Crisis Counseling Assistance and Training Program

Forms and Documents

Document Name	Status
Form HHS-5161-1 HHS Checklist Form	Unchanged
Project / Performance Site Location(s) Form Form	Unchanged
Form Standard Form 425 Federal Financial Report, SF-425 Form and Instruction	Unchanged
Form Standard Form 424A Budget Information - Non-Construction Programs, SF-424A Form	Unchanged
Form Standard Form 424 Application for Federal Assistance, SF-424 Form	Unchanged
Form FEMA Form 00-3-0-1 Crisis Counseling Assistance and Training Program, Immediate Services Program Application Form	Unchanged
Form FEMA Form 003-0-2 Crisis Counseling Assistance and Training Program, Regular Services Program Application Form	Unchanged
Privacy Notice FEMA - 1660-0085 FF 003-0-1.docx Supplementary Document	2019-02-14
30 Day FRN.pdf Supplementary Document	2019-02-14
6 0Day FRN Published.pdf Supplementary Document	2019-02-14
Forms Revision Chart - (RSP) FEMA Form 003-0-2, 1660-0085 - May 2014.doc Supplementary Document	2014-08-26
Forms Revision Chart for ISP (FEMA Form 003-0-1) - 1660-0085 - May 2014.doc Supplementary Document	2014-08-26
Supporting Statement 1660-0085 FINAL.docx Supporting Statement A	2019-02-14
Stafford Act Booklet 042213.pdf Supplementary Document	2014-08-04
Published 30 Day FRN for OMB Collection 1660-0085, 8-26-2014.pdf Supplementary Document	2014-08-26
Published 60 Day FRN for OMB Collection 1660-0085, 6-13-2014.pdf Supplementary Document	2014-08-05
CCPQuarterlyandFinalReportFormat used for ISP and RSP Programs.doc Supplementary Document	2014-08-05
SORN, Federal Register, Volume 77 Issue 141 (Monday, July 23, 2012).mht Supplementary Document	2014-07-29
PIA, Grants Management Programs 071409.pdf Supplementary Document	2013-02-05
PTA, FEMA - Crisis Counseling Assistance and Training Program 1660-0085, 20140512, PRIV FINAL.pdf Supplementary Document	2014-08-04
Narrative of Changes for OMB Collection 1660-0085.docx Supplementary Document	2014-07-29
CCP_Program_Guidance - Application Toolkit_4.0pdf.pdf Supplementary Document	2014-06-26
44 CFR 206-171.pdf Supplementary Document	2014-08-04
42 USC 5183.pdf Supplementary Document	2014-06-26

IC Document Collections

IC ID	Document Title	Status
46384	Final Report Narrative (Immediate Services Program)	Unchanged
212214	HHS Checklist Form	Unchanged
212213	Project / Performance Site Location(s) Form Form	Unchanged
212209	Federal Financial Report, SF-425 Form and Instruction	Unchanged
212206	Budget Information - Non-Construction Programs, SF-424A Form	Unchanged
212204	Application for Federal Assistance, SF-424 Form	Unchanged
21184	Crisis Counseling Assistance and Training Program, Immediate Services Program Application Form	Unchanged
205477	Final Report Narrative (Regular Services Program)	Unchanged
205476	Quarterly Report Narrative (Regular Services Program)	Unchanged
205468	Crisis Counseling Assistance and Training Program, Regular Services Program Application Form	Unchanged

ICR Details

OMB Control No: 1660-0085	ICR Reference No: 201801-1660-004
Status: Active	Previous ICR Reference No: 201406-1660-001
Agency/Subagency: DHS/FEMA	Agency Tracking No:
Title: Crisis Counseling Assistance and Training Program
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 11/04/2019
	Date Received in OIRA: 03/31/2018
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2022	36 Months From Approved	11/30/2018
Responses	165	0	165
Time Burden (Hours)	1,515	0	1,515
Cost Burden (Dollars)	0	0	0

---

Abstract: Respondents (States and Territories) can apply to FEMA for financial assistance for counseling services after a federally declared disaster. The respondents provide information to demonstrate a need for supplemental financial assistance to relieve mental health problems caused by or aggravated by a major disaster or its aftermath.

---

Authorizing Statute(s): PL: Pub.L. 93 - 288 416 Name of Law: Robert T. Stafford Disaster Relief and Emergency Assistance 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:
	83 FR 4234	01/30/2018
30-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 14021	04/02/2018
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 10

IC Title	Form No.	Form Name
Federal Financial Report, SF-425	Standard Form 425	Federal Financial Report
HHS Checklist	HHS-5161-1	Checklist
Final Report Narrative (Regular Services Program)
Crisis Counseling Assistance and Training Program, Immediate Services Program Application	FEMA Form 00-3-0-1	Application for Counseling Program Service (Immediate Services Program)
Final Report Narrative (Immediate Services Program)
Application for Federal Assistance, SF-424	Standard Form 424	Application for Federal Assistance
Budget Information - Non-Construction Programs, SF-424A	Standard Form 424A	Budget Information - Non-Construction Programs
Project / Performance Site Location(s) Form	None	Project / Performance Site Location(s)
Quarterly Report Narrative (Regular Services Program)
Crisis Counseling Assistance and Training Program, Regular Services Program Application	FEMA Form 003-0-2	Application for Crisis Counseling Program Services (Regular Services Program)

---

ICR Summary 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	165	165	0	0	0	0
Annual Time Burden (Hours)	1,515	1,515	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	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: $107,717

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.     No

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? Uncollected

---

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: 03/31/2018

---