Collection Instruments - State & Local Agencies

THE URBAN INSTITUTE 2100 M STREET, N.W. / WASHINGTON D.C. 20037
Carolyn O’Brien
Research Associate

phone: 202-261-5624
fax: 202-463-8522
e-mail: [email protected]
UI Survey Advance Letters to Counties/Local Offices
DATE

NAME
ADDRESS
Dear NAME:
As you are aware, the Urban Institute is conducting a study of the range of efforts states are undertaking
to enhance and improve the Food Stamp Program (FSP) certification process and to modernize FSP
administration. This study, Enhancing Food Stamp Certification, is being conducted for the U.S.
Department of Agriculture, Food and Nutrition Service (FNS). The goal of this large scale study is to
capture key features and select outcomes among early initiators of modernization efforts, develop a
national inventory of relevant state modernization initiatives, conduct a set of in-depth case studies to
assess program outcomes, and identify promising modernization practices that inform FNS and state
decisions.
We are currently preparing to administer the Survey on Enhancing Food Stamp Certification on the status
of these efforts to modernize the FSP. In addition to State FSP agency directors and selected
local/county FSP directors, selected officials with community partner organizations will be asked to
complete the survey. We are asking for your help in identifying organizations or vendors involved in
significant food stamp modernization activities within your county that should complete the survey.
Please complete the attached table and return it to me by DATE.
Please feel free to call or e-mail me or Robin Koralek, the Survey Team Leader, with any questions. I can
be reached at (202) 261-5624 or via e-mail at [email protected]. and Robin can be reached at (202)
261-5736 or by e-mail at [email protected]. You may also contact Rosemarie Downer, the Project
Officer at FNS, by telephone at (703) 305-2129 or by e-mail at [email protected].
Thank you in advance for your time and careful attention to this matter.
Sincerely,
Carolyn O’Brien
Principal Investigator

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid
OMB control number. The valid OMB control number for this information collection is 0584-XXXX and expires on XX/XX/XXXX. The time
required to complete this information collection is estimated to average 1 hour, including the time to review instructions, search existing data
resources, gather the data needed, and complete and review the information collection. If you have any comments concerning the accuracy of the
time estimate or suggestions for improving this form, please write to: U.S. Department of Agriculture, Food and Nutrition Service, ORNA,
Alexandria, VA 22302.

Please list the primary partner organizations or vendors you work with in the following food stamp
modernization activities (e.g., those who regularly or frequently conduct pre-screening or provide
application assistance). Do not include firms providing business services that do not involve contact with
food stamp applicants or recipients (e.g., development of information systems, management consulting,
etc.).

Outreach
x Call centers
x Off-site prescreening
x Off-site application assistance
x Combined applications
x Tracking and follow-up of applicants

x
x
x
x

Off-site application/document filing (e.g.,
mail, fax, telephone, internet)
Outstationing of food stamp workers
Application interviews
Interpretation/translation

COUNTY/LOCAL JURISDICTION, STATE: __________________________
Partner
Organization/
Vendor

Key Contact

Phone Number

E-mail Address

Services
Provided