CAN ALERT_4-4-16 REVISIONS_CSA.PDF

Maricopa County — Formal (2016-06-08)

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DEPARTMENT OF ECONOMIC SECURITY
Douglas A. Ducey Your Partner For A Stronger Arizona Timothy Jeffries
Governor Director
April 4, 2016
To: Community Action Network
Arizona Department of Housing
From: Lynn Larson, Assistant Director
Division of Aging and Adult Services
Subject SFY 2017 Revised Allocation, LIHEAP Income Chart, CSBG State Plan
Draft
The following ALERT is attached:
ALERT FUND SOURCE/TYPE
ALERT SFY-17-H1 CenturyLink Revised Allocation
ALERT SFY-17-K1 Simplified LIHEAP Income Chart - Corrected
ALERT SFY-17-L CSBG State Plan - Draft
The ALERTS are subject to change as additional information is received by the DAAS
pertaining to the funding sources identified. ALERTS are available on the DAAS Website
using the link: https://vvww.azdes.00vidaas/alerts . Scroll down to ALERTS at the bottom of
the Webpage and select the respective ALERT. Community Action Programs and Services
https://www.azdes.govidaas/policy.
Should you have any questions regarding the attached ALERTS, please contact your
assigned Contract Specialist.
cc: Lynn Larson, Jane Harrison, Tammy Frazee, George Robles, Diana Gravett, Nina Sutton,
Bridget Casey, Camille Kowal, Matt LeCrone, Cynthia Jennings, Rose Larsen, Rebecca
Clayton, Jason Bernbaum, Ethan Gaye, John Sours, Alyssa Tattrie, and DAAS file
1789 W. Jefferson, S/C 950A, Phoenix, AZ 85007 • P.O. Box 6123, Phoenix, AZ 85005
Telephone (602) 5424446 • Fax (602) 542-6655 • www.des.az.gov

Division of Aging and Adult Services
ALERT
SFY-17-H1
CenturyLink
Telephone Discount Programs (TDP)
for SFY 2017
Due to a decline in the use of landlines, fewer persons are signing up for the Telephone Discount
Programs (TDP). As a result, CenturyLink has determined it is best for them to administer TDP
directly.
As of April 18, 2016, persons interested in Lifeline applications should be referred to CenturyLink’s
Website at http://www.centurylink.com/LifeLine or (888) 833-9522. Department of Economic Security
(DES)/ Department of Adult and Aging Services (DAAS) TDP Customer Service representatives will
continue to process TDP applications through April 29, 2016. As of May 2, 2016, all callers and
paperwork received at DES/DAAS will be forwarded to CenturyLink for processing.
All programs will continue as usual with CenturyLink. CenturyLink has made a filing with the Arizona
Corporation Commission (ACC) to grandfather in the clients of the Telephone Assistance Program
(TAP) for the Medically Needy. If the ACC approves the filing, new applications for TAP will not be
accepted after April 1, 2017. CenturyLink will continue providing Medically Needy benefits
indefinitely for those who are enrolled in the program prior to April 1, 2017.
CenturyLink’s contract with DAAS will end June 30, 2016. Therefore, TDP funds for State Fiscal
Year (SFY) 2017 will not be available.
If you have any questions, please contact your assigned Contract Specialist.

COMMUNITY ACTION NETWORK FORMULA
INITIAL SFY 2017 ALLOCATIONS (Includes Hold Harmless >8%)
CSBG CSBG LIHEAP SFY 2017
CSBG Discretionary Carryover LIHEAP Re-distributed TANF SSBG CENTURYLINK NHN ALLOCATION
ACAA $ - $ 155,000 $ - $ 25,000 $ - $ - $ - $ - $ - $ 180,000
CAHRA $ 272,403 $ - $ - $ 994,866 $ - $ 205,170 $ 16,096 $ 5,972 $ 2,090 $ 1,496,597
City of Glendale $ 190,479 $ - $ - $ 695,736 $ - $ 150,000 $ 77,890 $ 4,178 $ 1,462 $ 1,119,745
City of Phoenix $ 1,286,962 $ - $ - $ 4,704,235 $ - $ 994,098 $ 574,714 $ 28,244 $ 9,885 $ 7,598,138
Coconino County $ 150,000 $ - $ - $ 359,108 $ - $ 150,000 $ 18,305 $ 2,155 $ 756 $ 680,324
Arizona Dept. of Housing $ - $ - $ - $ 2,936,124 $ - $ - $ - $ - $ - $ 2,936,124
Gila County $ 150,000 $ - $ - $ 139,802 $ - $ 150,000 $ 8,048 $ 840 $ 295 $ 448,985
Maricopa County $ 811,075 $ - $ - $ 2,963,226 $ - $ 588,117 $ 316,323 $ 17,792 $ 6,227 $ 4,702,760
MesaCAN $ 294,411 $ - $ - $ 1,075,201 $ - $ 222,564 $ 116,279 $ 6,456 $ 2,256 $ 1,717,167
NACOG $ 235,376 $ - $ - $ 860,483 $ - $ 178,054 $ 66,581 $ 5,166 $ 1,809 $ 1,347,469
Pima County $ 692,289 $ - $ - $ 794,470 $ - $ 528,413 $ - $ 15,201 $ 1,669 $ 2,032,042
PPEP $ 97,190 $ - $ - $ - $ - $ 74,480 $ - $ - $ - $ 171,670
SEACAP $ 208,297 $ - $ - $ 719,584 $ - $ 157,948 $ - $ 4,322 $ 1,511 $ 1,091,662
Tohono O'odham $ - $ - $ - $ 62,572 $ - $ - $ - $ - $ - $ 62,572
Tucson Urban League $ - $ - $ - $ 1,737,303 $ - $ - $ - $ - $ 3,651 $ 1,740,954
WACOG $ 471,007 $ - $ - $ 1,610,905 $ - $ 325,156 $ - $ 9,674 $ 3,389 $ 2,420,131
Totals $ 4,859,489 $ 155,000 $ - $ 19,678,615 $ - $ 3,724,000 $ 1,194,236 $ 100,000 $ 35,000 $ 29,746,339
Notes:
1. SSBG Funds are Locally Planned, only.
2. $25,000 LIHEAP funding for ACAA is for Leveraging activities.
Bolded numbers represent changes in funding.

COMMUNITY ACTION NETWORK FORMULA
REVISED SFY 2017 ALLOCATIONS
CSBG CSBG LIHEAP SFY 2016
CSBG Discretionary Carryover LIHEAP Re-distributed TANF SSBG CENTURYLINK NHN ALLOCATION
ACAA $ - $ 155,000 $ - $ 25,000 $ - $ - $ - $ - $ - $ 180,000
CAHRA $ 253,061 $ - $ - $ 833,932 $ - $ 183,081 $ 16,096 $ - $ 1,803 $ 1,287,973
City of Glendale $ 179,014 $ - $ - $ 632,382 $ - $ 150,000 $ 77,890 $ - $ 1,373 $ 1,040,659
City of Phoenix $ 1,303,378 $ - $ - $ 4,592,333 $ - $ 1,012,131 $ 574,714 $ - $ 9,999 $ 7,492,555
Coconino County $ 150,000 $ - $ - $ 373,760 $ - $ 150,000 $ 18,305 $ - $ 762 $ 692,827
Arizona Dept. of Housing $ - $ - $ - $ 3,016,480 $ - $ - $ - $ - $ - $ 3,016,480
Gila County $ 150,000 $ - $ - $ 148,509 $ - $ 150,000 $ 8,048 $ - $ 316 $ 456,873
Maricopa County $ 783,483 $ - $ - $ 2,714,544 $ - $ 557,179 $ 316,323 $ - $ 5,897 $ 4,377,426
MesaCAN $ 272,196 $ - $ - $ 960,541 $ - $ 204,778 $ 116,279 $ - $ 2,086 $ 1,555,880
NACOG $ 253,027 $ - $ - $ 898,476 $ - $ 180,645 $ 66,581 $ - $ 1,830 $ 1,400,559
Pima County $ 742,974 $ - $ - $ 791,791 $ - $ 557,179 $ - $ - $ 1,703 $ 2,093,647
PPEP $ 98,001 $ - $ - $ - $ - $ 74,480 $ - $ - $ - $ 172,481
SEACAP $ 217,846 $ - $ - $ 771,552 $ - $ 165,896 $ - $ - $ 1,684 $ 1,156,978
Tohono O'odham $ - $ - $ - $ 64,972 $ - $ - $ - $ - $ - $ 64,972
Tucson Urban League $ - $ - $ - $ 1,765,724 $ - $ - $ - $ - $ 3,842 $ 1,769,566
WACOG $ 497,080 $ - $ - $ 1,709,288 $ - $ 338,631 $ - $ - $ 3,705 $ 2,548,704
Totals $ 4,900,060 $ 155,000 $ - $ 19,299,284 $ - $ 3,724,000 $ 1,194,236 $ - $ 35,000 $ 29,307,580
Note:
1. SSBG Funds are Locally Planned, only.
2. $25,000 LIHEAP funding for ACAA is for Leveraging activities.
Bolded numbers represent changes in funding.

NET INCREASES/(DECREASES)
CSBG CSBG LIHEAP SFY 2017
CSBG Discretionary Carryover LIHEAP Re-distributed TANF SSBG CENTURYLINK NHN ALLOCATION
ACAA $ - $ - $ - $ - $ - $ - $ - $ - $ - $ -
CAHRA $ 19,342 $ - $ - $ 160,934 $ - $ 22,089 $ - $ (5,972) $ 287 $ 196,680
City of Glendale $ 11,465 $ - $ - $ 63,354 $ - $ - $ - $ (4,178) $ 89 $ 70,730
City of Phoenix $ (16,416) $ - $ - $ 111,902 $ - $ (18,032) $ - $ (28,244) $ (114) $ 49,096
Coconino County $ - $ - $ - $ (14,652) $ - $ - $ - $ (2,155) $ (6) $ (16,813)
Arizona Dept. of Housing $ - $ - $ - $ (80,356) $ - $ - $ - $ - $ - $ (80,356)
Gila County $ - $ - $ - $ (8,707) $ - $ - $ - $ (840) $ (21) $ (9,568)
Maricopa County $ 27,592 $ - $ - $ 248,682 $ - $ 30,938 $ - $ (17,792) $ 330 $ 289,750
MesaCAN $ 22,215 $ - $ - $ 114,660 $ - $ 17,786 $ - $ (6,456) $ 170 $ 148,375
NACOG $ (17,651) $ - $ - $ (37,993) $ - $ (2,591) $ - $ (5,166) $ (21) $ (63,422)
Pima County $ (50,685) $ - $ - $ 2,679 $ - $ (28,766) $ - $ (15,201) $ (34) $ (92,007)
PPEP $ (811) $ - $ - $ - $ - $ - $ - $ - $ - $ (811)
SEACAP $ (9,549) $ - $ - $ (51,968) $ - $ (7,948) $ - $ (4,322) $ (173) $ (73,960)
Tohono O'odham $ - $ - $ - $ (2,400) $ - $ - $ - $ - $ - $ (2,400)
Tucson Urban League $ - $ - $ - $ (28,421) $ - $ - $ - $ - $ (191) $ (28,612)
WACOG $ (26,073) $ - $ - $ (98,383) $ - $ (13,476) $ - $ (9,674) $ (316) $ (147,922)
Totals $ (40,571) $ - $ - $ 379,331 $ - $ 0 $ - $ (100,000) $ - $ 238,760
Bolded numbers represent changes in funding.

% INCREASES/(DECREASES)
CSBG CSBG LIHEAP SFY 2017
CSBG Discretionary Carryover LIHEAP Re-distributed TANF SSBG CENTURYLINK NHN ALLOCATION
ACAA 0% 0% 0% 0% 0% 0% 0% 0% 0% 0%
CAHRA 7% 0% 0% 16% 0% 11% 0% 100% 14% 14%
City of Glendale 6% 0% 0% 9% 0% 0% 0% 100% 6% 7%
City of Phoenix -1% 0% 0% 2% 0% -2% 0% 100% -1% 1%
Coconino County 0% 0% 0% -4% 0% 0% 0% 100% -1% -2%
Arizona Dept. of Housing 0% 0% 0% -3% 0% 0% 0% 0% 0% -3%
Gila County 0% 0% 0% -6% 0% 0% 0% 100% -7% -2%
Maricopa County 3% 0% 0% 8% 0% 5% 0% 100% 5% 7%
MesaCAN 8% 0% 0% 11% 0% 8% 0% 100% 8% 9%
NACOG -7% 0% 0% -4% 0% -1% 0% 100% -1% -4%
Pima County -7% 0% 0% 0% 0% -5% 0% 100% -2% -3%
PPEP -1% 0% 0% 0% 0% 0% 0% 0% 0% 0%
SEACAP -5% 0% 0% -7% 0% -5% 0% 100% -11% -6%
Tohono O'odham 0% 0% 0% -4% 0% 0% 0% 0% 0% -4%
Tucson Urban League 0% 0% 0% -2% 0% 0% 0% 0% -5% -2%
WACOG -6% 0% 0% -6% 0% -4% 0% 100% -9% -5%
Bolded numbers represent changes in funding.
Hold-harmless applies to those agencies with reductions of greater than 8%.

COMMUNITY ACTION NETWORK FORMULA
SFY 2017 ALLOCATIONS
CSBG CSBG LIHEAP SFY 2017
CSBG Discretionary Carryover LIHEAP Re-distributed TANF SSBG CENTURYLINK NHN ALLOCATION
ACAA $ - $ 155,000 $ - $ 25,000 $ - $ - $ - $ - $ - $ 180,000
CAHRA $ 272,403 $ - $ - $ 994,866 $ - $ 205,170 $ 16,096 $ - $ 2,090 $ 1,496,597
City of Glendale $ 190,479 $ - $ - $ 695,736 $ - $ 150,000 $ 77,890 $ - $ 1,462 $ 1,119,745
City of Phoenix $ 1,286,962 $ - $ - $ 4,704,235 $ - $ 994,098 $ 574,714 $ - $ 9,885 $ 7,598,138
Coconino County $ 150,000 $ - $ - $ 359,108 $ - $ 150,000 $ 18,305 $ - $ 756 $ 680,324
Arizona Dept of Housing $ - $ - $ - $ 2,936,124 $ - $ - $ - $ - $ - $ 2,936,124
Gila County $ 150,000 $ - $ - $ 139,802 $ - $ 150,000 $ 8,048 $ - $ 295 $ 448,985
Maricopa County $ 811,075 $ - $ - $ 2,963,226 $ - $ 588,117 $ 316,323 $ - $ 6,227 $ 4,702,760
MesaCAN $ 294,411 $ - $ - $ 1,075,201 $ - $ 222,564 $ 116,279 $ - $ 2,256 $ 1,717,167
NACOG $ 235,376 $ - $ - $ 860,483 $ - $ 178,054 $ 66,581 $ - $ 1,809 $ 1,347,469
Pima County $ 692,289 $ - $ - $ 794,470 $ - $ 528,413 $ - $ - $ 1,669 $ 2,032,042
PPEP $ 97,190 $ - $ - $ - $ - $ 74,480 $ - $ - $ - $ 171,670
SEACAP $ 208,297 $ - $ - $ 719,584 $ - $ 157,948 $ - $ - $ 1,511 $ 1,091,662
Tohono O'odham $ - $ - $ - $ 62,572 $ - $ - $ - $ - $ - $ 62,572
Tucson Urban League $ - $ - $ - $ 1,737,303 $ - $ - $ - $ - $ 3,651 $ 1,740,954
WACOG $ 471,007 $ - $ - $ 1,610,905 $ - $ 325,156 $ - $ - $ 3,389 $ 2,420,131
Totals $ 4,859,489 $ 155,000 $ - $ 19,678,615 $ - $ 3,724,000 $ 1,194,236 $ - $ 35,000 $ 29,746,339

ACAA
Fund Source SFY SFY SFY
2017 2017 2017
Initial Allocation Revised
Allocation Increase/(Decrease) Allocation
CSBG $ - $ - $ -
CSBG Discretionary $ 155,000 $ - $ 155,000
CSBG Carryover $ - $ -
LIHEAP $ 25,000 $ - $ 25,000
LIHEAP Re-distributed $ - $ -
TANF $ - $ - $ -
SSBG $ - $ - $ -
CENTURYLINK $ - $ - $ -
NHN $ - $ - $ -
TOTAL $ 180,000 $ - $ 180,000
Bolded numbers represent changes in funding.

CAHRA
Fund Source SFY SFY SFY
2017 2017 2017
Initial Allocation Revised
Allocation Increase/(Decrease) Allocation
CSBG $ 272,403 $ - $ 272,403
CSBG Discretionary $ - $ - $ -
CSBG Carryover $ - $ - $ -
LIHEAP $ 994,866 $ - $ 994,866
LIHEAP Re-distributed $ - $ - $ -
TANF $ 205,170 $ - $ 205,170
SSBG $ 16,096 $ - $ 16,096
CENTURYLINK $ 5,972 $ (5,972) $ -
NHN $ 2,090 $ - $ 2,090
TOTAL $ 1,496,597 $ (5,972) $ 1,490,625
Bolded numbers represent changes in funding.

CITY OF GLENDALE
Fund Source SFY SFY SFY
2017 2017 2017
Initial Allocation Revised
Allocation Increase/(Decrease) Allocation
CSBG $ 190,479 $ - $ 190,479
CSBG Discretionary $ - $ - $ -
CSBG Carryover $ - $ - $ -
LIHEAP $ 695,736 $ - $ 695,736
LIHEAP Re-distributed $ - $ - $ -
TANF $ 150,000 $ - $ 150,000
SSBG $ 77,890 $ - $ 77,890
CENTURYLINK $ 4,178 $ (4,178) $ -
NHN $ 1,462 $ - $ 1,462
TOTAL $ 1,119,745 $ (4,178) $ 1,115,567
Bolded numbers represent changes in funding.

CITY OF PHOENIX
Fund Source SFY SFY SFY
2017 2017 2017
Initial Allocation Revised
Allocation Increase/(Decrease) Allocation
CSBG $ 1,286,962 $ - $ 1,286,962
CSBG Discretionary $ - $ - $ -
CSBG Carryover $ - $ - $ -
LIHEAP $ 4,704,235 $ - $ 4,704,235
LIHEAP Re-distributed $ - $ - $ -
TANF $ 994,098 $ - $ 994,098
SSBG $ 574,714 $ - $ 574,714
CENTURYLINK $ 28,244 $ (28,244) $ -
NHN $ 9,885 $ - $ 9,885
TOTAL $ 7,598,138 $ (28,244) $ 7,569,894
Bolded numbers represent changes in funding.

