DEPARTMENT OF HEALTH AND HUMAN SERVICES
Administration on Aging
Circumstances Making the Collection of Information Necessary
AoA is requesting approval of Certification of Maintenance of Effort Information Collection, OMB number 0985-0009. Title III of the Older Americans Act, as amended, 42 USC 3029(c), requires that a State’s allotment for a given fiscal year be reduced by the percentage (if any) by which its expenditures from State sources are less than its average annual expenditures from such sources for the period of three consecutive fiscal years preceding such fiscal year. Since the information collected on the SF 269 report combines the funds from State and local sources, the Administration on Aging is unable to identify funds solely from State sources without the requested financial data.
Under Title III of the Older Americans Act, as amended, 42 USC 3027(a)(9) assurances are required from the State agency that they will carry out a State Long-Term Care Ombudsman Program and will expend for such purposes an amount that is not less than an amount expended by the State agency with funds received under Title III for fiscal year 2000. An additional assurance is established in Title VII of the Older Americans Act, as amended;
42 USC 3058d(a)(4) requires that the State will use funds made available in addition to, and will not supplant, any funds that are expended under Federal or State law.
Purpose and Use of the Information Collection
The information contained on the Certification of Maintenance of Effort form will be used by the Administration on Aging to verify the amount of State expenditures and make comparisons with the average annual expenditures for the period of three consecutive fiscal years preceding the given year to assure that a State is in compliance with 45 CFR 1321.49 and 42 USC 3027(a) and 42 USC 3058d.
Use of Improved Information Technology and Burden Reduction
The information may be submitted in electronic form.
Efforts to Identify Duplication and Use of Similar Information
No other data source collects this or similar information.
Impact on Small Business or Other Small Entities
This information does not impact small entities. It is collected from the 56 state agencies on aging.
Consequences of Collecting the Information Less Frequently
The information collection occurs on an annual basis in order to allow the Administration on Aging to ensure compliance with 42 USC 3029(c), 42 USC 3027(a), and USC 3058d of the Older Americans Act for each fiscal year.
There are no special circumstances related to this request.
The Federal Register Notice was published on Tuesday, March 29, 2011 (Vol. 76, No. 60). The Administration on Aging received the following comment in response:
“The forms are necessary for proper stewardship of public funds and to assure that states are complying with the requirements of the Older Americans Act. From a practical standpoint, the forms could be combined.”
“We are appreciative of the addition of the State Ombudsman signature and reference on the Certification form to the minimum funding requirements as footnoted.”
The comment was received from the National Association of State Long-Term Care Ombudsmen (NASOP) on May 27, 2011. AoA concurs with the comment received.
No payment provided.
Information provided, financial data regarding state expenditures, is not of a confidential nature.
This request does not involve questions of a sensitive nature.
Estimated Number of Respondents---------------------------56
Frequency of Response-----------------------------------------1 x annually
Estimated Annual Hour Burden-------------------------------28 hours (Annual hour burden derived from the following estimates: 56 respondents prepare 1 report a year; each report takes an average of 1/2 hour to complete; 56x1/2 hour = 28 hours).
Estimated Annual Costs for Respondents:
Per Respondent---------------------------------------------------$17
(based GS 13 Step 1 salary of $71,674 and an hourly rate of $34.45 x 28 hours = $965 for the 56 respondents or $17 per respondent)
Total for 56 Respondents--------------------------------------$965
There is no additional cost burden to respondents and record keepers.
Annualized Cost to Federal Government
Regional Office review of 56 reports -------------------------------------------28 hours
Grants Office Processing of reports ---------------------------------------------28 hours
TOTAL GOVERNMENT HOURS----------------------------------------------56 hours
GOVERNMENT SALARIES
GS-13-1, annual salary of $71,674 and an hourly rate of $34.45,
which equates to 28 hours x $34.45 -------------------------------------------------$965
GS-13-1, annual salary of $71,674 and an hourly rate of $34.45,
which equates to 28 hours x $34.45 ------------------------------------------------$965
TOTAL COST TO THE FEDERAL GOVERNMENT-------------------------------$1930
The MOE form for Ombudsman expenditures now requires the signature of the State Long-Term Care Ombudsman. This change is being made in order to improve the coordination and accuracy of the financial data submitted to the Administration on Aging. The burden hours and number of respondents remain the same.
This information collection is not published
The Administration on Aging has no reason not to display the expiration date of OMB approval for this collection of information.
There are no exceptions to the certification statement
I certify that the form submitted for approval is necessary for the proper performance of the agency’s functions; that the proposed data collection represents the minimum burden on respondents consistent with the need for information; that the information collected is not available from any other source; that the request complies with the requirements of the Freedom of Information Act and the Privacy Act of 1974, and is consistent with applicable OMB and agency policy directives.
__________________________________________ __________________
Dan Berger Date
Acting Director, Center for Management and Budget
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Title | Supporting Statement for Form OMB 83 |
| Author | gcase |
| File Modified | 0000-00-00 |
| File Created | 2021-02-01 |