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CSBG Model Plan Tribal FY 2015

Published: June 4, 2014
Audience:
Community Services Block Grants (CSBG)
Category:
Guidance, Policies, Procedures, Model Plan

Outline for Model Tribe/Tribal Organization CSBG Application

 

I. Federal Fiscal Year or Years Covered by this Tribal Plan and Application
Please specify the Federal fiscal year or years covered by this plan.
     FFY ____ only
     FFY ____ and FFY ____

II. Letter of Transmittal - Cover letter to the Director, Office of Community Services.  Include the Tribal CSBG Program Contact Person, the Tribal CSBG Official who is to receive the CSBG Grant Award with complete address, e-mail address, and telephone and fax numbers.  If there is a delegation of authority made by the CEO of the Tribe/Tribal Organization to certify the plan on their behalf, this information must be referenced.

III. Executive Summary
 

A. Public Inspection of Tribal Plan – Describe how the Tribe/Tribal Organization made available for public inspection and comment the current Tribal plan or revision to the Tribal plan.  Section 676(a)(2)(B) of the Act requires that the plan be made available for public inspection by members of the Tribe in such a manner as will facilitate review of, and comment on, the plan or revision.

B. Tribal Resolutions – A Tribal organization representing more than one Indian Tribe will be eligible to receive block grant funds on behalf of a particular Tribe only if the Tribe has by resolution authorized the organization’s action.  Attach copies of resolutions giving a Tribal organization authority to seek funding for specific Tribal organizations.

OMB Approval No. 0970-0382

Expiration Date:  08/31/2016

THE PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13)

Public reporting burden for this collection of information is estimated to average 10 hours per response, including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information.

An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number.

C. State or Federal Recognition – Include documentation verifying State or Federal recognition of the Tribe or Tribal organization covered by this plan.  The statement of the State’s chief executive office (Office of the Governor) verifying that a Tribe is recognized by that State will also be sufficient to verify State recognition for the purpose of direct funding.

IV. Statement of CSBG Assurances (which includes programmatic, administrative, financial and federal certifications)
As a part of the annual or biannual application and plan required by Section 676(b) of the Community Services Block Grant Act, as amended, (42 U.S.C. 9901 et seq.) (The Act), the CEO of the Tribe/Tribal Organization shall certify that the Tribe/Tribal Organization agrees to implement at least one of the programmatic assurances contained in Sections 676(b)(1)(A)-(C) of the Act – by signature at the end of this section.  Section V. requires detailed narrative descriptions of how the assurances will be carried out and how the organization will comply with the certifications.  (Tribes or Tribal Organizations are not required to comply with other sections or certifications of the Act other than those outlined here.)

A. Programmatic Assurances
 

(1) Funds made available through this grant or allotment will be used:

(a) to support activities that are designed to assist low-income families and individuals, including families and individuals receiving assistance under part A of title IV of the Social Security Act (42 U.S.C. 601 et seq.), homeless families and individuals, migrant or seasonal farmworkers, and elderly low-income individuals and families, and a description of how such activities will enable the families and individuals

(i) to remove obstacles and solve problems that block the achievement of self-sufficiency (including self-sufficiency for families and individuals who are attempting to transition off a State program carried out under part A of title IV of the Social Security Act);

(ii) to secure and retain meaningful employment;

(iii) to attain an adequate education, with particular attention towards improving literacy skills of the low-income families in the communities involved, which may include carrying out family literacy initiatives;

(iv) to make better use of available income;

(v) to obtain and maintain adequate housing and a suitable living environment;

(vi) obtain emergency assistance through loans, grants, or other means to meet immediate and urgent family and individual needs; and

(vii) to achieve greater participation in the affairs of the communities;

(3) To provide information containing –

(A) a description of the service delivery system;

(B) a description of how linkages will be developed to fill identified gaps in the services, through the provision of information, referrals, case management, and follow up consultations;

(C) a description of how funds made available through grants made under section 675C (a) will be coordinated with other public and private resources;

(D) a description of how the Tribe will use the funds to support innovative initiatives, which may include fatherhood initiatives and other initiatives with the goal of strengthening families and encouraging effective parenting. 676(b)(3)(A)-(D)

(4) To assure that the Tribe will provide, on an emergency basis, for the provision of such supplies and services, nutritious foods, and related services, as may be necessary to counteract conditions of starvation and malnutrition among low-income individuals. 676(b)(4)

(6) To assure that the Tribe will ensure coordination between antipoverty programs in each community within the Tribe, and ensure, where appropriate that emergency energy crisis intervention programs under title XXVI (relating to low-income home energy assistance) are conducted in such community. 676(b)(6)

(7) To assure that the Tribe will permit and cooperate with Federal investigations undertaken in accordance with section 678D. 676(b)(7)

(8) To assure that the Tribe will participate in the Results Oriented Management and Accountability System, another performance measure system for which the Secretary facilitated development pursuant to section 678E (b), or an alternative system for measuring performance and results that meets the requirements of that section, and a description of outcome measures to be used to measure performance in promoting self-sufficiency, family stability, and community revitalization. 676(b)(12)

B. Administrative and Financial Assurances
 

The Chief Executive Officer certifies that the Tribe/Tribal Organization further agrees to prohibit any activities to provide voters and perspective voters with transportation to the polls or provide similar assistance in connection with an election or any voter registration activity as required by Section 678F(b)(2)(B) and (C) of the Act.

To expend for administrative expenses an amount not to exceed the greater of five percent of its allotment or the percentage represented by the ratio of $55,000 to the smallest State allotment for the fiscal year as required by Section 675C(b)(2) of the Act.