COCONINO COUNTY
Fund Source SFY SFY SFY
2017 2017 2017
Initial Allocation Revised
Allocation Increase/(Decrease) Allocation
CSBG $ 150,000 $ - $ 150,000
CSBG Discretionary $ - $ - $ -
CSBG Carryover $ - $ - $ -
LIHEAP $ 359,108 $ - $ 359,108
LIHEAP Re-distributed $ - $ - $ -
TANF $ 150,000 $ - $ 150,000
SSBG $ 18,305 $ - $ 18,305
CENTURYLINK $ 2,155 $ (2,155) $ -
NHN $ 756 $ - $ 756
TOTAL $ 680,324 $ (2,155) $ 678,169
Bolded numbers represent changes in funding.

GILA COUNTY
Fund Source SFY SFY SFY
2017 2017 2017
Initial Allocation Revised
Allocation Increase/(Decrease) Allocation
CSBG $ 150,000 $ - $ 150,000
CSBG Discretionary $ - $ - $ -
CSBG Carryover $ - $ - $ -
LIHEAP $ 139,802 $ - $ 139,802
LIHEAP Re-distributed $ - $ - $ -
TANF $ 150,000 $ - $ 150,000
SSBG $ 8,048 $ - $ 8,048
CENTURYLINK $ 840 $ (840) $ -
NHN $ 295 $ - $ 295
TOTAL $ 448,985 $ (840) $ 448,145
Bolded numbers represent changes in funding.

ARIZONA DEPARTMENT OF HOUSING
Fund Source SFY SFY SFY
2017 2017 2017
Initial Allocation Revised
Allocation Increase/(Decrease) Allocation
CSBG $ - $ - $ -
CSBG Discretionary $ - $ - $ -
CSBG Carryover $ - $ - $ -
LIHEAP $ 2,936,124 $ - $ 2,936,124
LIHEAP Re-distributed $ - $ - $ -
TANF $ - $ - $ -
SSBG $ - $ - $ -
CENTURYLINK $ - $ - $ -
NHN $ - $ - $ -
TOTAL $ 2,936,124 $ - $ 2,936,124
Bolded numbers represent changes in funding.

MARICOPA COUNTY
Fund Source SFY SFY SFY
2017 2017 2017
Initial Allocation Revised
Allocation Increase/(Decrease) Allocation
CSBG $ 811,075 $ - $ 811,075
CSBG Discretionary $ - $ - $ -
CSBG Carryover $ - $ - $ -
LIHEAP $ 2,963,226 $ - $ 2,963,226
LIHEAP Re-distributed $ - $ - $ -
TANF $ 588,117 $ - $ 588,117
SSBG $ 316,323 $ - $ 316,323
CENTURYLINK $ 17,792 $ (17,792) $ -
NHN $ 6,227 $ - $ 6,227
TOTAL $ 4,702,760 $ (17,792) $ 4,684,968
Bolded numbers represent changes in funding.

MESA CAN
Fund Source SFY SFY SFY
2017 2017 2017
Initial Allocation Revised
Allocation Increase/(Decrease) Allocation
CSBG $ 294,411 $ - $ 294,411
CSBG Discretionary $ - $ - $ -
CSBG Carryover $ - $ - $ -
LIHEAP $ 1,075,201 $ - $ 1,075,201
LIHEAP Re-distributed $ - $ - $ -
TANF $ 222,564 $ - $ 222,564
SSBG $ 116,279 $ - $ 116,279
CENTURYLINK $ 6,456 $ (6,456) $ -
NHN $ 2,256 $ - $ 2,256
TOTAL $ 1,717,167 $ (6,456) $ 1,710,711
Bolded numbers represent changes in funding.

NACOG
Fund Source SFY SFY SFY
2017 2017 2017
Initial Allocation Revised
Allocation Increase/(Decrease) Allocation
CSBG $ 235,376 $ - $ 235,376
CSBG Discretionary $ - $ - $ -
CSBG Carryover $ - $ - $ -
LIHEAP $ 860,483 $ - $ 860,483
LIHEAP Re-distributed $ - $ - $ -
TANF $ 178,054 $ - $ 178,054
SSBG $ 66,581 $ - $ 66,581
CENTURYLINK $ 5,166 $ (5,166) $ -
NHN $ 1,809 $ - $ 1,809
TOTAL $ 1,347,469 $ (5,166) $ 1,342,303
Bolded numbers represent changes in funding.

PIMA COUNTY
Fund Source SFY SFY SFY
2017 2017 2017
Initial Allocation Revised
Allocation Increase/(Decrease) Allocation
CSBG $ 692,289 $ - $ 692,289
CSBG Discretionary $ - $ - $ -
CSBG Carryover $ - $ - $ -
LIHEAP $ 794,470 $ - $ 794,470
LIHEAP Re-distributed $ - $ - $ -
TANF $ 528,413 $ - $ 528,413
SSBG $ - $ - $ -
CENTURYLINK $ 15,201 $ (15,201) $ -
NHN $ 1,669 $ - $ 1,669
TOTAL $ 2,032,042 $ (15,201) $ 2,016,841
Bolded numbers represent changes in funding.

PPEP
Fund Source SFY SFY SFY
2017 2017 2017
Initial Allocation Revised
Allocation Increase/(Decrease) Allocation
CSBG $ 97,190 $ - $ 97,190
CSBG Discretionary $ - $ - $ -
CSBG Carryover $ - $ - $ -
LIHEAP $ - $ - $ -
LIHEAP Re-distributed $ - $ - $ -
TANF $ 74,480 $ - $ 74,480
SSBG $ - $ - $ -
CENTURYLINK $ - $ - $ -
NHN $ - $ - $ -
TOTAL $ 171,670 $ - $ 171,670
Bolded numbers represent changes in funding.

SEACAP
Fund Source SFY SFY SFY
2017 2017 2017
Initial Allocation Revised
Allocation Increase/(Decrease) Allocation
CSBG $ 208,297 $ - $ 208,297
CSBG Discretionary $ - $ - $ -
CSBG Carryover $ - $ - $ -
LIHEAP $ 719,584 $ - $ 719,584
LIHEAP Re-distributed $ - $ - $ -
TANF $ 157,948 $ - $ 157,948
SSBG $ - $ - $ -
CENTURYLINK $ 4,322 $ (4,322) $ -
NHN $ 1,511 $ - $ 1,511
TOTAL $ 1,091,662 $ (4,322) $ 1,087,340
Bolded numbers represent changes in funding.

TOHONO O'ODHAM
Fund Source SFY SFY SFY
2017 2017 2017
Initial Allocation Revised
Allocation Increase/(Decrease) Allocation
CSBG $ - $ - $ -
CSBG Discretionary $ - $ - $ -
CSBG Carryover $ - $ - $ -
LIHEAP $ 62,572 $ - $ 62,572
LIHEAP Re-distributed $ - $ - $ -
TANF $ - $ - $ -
SSBG $ - $ - $ -
CENTURYLINK $ - $ - $ -
NHN $ - $ - $ -
TOTAL $ 62,572 $ - $ 62,572
Bolded numbers represent changes in funding.

TUCSON URBAN LEAGUE
Fund Source SFY SFY SFY
2017 2017 2017
Initial Allocation Revised
Allocation Increase/(Decrease) Allocation
CSBG $ - $ - $ -
CSBG Discretionary $ - $ - $ -
CSBG Carryover $ - $ - $ -
LIHEAP $ 1,737,303 $ - $ 1,737,303
LIHEAP Re-distributed $ - $ - $ -
TANF $ - $ - $ -
SSBG $ - $ - $ -
CENTURYLINK $ - $ - $ -
NHN $ 3,651 $ - $ 3,651
TOTAL $ 1,740,954 $ - $ 1,740,954
Bolded numbers represent changes in funding.

WACOG
Fund Source SFY SFY SFY
2017 2017 2017
Initial Allocation Revised
Allocation Increase/(Decrease) Allocation
CSBG $ 471,007 $ - $ 471,007
CSBG Discretionary $ - $ - $ -
CSBG Carryover $ - $ - $ -
LIHEAP $ 1,610,905 $ - $ 1,610,905
LIHEAP Re-distributed $ - $ - $ -
TANF $ 325,156 $ - $ 325,156
SSBG $ - $ - $ -
CENTURYLINK $ 9,674 $ (9,674) $ -
NHN $ 3,389 $ - $ 3,389
TOTAL $ 2,420,131 $ (9,674) $ 2,410,457
Bolded numbers represent changes in funding.

STATE TOTALS
Fund Source ALERT DATE ISSUED SFY SFY SFY
2017 2017 2017
Initial Allocation Revised
Allocation Increase/(Decrease) Allocation
CSBG ALERT SFY 17-A 3/18/2016 $ 4,859,489 $ - $ 4,859,489
CSBG Discretionary ALERT SFY 17-A 3/18/2016 $ 155,000 $ - $ 155,000
CSBG Carryover $ - $ - $ -
LIHEAP ALERT SFY 17-B 3/18/2016 $ 19,678,615 $ - $ 19,678,615
LIHEAP Re-distributed $ - $ - $ -
TANF ALERT SFY 17-E 3/18/2016 $ 3,724,000 $ - $ 3,724,000
SSBG ALERT SFY 17-G 3/18/2016 $ 1,194,236 $ - $ 1,194,236
CENTURYLINK ALERT SFY 17-H1 4/1/2016 $ 100,000 $ (100,000) $ -
NHN ALERT SFY 17-I 3/18/2016 $ 35,000 $ - $ 35,000
TOTAL $ 29,746,340 $ (100,000) $ 29,646,340
Bolded numbers represent changes in funding.

Division of Aging and Adult Services
ALERT
SFY-17-K1
Technical Assistance
for SFY 2017
Technical Assistance ALERTS are generated periodically to update contractual and/or
programmatic requirements and/or clarifications. Please ensure that appropriate Community
Action Agency (CAA) staff are aware of this technical assistance.
Community Action Program Services (CAPS) – SFY 2017 Simplified LIHEAP Income Chart
The income thresholds on the simplified LIHEAP-only chart (Attachment #1) has been corrected.
For households with seven members, the correct income threshold is $4,591.
If you have any questions or require additional information, please contact Diana Gravett,
Community Action Program Specialist, at dgravett@azdes.gov or (602) 542-6594.

SFY-17-K1 Attachment 1
Department of Economic Security (DES)
Division of Aging and Adult Services (DAAS)
SFY 2017 Simplified LIHEAP Income Chart
60 % of State Median Income (SMI) is used for households sized 6 and under
150% of Federal Poverty Guideline (FPG) is used for households sized 7 and over
Household Size 30 Day Gross Income Limit
(Dollar Amount)
1 SM I60% $1,749
2 2,287
3 2,825
4 3,364
5 3,902
6 4,440
7 FPG 150% 4,591
8 5,111
9 5,631
10 6,151
11 6,671
12 7,191
For each additional household member, add $520
3/18/16

Division of Aging and Adult Services
ALERT
SFY-17-L
Plans
for SFY 2017
Please ensure that all appropriate CAN staff is provided with this information.
DRAFT CSBG State Plan for Federal Fiscal Years (FFYs) 2017-2018: The document is in a
workbook format and the language was drafted per the new CSBG Model State Plan that was
disseminated by OCS to States in October 2015, in accordance with IM #144. The new Plan
provides narrative responses to federal assurances, updates funding allocations, public hearing
dates, and communicates administrative personnel changes.
DAAS requests that the Network review the draft CSBG State Plan workbook and provide input in
the comment boxes inserted into the draft. Please respond no later than May 4, 2016. The face-
to-face Network meeting on Wednesday, April 20, 2016, will also allow time for State Plan input
and discussion. DAAS anticipates posting the revised draft of the CSBG State Plan for FFYs
2017-2018 on the DES Website for public inspection no later than May 10, 2016.
The LIHEAP State Plan is being reviewed at this time. There will be an opportunity for Network
participation in its development as well.
The Public Hearings will be held in the following locations:
Date/Time Location Topic
Flagstaff Health & Community Services Building CSBG and
June 14, 2016 2625 N. King Street, 1st Floor LIHEAP State
11:00 am to 2:00 pm Ponderosa Conference Room Plans
Flagstaff, AZ 86004
Phoenix Third Floor Meeting Room - Executive CSBG and
June 15, 2016 Tower, 1700 West Washington Street, LIHEAP State
9:30 am to 12:30 pm Phoenix, AZ 85007 Plans
Tucson Pima County Kino Veterans Center CSBG and
June 21, 2016 2801 E. Ajo Way LIHEAP State
12:00 pm to 3:00 pm Tucson, AZ 85713 Plans
If you have any questions or require additional information, please contact Diana Gravett,
Community Action Program Specialist, at dgravett@azdes.gov or (602) 542-6594.

Form Approved
OMB No: 0970-0382
Expires: 07/31/2018
Community Services Block Grant (CSBG) Model State Plan
Federal Fiscal Years (FFYs) 2017-2018
Table of Contents
CSBG Cover Page (SF-424M)
Section 1: CSBG Lead Agency, CSBG Authorized Official, CSBG Point of Contact, and Official State
Designation Letter
Section 2: State Legislation and Regulation
Section 3: State Plan Development and Statewide Goals
Section 4: CSBG Hearing Requirements
Section 5: CSBG Eligible Entities
Section 6: Organizational Standards for Eligible Entities
Section 7: State Use of Funds
Section 8: State Training and Technical Assistance
Section 9: State Linkages and Communication
Section 10: Monitoring, Corrective Action, and Fiscal Controls
Section 11: Eligible Entity Tripartite Board
Section 12: Individual and Community Income Eligibility Requirements
Section 13: Results Oriented Management and Accountability (ROMA) System
Section 14: CSBG Programmatic Assurances and Information Narrative
Section 15: Federal Certifications
Attachments
Attachment 1: Delegation of Authority
Attachment 2: Change Matrix (Placeholder)
Attachment 3: Allocations
Attachment 3B: Funding Formula
Attachment 4: Sections 9 and 14 Service Delivery System and Program Narratives (overflow text)
Attachment 5: Arizona Administrative Code Title 6, Chapter 13 (Regarding STCS)
Attachment 6: Request for Application (RFA) Placeholder
Attachment 7: Scope of Work (SOW)
Attachment 8: DES Single Audit Policy
Attachment 9: Su recipient Monitoring Policy
Attachment 10: Income Thresholds for State Fiscal Year 2017.
Attachment 11: Network and Public Comments

Community Services Block Grant (CSBG) Model State Plan Worksheet
State of Arizona - CSBG State Plan FFYs 2017-2018 – What’s new
Beginning in 2016, the development year for the FFY 2017-2018 CSBG State Plan, DAAS/CSA will no
longer prepare or submit a paper State Plan document using the existing model plan to the Office of
Community Services (OCS). OCS has implemented an electronic system and finalized a new Model Plan.
The form below is a representation of data entry screens from the MSP Mandatory Grant Application SF-
424, in the OLDC system. All states are required in FFY 2017 to provide responses to each element of the
Model Plan, unless otherwise indicated, using the Online Data Collection system (OLDC). This workbook
document will be retained to record changes and comments for future CSBG State Plans. This worksheet
is NOT submitted to OCS. This document represents the final language of the new CSBG Model State Plan
as approved by OMB in August 2015. The finished draft document will illustrate the development process
of the State Plan and include comments from the Network, as well as the actual text that is entered into the
OLDC system. Text format legend below:
Font Text Type Format
Calibri OCS CSBG Model Plan template text – do not 12 pt. black - regular
change. or bold
Calibri OCS instructions or comments - do not change 11pt red regular or
bold
Times New Roman CSBG Program Staff or Administration comment – 12 pt. red italics –
does not appear in electronic document. regular or bold
Times New Roman Network Comment boxes 12 point black –
regular or bold
Times New Roman Current language; unchanged from the FFY 2016 12 pt. italics -
State Plan amendment and/or electronic regular
submission
Times New Roman New or changed text or strikeout/deleted text. 12 pt. bold italics.
Will need Network input.
Highlighted entry Needs new or revised text, review or other change; Any font or color
space or text link or attachment needed
Below each applicable section, boxes like the ones below (next page) will appear for comments and/or
questions from the Network and/or DES administration and staff.
Network Comments – Section # Date(s):
Comment boxes will not appear in the final electronic document, but will be retained in this
workbook document for historical purposes. Network will enter input here. These grey boxes do not
appear in the final document.
DAAS/CSA Comments – Section # Date(s):
Reason(s) for Change: [Indicate change reason here]
DAAS/CSA will explain changes, cite references, note attachments, make recommendations, or
request input here. Does NOT appear in final electronic document. This page will not appear in the
DES routed document.
Actual form SF-424M (CSBG State Plan) questions and answers begin on next page

SECTION 1
CSBG Lead Agency, CSBG Authorized Official, CSBG Point of Contact, and Official State
Designation Letter
1.1. Provide the following information in relation to the lead agency designated to administer CSBG
in the State, as required by Section 676(a) of the CSBG Act. The following information should
mirror the information provided on the Application for Federal Assistance, SF-424M.
1.1a. Lead agency [Narrative, 2500 Characters]
The Arizona Department of Economic Security (DES) is the designated State agency responsible for the
administration of the CSBG as identified by the Governor. All activities of DES are the responsibility
of the Director. Primary responsibility for CSBG program planning, development, contracting,
reporting, and monitoring is delegated to the Division of Aging and Adult Services (DAAS), Community
Services Administration (CSA). DAAS/CSA contracts directly with Community Action Agencies
(CAAs), one migrant organization, and the Arizona Community Action Association. Some of these
agencies subcontract with other community agencies within their service delivery area. For example,
in Maricopa County, there are CAAs in each of the major cities in the service.
DAAS/CSA Comments Section 1.1 Date(s): 1/4/16
Reason(s) for Change: Language modified to match new DES webpage.
Sources: Form 2015-2016 OLDC SF-424M submitted to OCS August 2015 and new text from
www.des.az.gov
1.1b. Cabinet or administrative department of this lead agency [Check One and narrative
where applicable]
 Community Services Department
 Human Services Department
 Social Services Department
 Governor’s Office
 Community Affairs Department
 Other, describe: [Narrative, 2500 Characters]
1.1c. Division, bureau, or office of the CSBG authorized official [Narrative, 2500 Characters]
DES Division of Aging and Adult Services (DAAS), Community Services Administration (CSA)
1.1d. Authorized official of the lead agency [Narrative, 2500 Characters]
Timothy Jeffries, Director, DES
Instructional note: The authorized official could be the director, secretary,
commissioner etc. as assigned in the designation letter (attached under item 1.3).
The authorized official is the person indicated as authorized representative on the
SF-424M.

