Appendix B to Part 96 - SSBG Reporting Form and Instructions
45:1.0.1.1.55.14.57.1.34 : Appendix B
Appendix B to Part 96 - SSBG Reporting Form and Instructions
Instructions
This form must be used by states as the reporting instrument to
satisfy the requirements of 45 CFR 96.74(a) (1) through (4).
Following are instructions on how to complete the form:
General
1. Enter the name of the state submitting the form.
2. Enter the fiscal year for which the form is being submitted.
Either the state or federal fiscal year may be used.
3. Enter the month and year of the beginning and end of the
fiscal year - e.g., 07/91 to 06/92.
Services
4. The “service” column contains a list of services that are to
be used for national reporting. This list in no way mandates how a
state is to design its program of services under the SSBG, but
rather is to be used only to obtain nationally comparable
statistics. If the services that your state provides reasonably fit
the uniform service definitions in appendix A, use them. In cases
where no fit is possible between the state services and the
services on the form, use item number 29 - the other services
category. Please list all services reported under item 29, using a
separate sheet if necessary. The state's definition of these
services must appear in the state's annual report.
Recipient Data
In reporting the following data:
• Each state should use its own definitions of the terms “adult”
and “child.” These definitions should be described elsewhere in the
annual report. If the definitions of adult and child vary by
services, all such definitions must be included.
• States should, if possible, consider as the “recipient” of the
service the individual to whom the service is provided. This means
that the child would be considered the recipient of child day care
services, even if such services are provided to allow the child's
adult caretaker to pursue employment. Similarly, an adult who
receives counseling services should be considered as the recipient
of that service, even if the service is provided as part of a
child's protective services plan. In cases where each member of a
family, for example, receives an individual service such as
counseling, each family member should be considered as a separate
recipient.
• States should, if possible, consider as a service, i.e., a
count of one, any service provided to a single recipient for the
duration of the reporting period (one year), or any fraction
thereof. In cases where an individual received a service during the
reporting period, then discontinued the service, and then received
the service again, the individual should only be counted once, if
possible.
• The criteria applied in determining eligibility for each
service - such as income eligibility guidelines, sliding fee
scales, the effect of public assistance benefits, and any
requirements for enrollment in school or training programs - should
be described elsewhere in the annual report.
5. Under “Number of Recipients - Adults” enter the number of
adults who have received each service funded in whole or part under
the SSBG.
6. Under “Number of Recipients - Children” enter the number of
children who have received each service funded in whole or part
under the SSBG.
7. Under “Number of Recipients - Total” enter the total number
of recipients of each service. This should be the sum of the adults
and children reported in the preceding “adult” and “children”
columns.
Expenditure Data
8. Under “Expenditures - Total $” enter all funds that the state
expends on each service. This should include SSBG funds as well as
funds from other federal sources, state funds, and local funds. A
listing of the sources of these funds, and the amounts allocated,
should appear elsewhere in the annual report.
9. Under “Expenditures - SSBG $” enter the total SSBG funds
expended for each service. This column should be totaled, and the
sum placed at the bottom of the column in the “Totals” box.
10. Under “Expenditures - Per Adult” enter the average amount of
SSBG funds expended on each adult recipient of each service.
11. Under “Expenditures - Per Child” enter the average amount of
SSBG funds expended on each child recipient of each service.
12. Item 30 in the “Total SSBG $” column should contain other
expenditures and income as follows:
a. “Transfers In” should contain funds transferred from other
federal block grants to the SSBG program. A listing of the
source(s) of block grant funds and their amounts should appear
elsewhere in the annual report.
b. “Transfers Out” should show funds transferred from the SSBG
program to other federal block grants. A listing of the program(s)
to which SSBG funds were transferred, and the amounts, should
appear elsewhere in the annual report.
c. “Carry Forward” should show funds the state intends to carry
over from the reporting fiscal year to the following fiscal year.
The SSBG statute permits states two years to expend SSBG funds.
d. “Carry Over” should show funds carried from a previous fiscal
year into the current reporting year.
e. “Administrative Costs” should show all other non-service use
of SSBG funds - e.g., funds expended for training, licensing
activities, or overhead costs.
f. This column should be totaled, and the sum placed at the
bottom of the column in the “Totals” box.
13. Under “Provisions Method - Public/Private” enter a check
mark on “X” in the appropriate column(s) to indicate whether a
service was provided by public agencies or private agencies. In
some cases, a given service may have been provided by both methods,
in which case both columns would be checked for that service.
14. Enter the name, title, and telephone number of a contact
person who can answer questions about the data.
15. Code Column:
Six of the columns on this form have a “C” column to the right
of them. These are “Code” columns to permit a state to indicate,
for expenditure data, whether each cell of data is A (actual), E
(estimated), or S (sampled), and for recipient data, whether the
data is based on an unduplicated (U) or duplicated (D) count of
recipients. These codes will permit the Department to determine the
relative degree of statistical validity of the data. Actual
recipient counts and expenditure amounts must be used when
available. If actual counts are not available, sampling and/or
estimating may be used to derive the numbers in this report. A
description of the sampling and/or estimation methods used to
derive any data must appear elsewhere in the annual report.
Report Submission Using PC Diskettes
States with personal computer (PC) equipment may submit this
data using PC diskettes in addition to the hardcopy form which will
be included in the complete annual report. Diskettes may be either
5 1/4″ or 3 1/2″; data may be submitted using Lotus 1-2-3, Quattro
Pro, DBase III or IV, Wordstar, Word Perfect, or ASCII formats. Use
of Lotus 1-2-3 is preferred, but any of the other formats listed
may be used. If a state wishes to use a format other than one
listed here, please call Bryant Tudor on (202) 401-5535 or Frank
Burns on (202) 401-5536, or write to the Office of Community
Services, Administration for Children and Families, Fourth Floor -
East Wing, 370 L'Enfant Promenade, SW., Washington, DC 10447. Use
of diskettes can greatly reduce transcription errors and also
facilitate processing of the data once received. We anticipate that
many states will want to avail themselves of this method of
reporting.
[58 FR
60128, Nov. 15, 1993]