At least annually, each Indian Tribe or Tribal Organization that receives $500,000 or more (during the fiscal year) in all types of Federal financial assistance must conduct an audit in accordance with the Single Audit Act, P.L. 98-502 (31 U.S.C. 75 and OMB Circular A-128) as required by Section 678D(a)(2)(B) of the Act.

The Chief Executive Officer certifies that the Tribe/Tribal Organization agrees to provide that fiscal control and fund accounting procedures will be established as may be necessary to assure the proper disbursal of and accounting for Federal funds paid to the Tribe or Tribal Organization under this subtitle, including monitoring the assistance under this subtitle as required by Section 678D(a)(1)(A) of the Act.

C. Other Administrative Certifications
The Tribe also certifies the following:

(1) To provide assurances that cost and accounting standards of the Office of Management and Budget shall apply to a recipient of Community Services Block Grant program funds as required by Section 678D(a)(1)(B). (OMB Circulars A-110 and A-122)

Signature (indicates the sign off of assurances in previous Section IV)

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Tribal Chairperson/CEO Signature      
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Print Name Date

V. The Narrative Section of the CSBG Tribal Plan ("How to Develop Plan" Instructions)
 

Provide the following information describing how the Tribe will carry out these assurances, as outlined below:

A. Tribal Administrative Structure
 

(a) Outline the mission and responsibilities to administer the Tribe’s Community Services Block Grant program.

(b) Outline the goals and objectives of the Tribal organization to administer the Community Services Block Grant program.

(c) Planned distribution of funds for the current fiscal year(s).

B. Description of Use of Administrative Funds
Describe and provide a breakdown of planned administrative expenses for the fiscal year or years covered by this plan.

C. Program Implementation - Describe the following:

(a) The Service Delivery System – a description of the service delivery system for services provided or coordinated with funds targeted to low-income individuals and families.  Include a description of the service areas, if applicable.

(b) Linkages – a description of how linkages will be developed to fill identified gaps in services, through the provision of information, referrals, case management, and follow up consultations.

(c) Coordination with Other Public and Private Resources – a description of how funds made available will be coordinated with other public and private resources.

(d) Innovative Community and Neighborhood-based Initiatives – a description of how funds will be used to support innovative community and neighborhood-based initiatives related to the purposes of the CSBG, which may include fatherhood initiatives and other initiatives with the goal of strengthening families and encouraging effective parenting.

D. Programmatic Assurances
 

Information describing how each of the implemented assurances from Section 676(b)(1)(A) – (C) will be carried out by the Tribe or Tribal organization.  Include a description of how these activities will enable families and individuals to achieve the objectives of the CSBG program.  If funds are used to address more than one programmatic assurance, do include a description of the activities.

Information describing how the Tribe or Tribal organization will carry out this assurance: To assure that the Tribe will provide, on an emergency basis, for the provision of such supplies and services, nutritious foods, and related services, as may be necessary to counteract conditions of starvation and malnutrition among low-income individuals. Assurance 676(b)(4)

Information describing how the Tribe or Tribal organization will carry out this assurance: To assure that the Tribe will ensure coordination between antipoverty programs in each community within the Tribe, and ensure, where appropriate that emergency energy crisis intervention programs under title XXVI (relating to low-income home energy assistance) are conducted in such community. Assurance 676(b)(6)

Information describing how the Tribe or Tribal organization will carry out this assurance: To assure that the Tribe will permit and cooperate with Federal investigations undertaken in accordance with section 678D. Assurance 676(b)(7)

Information describing how the Tribe or Tribal organization will carry out this assurance.  Include a description of outcome measures to be used to measure performance in promoting self-sufficiency, family stability and community revitalization: To assure that the Tribe will participate in the Results Oriented Management and Accountability System, another performance measure system for which the Secretary facilitated development pursuant to section 678E(b), or an alternative system for measuring performance and results that meets the requirements of that section, and a description of outcome measures to be used to measure performance in promoting self-sufficiency, family stability, and community revitalization.  Assurance 676(b)(12)

E. Fiscal Controls, Administrative, Financial Assurances and Certifications
 

• Information describing how the Tribe or Tribal organization will carry out these assurances:

o  Describe the Tribe or Tribal Organization’s plan for complying with the requirement to prohibit any activities to provide voters and perspective voters with transportation to the polls or  provide similar assistance in connection with an election or any voter registration activity;

o Describe the Tribe or Tribal Organization’s systems of fiscal controls, procedures, and plans for audits and inspections.  Specify the date of the last audit conducted and the period covered by the audit.

o Sign and include the required certifications regarding Anti-Lobbying, Drug Abuse, Debarment and Suspension and the Environmental Tobacco Smoke, also known as the Pro-Children Act of 1994, P.L. 103-227

F. Annual Report
 

Provide a narrative description of how the Tribe met its CSBG goals and objectives and information on the types of projects supported with CSBG funds for the prior year.  Include information on accomplishments of projects and activities relating to the required assurances supported with CSBG funds received for the prior year.  Include outcome data that addresses the implementation of the stated national goals of the CSBG for the prior year’s funding.  Provide a description of information on the use and distribution of the prior year’s CSBG funding.

The stated national goals are:
Goal 1 – Low-income people become more self-sufficient (self-sufficiency).
Goal 2 - The conditions in which low-income people live are improved (community revitalization).
Goal 3 – Low-income people own a stake in their community.
Goal 4 – Partnerships among supporters and providers of services to low-income people are achieved.
Goal 5 – Agencies increase their capacity to achieve results.
Goal 6 – Low-income people, especially vulnerable populations, achieve their potential by strengthening family and other supportive systems. (family stability)

VI. Appendices
 

A. Additional Data or Information (as needed)