1.1e. Street address [Narrative, 2500 Characters]
1789 West Jefferson St.
1.1f. City [Narrative, 2500 Characters]
Phoenix
1.1g. State [Dropdown]
AZ
1.1h. Zip [Narrative, 5 characters]
85007
1.1i. Telephone number and extension [Narrative, 10 – 15 characters which includes option
for 5 digit extension]
(602)542-5757
1.1j. Fax number [Narrative, 10 characters]
602-542-5339
1.1k. Email address [Narrative, 2500 Characters]
director@azdes.gov
1.1l. Lead agency website [Narrative, 2500 Characters]
https://des.az.gov/
1.2. Provide the following information in relation to the designated State CSBG point of contact.
Instructional Note: The State CSBG point of contact should be the person that will be the
main point of contact for CSBG within the State.
1.2a. Agency name [Narrative, 2500 Characters]
Arizona Department of Economic Security, Division of Aging and Adult Services, Community
Services Administration
1.2b. Name of the point of contact [Narrative, 2500 Characters]
Jane Bruzzese Harrison, Arizona Department of Economic Security, Division of Aging and
Adult Services
1.2c. Street address [Narrative, 2500 Characters]
1789 W. Jefferson St., Site Code 950A
1.2d. City [Narrative, 2500 Characters]
Phoenix

1.2e. State [Dropdown]
AZ
1.2f. Zip [Narrative, 5 characters]
85007
1.2g. Point of contact telephone number [Narrative, 10 – 15 characters which includes
option for entering up to 5 digit extension]
602-542-6607
1.2h. Fax number [Narrative, 10 characters]
602-542-6655
1.2i. Point of contact email address [Narrative, 2500 Characters]
jbruzzese@azdes.gov
1.2j. Point of contact agency website [Narrative, 2500 Characters]
https://des.az.gov/
1.3. Designation Letter: Attach the State’s official CSBG designation letter. If either the governor or
designated agency has changed, update the letter accordingly. [Attach a document]
Attachment 1 – Designation of Authority
Instructional Note: The letter should be from the chief executive officer of the State and
include, at minimum, the designated State CSBG lead agency and title of the authorized
official of the lead agency who is to administer the CSBG grant award.
DAAS/CSA Comments - Section 1.2b and 1.3 Date(s): 1/4/16
Reason(s) for Change: Community Services Administrator changed. Appendices eliminated
Will attach scanned copy of designation letter to electronic OLDC. See Attachment 1
End of Section 1

SECTION 2
State Legislation and Regulation
2.1. CSBG State Legislation: Does the State have a statute authorizing CSBG?  Yes  No
2.2. CSBG State Regulation: Does the State have regulations for CSBG?  Yes  No
2.3. If yes was selected in item 2.1 or 2.2, attach a copy (or copies) of legislation and/or regulations
or provide a hyperlink(s), as appropriate. [Attach a document and/or provide a link]
2.4. State Authority: Select a response for each question about the State statute and/or regulations
authorizing CSBG:
2.4a. Did the State legislature enact authorizing legislation, or amendments to an existing
authorizing statute, last year?  Yes  No
2.4b. Did the State establish or amend regulations for CSBG last year?  Yes  No
2.4c. Does the State statutory or regulatory authority designate the bureau, division, or office
in the State government that is to be the State administering agency?  Yes  No
DAAS/CSA Comments – Section 2 Date(s): 1/4/16
Reason(s) for Change: Changes in DES/DAAS Administration and CSBG State contacts
Changed from: Lynn Larson, Acting Assistant Director (Ms. Larson was Acting AD when the previous
State Plan was submitted), to Jane Bruzzese Harrison, Community Services Program Administrator,
and updated phone numbers and email addresses. Attachment reference text tweaked as Appendices
are eliminated from the new Model Plan. “Lead Agency” opening paragraph modified to match new
DES website text.
End of Section 2

SECTION 3
State Plan Development and Statewide Goals
3.1. CSBG Lead Agency Mission and Responsibilities: Briefly describe the mission and
responsibilities of the State agency that serves as the CSBG lead agency. [Narrative, 2500
Characters]
The Arizona Department of Economic Security (DES) is the designated State agency responsible for the
administration of the CSBG as identified by the Governor. All activities of DES are the responsibility
of the Director. Primary responsibility for CSBG program planning, development, contracting,
reporting, and monitoring is delegated to the Division of Aging and Adult Services (DAAS), Community
Services Administration.
DES came under new administration in 2015 under newly elected Governor Douglas A. Ducey, and
the newly appointed Director of DES, Timothy Jeffries. The agency mission statement was revised
in Federal Fiscal Year (FFY) 2015 to read as follows: “The Arizona Department of Economic
Security makes Arizona stronger by helping Arizonans reach their potential through temporary
assistance for those in need, and care for the vulnerable.”
DES administers the Unemployment Insurance (UI), Workforce Innovation and Opportunity
(WIOA) Act programs, and the Supplemental Nutrition Assistance (SNAP) programs. The Agency
also provides child support enforcement services and comprehensive programs to assist persons with
developmental disabilities. The Division of Aging and Adult Services (DAAS) administers the
Community Action Program, the State Adult Protective Services program, Refugee Resettlement
Program, Independent Living Support Services (for seniors and persons with disabilities), State
Homeless Program, Low Income Home Energy Assistance (LIHEAP) and Domestic Violence
Programs.
DES Values:
 Teamwork – We collaborate with humility, and partner with kindness
 Respect – We appreciate each other, and value those we serve
 Integrity – We never lie, cheat, steal, bully or harass – nor tolerate those who do
 Accountability – We commit to excellence, innovation and transparency
 Diversity – We respect all Arizonans, and honor those in need
DES Vision: Opportunity, assistance and care for Arizonans in need
DES Goals: Serve Arizonans with integrity, humility, and kindness
 Support Arizonans to reach their potential through social services that train, rehabilitate,
and connect them with job creators
 Provide temporary assistance to Arizonans in need while they work toward greater self-
sufficiency
 Provide children with food, health care, and parental financial support; provide services to
individuals with disabilities; and protect the vulnerable by investigating allegations of abuse,
neglect, and exploitation.

DAAS/CSA Comments -Section 3.1 Date(s): 1/4/16
Reason for Change: New administration and changes to mission and vision statements
Text revised to reflect DES changes in mission, vision, and goals. This text is derived from the agency
website. Source: https://des.az.gov/about. This text may become an attachment due to character limits
in OLDC electronic data entry system. Quotation marks and references to the paper CSBG State Plan
document are removed from all sections of the State Plan going forward. These references may still
appear in the DAAS/CSA Comments box to aid in review of this document. Sources: Paper document:
FFYs 2015-2016 CSBG State Plan Amended, Section V Section V. A.1.,(a) and 2015-2016 OLDC SF-
424M
3.2. State Plan Goals: Describe the State’s CSBG-specific goals for State administration of CSBG under
this State Plan. [Narrative, 2500 Characters]
(a) DAAS/CSA coordinates with the state association to provide training and technical
assistance using State CSBG discretionary dollars, providing training and technical
assistance to those entities in need of such assistance and such activities will not be considered
administrative expenses;
(b) coordinating state-operated programs and services targeted to low-income individuals, and
families with children, and at the option of the State, locally operated programs, and services,
targeted to low-income individuals and families with children, with services provided by
eligible entities and other organizations funded under the CSBG Act, including out-posting
appropriate state or local public employees into entities funded to ensure increased access to
services provided by such state or local entities;
(c) supporting statewide coordination and communication among eligible entities; a portion of
CSBG discretionary funds will be targeted to support statewide coordination and
communication among eligible entities on a yearly basis that will be accomplished through
support of the Community Action Agencies and the state association;
(d) analyzing the distribution of funds made available under the CSBG Act, to determine if such
funds have been targeted to the areas of greatest need. The State utilizes a funding distribution
formula that analyzes local rates of poverty and unemployment, accounts for rural factors and
tribal populations, and makes an adjustment for a limited purpose entity that serves migrant
and seasonal farmworkers. The State also uses a minimum funding variable in the distribution
formula that allows entities with smaller populations to receive at least $150,000;
(e) supporting asset-building programs for low-income individuals, such as programs supporting
individual development accounts; four eligible entities conduct Individual Development
Account (IDA) programs;
(f) supporting innovative programs and activities conducted by eligible entities or other
neighborhood-based organizations to eliminate poverty, promote self-sufficiency, and
promote community revitalization; and
(h) supporting other activities, consistent with the purposes of the CSBG Act.
Network Comments – Section 3.2 Date(s):
DAAS/CSA Comments - Section 3.2 Date(s): 1/4/16
Reason for Change: The paper CSBG Model State Plan is no longer in use.

The above list is derived from Section V.C. (a-h, omitting item (g) that references state charity tax
credits), of the FFY 2015-2016 Amended CSBG State Plan. This language is in turn derived from the
CSBG Act and paraphrased slightly. Capitalization made consistent throughout list. Minor
adjustments made for clarity; see bolded text.
Instructional Note: For examples of “goals,” see State Accountability Measure 1Sa(i).
Note: This information is associated with State Accountability Measure 1Sa(i) and may pre-
populate the State’s annual report form.
3.3. State Plan Development: Indicate the information and input the State accessed to develop this
State Plan.
3.3a. Analysis of [Check all that applies and narrative where applicable]
 State Performance Indicators and/or National Performance Indicators (NPIs)
 U.S. Census data
 State performance management data (e.g., accountability measures, ACSI survey
information, and/or other information from annual reports)
 Other data (describe) [Narrative, 2500 Characters]
 Eligible entity community needs assessments
 Eligible entity plans
 Other information from eligible entities, e.g., State required reports (describe)
[Narrative, 2500 Characters]
1. Poverty and rural statistics are obtained from the most current U.S. Decennial Census data
available for the State of Arizona and updated annually using the 2015 American Community
Survey (ACS) for a five-year period 2010-2014. These numbers are updated annually using
the ACS 5-year Survey.*
2. Employment statistics are obtained from the most current Local Area Unemployment
Survey (LAUS) for 2014.
*U.S. Census Table S1701:
http://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?src=CF
Network Comments -Section 3.3 Date(s):
DAAS/CSA Comments - Section 3.3 Date(s): 1/4/16
Reason for Change: Revised data source.
Employment data source changed from the Arizona Department of Administration (ADOA),
Unemployment Program Statistics Special Unemployment Report, as this report has been
discontinued. Text added indicating data sources are updated annually. FFYs 2015-2016 CSBG
State Plan Amended, Section V. B.

3.3b. Consultation with [Check all that applies and narrative where applicable]
 Eligible entities (e.g., meetings, conferences, webinars; not including the public
hearing)
 State community action association and regional CSBG T & TA providers
 State partners and/or stakeholders (describe) [Narrative, 2500 Characters]
 National organizations (describe) [Narrative, 2500 Characters]
 Other (describe) [Narrative, 2500 Characters]
In submittal year FFY 2016, DES/DAAS prepared a draft of the State Plan and met with the CAA
Network to discuss the draft plan and request comments. The State prepared a matrix of proposed
changes for the Network to review. DAAS/CSA utilized program narratives from CAAs from SFY 2015
to highlight regional programs. The State then met again with the CAA network to discuss comments
and finalize changes. In April 2016, DAAS/CSA sent a draft of the CSBG State Plan Workbook to
the CAA Network for a 30-day review and comment period. DAAS/CSA also met with the Network
for further development during April. On May 6, 2016, the draft of the CSBG State Plan was posted
to the DES Website for public review for another 30-day period. Following public inspection, three
public hearings were conducted during the month of June, 2016: one in Flagstaff, one in Phoenix,
and another in Tucson. In August of 2014, DAAS/CSA conducted a legislative hearing. DAAS/CSA
will conduct its next legislative hearing in the summer of 2017.
DAAS/CSA updated and added new program narratives to describe the emphasis, activities, and
outcomes of individual CAAs prior to finalizing the Plan. DAAS/CSA will post updates for the
intervening year (FFY 2018) to the DES website in April/May 2017. Also in 2017, DAAS/CSA will
conduct one public hearing of updates to the FFYs 2017-2018 State Plan.
3.4. Eligible Entity Involvement
3.4a. Describe the specific steps the State took in developing the State Plan to involve the
eligible entities. [Narrative, 2500 Characters]
DAAS/CSA informed the CAA Network in February 2016 about the new Model State Plan format for
FFYs 2017-2018. DAAS/CSA circulated within the Community Action Network draft State Plan
proposed changes in late March 2016, and requested comments in mid-April 2016. In response to the
Network comments and subsequent discussion with the group, the following additional changes were
made: [will insert text and reference to change matrix once network comments are incorporated into
this document].
Network Comments -Sections 3.3 and 3.4 Date(s):
DAAS/CSA Comments - Sections 3.3 and 3.4 Date(s): 1/4/16
Reason for Change: Revised dates and clarity.
Updates and detail regarding the two-year process. New program narratives requested for SFY 2017.
These can be derived from the previous grant period or represent new and/or ongoing programs. Some
text revised for clarity. This text derives from the 2016 State Plan OCS questionnaire for states with
two year plans. See Attachment 2 2017 CSBG State Plan Change Matrix


Note: This information is associated with State Accountability Measures 1Sa(ii) and
may pre-populate the State’s annual report form.
If this is the first year filling out the automated State Plan, skip the following
question.
3.4b. Performance Management Adjustment: How has the State adjusted State Plan
development procedures under this State Plan, as compared to past plans, in order 1) to
encourage eligible entity participation and 2) to ensure the State Plan reflects input
from eligible entities? Any adjustment should be based on the State’s analysis of past
performance in these areas, and should consider feedback from eligible entities, OCS,
and other sources, such as the public hearing. If the State is not making any
adjustments, provide further detail. [Narrative, 2500 Characters]
In SFY 2015, the development year of the FFY 2015-2016 State Plan, DAAS/CSA scheduled three
public hearings, two outside of the Phoenix metropolitan area, in response to feedback from the
Network, indicating a desire for broader public availability to review and provide public testimony.
Also in SFY 2015, DAAS/CSA shortened its development time period to provide more time for public
review of the State Plan draft document prior to public hearings. DAAS/CSA has created a
scheduled process for development of the two-year Plan that includes scheduled meetings with the
Network and opportunities for comment and discussion prior to posting the State Plan draft for
formal public review.
Note: This information is associated with State Accountability Measures 1Sb(i) and (ii)
and may pre-populate the State’s annual report form.
Network Comments – Section 3.4b Date(s):
DAAS/CSA Comments Section 3.4b Date(s):
Reason(s) for Change: OCS requests description of State Plan development process changes that
were made due to comments from the Network or the public.
Narrative response added.
If this is the first year filling out the automated State Plan, skip the following question.
3.5. Eligible Entity Overall Satisfaction: Provide the State’s target for eligible entity Overall
Satisfaction during the performance period: 075.
Instructional Note: The State’s target score will indicate improvement or maintenance of the
States’ Overall Satisfaction score from the most recent American Customer Survey Index
(ACSI) survey of the State’s eligible entities. (See information about the ACSI in the CSBG
State Accountability Measures document.)

Note: Item 3.5 is associated with State Accountability Measure 8S and may pre-populate the
State’s annual report form.
Network Comments – Section 3.5 Date(s):
DAAS/CSA Comments – Section 3.5 Date(s):
Reason(s) for Change: No changes; new item
New information requested
End of Section 3

SECTION 4
CSBG Hearing Requirements
4.1. Public Inspection: Describe how the State made this State Plan, or revision(s) to the State
Plan, available for public inspection, as required under Section 676(e)(2) of the Act.
[Narrative, 2500 Characters]
The FFYs 2017-2018 CSBG State Plan was made available for public inspection and comment via
publication and the public hearing process in 2016. Paper copies of the State Plan are available upon
request. The draft State Plan was posted on the DES website in May 2016. Oral and written testimony
were solicited and accepted via the DES website and at public hearings from May [6], 2016 through
June 24, 2016.
4.2. Public Notice/Hearing: Describe how the State ensured there was sufficient time and
statewide distribution of notice of the public hearing(s) to allow the public to comment on
the State Plan, as required under 676(a)(2)(B) of the CSBG Act. [Narrative, 2500 Characters]
FFYs 2017-2018 - DAAS/CSA conducts multiple public hearings throughout the State in conjunction
with the development of the biennial State Plan. DAAS/CSA also conducts a single public hearing in
Phoenix in the intervening years, to solicit public comment regarding amendments to the current Plan.
DAAS/CSA will post a public notice, via its website, of the hearing schedule at least 30 days prior to
any public hearing(s). The Department conducted several public hearings in 2016 to ensure public
inspection, facilitate review, and solicit comments regarding the FFY 2017-2018 CSBG State Plan,
and to provide opportunities for the public in various parts of the State to offer comments without the
necessity of traveling to Phoenix. The first public hearing was held in Flagstaff (northern Arizona) on
June 14, 2016; the second in Phoenix on June 15, 2016; and the third in Tucson (southern Arizona)
on June 21, 2016. In the intervening year, 2017, DAAS/CSA will conduct one public hearing in
Phoenix in May or June, to ensure public inspection and review of amendments to the FFYs 2017-
2018 CSBG State Plan.
4.3. Public and Legislative Hearings: Specify the date(s) and location(s) of the public and
legislative hearing(s) held by the designated lead agency for this State Plan, as required under
Section
676(a)(2)(B) and Section 676(a)(3) of the Act. (If the State has not held a public hearing in
the prior fiscal year and/or a legislative hearing in the last three years, provide further
detail).
Legislative hearings are held once every three years in accordance with Section 676(a)(3) of the Act.
The last legislative hearing was held on August 6, 2014. DAAS/CSA will hold the next legislative
hearing in July or August 2017.
Instructional Note: The date(s) for the public hearing(s) must have occurred in the year prior
to the first Federal fiscal year covered by this plan. Legislative hearings are held at least every
three years, and must have occurred within the last three years prior to the first Federal
fiscal year covered by this plan.

