development and the federal review of the information. In addition, with the revised and automated plan, state and federal staff will interact with and use the data to improve performance and track results from year-to-year. This data collection also includes the collection of the CSBG Eligible Entity Master List. The CSBG Eligible Entity Master List interacts with the CSBG State Plan to ensure that eligible entities are correctly identified across all forms. Proposed revisions to the Master List include requesting information about the executive director and a website address (if applicable) for each agency listed. There are no proposed revisions to the ACSI.

Authorizing Statute(s): US Code: 42 USC 9908 Name of Law: Community Service Block Grant (CSBG) Act

Citations for New Statutory Requirements: None

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:
	86 FR 22057	04/26/2021
30-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 34018	06/28/2021
Did the Agency receive public comments on this ICR? No

Number of Information Collection (IC) in this ICR: 3

IC Title	Form No.	Form Name
CSBG ACSI Survey of Eligible Entities	1
CSBG Eligible Entity Master List	1
CSBG State Plan Application for States	1, 1 (2018-2021)	,

ICR Summary of Burden

	Total Approved	Previously Approved
Annual Number of Responses	448	448
Annual Time Burden (Hours)	1,959	1,959
Annual Cost Burden (Dollars)	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:

Annual Cost to Federal Government: $17,544

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. 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

Agency Contact: Molly Buck 202 205-4724 mary.buck@acf.hhs.gov

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