Type of Hearing [Select an
Date Location option]
• Public
[Select a date] [Narrative, Insert Address] • Legislative
• Combined
June 14 2016 Flagstaff, Arizona  Public
June 15 2016 Phoenix, Arizona  Public
June 21, 2016 Tucson, Arizona  Public
ADD a ROW function Note: rows will be able to be added for each additional hearing
4.4. Attach supporting documentation or a hyperlink for the public and legislative hearings.
[Attach a document or provide a hyperlink.]
Need to include links or attach notice document to public hearing announcements.
http://www.azleg.gov/iminute/house/080614%20jt%20leg%20committee%20on%20des%20block%
20grants.doc.htm 2014 – Legislative Hearing
For Public Hearing documents, see Attachment 11, Public Hearings [to be created]
Network Comments – Section 4 Date(s):
DAAS/CSA Comments – Section 4 Date(s): 1/4/16
Reason(s) for Change: Updated for hearing dates
Dates updated. Source for text: FFYs 2015-2016 Amended CSBG State Plan Section V.C.
End of Section 4

SECTION 5
CSBG Eligible Entities
5.1. CSBG Eligible Entities: In the table below, list each eligible entity in the State, and indicate
public or private, the type(s) of entity, and the geographical area served by the entity. (This
table should include every CSBG Eligible Entity to which the State plans to allocate 90 percent
funds, as indicated in the table in item 7.2. Do not include entities that only receive
remainder/discretionary funds from the State or tribes/tribal organizations that receive direct
funding from OCS under Section 677 of the CSBG Act.)
Geographical Area Brief
CSBG Eligible Public or Type of Entity
Served by county Description of
Entity Nonprofit (choose all that apply)
(Provide all counties) “Other”
[Narrative, 2500 [Select • Community Action [Narrative, [Narrative,
Characters] Public or Agency 2500 2500
Nonprofit] • Limited Purpose Agency Characters] characters]
• Local Government
Agency If “Other” is
• Migrant or Seasonal selected in
Farmworker column 3,
Organization provide further
• Tribe or Tribal detail here
Organization
• Other (describe
City of Glendale Public Local Government Agency City of Glendale
Community Action (Maricopa County)
Program
City of Phoenix Public Local Government Agency City of Phoenix
Human Services (Maricopa County)
Department
Coconino County Public Local Government Agency Coconino County
Community Services
Department
Community Action Private Community Action Agency Pinal County
Human Resources
Agency
Gila County Public Local Government Agency Gila County
Community Action
Agency
Maricopa County Public Local Government Agency Balance of
Human Services Maricopa County
Department
Mesa Community Private Community Action Agency City of Mesa
Action Network (Maricopa County)

Northern Arizona Public Other Yavapai, Navajo, Quasi-
Council of and Apache Governmental
Governments Counties Agency/
Association of
Governments
Pima County Public Local Government Agency Pima County
Community Action
Agency
Southeastern Private Community Action Agency Greenlee, Graham,
Arizona Community Cochise, and Santa
Action Program Cruz Counties
Western Arizona Public Other Mohave, Yuma and Quasi-
Council of La Paz Counties Governmental
Governments Agency/
Association of
Governments
Portable, Practical, Private Migrant or Seasonal Statewide
Education Farmworker Organization
Preparation, Inc.
ADD A ROW function Note: rows will be able to be added for each eligible entity funded in the State
5.2. Total number of CSBG eligible entities: 12 [This will automatically update based on chart
in 5.1]
5.3. Changes to Eligible Entities List: Has the list of eligible entities under item 5.1 changed since
the State’s last State Plan submission? If yes, briefly describe the changes.  Yes  No
[If yes is selected – Narrative, 2500 characters]
Instructional Note: Limited Purpose Agency refers to an eligible entity that was designated as
a limited purpose agency under title II of the Economic Opportunity Act of 1964 for fiscal year
1981, that served the general purposes of a community action agency under title II of the
Economic Opportunity Act, that did not lose its designation as a limited purpose agency
under title II of the Economic Opportunity Act as a result of failure to comply with that Act
and that has not lost its designation as an eligible entity under the CSBG Act.
Instructional Note: 90 percent funds are the funds a State provides to eligible entities to
carry out the purposes of the CSBG Act, as described under Section 675C of the CSBG Act. A
State must provide “no less than 90 percent” of their CSBG allocation, under Section 675B, to
the eligible entities.
DAAS/CSA Comments Section 5 Date(s): 1/4/16
Reason(s) for Change: No changes
End of Section 5

SECTION 6
Organizational Standards for Eligible Entities
Note: Reference IM 138, State Establishment of Organizational Standards for CSBG Eligible Entities, for
more information on Organizational Standards. Click HERE for IM 138.
6.1. Choice of Standards: Check the box that applies. If using alternative standards, a) attach the
complete list of alternative organizational standards, b) describe the reasons for using
alternative standards, and c) describe how the standards are at least as rigorous as the COE-
developed standards.
 The State will use the CSBG Organizational Standards Center of Excellence (COE)
organizational standards (as described in IM 138)
 The State will use an alternative set of organizational standards [Attach supporting
documentation if this option is selected]
6.2. If the State is using the COE-developed organizational standards, does the State propose
making a minor modification to the standards, as described in IM 138?  Yes  No
6.2a. If yes was selected in item 6.2, describe the State’s proposed minor modification to the
COE-developed organizational standards, and provide a rationale. [Narrative, 2500
Characters]
N/A
6.3. How will/has the State officially adopt(ed) organizational standards for eligible entities in the
State in a manner consistent with the State’s administrative procedures act? If “Other” is
selected, provide a timeline and additional information, as necessary. [Check all that applies
and narrative where applicable]
 Regulation
 Policy
 Contracts with eligible entities
 Other, describe: [Narrative, 2500 Characters]
6.4. How will the State assess eligible entities against organizational standards, as described in IM
138? [Check all that applies]
 Peer-to-peer review (with validation by the State or State-authorized third party)
 Self-assessment (with validation by the State or State-authorized third party)
 Self-assessment/peer review with State risk analysis
 State-authorized third party validation
 Regular, on-site CSBG monitoring
 Other

6.4a. Describe the assessment process. [Narrative, 2500 Characters]
In SFY 2015, all eligible entities completed an agency self-assessment. Agencies were instructed to
provide technical assistance requests related to Standards that were partially met, were not met, or if
agencies were unsure of their status relative to each standard. In SFY 2016, the State is developing a
technical assistance plan in coordination with the eligible entities. The state association provided
technical assistance on the topic of strategic planning in SFY 2016. In CSBG State program years SFYs
2016 and 2017, DAAS/CSA will conduct an assessment of all eligible entities in conjunction with the
State monitoring schedule to assess compliance with standards and develop individual technical
assistance plans with each entity as needed. DAAS/CSA began agency assessments in the fall of 2015,
in coordination with the State monitoring schedule. Technical assistance plans will be created for
agencies who fail to meet Standards, or who are implementing Standards in FFY 2016. [#] Agencies
have been assessed since October 2015 and are substantially compliant with most Standards, and are
implementing remaining Standards in FFY 2016. DAAS/CSA will complete assessments in SFY 2017
and update this section in the FFY 2018 State Plan amendment.
Network Comments Section 6.1-6.4 Date(s):
DAAS/CSA Comments – Section 6.1-6.4 Date(s):
Reason(s) for Change: New question – added text
Narrative updated for FFY 2017. See State Plan document FFYs 2015-2016, Section V.A.B. Agencies
assessed by August 1, 2016 will be included in final count. Language tweaked for clarity.
6.5. Will the State make exceptions in applying the organizational standards for any eligible entities
due to special circumstances or organizational characteristics, as described in IM 138?
 Yes  No
Standard 8.5: A non-profit eligible entity that is a smaller “agency within an agency” whose tripartite
board does not have the authority to procure accounting services, and whose CSBG allocations do
not exceed the minimum funding variable of $150,000, will not be bound by the Standard requirement
to have “solicited bids for its audit within the past 5 years.” See IM 138. At the discretion of the
State, Standard 8.5, as written for public agencies, shall apply to such non-profit agencies. The State
will require justification from agencies that take this position, and will approve such an exemption
only if it is determined by the State that this activity is out of the purview of the agency Tripartite
Board, and agency allocations do not exceed the funding allocation indicated above.
6.5a. If yes was selected in item 6.5, list the specific eligible entities the State will exempt from
meeting organizational standards, and provide a description and a justification for each
exemption. [Narrative, 2500 characters or attach document]
Portable Practical Education Preparation – Standard 8.5: Agency receives approximately $100,000 in
CSBG funding per SFY to support programs funded by over $2,000,000 million in federal, local, and
private funds. This agency has an annual budget of nearly $24,000,000. The agency Tripartite Board
operates under the authority of a larger governing board and only has authority over CSBG and other
leveraged funds under its Community Action program. CSBG funds are not used to pay for the services

of the agency’s accounting firm and the Board does not have the authority to approve the selection of
an agency-wide auditor.
Network Comments – Section 6.5 Date(s):
DAAS/CSA Comments – Section 6.5 Date(s):
Reason(s) for Change: New question – added text
Narrative added
If this is the first year filling out the automated State Plan, skip the following question.
6.6. Performance Target: What percentage of eligible entities in the State does the State expect will
meet all the State-adopted organizational standards in the next year? [Insert a percentage]
100%
Note: This information is associated with State Accountability Measures 6Sa and may pre-
populate the State’s annual report form.
Network Comments – Section 6.6 Date(s):
DAAS/CSA Comments – Section 6.6 Date(s):
Reason(s) for Change: New question for FFY 2017
End of Section 6

SECTION 7
State Use of Funds
Eligible Entity Allocation (90 Percent Funds) [Section 675C(a) of the CSBG Act]
7.1 Formula: Select the method (formula) that best describes the current practice for allocating
CSBG funds to eligible entities. [Check one and narrative where applicable]
 Historic
 Base + Formula
 Formula Alone
 Formula with Variables
 Hold Harmless + Formula
 Other [Narrative, 2500 Characters]
7.1a. Does the State statutory or regulatory authority specify the terms or formula for
allocating the 90 percent funds among eligible entities?  Yes No
7.2. Planned Allocation: Specify the planned allocation of 90 percent funds to eligible entities, as
described under Section 675C(a) of the CSBG Act. The estimated allocations may be in
dollars or percentages. For each eligible entity receiving funds, provide the Funding Amount
in either dollars (columns 2 and 4) or percentage (columns 3 and 5) for the fiscal years
covered by this plan.
Planned CSBG 90 Percent Funds
Year One Year Two
CSBG Eligible
Funding Amount Funding Amount Funding Amount Funding Amount
Entity
$ % $ %
Will be auto- Enter either the dollar amount or
populated from Enter either the dollar amount or percentage for each eligible entity for
Section 5, Table percentage for each eligible entity for the second year that this plan covers
5.1, Column 1 the first year that this plan covers (If this is a one-year plan, these
columns can be left blank)
City of Glendale
Community Action $ 190,479 $ 190,479
Program
City of Phoenix Human $ 1,286,962 $ 1,286,962
Services Department
Coconino County
Community Services $ 150,000 $ 150,000
Department
Community Action
Human Resources $ 272,403 $ 272,403
Agency
Gila County Community $ 150,000 $ 150,000
Action Agency
Maricopa County Human $ 811,075 $ 811,075
Services Department
Mesa Community Action $ 294,411 $ 294,411
Network

Northern Arizona $ 235,376 $ 235,376
Council of Governments
Pima County Community $ 692,289 $ 692,289
Action Agency
Southeastern Arizona
Community Action $ 208,297 $ 208,297
Program
Western Arizona Council $ 471,007 $ 471,007
of Governments
Portable, Practical,
Education Preparation, $ 97,190 $ 97,190
Inc.
Total Totals will be auto-populated Totals will be auto-populated
Network Comments - Section 7.2 Date(s):
DAAS/CSA Comments - Section 7.2 Date(s):
Reason(s) for Change: Updated allocations
Allocations updated using March 2016 Alert numbers. No other changes. Source: FFYs 2015-2016
CSBG State Plan Amended, FFYs 2015-2016, Section V.3.
7.3. Distribution Process: Describe the specific steps in the State’s process for distributing 90
percent funds to the eligible entities and include the number of days each step is expected
to take; include information about State legislative approval or other types of
administrative approval (such as approval by a board or commission). [Narrative, 2500
Characters]
The State operates the Community Action Program on the State Fiscal Year (SFY): July 1 through
June 30. The State enters into five-year budget based/cost reimbursement contracts with eligible
entities. Upon notification from OCS of annual allotment, DAAS/CSA communicates estimated
annual allocations to eligible entities for the upcoming SFY in February or March prior to the
beginning of the upcoming SFY.
DAAS/CSA calls these communications “ALERTS”. Following any subsequent federal allocation
change, OCS Notices of Award, etc., dollars are announced each quarter as they occur. The award
of the previous year’s carryover is also announced in August of the current fiscal year. If contract
dollar amounts are changed, DAAS/CSA amends the contract to reflect funding changes.
Network Comments – Section 7.3 Date:
DAAS/CSA Comments – Section 7.3 Date(s):
Reason(s) for Change: New question – added text
Narrative updated for FFY 2017. See Attachment 3, FFY 2017 Funding Formula. Information derived
from the FFY 2016 State Plan Amendment document, Section V. B. Note: The source for the
unemployment factor has been changed from the Arizona Department of Administration Unemployment

Statistics Program Special Unemployment Report to the most recent annual Local Area Unemployment
Survey (LAUS).
7.4. Distribution Timeframe: Does the State plan to make funds available to eligible entities no
later than 30 calendar days after OCS distributes the Federal award?  Yes  No
7.4a. If no, describe State procedures to ensure funds are made available to eligible entities
consistently and without interruption. [Narrative, 2500 Characters]
Eligible entities annually submit a proposed Itemized Service Budget (ISB) document for allowable
expenditures for activities included in the agency’s CAP Plan. Eligible entities invoice the State on
a monthly basis for these allowable expenditures under CSBG. Invoices are due on the 25th of each
month. Larger public entities may be allowed to invoice semi-monthly upon DAAS/CSA approval.
Invoices must include backup documentation for expenditures billed. DAAS/CSA is bound by
contract with the eligible entities to make payments on approved invoices within 30 days.
Payments on invoices may be delayed temporarily pending the submission of past due contract
deliverables, such as Community Action Plan documents or required reports, or for incomplete
documentation.
Network Comments – Section 7.4 Date(s):
DAAS/CSA Comments – Section 7.4 Date(s): 1/4/16
Reason(s) for Change: New question – added text
New section; not in previous Plan document. This new section would have fallen under FFY 2016 State
Plan Amendment document, Sections V. B. and C. The previous model plan did not request a
distribution timeframe.
Note: Item 7.4 is associated with State Accountability Measure 2Sa and may pre-populate the
State’s annual report form.
If this is the first year filling out the automated State Plan, skip the following question.
7.5. Performance Management Adjustment: How is the State improving grant and/or contract
administration procedures under this State Plan as compared to past plans? Any improvements
should be based on analysis of past performance, and should consider feedback from eligible
entities, OCS, and other sources, such as the public hearing. If the State is not making any
improvements, provide further detail. [Narrative, 2500 Characters]
The State is currently participating Government Transformation with a focus on implementing lean
initiatives to dramatically shorten the time for developing Requests for Applications (RFAs). Once
implemented, a shorter timeframe will benefit eligible entities by communicating contract changes
sooner and reduce State administrative costs.
Note: This information is associated with State Accountability Measure 2Sb and may pre-
populate the State’s annual report form.

Network Comments – Section 7.5 Date(s):
DAAS/CSA Comments Section 7.5 Date(s): 1/4/16
Reason(s) for Change: New question – added text
Not required in FFY 2016. Narrative response added as new question for FFY 2017 and going
forward requests description of the State’s contract administration procedures.
Administrative Funds [Section 675C(b)(2) of the CSBG Act]
7.6. What amount of State CSBG funds does the State plan to allocate for administrative activities,
under this State Plan? The estimate may be in dollars or a percentage. [Numeric response,
specify $ or %]
5%
7.7. How many State staff positions will be funded in whole or in part with CSBG funds under this
State Plan? [Insert a number between 0 – 99]
8
7.8. How many State Full Time Equivalents (FTEs) will be funded with CSBG funds under this State
Plan? [Insert a number between 0 – 99]
1.78
Network Comments – Section 7 - General Date(s):
DAAS/CSA Comments – Section 7 - General Date(s):
Reason(s) for Change: New question – added text
7.6 -7.8: These numbers have been historically reported on the CSBG IS Survey and are updated
annually in late March.
Remainder/Discretionary Funds [Section 675C(b) of the CSBG Act]
7.9. Does the State have remainder/discretionary funds?  Yes  No
If yes was selected, describe how the State plans to use remainder/discretionary funds in the
table below.
Note: This response will link to the corresponding assurance, item 14.2.
Instructional Note: The assurance under 676(b)(2) of the Act (item 14.2 of this State Plan)
specifically requires a description of how the State intends to use remainder/discretionary
funds to “support innovative community and neighborhood-based initiatives related to the
purposes of [the CSBG Act].” Include this description in row “f” of the table below and/or
attach the information.
If a funded activity fits under more than one category in the table, allocate the funds among
the categories. For example, if the State provides funds under a contract with the State

Community Action association to provide training and technical assistance to eligible
entities and to create a statewide data system, the funds for that contract should be
allocated appropriately between row a and row c. If allocation is not possible, the State may
allocate the funds to the main category with which the activity is associated.
Note: This information is associated with State Accountability Measures 3Sa; the
responses may pre-populate the State’s annual report form.
Use of Remainder/Discretionary Funds
Remainder/ Year One Year Two
Brief description of
Discretionary Fund Uses
Planned $ Planned % Planned $ Planned % services/activities
(See 675C(b)(1) of the CSBG Act)
[Enter either a planned $ or % for each item listed for the first
year that this plan covers. If entering a percentage, the
percentages must total 100%.]
[Not Fillable] These
planned
a. Training/technical
$ 100,000 $ 100,000 services/activities
assistance to eligible entities
will be described in
State Plan item 8.1
[Optional Narrative,
2500 characters]
These planned
b. Coordination of State-
services/activities
operated programs and/or
will be described in
local programs
State Plan section 9,
State Linkages and
Communication.
[Optional Narrative,
2500 characters]
These planned
c. Statewide coordination and
services/activities
communication among $ 55,000 $ 55,000
will be described in
eligible entities
State Plan section 9,
State Linkages and
Communication.
d. Analysis of distribution of
[Narrative, 2500
CSBG funds to determine if
Characters]
targeting greatest need
[Narrative, 2500
e. Asset-building programs
Characters]
[REQUIRED
Narrative, 2500
characters] Describe
f. Innovative programs/
activities by eligible entities $ 88,820 $ 88,820 here or attach
additional
or other neighborhood
information. Special
groups
Projects - See
below:
Totals Auto- Auto- Auto- Auto-
Calculated Calculated Calculated Calculated

A portion of CSBG discretionary funds are made available, at the discretion of the State, to support
statewide activities, or to support innovative programs or projects aimed at eliminating one or more
causes of poverty and/or promoting self-sufficiency among low-income households. Funds made
available under Special Projects are intended to provide support for a specified timeframe. For FFYs
2017 and 2018, requests for funds to support Special Projects will be accepted from eligible entities
between March 1 and April 30 of each year and identified as a funding opportunity through a
Community Action Network ALERT (notification of funding distributions and/or policy/contract
modifications). Requests must provide an outline of the objectives, employment impacts, and expected
outcomes; a listing of the proposed partner organizations and description of the roles those
organizations will play; and particular ROMA National Performance Indicators (NPIs) where outcomes
were reported.
City of Phoenix Human Service Department (COPHSD), was awarded $49,500 in CSBG discretionary
Special Projects funds in SFY 2016. COPHSD will continue to upgrade its technology at its three
Family Service Centers and fifteen Senior Service Centers by purchasing and installing 60 electronic
signature pads and three additional computer stations to facilitate electronic document collection and
retention, and expedite client services. This project will continue to improve upon the ongoing
implementation of a paperless service delivery model. This project will maintain and increase the
agency’s capacity to serve low-income households more efficiently and with greater flexibility. The
agency estimated in SFY 2015 the system once fully operational, will save over $30,000 per year in
administrative costs incurred by creating, copying, printing and maintaining hard files.
Maricopa County Human Services Department (MCHSD), was allowed to carryover $55,000 in CSBG
discretionary Special Project Funds from SFY 2015. These funds were originally awarded in SFY 2015
for a case management research and development project, but the agency has identified a community
need that takes priority over agency development at this time. Maricopa County Human Services
Department has identified that the funds will be used for the assessment, service coordination, and
overnight accommodations for homeless individuals at the Human Services Campus.
Homeless women and men who are unable to obtain formal shelter or housing will be engaged, assessed,
assisted, receive coordinated services, and be provided safe overnight accommodations. The funds will
be used towards achieving the following goals: reducing the length of stay in shelters, increasing the
percentage of homeless clients assessed and placed in housing, reducing chronic homelessness, and
reducing the number of homeless persons in our community. It is expected that these funds will assist
approximately 400 homeless individuals per night in receiving shelter accommodations. These funds
will be used in coordination with funding from other community collaborators, including Valley of the
Sun United Way and the City of Phoenix, to ensure the regional success of this initiative.
Network Comments- Section 7.9 Date(s):
DAAS/CSA Comments - - Section 7.9 Date(s): 1/11/16
Reason(s) for Change: Updates
Relevant dates updated. Maricopa County discretionary narrative will be updated to describe current
use of carryover discretionary funds. Source for DAAS narrative: FFYs 2015-2016 CSBG State Plan
Amended, Section V, Section V. D., FFYs, 2015-2016

7.10. What types of organizations, if any, does the State plan to work with (by grant or contract using
remainder/discretionary funds) to carry out some or all of the activities in table 7.9.
[Check all that apply and narrative where applicable]
 CSBG eligible entities (if checked, include the expected number of CSBG eligible entities to
receive funds) [Narrative, 2500 Characters]
 Other community-based organizations
 State Community Action association
 Regional CSBG technical assistance provider(s)
 National technical assistance provider(s)
 Individual consultant(s)
 Tribes and Tribal Organizations
 Other [Narrative, 2500 Characters]
 None (the State will carry out activities directly)
Note: This response will link to the corresponding CSBG assurance, item 14.2.
If this is the first year filling out the automated State Plan, skip the following question.
7.11. Performance Management Adjustment: How is the State adjusting the use of
remainder/discretionary funds under this State Plan as compared to past plans? Any
adjustment should be based on the State’s analysis of past performance, and should consider
feedback from eligible entities, OCS, and other sources, such as the public hearing. If the
State is not making any adjustments, provide further detail. [Narrative, 2500 Characters]
Note: This information is associated with State Accountability Measures 3Sb, and will
pre- populate the State’s annual report form.
Network Comments - Section 7 Date(s):
DAAS/CSA Comments- Section 7 Date(s): 1/11/16
Reason(s) for Change: Updates
No response in FFY 2017. DAAS/CSA will work with the Community Action Network to develop a
response for the FFY 2018 Amendment.
End of Section 7

SECTION 8
State Training and Technical Assistance
8.1. Describe the State’s plan for delivering CSBG-funded training and technical assistance to eligible
entities under this State Plan by completing the table below. Add a row for each activity: indicate
the timeframe; whether it is training, technical assistance or both; and the topic. (CSBG funding
used for this activity is referenced under item 7.9(a), Use of remainder/discretionary Funds.)
Note: 8.1 is associated with State Accountability Measure 3Sc and may pre-populate the
State’s annual report form.
Training and Technical Assistance
Fiscal Year (Y) Quarter Training, Technical
Topic Brief Description of “Other”
(Q) / Timeframe Assistance, or Both
Dropdown options: Toggle Options: Dropdown Options: [Narrative, 2500 Characters]
• FY1 – Q1 • Training • Fiscal
• FY1 – Q2 • Technical Assistance • Governance/Tripartite If “Other" is selected in
• FY1 – Q3 • Both Boards column 3, describe in this
• FY1 – Q4 • Organizational Standards column
• FY2 – Q1 – General
• FY2 – Q2 • Organizational Standards
• FY2 – Q3 – for eligible entities with
• FY2 – Q4 unmet standards on
• Ongoing / Multiple Technical Assistance
Quarters Plans (TAPs) or Quality
• All quarters Improvement Plans
(QIPs)
• Correcting Significant
Deficiencies Among
Eligible Entities
• Reporting
• ROMA
• Community Assessment
• Strategic Planning
• Monitoring
• Communication
• Technology
• Other
ADD a ROW function Note: Rows will be able to be added for each additional training

SAMPLE: The following is a sample of how this table can be completed:
Training and Technical Assistance
Fiscal Year (FY) Quarter Training, Technical
Topic Brief Description of “Other”
(Q) / Timeframe Assistance, or Both
FY1 - Q1 Training Fiscal
FY1 - Q1 Technical Assistance Monitoring
FY1 - Q3 Both Other Conference to include T/TA
Training and Technical Assistance
Fiscal Year (FY) Quarter Training, Technical
Topic Brief Description of “Other”
(Q) / Timeframe Assistance, or Both
FY1 - Q4 Training ROMA
38T 38T 38T
State Response Training and Technical Assistance
FY1 - Q1 Technical Assistance Organizational Standards -
General
FY1 - Q1 Technical Assistance Monitoring - General
FY1 - Q2 Technical Assistance Monitoring - General
FY1 - Q2 Training ROMA
FY1 - Q2 Technical Assistance Monitoring
FY1 - Q3 Training ROMA
FY1 - Q3 Training Other Program delivery
FY2 - Q4 Technical Assistance Reporting
FY1 - Q4 Technical Assistance Fiscal
FY2 - Q1 Technical Assistance Organizational Standards -
for eligible entities with
unmet standards
FY2 - Q1 Training Monitoring
FY2 - Q1 Training Governance/Tripartite Boards
FY2 - Q3 Training ROMA
FY1 - Q4 Training Monitoring
Choose an item. Choose an item. Choose an item.
A portion of CSBG discretionary funds will be targeted to provide the training and technical assistance
needs of eligible entities. The State will work closely with the statewide association in consultation with
the Community Action Network, to develop a training and technical assistance (T/TA) strategy that will
outline the various T/TA activities to be conducted including, but not limited to, the following:
 Tripartite boards, such as new member orientation and low-income representative recruitment;
 ROMA training for agency staff and board members with respect to goal setting and evaluation
of outcomes; and
 Basics of preparing the annual CSBG Information System Survey/CSBG Annual Report.

The State will investigate options in conjunction with the Community Action Network, to develop
further training and technical assistance priorities for implementation in SFY 2018. This schedule will
be adjusted based on the availability of agency staff, boards and trainers. The FFY 2018 amendment
will reflect any changes.
Network Comments – Section 8.1 Date(s):
DAAS/CSA Comments – Section 8.1 Date(s): 1/4/16
Reason(s) for Change: Added section
Sources: CSBG State Plan Document, Section V. D., FFYs, 2015-2016, Amended for FFY 2016 and FFY
2016 form SF-424. OCS requests a description of the State’s technical assistance plan with timeframes.
CSBG Administration and the State Association personnel should review and agree upon dates and subject
matter for SFY 2017 and 2018. Sec. 8.1a. will prepopulate from sec. 7.9. Language tweaked for clarity.
8.1a. The planned budget for the training and technical assistance plan (as indicated in the
remainder/discretionary funds table in item 7.9): [$100,000][Prepopulated with the
budget allocation for years one and two under 7.9a]
If this is the implementation year for organizational standards, skip question 8.2.
8.2. Does the State have in place Technical Assistance Plans (TAPs) or Quality Improvement Plans
(QIPs) for all eligible entities with unmet organizational standards, if appropriate?  Yes  No
Note: 8.2 is associated with State Accountability Measure 6Sb. QIPs are described in Section
678C(a)(4) of the CSBG Act. If the State, according to their corrective action procedures, does
not plan to put a QIP in place for an eligible entity with one or more unmet organizational
standards, the State should put a TAP in place to support the entity in meeting the
standard(s).
8.3. Indicate the types of organizations through which the State plans to provide training and/or
technical assistance as described in item 8.1, and briefly describe their involvement? (Check all
that apply.) [Check all that applies and narrative where applicable]
 CSBG eligible entities (if checked, provide the expected number of CSBG eligible entities to
receive funds) [Narrative, 2500 Characters]
 Other community-based organizations
 State Community Action association
 Regional CSBG technical assistance provider(s)
 National technical assistance provider(s)
 Individual consultant(s)
 Tribes and Tribal Organizations
 Other [Narrative, 2500 Characters]

If this is the first year filling out the automated State Plan, skip the following question.
8.4. Performance Management Adjustment: How is the State adjusting the training and technical
assistance plan under this State Plan as compared to past plans? Any adjustment should be
based on the State’s analysis of past performance, and should consider feedback from eligible
entities, OCS, and other sources, such as the public hearing. If the State is not making any
adjustments, provide further detail. [Narrative, 2500 Characters]
Note: This information is associated with State Accountability Measures 3Sd and may pre-
populate the State’s annual report form.
Network Comments – Section 8 Date(s):
DAAS/CSA Comments – Section 8 Date (s): 2/8/16
Reason(s) for Change: New question for FFY 2017.
The State will develop a response in consultation with the Community Action Network for this item
for FFY 2018.
End of Section 8

SECTION 9
State Linkages and Communication
Note: This section describes activities that the State may support with CSBG remainder/discretionary
funds, described under Section 675C(b)(1) of the CSBG Act. The State may indicate planned use of
remainder/discretionary funds for linkage/communication activities in Section 7, State Use of Funds,
items 7.9(b) and (c).
9.1. State Linkages and Coordination at the State Level: Describe the linkages and coordination at
the State level that the State plans to create or maintain to ensure increased access to CSBG
services to low-income people and communities under this State Plan and avoid duplication of
services (as required by the assurance under Section 676(b)(5)). Describe or attach additional
information as needed. [Check all that apply from the list below and provide a Narrative, 2500
Characters]
Note: This response will link to the corresponding CSBG assurance, item 14.5. In addition, this
item is associated with State Accountability Measure 7Sa and may pre-populate the State’s
annual report form.
 State Low Income Home Energy Assistance Program (LIHEAP) office
 State Weatherization office
 State Temporary Assistance for Needy Families (TANF) office
 State Head Start office
 State public health office
 State education department
 State Workforce Innovation and Opportunity Act (WIOA) agency
 State budget office
 Supplemental Nutrition Assistance Program (SNAP)
 State child welfare office
 State housing office
 Other
9.2. State Linkages and Coordination at the Local Level: Describe the linkages and coordination at
the local level that the State plans to create or maintain with governmental and other social
services, especially antipoverty programs, to assure the effective delivery of and coordination
of CSBG services to low-income people and communities and avoid duplication of services (as
required by assurances under Sections 676(b)(5) and (b)(6)). Attach additional information as
needed. [Narrative, 2500 Characters]
Linkage programs may include family/individual counseling, transportation, programs for persons
with disabilities and seniors, neighborhood activities, food and nutrition, information and referral,
local needs assessments, community outreach summer recreation, and other miscellaneous projects
involving formal and informal partnerships and organizational relationships in the community.

Network Comments – Sections 9.1 and 9.2 Date (s):
DAAS/CSA Comments – Sections 9.1 and 9.2 Date(s):
Reason(s) for Change: Updated text
See FFYs 2015-2016 CSBG State Plan document Amended, Section V.F. b.
Note: This response will link to the corresponding CSBG assurances, items 14.5 and 14.6.
9.3. Eligible Entity Linkages and Coordination
9.3a State Assurance of Eligible Entity Linkages and Coordination: Describe how the State
will assure that the eligible entities will coordinate and establish linkages to assure the
effective delivery of and coordination of CSBG services to low-income people and
communities and avoid duplication of services (as required by the assurance under
Section 676(b)(5)). Attach additional information as needed. [Narrative, 2500
Characters]
Eligible entities are required by contract to establish linkages per Section 676(b)(5). Eligible entities
develop linkages to fill identified gaps in services, through the provision of information, referrals, case
management, and follow-up consultations. Some eligible entities develop linkages with local private
organizations, such as financial institutions, to develop IDA programs. Others contract with local non-
profit agencies to provide specific services in their communities not offered by the eligible entity, such
as food banks and job training programs. Some of these relationships are informal, others are
subcontracted, and still others operate under Memorandums of Understanding (MOUs).
See attached examples provided by select CAAs. See Attachment 4, Sections 9 and 14 - Service
Delivery System and Program Narratives and Attachment 6, Scope of Work.
Note: This response will link to the corresponding CSBG assurance, item 14.5.
9.3b State Assurance of Eligible Entity Linkages to Fill Service Gaps: Describe how the eligible
entities will develop linkages to fill identified gaps in the services, through the provision
of information, referrals, case management, and follow-up consultations, according to
the assurance under Section 676(b)(3)(B) of the CSBG Act. [Narrative, 2500 Characters]
Eligible entities are required by contract to establish linkages to fill service gaps per Section
676(b)(3)(B). See attached examples provided by select CAAs. DAAS/CSA requires eligible entities
to describe in detail, in their annual/biannual CAP Plans and in their five-year contract renewal
RFA responses, how they will fulfill this assurance. See Attachment 6, Scope of Work 2016-2020.
Note: This response will link to the corresponding CSBG assurance, item 14.3b.
9.4. Workforce Innovation and Opportunity Act (WIOA) Employment and Training Activities: Does
the State intend to include CSBG employment and training activities as part of a WIOA
Combined State Plan, as allowed under the Workforce Innovation and Opportunity Act (as
required by the assurance under Section 676(b)(5) of the CSBG Act)?  Yes  No

Coordination occurs through joint planning, formal and informal meetings, cooperative contracting
procedures, Memorandums of Understanding, and the exchange of significant correspondence and
information. The State will encourage coordination and collaborative efforts between programs at
the community level. DES administers the Workforce Innovation and Opportunity Act (WIOA)
program. Through the eligible entities, coordination and/or referral services are provided among
private local agencies such as, United Way and other local charities.
The Community Services Administration (CSA) is further developing a coordination strategy with
the DES Division of Employment and Rehabilitation Services (DERS), which administers the State
WIOA office. At present, this office operates separately from the State CSBG Office. The new DES
Office of Community Engagement is also encouraging communication and coordination efforts
across divisions, among other State agencies and in the community at large. DAAS/CSA is
participating in these activities to promote Community Action.
Note: This response will link to the corresponding CSBG assurance, item 14.5.
9.4a If the State selected “yes” under item 9.4, provide the CSBG-specific information
included in the State’s WIOA Combined Plan. This information includes a description of
how the State and the eligible entities will coordinate the provision of employment and
training activities through statewide and local WIOA workforce development systems.
This information may also include examples of innovative employment and training
programs and activities conducted by community action agencies or other neighbor-
hood-based organizations as part of a community antipoverty strategy. [Narrative, 2500
Characters]
9.4b. If the State selected “no” under item 9.4, describe the coordination of employment and
training activities, as defined in Section 3 of WIOA, by the State and by eligible entities
providing activities through the WIOA system. [Narrative, 2500 Characters]
WIOA coordination activities are conducted at the CAA level within local communities. DAAS/CSA
initiated coordination with the State WIOA office in SFY 2015. These efforts will continue in SFY
2016. Some agencies have the WIOA offices on their own premises, while others make referrals to
the local WIOA office. DAAS/CSA interviews agency staff during monitoring site visits regarding
the details of the eligible entity’s WIOA activities. Updates to this initiative will be included in the
amended two-year Plan for FFY 2018.
9.5. Emergency Energy Crisis Intervention: Describe how the State will assure, where appropriate,
that emergency energy crisis intervention programs under title XXVI (relating to Low-Income
Home Energy Assistance) are conducted in each community in the State, as required by the
assurance under Section 676(b)(6) of the CSBG Act). [Narrative, 2500 Characters]
DES coordinates with the Low Income Home Energy Assistance Program (LIHEAP) and the
Temporary Assistance to Needy Families (TANF)-funded State Short-Term Crisis Services (STCS)
program via the Community Action Program Services contracts with eligible entities. CAAs utilize
CSBG funds to manage and deliver energy assistance programs, including emergency energy crisis
services.

Note: This response will link to the corresponding CSBG assurance, item 14.6.
Network Comments – Section 9.3 – 9.5 Date(s):
DAAS/CSA Comments – Section 9.3 – 9.5 Date(s): 1/11/16
Reason(s) for Change: New narrative requested by OCS.
9.6. State Assurance: Faith-based Organizations, Charitable Groups, Community Organizations:
Describe how the State will assure local eligible entities will coordinate and form
partnerships with other organizations, including faith-based organizations, charitable
groups, and community organizations, according to the State’s assurance under Section
676(b)(9) of the CSBG Act. [Narrative, 2500 characters OR attach a document]
This assurance is required by the DAAS/CSA Community Action Program Services contract.
Eligible entities are required to describe in their CAP Plans and in their five-year RFA response
how they will meet this assurance. State monitoring staff inquire at monitoring site visits regarding
community coordination activities. Agencies document these efforts in annual narratives and on
their annual CSBG IS reports. See Attachment 4, Sections 9 and 14 - Service Delivery System and
Program Narratives
Note: this response will link to the corresponding assurance, item 14.9
9.7 Coordination of Eligible Entity 90 Percent Funds with Public/Private Resources: Describe
how the eligible entities will coordinate CSBG 90 percent funds with other public and private
resources, according to the assurance under Section 676(b)(3)(C) of the CSBG Act. [Narrative,
2500 Characters]
DAAS/CSA requires eligible entities to describe in detail in their annual/biannual CAP Plans and
in their five-year contract RFA responses how they will fulfill this assurance. Eligible entities
report on these efforts in their Annual CSBG IS Report.
Note: this response will link to the corresponding assurance, item 14.3c.
9.8. Coordination among Eligible Entities and State Community Action Association: Describe
State activities for supporting coordination among the eligible entities and the State
Community Action Association. [Narrative, 2500 Characters]
DAAS/CSA conducts monthly meetings via teleconference and/or face to face meetings with the
eligible entities and the state association, and provides funding to the state association for
coordination activities.

9.9 Communication with Eligible Entities and the State Community Action Association: In the
table below, describe the State’s plan for communicating with eligible entities, the State
Community Action Association, and other partners under this State Plan. Include
communication about annual hearings and legislative hearings, as described under Section
4, CSBG Hearing Requirements.
Communication
Topic Expected Frequency Format (drop down) Brief Description of “Other”
[Narrative, 2500 Dropdown Options: Dropdown Options: [Narrative, 2500 Characters]
Characters] Meetings, • Daily • Newsletter
teleconferences, and • Weekly • Mailing If “Other" is selected in
technical bulletins called • Twice-Monthly • Meetings/Presentation columns 2 and/or 3, describe
“Alerts” that are sent • Monthly • Blog in this column
directly to eligible entities
• Quarterly • Email
and posted on the DES
website. • Semi-Annually • Website
• Annually • Social Media
• Other • Other
ADD a ROW function Note: As many rows that are needed will be able to be added
9.10. Feedback to Eligible Entities and State Community Action Association: Describe how the
State will provide feedback to local entities and State Community Action Associations
regarding performance on State Accountability Measures. [Narrative, 2500 Characters]
DAAS/CSA has initiated discussions with the Network in 2016 on State Accountability Measures.
A more detailed narrative for this item is being developed in coordination with the Network for the
FFY 2018 CSBG State Plan Amendment.
Note: This information is associated with State Accountability Measure 5S(iii). The
measure indicates feedback should be provided within 60 calendar days of the State
getting feedback from OCS
Network Comments – Sections 9.6 – 9.10 Date(s):
DAAS/CSA Comments– Sections 9.6 – 9.10 Date(s):
Reason(s) for Change: Existing assurance, new narrative requested in FFY 2016 –
Further discussion regarding a Communications Plan will be discussed with the Community Action
Network and narrative developed for FFY 2018. More detailed narrative may be included for FFY
2017 pending the outcome of discussions with the Community Action Network prior to the finalization
of the Plan.

If this is the first year filling out the automated State Plan, skip the following question.
9.11. Performance Management Adjustment: How is the State adjusting the Communication Plan in
this State Plan as compared to past plans? Any adjustment should be based on the State’s
analysis of past performance, and should consider feedback from eligible entities, OCS, and
other sources, such as the public hearing. If the State is not making any adjustments, provide
further detail. [Narrative, 2500 Characters]
Note: This information is associated with State Accountability Measures 7Sb; this response
may pre-populate the State’s annual report form.
A Communication Plan is being developed in coordination with the Network. A narrative response
to this item will be provided for the FFY 2018 CSBG State Plan Amendment.
Network Comments – Section 9 Date(s):
DAAS/CSA Comments – Section 9 Date (s):1/4/16
Reason(s) for Change: New narrative required
Not required in previous State Plans. New text to be added for FFY 2018.
End of Section 9

SECTION 10
Monitoring, Corrective Action, and Fiscal Controls
Monitoring of Eligible Entities (Section 678B(a) of the CSBG Act)
10.1. Specify the proposed schedule for planned monitoring visits including: full on-site reviews; on-
site reviews of newly designated entities; follow-up reviews – including return visits to entities
that failed to meet State goals, standards, and requirements; and other reviews as appropriate.
This is an estimated schedule to assist States in planning. States may indicate “no review”
for entities the State does not plan to monitor in the performance period.
For States that have a monitoring approach that does not fit within the table
parameters, attach the State’s proposed monitoring schedule.
Note: This information is associated with State Accountability Measure 4Sa(i); this
response may pre-populate the State’s annual report form.
CSBG Eligible Entity Review Type Target Date Date of Last Full Brief Description of
Onsite Review “Other”
(if applicable)
Dropdown Dropdown Options:
Options: • FY1 Q1
• FY1 Q2 [Narrative,
• Full onsite • FY1 Q3 2500
Will auto-populate from • Newly • FY1 Q4 Characters]
item 5.1 Designated • FY2 Q1 Select a date
• Follow-up • FY2 Q2 If “Other" is selected in
• Other • FY2 Q3 column 2, describe in
• No review • FY2 Q4 this column
To be determined
Network Comments – Section 10.1 Date(s):
DAAS/CSA Comments – Section 10.1 Date (s):1/4/16
Reason(s) for Change: New item
Schedule not required in previous State Plans. Refer to FFYs 2015-2016 CSBG State Plan document
Amended, Section V. G. for previous assurances regarding monitoring of eligible entities. DAAS/CSA
will respond in the dropdown boxes above with the monitoring schedule for SFY 2017 when determined.
Dropdown box entries will be included in the final draft for DAAS/CSA approval.

10.2. Monitoring Policies: Provide a copy of State monitoring policies and procedures by
attaching and/or providing a hyperlink. [Attach a document or add a link]
See Attachment 8 Attachments\Attachment 8 subrecipient_monitoring.pdf
10.3. Initial Monitoring Reports: According to the State’s procedures, by how many calendar days
must the State disseminate initial monitoring reports to local entities? [Insert a number from
1 – 100]
30
Note: This item is associated with State Accountability Measure 4Sa(ii) and may pre-
populate the State’s annual report form.
Corrective Action, Termination and Reduction of Funding and Assurance Requirements (Section 678C
of the Act)
10.4. Closing Findings: Are State procedures for addressing eligible entity findings/deficiencies, and
the documenting of closure of findings included in the State monitoring protocols attached
above?  Yes  No
10.4a. If no, describe State procedures for addressing eligible entity findings/deficiencies, and
the documenting of closure of findings. [Narrative, 2500 Characters]
DAAS/CSA prepares a Corrective Improvement Plan (CIP) or a Technical Assistance Plan (TAP)
and tracks time-bound objectives toward the remedy of findings and deficiencies. For serious
deficiencies, the State Office of Procurement may issue a demand for assurance letter to the eligible
entity for findings related to fiscal and administrative terms and conditions of the DAAS/CSA
contract. DAAS/CSA follows up with the agency to assure the completion of the CIP/TAP, making
follow up visits if necessary and providing technical assistance.
5. Quality Improvement Plans (QIPs): How many eligible entities are currently on Quality
Improvement Plans? [Numeric, 3 digits]
0
Note: The QIP information is associated with State Accountability Measures 4Sc.
10.6. Reporting of QIPs: Describe the State’s process for reporting eligible entities on QIPs to the
Office of Community Services within 30 calendar days of the State approving a QIP? [Narrative,
2500 characters]
Note: This item is associated with State Accountability Measure 4Sa(iii)).
DAAS/CSA does not currently report eligible entities on QIPs to the Office of Community Services.
As the CSBG Organizational Standards are still in the State approved assessment and
implementation period until SFY 2018, eligible entities that do not meet all applicable Standards
are placed on a TAP and assisted as needed to become compliant by SFY 2018. DAAS/CSA does
not currently have any eligible entities on QIPs.

10.7. Assurance on Funding Reduction or Termination: Does the State assure, according to Section
676(b)(8), that “any eligible entity that received CSBG funding the previous fiscal year will not
have its funding terminated or reduced below the proportional share of funding the entity
received in the previous fiscal year unless, after providing notice and an opportunity for a
hearing on the record, the State determines that cause exists for such termination or such
reduction, subject to review by the Secretary as provided in Section 678C(b).”  Yes  No
Note: This response will link with the corresponding assurance under item 14.8.
Policies on Eligible Entity Designation, De-designation, and Re-designation
10.8. Does the State CSBG statute and/or regulations provide for the designation of new eligible
entities? Yes  No
10.8a. If yes, provide the citation(s) of the law and/or regulation. If no, describe State
procedures for the designation of new eligible entities. [Narrative, 2500 Characters]
In designating a new eligible entity, the DAAS/CSA initiates a public solicitation process in
coordination with the State Office of Procurement within the unserved area. A public hearing is
held in the unserved area to inform the community of the proposed designation. A public Request
for Proposals is published via the State procurement office’s website, www.ProcureAZ.gov . Local
human service agencies may submit proposals for designation that contain all federal assurances
under CSBG, and State assurances as required. An evaluation committee within DAAS/CSA
determines the best qualified agency to be designated based upon qualifications stated and
completeness of response to required assurances in the RFP response. The agency selected then
completes a Request for Applications (RFA) response package identical to the RFA completed by
existing eligible entities every five years as mentioned 10.10a below. This RFA includes federal
CSBG assurances, agency fiscal information, and a detailed Scope of Work that includes allowable
and required activities under the Community Action Program Services contract. During the annual
State public hearing process, the statewide public at large will be informed of the designation of a
new entity. See Attachment 5, RFA.
10.9. Does the State CSBG statute and/or regulations provide for de-designation of eligible entities?
 Yes  No
10.9a. If yes, provide the citation(s) of the law and/or regulation. If no, describe State
procedures for de-designation of new eligible entities. [Narrative, 2500 Characters]
N/A
10.10. Does the State CSBG statute and/or regulations specify a process the State CSBG agency must
follow to re-designate an existing eligible entity?  Yes  No
10.10a. If yes, provide the citation(s) of the law and/or regulation. If no, describe State
procedures for re-designation of existing eligible entities. [Narrative, 2500 Characters]

The State process for de-designation of any eligible entity is as follows: In the event that the State
determines that an eligible entity fails to comply with the terms of an agreement or the State Plan, to
provide services under the CSBG Program, or to meet appropriate standards, goals, and other
requirements established by the State (including performance objectives), the State will comply with
the requirements outlined under Section 678C of the Act, and using guidance from OCS Information
Memo 116 to:
(a) inform the eligible entity of the deficiency to be corrected;
(b) require the eligible entity to correct the deficiency;
(c) offer training and technical assistance as appropriate to help correct the deficiency, and
submit to the Secretary a report describing the training and technical assistance offered or stating the
reasons for determining that training and technical assistance are not appropriate;
(d) at the discretion of the State, offer the eligible entity an opportunity to develop and implement,
within 60 days after being informed of the deficiency, a Quality Improvement Plan and to either
approve the proposed plan or specify reasons why the proposed plan cannot be approved; and
(e) after providing adequate notice and an opportunity for a hearing, initiate proceedings to
terminate the designation of or reduce the funding to the eligible entity unless the eligible entity
corrects the deficiency. [‘678C(a)]
The State CSBG Office does not have separate procedures for the de-designation of a new or an
existing entity.
Network Comments – Section 10.9A
DAAS/CSA Comments – Section 10.9A Date(s): 1/11/16
Reason(s) for Change: Narrative required
From the FFYs 2015-2016 CSBG State Plan document Section IV (B)(a)-(e). See also Attachment 7
Scope of Work 2016-2020. Bold text added for clarification.
Fiscal Controls and Audits and Cooperation Assurance
10.11. Fiscal Controls and Accounting: Describe how the State’s fiscal controls and accounting
procedures will a) permit preparation of the SF-425 Federal fiscal reports (FFR) and b) permit
the tracing of expenditures adequate to ensure funds have been used appropriately under the
block grant, as required by Block Grant regulations applicable to CSBG at 45 CFR 96.30(a).
[Narrative, 2500 Characters or attach a document]
The State has established fiscal controls, procedures, audits, and inspections, as required under Sections
678D(a)(1) and 678D(a)(2) of the Act. Arizona assures that fiscal control and fund accounting procedures
established shall be sufficient to assure the proper disbursal of and accounting for federal funds paid to
the State under this subtitle, including procedures for monitoring the assistance provided under this
subtitle. Arizona assures the eligible entities and any other recipients of funds under this subtitle shall
comply with the Office of Management and Budget cost and accounting principles. These assurances will
be implemented by the State and/or through contract agreements with service providers. Each provider
agreement will include requirements that the provider adhere to these areas as applicable to them.

Network Comments – Section 10.9A
DAAS/CSA Comments – Section 10.11 Date(s): 1/11/16
Reason(s) for Change: Tweaked to indicate past instead of future tense.
Text added. From the FFYs 2015-2016 CSBG State Plan document Section
10.12. Single Audit Management Decisions: Describe State procedures for issuing management
decisions for eligible entity single audits, as required by Block Grant regulations applicable to
CSBG at 45 CFR 75.521. If these procedures are described in the State monitoring protocols
attached under item 10.2, indicate the page number. [Narrative, 2500 Characters]
Note: This information is associated with State Accountability Measure 4Sd.
At least annually, each state, local government and American Indian Tribe or tribal organization that
receives $100,000 or more (during the fiscal year) in all types of federal financial assistance must
conduct an audit in accordance with the Single Audit Act, Public Law 98-502. [31 U.S.C. 75 and OMB
Circular A-128), ‘678D(a)(1) and ‘678D(a)(2)]
The State further assures that a copy of such audit shall be made available to the eligible entities, State
Legislature and the Secretary of the U.S. Department of Health and Human Services.
Network Comments – Section 10.11 and 10.12 Date:
DAAS/CSA Comments for 10.11 and 10.12 Date(s): 1/11/16
Reason(s) for Change: No substantive changes – 10.11 tweaked for clarity
Source: Previous Model Plan - CSBG State Plan FFYs 2015-2016 document Section V. (G)(3). See
also Attachment 8, Single Audit DES
10.13. Assurance on Federal Investigations: Will the State “permit and cooperate with Federal
investigations undertaken in accordance with Section 678D” of the CSBG Act, as required by the
assurance under Section 676(b)(7) of the CSBG Act?  Yes  No
Note: This response will link with the corresponding assurance, item 14.7
If this is the first year filling out the automated State Plan, skip the following question.
10.14. Performance Management Adjustment: How is the State adjusting monitoring procedures in
this State Plan as compared to past plans? Any adjustment should be based on the State’s
analysis of past performance, and should consider feedback from eligible entities, OCS, and
other sources, such as the public hearing. If this State is not making any adjustments, provide
further detail. [Narrative, 2500 Characters]
DAAS/CSA does not have plans to revise its monitoring processes for SFY 2017. Any adjustments
following internal discussion and feedback from eligible entities will be described in the amendment
for FFY 2018. Current monitoring includes the following for assessing the CAAs status in
implementing the CSBG Organizational Standards. Beginning in SFY 2016 and continuing in SFY

2017, the State is conducting an informal assessment of each eligible entity using the same model. The
informal assessment will be conducted in conjunction with the existing monitoring schedule. The intent
of this assessment is to identify training and technical assistance needs. Agencies in need of technical
assistance may request State assessment and technical assistance earlier than their scheduled
monitoring dates. The ADES will provide appropriate technical assistance to support eligible entities
in achieving compliance with the organizational standards. The State will require full compliance with
the organizational standards, as may be amended, by SFY 2018, and will monitor each eligible entity
in accordance with its regular monitoring schedule.
Note: This item is associated with State Accountability Measure 4Sb and may pre-populate
the State’s annual report form.
Network Comments – Section 10.14 Date:
DAAS/CSA Comments for 10.11 and 10.12 Date(s): 1/11/16
Reason(s) for Change: Language carried forward from previous plan and tweaked for clarity.
Source: Previous Model Plan - CSBG State Plan FFYs 2015-2016 document Section D. F., Training
and Technical Assistant (T/TA) and Section G. See also Attachment 8, Single Audit DES
End of Section 10

SECTION 11
Eligible Entity Tripartite Board
11.1. Which of the following measures are taken to ensure that the State verifies CSBG Eligible
Entities are meeting Tripartite Board requirements under Section 676B of the CSBG Act? [Check
all that applies and narrative where applicable]
 Attend Board meetings
 Review copies of Board meeting minutes
 Track Board vacancies/composition
 Other [Narrative, 2500 Characters]
11.2. How often does the State require eligible entities (which are not on TAPs or QIPs) to provide
updates (e.g., copies of meeting minutes, vacancy alerts, changes to bylaws, low-income
member selection process, etc.) regarding their Tripartite Boards? [Check all that applies and
narrative where applicable]
 Annually
 Semiannually
 Quarterly
 Monthly
 Other [Narrative, 2500 Characters]
11.3. Assurance on Eligible Entity Tripartite Board Representation: Describe how the State will carry
out the assurance under Section 676(b)(10) of the CSBG Act that the State will require eligible
entities to have policies and procedures by which individuals or organizations can petition for
adequate representation on an eligible entities’ Tripartite Board. [Narrative, 2500 Characters]
DAAS/CSA will require that each eligible entity in the State establish procedures under which a low-
income individual, community organization, religious organization, or representative of low-income
individuals that considers its organization or low-income individuals to be inadequately represented
on the board (or other mechanism) of the eligible entity can petition for adequate representation.
Network Comments – Section 10.11 and 10.12 Date:
DAAS/CSA Comments for 10.11 and 10.12 Date(s): 1/11/16
Reason(s) for Change: No substantial changes.
Source: CSBG State Plan FFYs 2015-2016 Amended document Section IV A. (6)
Note: This response will link with the corresponding assurance, item 14.10.
11.4. Does the State permit public eligible entities to use, as an alternative to a Tripartite Board,
“another mechanism specified by the State to assure decision-making and participation by low-
income individuals in the development, planning, implementation, and evaluation of programs”
as allowed under Section 676B(b)(2) of the CSBG Act.  Yes  No

11.4a. If yes, describe the mechanism used by public eligible entities as an alternative to a
Tripartite Board. [Narrative, 2500 Characters]
Private non-profit eligible entities are required to seat a tripartite board as set forth in Section
676B(b)(1) of the Act. Public entities may follow the provision stated above from 676B(b)(2) of the
CSBG Act. The DAAS/CSA contract Scope of Work Section 9.3.2 for public eligible entities reads
as follows: “Select members to serve on a Board in which one-third of the board members are
persons chosen in accordance with democratic selection procedures adequate to assure that these
members are representative of low-income individuals and families. Select representatives to fill
balance of seats as set forth in governing documents.” Currently, all public eligible entities
voluntarily maintain tripartite boards per Section 676B(b)(1) of the Act.
Network Comments – Section 11 Date(s):
DAAS/CSA Comments – Section 11 Date(s): 1/11/16
Reason(s) for Change: New narrative requirement.
Text added. See FFY 2015-2016 State Plan Amended paper document Section F (3) and (6) and
Community Action Program Services Scope of Work Section 9.3.2 for reference.
Attachments\Attachment 7 SOW 2016-2020.pdf
End of Section 11

SECTION 12
Individual and Community Income Eligibility Requirements
12.1. Required Income Eligibility: What is the income eligibility threshold for services in the State?
[Check one item below.]
 125% of the HHS poverty line
 150 % of the HHS poverty line (fill in the threshold): 150% [insert up to a 3 digit
percentage]
 Varies by eligible entity
12.1a. Describe any State policy and/or procedures for income eligibility, such as treatment of
income and family/household composition. [Narrative, 2500 Characters, or attachment]
Income eligibility statewide varies by program. DAAS/CSA follows program rules and State laws for
State and federally funded programs conducted under Community Action Program Services
contracts. For CSBG funded crisis services, eligible entities may set the income eligibility threshold
at 150 percent of the federal poverty level for households with one or more members that are seniors
aged 60 and over, or persons with disabilities. Households that do not meet this criteria are income
eligible at or below 125 percent of poverty. This is in keeping with State laws regarding assistance
provided under the TANF funded Short-Term Crisis Services (STCS), as set forth in Title 6, Article
8 of the Arizona Administrative Code.
This uniform eligibility threshold maintains fairness for households without children that have one
or more vulnerable members, but do not qualify for crisis services under STCS/TANF. Using a
uniform threshold and criteria avoids confusion, offers flexibility for case managed clients, reduces
the administrative burden on CAAs and will reduce technical assistance requests to DAAS/CSA. The
income eligibility limit for LIHEAP energy assistance programs administered with CSBG dollars is
60 percent of the State Median Income (SMI), adjusted for household size; or 150 percent of the
Federal Poverty Guideline (FPG), whichever is greater for a given household. For SFY 2016 in
Arizona, the FPG is greater for households with seven or more members.
See Attachment 10 Income Thresholds Attachments\Attachment 10 2017 Income Thresholds.pdf
Network Comments – Section 12.1.a
DAAS/CSA Comments – Section 12.1.a Date(s): 1/11/16
Reason(s) for Change: 150 percent of poverty threshold for households with vulnerable members for
CSBG explained and justified
New text added. See FFYs 2015-2016 CSBG State Plan Amended, Section V.F. b): for reference. Link
provided for Arizona Administrative Code referencing STCS.

12.2. Income Eligibility for General/Short Term Services: For services with limited in-take procedures
(where individual income verification is not possible or practical), how does the State ensure
eligible entities generally verify income eligibility for services? An example of these services is
emergency food assistance. [Narrative, 2500 Characters]
CAAs target limited intake, general and short-term community based services such as: medical copay
and prescription assistance, school supply, clothing and personal care product and emergency food
assistance, to existing case managed client households. CAAs also offer these services to households
referred by other programs where clients have qualified for means tested benefits elsewhere, and by
conducting outreach in low-income neighborhoods. In addition, agencies may deliver such programs
in low-income neighborhoods through local partner service centers, shared facilities that are
frequented by the target populations. CAAs coordinate extensively with local partners in delivering
these community based services to the households in the greatest need. CAAs may conduct or promote
periodic mass events offering the services mentioned above by inviting program participants from their
own and/or partners client lists who are known to have qualified for benefits. The State CSBG Office
may make CSBG discretionary funds available in the event of a neighborhood emergency or disaster
when other programs have not responded to the crisis. In SFY 2015, Gila County Community Services
Department received CSBG discretionary funds in a local crisis to temporarily house low-income
seniors and provide congregate meals while their apartment building was renovated following a small
fire that resulted in extensive fire sprinkler damage to the units. Even though the residents’ units were
uninhabitable, the crisis did not meet the criteria for Red Cross assistance, and the owner disavowed
liability for damage caused by the actions of others. The agency partnered with the local Humane
Society and other animal welfare groups to provide temporary shelter for the senior residents’ pets.
12.3. Community-Targeted Services: For services that provide a community-wide benefit (e.g.,
development of community assets/facilities, building partnerships with other organizations),
how does the State ensure eligible entities’ services target and benefit low-income
communities? [Narrative, 2500 Characters]
Some CAAs offer community targeted services within their own or partner facilities that are located
in low-income neighborhoods and/or senior centers. For example, some CAAs operate food banks
inside their own facilities, while others refer low-income households to partner-operated emergency
food centers nearby. Others coordinate with local education institutions and refer existing case
managed households to community based education services. Still others offer community based
services themselves at their own facilities and make them available to existing client households and
applicants. These services include financial services, community gardens, career centers, education,
and income management. DAAS/CSA documents these activities during monitoring visits and
encourages CAAs to submit program narratives annually to highlight these activities.
Network Comments - Section 12 Date(s):
DAAS/CSA Comments – Section 12 Date (s):
Reason(s) for Change: New narrative requirement
New text added. Reference made to attached additional program narratives.
End of Section 12

SECTION 13
Results Oriented Management and Accountability (ROMA) System
13.1. ROMA Participation: In which performance measurement system will the State and all eligible
entities participate, as required by Section 678E(a) of the CSBG Act and the assurance under
Section 676(b)(12) of the CSBG Act? [Check one]
Note: This response will also link to the corresponding assurance, item 14.12.
 The Results Oriented Management and Accountability (ROMA) System
 Another performance management system that meets the requirements of section 678E(b)
of the CSBG Act
 An alternative system for measuring performance and results
13.1a. If ROMA was selected in item 13.1, attach and/or describe the State’s written policies,
procedures, or guidance documents on ROMA. [Attachment and Narrative, 2500
characters]
Participation and utilization of ROMA in program planning is required by DAAS/CSA
Community Action Program Services contracts. DAAS/CSA utilizes guidance from federal
partners and OCS IMs 49, and 82. See Community Action Program Services Scope of Work
(SOW) sections 9.2.1 and 9.4.1
Attachment 7. Attachments\Attachment 7 SOW 2016-2020.pdf
13.1b. If ROMA was not selected in item 13.1, describe the system the State will use for
performance measurement. [Narrative, 2500 Characters]
13.2. Indicate and describe the outcome measures the State will use to measure eligible entity
performance in promoting self-sufficiency, family stability, and community revitalization, as
required under Section 676(b)(12) of the CSBG Act? [Check one and Narrative, 2500
characters]
Note: This response will also link to the corresponding assurance, item 14.12.
 CSBG National Performance Indicators (NPIs)
 NPIs and others
 Others
13.3. How does the State support the eligible entities in using the ROMA system (or alternative
performance measurement system)? [Narrative, 2500 characters or attach a document]
Note: The activities described under item 13.3 may include activities listed in “Section 8:
Training and Technical Assistance.” If so, mention briefly, and/or cross-reference as needed.
This response will also link to the corresponding assurance, item 14.12.
DAAS/CSA provides funds to the state association to provide ROMA training and offers technical
assistance to individual eligible entities upon request, responding to questions and conducting
research on the agency’s behalf.

13.4. Eligible Entity Use of Data: How is the State validating that the eligible entities are using data to
improve service delivery? [Narrative, 2500 characters or attach a document]
DAAS/CSA program staff interview agency staff and Tripartite Board members, attend board
meetings and review meeting minutes to ascertain the agency’s use of ROMA NPIs to evaluate
programs. Agencies demonstrate the use of data through formal decisions made in Board meetings
relative to data collected in the previous program year.
Note: This response will also link to the corresponding assurance, item 14.12.
Network Comments - Section 13.1-13.4 Date(s):
DAAS/CSA Comments – Section 13.1-13.4 Date (s):1/4/16
Reason(s) for Change: New narrative requirement
New text added. Assurances previously listed and signed only.
Community Action Plans and Needs Assessments
13.5. Describe how the State will secure a Community Action Plan from each eligible entity, as a
condition of receipt of CSBG funding by each entity, as required by Section 676(b)(11) of the
CSBG Act. [Narrative, 2500 characters or attach a document]
Submission of a Community Action Plan is required by contract at least once every two years, and
during the contract renewal period, as part of the eligible entity’s application package.
Note: this response will link to the corresponding assurance, item 14.11.
13.6. State Assurance: Describe how the State will assure that each eligible entity includes a
community needs assessment for the community served (which may be coordinated with
community needs assessments conducted by other programs) in each entity’s Community Action
Plan, as required by Section 676(b)(11) of the CSBG Act. [Narrative, 2500 characters or attach a
document]
Submission of a Community Needs Assessment is required by contract at least once every three
years. This period may be extended for eligible entities with an active assessment project under
way during the year the assessment document is due. An extension may also be granted by
DAAS/CSA for agencies coordinating community assessments with other programs such as Head
Start. Agencies requesting extensions must demonstrate that they are engaged in an active
assessment project and provide a written methodology and timeline for completion.
Note: this response will link to the corresponding assurance, item 14.11.
Network Comments - Section 13.5-13.6 Date(s):

DAAS/CSA Comments – Section 13.5-13.6 Date (s):
Reason(s) for Change: New narrative requirement
New text added. Assurances previously listed, indicating State agreement only. See FFYs 2015-2016
CSBG State Plan Amended, Section IV. A. (13)
End of Section 13

SECTION 14
CSBG Programmatic Assurances and Information Narrative
(Section 676(b) of the CSBG Act)
14.1 Use of Funds Supporting Local Activities
CSBG Services
14.1a. 676(b)(1)(A): Describe how the State will assure “that funds made available through
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 title IV of the Social
Security Act, 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 (particularly 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 toward improving
literacy skills of the low-income families in the community, which may
include family literacy initiatives;
(iv) to make better use of available income;
(v) to obtain and maintain adequate housing and a suitable living environment;
(vi) to obtain emergency assistance through loans, grants, or other means to
meet immediate and urgent individual and family needs;
(vii) to achieve greater participation in the affairs of the communities involved,
including the development of public and private grassroots partnerships with
local law enforcement agencies, local housing authorities, private
foundations, and other public and private partners to –
(I) document best practices based on successful grassroots intervention in
urban areas, to develop methodologies for widespread replication; and
(II) strengthen and improve relationships with local law enforcement
agencies, which may include participation in activities such as
neighborhood or community policing efforts;
[Narrative, 2500 or attach a document]
See Attachment 4, Sections 9 and 14 Delivery System and Program Narratives.

Needs of Youth
14.1b. 676(b)(1)(B) Describe how the State will assure “that funds made available through
grant or allotment will be used –
(B) to address the needs of youth in low-income communities through youth
development programs that support the primary role of the family, give priority to
the prevention of youth problems and crime, and promote increased community
coordination and collaboration in meeting the needs of youth, and support
development and expansion of innovative community-based youth development
programs that have demonstrated success in preventing or reducing youth crime,
such as--
(i) programs for the establishment of violence-free zones that would involve
youth development and intervention models (such as models involving youth
mediation, youth mentoring, life skills training, job creation, and
entrepreneurship programs); and
(ii) after-school child care programs;
[Narrative, 2500 characters OR attach a document]
See Attachment 4, Sections 9 and 14 Delivery System and Program Narratives.
Coordination of Other Programs
14.1c. 676(b)(1)(C) Describe how the State will assure “that funds made available through
grant or allotment will be used –
(C) to make more effective use of, and to coordinate with, other programs related to
the purposes of this subtitle (including State welfare reform efforts)
[Narrative, 2500 characters OR attach a document]
See Attachment 4, Sections 9 and 14 Delivery System and Program Narratives.
State Use of Discretionary Funds
14.2 676(b)(2) Describe “how the State intends to use discretionary funds made available from the
remainder of the grant or allotment described in section 675C(b) in accordance with
this subtitle, including a description of how the State will support innovative
community and neighborhood-based initiatives related to the purposes of this
subtitle.”
Note: the State describes this assurance under “State Use of Funds: remainder/discretionary,”
items 7.9 and 7.10
[No response; links to items 7.9 and 7.10.]
Eligible Entity Service Delivery, Coordination, and Innovation
14.3. 676(b)(3) “Based on information provided by eligible entities in the State, a description of…”

See Attachment 4, Sections 9 and 14 Delivery System and Program Narratives.
Eligible Entity Service Delivery System
14.3a. 676(b)(3)(A) Describe “the service delivery system, for services provided or coordinated
with funds made available through grants made under 675C(a), targeted to low-income
individuals and families in communities within the State;
See Attachment 4, Sections 9 and 14 Delivery System and Program Narratives.
[Narrative, 2500 characters OR attach a document]
Eligible Entity Linkages – Approach to Filling Service Gaps
14.3b. 676(b)(3)(B) Describe “how linkages will be developed to fill identified gaps in the
services, through the provision of information, referrals, case management,
and follow up consultations.”
Note: the State describes this assurance in the State Linkages and Communication
section, item 9.3b. [No response; links to 9.3b.]
Coordination of Eligible Entity Allocation 90 Percent Funds with Public/Private Resources
14.3c. 676(b)(3)(C) Describe how funds made available through grants made under 675C(a)will
be coordinated with other public and private resources.”
Note: the State describes this assurance in the State Linkages and Communication
section, item 9.7. [No response; links to 9.7]
Eligible Entity Innovative Community and Neighborhood Initiatives, Including
Fatherhood/Parental Responsibility
14.3d. 676(b)(3)(D) Describe “how the local entity will use the funds [made available under
675C(a)] to support innovative community and neighborhood-based
initiatives related to the purposes of this subtitle, which may include
fatherhood initiatives and other initiatives with the goal of strengthening
families and encouraging parenting.”
Note: The description above is about eligible entity use of 90 percent funds to support
these initiatives. States may also support these types of activities at the local level using
State remainder/discretionary funds, allowable under Section 675C(b)(1)(F). In this State
Plan, the State indicates funds allocated for these activities under item 7.9(f).
[Narrative, 2500 characters OR attach a document]
See Attachment 4, Sections 9 and 14 Delivery System and Program Narratives.

Eligible Entity Emergency Food and Nutrition Services
14.4. 676(b)(4) Describe how the State will assure “that eligible entities in the State 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.”
[Narrative, 2500 characters OR attach a document]
State and Eligible Entity Coordination/linkages and Workforce Innovation and Opportunity Act
Employment and Training Activities
14.5. 676(b)(5) Describe how the State will assure “that the State and eligible entities in the State
will coordinate, and establish linkages between, governmental and other social
services programs to assure the effective delivery of such services, and [describe]
how the State and the eligible entities will coordinate the provision of employment
and training activities, as defined in section 3 of the Workforce Innovation and
Opportunity Act, in the State and in communities with entities providing activities
through statewide and local workforce development systems under such Act.”
Note: The State describes this assurance in the State Linkages and Communication section,
items 9.1, 9.2, 9.3a, 9.4, 9.4a, and 9.4b.
[No response; links to items 9.1, 9.2, 9.3a, 9.4, 9.4a, and 9.4b]
State Coordination/Linkages and Low-income Home Energy Assistance
14.6. 676(b)(6) Provide “an assurance that the State will ensure coordination between antipoverty
programs in each community in the State, 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.”
Note: The State describes this assurance in the State Linkages and Communication section,
items 9.2 and 9.5.
[No response; links to 9.2 and 9.5]
Federal Investigations
14.7. 676(b)(7) Provide “an assurance that the State will permit and cooperate with Federal
investigations undertaken in accordance with section 678D.”
Note: the State addresses this assurance in the Fiscal Controls and Monitoring section, item
10.13. [No response; links to 10.13]

Funding Reduction or Termination
14.8. 676(b)(8) Provide “an assurance that any eligible entity in the State that received funding in
the previous fiscal year through a community services block grant made under this
subtitle will not have its funding terminated under this subtitle, or reduced below
the proportional share of funding the entity received in the previous fiscal year
unless, after providing notice and an opportunity for a hearing on the record, the
State determines that cause exists for such termination or such reduction, subject to
review by the Secretary as provided in section 678C(b).”
Note: the State addresses this assurance in the Fiscal Controls and Monitoring section, item
10.7. [No response; links to 10.7]
Coordination with Faith-based Organizations, Charitable Groups, Community Organizations
14.9. 676(b)(9) Describe how the State will assure “that the State and eligible entities in the State
will, to the maximum extent possible, coordinate programs with and form
partnerships with other organizations serving low-income residents of the
communities and members of the groups served by the State, including religious
organizations, charitable groups, and community organizations.”
Note: the State describes this assurance in the State Linkages and Communication section, item
9.6. [No response; links to 9.6]
Eligible Entity Tripartite Board Representation
14.10. 676(b)(10) Describe how “the State will require each eligible entity in the State to establish
procedures under which a low-income individual, community organization, or
religious organization, or representative of low-income individuals that considers its
organization, or low-income individuals, to be inadequately represented on the
board (or other mechanism) of the eligible entity to petition for adequate
representation.”
Note: the State describes this assurance in the Eligible Entity Tripartite Board section, 11.3. [No
response; links to item 11.3]
Eligible Entity Community Action Plans and Community Needs Assessments
14.11. 676(b)(11) Provide “an assurance that the State will secure from each eligible entity in the
State, as a condition to receipt of funding by the entity through a community
services block grant made under this subtitle for a program, a community action
plan (which shall be submitted to the Secretary, at the request of the Secretary, with
the State plan) that includes a community-needs assessment for the community
served, which may be coordinated with community-needs assessments conducted
for other programs.”
[No response; links to items 13.5 and 13.6]


State and Eligible Entity Performance Measurement: ROMA or Alternate system
14.12. 676(b)(12) Provide “an assurance that the State and all eligible entities in the State will, not
later than fiscal year 2001, 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 [describe] outcome measures to be used to measure eligible entity
performance in promoting self-sufficiency, family stability, and community
revitalization.”
Note: The State describes this assurance in the ROMA section, items 13.1, 13.2, 13.3, and 13.4.
[No response; links to 13.1, 13.2, 13.3, and 13.4]
Validation for CSBG Eligible Entity Programmatic Narrative Sections
14.13. 676(b)(13) Provide “information describing how the State will carry out the assurances
described in this section.”
Note: The State provides information for each of the assurances directly in section 14 or in
corresponding items throughout the State Plan, which are included as hyperlinks in section 14.
[No response for this item]
 By checking this box, the State CSBG authorized official is certifying the assurances set out
above.
End of Section 14

SECTION 15
Federal Certifications
The box after each certification must be checked by the State CSBG authorized official.
15.1 Lobbying
Certification for Contracts, Grants, Loans, and Cooperative Agreements
The undersigned certifies, to the best of his or her knowledge and belief, that:
(1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the
undersigned, to any person for influencing or attempting to influence an officer or employee of
an agency, a Member of Congress, an officer or employee of Congress, or an employee of a
Member of Congress in connection with the awarding of any Federal contract, the making of
any Federal grant, the making of any Federal loan, the entering into of any cooperative
agreement, and the extension, continuation, renewal, amendment, or modification of any
Federal contract, grant, loan, or cooperative agreement.
(2) If any funds other than Federal appropriated funds have been paid or will be paid to any person
for influencing or attempting to influence an officer or employee of any agency, a Member of
Congress, an officer or employee of Congress or an employee of a Member of Congress in
connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned
shall complete and submit Standard Form-LLL, “Disclosure Form to Report Lobbying,” in
accordance with its instructions.
(3) The undersigned shall require that the language of this certification be included in the award
documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under
grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclose
accordingly. This certification is a material representation of fact upon which reliance was
placed when this transaction was made or entered into. Submission of this certification is a
prerequisite for making or entering into this transaction imposed by section 1352, title 31, U.S.
Code. Any person who fails to file the required certification shall be subject to a civil penalty of
not less than $10,000 and not more than $100,000 for each such failure.
Statement for Loan Guarantees and Loan Insurance
The undersigned states, to the best of his or her knowledge and belief, that:
If any funds have been paid or will be paid to any person for influencing or attempting to influence an
officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an
employee of a Member of Congress in connection with this commitment providing for the United
States to insure or guarantee a loan, the undersigned shall complete and submit Standard Form-LLL,
“Disclosure Form to Report Lobbying,” in accordance with its instructions. Submission of this
statement is a prerequisite for making or entering into this transaction imposed by section 1352, title

31, U.S. Code. Any person who fails to file the required statement shall be subject to a civil
penalty of not less than $10,000 and not more than $100,000 for each such failure.
 By checking this box, the State CSBG authorized official is providing the certification set
out above.
15.2 Drug-Free Workplace Requirements
This certification is required by the regulations implementing the Drug-Free Workplace Act of 1988: 45
CFR Part 76, Subpart, F. Sections 76.630(c) and (d)(2) and 76.645 (a)(1) and (b) provide that a Federal
agency may designate a central receipt point for STATE-WIDE AND STATE AGENCY-WIDE
certifications, and for notification of criminal drug convictions. For the Department of Health and
Human Services, the central point is: Division of Grants Management and Oversight, Office of
Management and Acquisition, Department of Health and Human Services, Room 517-D, 200
Independence Avenue, SW Washington, DC 20201.
Certification Regarding Drug-Free Workplace Requirements (Instructions for Certification)
(1) By signing and/or submitting this application or grant agreement, the grantee is providing
the certification set out below.
(2) The certification set out below is a material representation of fact upon which reliance is
placed when the agency awards the grant. If it is later determined that the grantee knowingly
rendered a false certification, or otherwise violates the requirements of the Drug-
Free Workplace Act, the agency, in addition to any other remedies available to the
Federal Government, may take action authorized under the Drug-Free Workplace
Act.
(3) For grantees other than individuals, Alternate I
applies. (4) For grantees who are individuals, Alternate II
applies.
(5) Workplaces under grants, for grantees other than individuals, need to be identified on the
certification. If known, they may be identified in the grant application. If the grantee does not
identify the workplaces at the time of application, or upon award, if there is no application, the
grantee must keep the identity of the workplace(s) on file in its office and make the
information available for Federal inspection. Failure to identify all known workplaces
constitutes a violation of the grantee’s drug-free workplace requirements.
(6) Workplace identifications must include the actual address of buildings (or parts of buildings)
or other sites where work under the grant takes place. Categorical descriptions may be used
(e.g., all vehicles of a mass transit authority or State highway department while in operation,
State employees in each local unemployment office, performers in concert halls or radio
studios).

(7) If the workplace identified to the agency changes during the performance of the grant, the
grantee shall inform the agency of the change(s), if it previously identified the workplaces
in question (see paragraph five).
(8) Definitions of terms in the Nonprocurement Suspension and Debarment common rule and
Drug-Free Workplace common rule apply to this certification. Grantees’ attention is called,
in particular, to the following definitions from these rules:
Controlled substance means a controlled substance in Schedules I through V of the Controlled
Substances Act (21 U.S.C. 812) and as further defined by regulation (21 CFR 1308.11 through 1308.15);
Conviction means a finding of guilt (including a plea of nolo contendere) or imposition of sentence,
or both, by any judicial body charged with the responsibility to determine violations of the Federal or
State criminal drug statutes;
Criminal drug statute means a Federal or non-Federal criminal statute involving the
manufacture, distribution, dispensing, use, or possession of any controlled substance;
Employee means the employee of a grantee directly engaged in the performance of work under a
grant, including: (i) All direct charge employees; (ii) All indirect charge employees unless their impact
or involvement is insignificant to the performance of the grant; and, (iii) Temporary personnel and
consultants who are directly engaged in the performance of work under the grant and who are on the
grantee’s payroll. This definition does not include workers not on the payroll of the grantee (e.g.,
volunteers, even if used to meet a matching requirement; consultants or independent contractors not
on the grantee’s payroll; or employees of subrecipients or subcontractors in covered workplaces).
Certification Regarding Drug-Free Workplace Requirements
Alternate I. (Grantees Other Than Individuals)
The grantee certifies that it will or will continue to provide a drug-free workplace by:
(a) Publishing a statement notifying employees that the unlawful manufacture, distribution,
dispensing, possession, or use of a controlled substance is prohibited in the grantee’s
workplace and specifying the actions that will be taken against employees for violation of such
prohibition;
(b) Establishing an ongoing drug-free awareness program to inform employees about -
- (1) The dangers of drug abuse in the workplace;
(2) The grantee’s policy of maintaining a drug-free workplace;
(3) Any available drug counseling, rehabilitation, and employee assistance programs; and
(4) The penalties that may be imposed upon employees for drug abuse violations occurring in
the workplace;

(c) Making it a requirement that each employee to be engaged in the performance of the grant
be given a copy of the statement required by paragraph (a);
(d) Notifying the employee in the statement required by paragraph (a) that, as a condition
of employment under the grant, the employee will (1) Abide by the terms of the
statement; and
(2) Notify the employer in writing of his or her conviction for a violation of a criminal drug
statute occurring in the workplace no later than five calendar days after such
conviction;
(e) Notifying the agency in writing, within 10 calendar days after receiving notice under paragraph
(d)(2) from an employee or otherwise receiving actual notice of such conviction. Employers of
convicted employees must provide notice, including position title, to every grant officer or other
designee on whose grant activity the convicted employee was working, unless the Federal
agency has designated a central point for the receipt of such notices. Notice shall include the
identification number(s) of each affected grant;
(f) Taking one of the following actions, within 30 calendar days of receiving notice under paragraph
(d)(2), with respect to any employee who is so convicted - -
(1) Taking appropriate personnel action against such an employee, up to and including
termination, consistent with the requirements of the Rehabilitation Act of 1973, as
amended; or
(2) Requiring such employee to participate satisfactorily in a drug abuse assistance or
rehabilitation program approved for such purposes by a Federal, State, or local health,
law enforcement, or other appropriate agency;
(g) Making a good faith effort to continue to maintain a drug-free workplace
through implementation of paragraphs (a), (b), (c), (d), (e) and (f).
The grantee may insert in the space provided below the site(s) for the performance of work done
in connection with the specific grant:
Place of Performance (Street address, city, county, state, zip code) [Narrative, 2500 Characters]
N/A
Check if there are workplaces on file that are not identified
here. Alternate II. (Grantees Who Are Individuals)
(a) The grantee certifies that, as a condition of the grant, he or she will not engage in the unlawful
manufacture, distribution, dispensing, possession, or use of a controlled substance in
conducting any activity with the grant;
(b) If convicted of a criminal drug offense resulting from a violation occurring during the conduct of
any grant activity, he or she will report the conviction, in writing, within 10 calendar days of the

conviction, to every grant officer or other designee, unless the Federal agency designates a
central point for the receipt of such notices. When notice is made to such a central point, it
shall include the identification number(s) of each affected grant. [55 FR 21690, 21702, May 25,
1990]
 By checking this box, the State CSBG authorized official is providing the certification set out above.
15.3 Debarment
CERTIFICATION REGARDING DEBARMENT, SUSPENSION AND OTHER RESPONSIBILITY MATTERS
Certification Regarding Debarment, Suspension, and Other Responsibility Matters -
Primary Covered Transactions
Instructions for Certification
(1) By signing and submitting this proposal, the prospective primary participant is providing
the certification set out below.
(2) The inability of a person to provide the certification required below will not necessarily result
in denial of participation in this covered transaction. The prospective participant shall submit
an explanation of why it cannot provide the certification set out below. The certification or
explanation will be considered in connection with the department or agency’s determination
whether to enter into this transaction. However, failure of the prospective primary participant
to furnish a certification or an explanation shall disqualify such person from participation in
this transaction.
(3) The certification in this clause is a material representation of fact upon which reliance was
placed when the department or agency determined to enter into this transaction. If it is
later determined that the prospective primary participant knowingly rendered an erroneous
certification, in addition to other remedies available to the Federal Government, the
department or agency may terminate this transaction for cause or default.
(4) The prospective primary participant shall provide immediate written notice to the department
or agency to which this proposal is submitted if at any time the prospective primary participant
learns that its certification was erroneous when submitted or has become erroneous by reason
of changed circumstances.
(5) The terms covered transaction, debarred, suspended, ineligible, lower tier covered transaction,
participant, person, primary covered transaction, principal, proposal, and voluntarily excluded,
as used in this clause, have the meanings set out in the Definitions and Coverage sections of the
rules implementing Executive Order 12549. You may contact the department or agency to
which this proposal is being submitted for assistance in obtaining a copy of those regulations.
(6) The prospective primary participant agrees by submitting this proposal that, should the
proposed covered transaction be entered into, it shall not knowingly enter into any lower tier
covered transaction with a person who is proposed for debarment under 48 CFR part 9,

subpart 9.4, debarred, suspended, declared ineligible, or voluntarily excluded from
participation in this covered transaction, unless authorized by the department or agency
entering into this transaction.
(7) The prospective primary participant further agrees by submitting this proposal that it will
include the clause titled “Certification Regarding Debarment, Suspension, Ineligibility and
Voluntary Exclusive-Lower Tier Covered Transaction,” provided by the department or agency
entering into this covered transaction, without modification, in all lower tier covered
transactions and in all solicitations for lower tier covered transactions.
(8) A participant in a covered transaction may rely upon a certification of a prospective
participant in a lower tier covered transaction that is not proposed for debarment under 48
CFR part 9, subpart 9.4, debarred, suspended, ineligible, or voluntarily excluded from the
covered transaction, unless it knows that the certification is erroneous. A participant may
decide the method and frequency by which it determines the eligibility of its principals. Each
participant may, but is not required to, check the List of Parties Excluded from Federal
Procurement and Nonprocurement Programs.
(9) Nothing contained in the foregoing shall be construed to require establishment of a system of
records in order to render in good faith the certification required by this clause. The knowledge
and information of a participant is not required to exceed that which is normally possessed by
a prudent person in the ordinary course of business dealings.
(10) Except for transactions authorized under paragraph 6 of these instructions, if a participant in a
covered transaction knowingly enters into a lower tier covered transaction with a person who
is proposed for debarment under 48 CFR part 9, subpart 9.4, suspended, debarred, ineligible,
or voluntarily excluded from participation in this transaction, in addition to other remedies
available to the Federal Government, the department or agency may terminate this transaction
for cause or default.

Certification Regarding Debarment, Suspension, and Other Responsibility Matters
Primary Covered Transactions
(1) The prospective primary participant certifies to the best of its knowledge and belief, that it
and its principals:
(a) Are not presently debarred, suspended, proposed for debarment, declared ineligible,
or voluntarily excluded by any Federal department or agency;
(b) Have not within a three-year period preceding this proposal been convicted of or had a
civil judgment rendered against them for commission of fraud or a criminal offense in
connection with obtaining, attempting to obtain, or performing a public (Federal, State or
local) transaction or contract under a public transaction; violation of Federal or State
antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or
destruction of records, making false statements, or receiving stolen property;
(c) Are not presently indicted for or otherwise criminally or civilly charged by a governmental
entity (Federal, State or local) with commission of any of the offenses enumerated in
paragraph (1)(b) of this certification; and
(d) Have not within a three-year period preceding this application/proposal had one or
more public transactions (Federal, State or local) terminated for cause or default.
(2) Where the prospective primary participant is unable to certify to any of the statements in
this certification, such prospective participant shall attach an explanation to this proposal.
Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - - Lower Tier
Covered Transactions
Instructions for Certification
(1) By signing and submitting this proposal, the prospective lower tier participant is providing
the certification set out below.
(2) The certification in this clause is a material representation of fact upon which reliance was
(3) placed when this transaction was entered into. If it is later determined that the prospective
lower tier participant knowingly rendered an erroneous certification, in addition to other
remedies available to the Federal Government the department or agency with which this
transaction originated may pursue available remedies, including suspension and/or
debarment.
(4) The prospective lower tier participant shall provide immediate written notice to the person to
which this proposal is submitted if at any time the prospective lower tier participant learns that
its certification was erroneous when submitted or had become erroneous by reason of
changed circumstances.

(5) The terms covered transaction, debarred, suspended, ineligible, lower tier covered
transaction, participant, person, primary covered transaction, principal, proposal, and
voluntarily excluded, as used in this clause, have the meaning set out in the Definitions and
Coverage sections of rules implementing Executive Order 12549. You may contact the person
to which this proposal is submitted for assistance in obtaining a copy of those regulations.
(6) The prospective lower tier participant agrees by submitting this proposal that, should the
proposed covered transaction be entered into, it shall not knowingly enter into any lower tier
covered transaction with a person who is proposed for debarment under 48 CFR part 9,
subpart
9.4, debarred, suspended, declared ineligible, or voluntarily excluded from participation in
this covered transaction, unless authorized by the department or agency with which this
transaction originated.
(7) The prospective lower tier participant further agrees by submitting this proposal that it will
include this clause titled “Certification Regarding Debarment, Suspension, Ineligibility and
Voluntary Exclusion-Lower Tier Covered Transaction,” without modification, in all lower
tier covered transactions and in all solicitations for lower tier covered transactions.
(8) A participant in a covered transaction may rely upon a certification of a prospective
participant in a lower tier covered transaction that it is not proposed for debarment under
48 CFR part 9, subpart 9.4, debarred, suspended, ineligible, or voluntarily excluded from
covered transactions, unless it knows that the certification is erroneous. A participant may
decide the method and frequency by which it determines the eligibility of its principals.
Each participant may, but is not required to, check the List of Parties Excluded from Federal
Procurement and Nonprocurement Programs.
(9) Nothing contained in the foregoing shall be construed to require establishment of a system of
records in order to render in good faith the certification required by this clause. The knowledge
and information of a participant is not required to exceed that which is normally possessed by
a prudent person in the ordinary course of business dealings.
(10) Except for transactions authorized under paragraph five of these instructions, if a participant in
a covered transaction knowingly enters into a lower tier covered transaction with a person
who is proposed for debarment under 48 CFR part 9, subpart 9.4, suspended, debarred,
ineligible, or voluntarily excluded from participation in this transaction, in addition to other
remedies available to the Federal Government, the department or agency with which this
transaction originated may pursue available remedies, including suspension and/or
debarment.
Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - - Lower Tier
Covered Transactions
(1) The prospective lower tier participant certifies, by submission of this proposal, that neither
it nor its principals is presently debarred, suspended, proposed for debarment, declared

ineligible, or voluntarily excluded from participation in this transaction by any Federal
department or agency.
(2) Where the prospective lower tier participant is unable to certify to any of the statements in
this certification, such prospective participant shall attach an explanation to this proposal.
 By checking this box, the State CSBG authorized official is providing the certification set
out above.
15.4 Environmental Tobacco Smoke
Public Law 103227, Part C Environmental Tobacco Smoke, also known as the Pro Children Act of
1994, requires that smoking not be permitted in any portion of any indoor routinely owned or
leased or contracted for by an entity and used routinely or regularly for provision of health,
day care, education, or library services to children under the age of 18, if the services are
funded by Federal programs either directly or through State or local governments, by Federal
grant, contract, loan, or loan guarantee. The law does not apply to children’s services provided
in private residences, facilities funded solely by Medicare or Medicaid funds, and portions of
facilities used for inpatient drug or alcohol treatment. Failure to comply with the provisions
ofthe law may result in the imposition of a civil monetary penalty of up to $1000 per day
and/or the imposition of an administrative compliance order on the responsible entity by
signing and submitting this application the applicant/grantee certifies that it will comply with
the requirements of the Act.
The applicant/grantee further agrees that it will require the language of this certification be
included in any subawards which contain provisions for the children’s services and that all
subgrantees shall certify accordingly.
 By checking this box, the State CSBG authorized official is providing the certification set out
above.
End of Document