Healthy Incentives Pilot Evaluation

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Change Justification Memo to OMB - HIP Incentives[RG].docx	Justification for No Material/Nonsubstantive Change	Uploaded 2012-02-08	Available
Appendix J - Analysis Plan.pdf	Supplementary Document	Uploaded 2011-05-06	Available
Appendix H - TWG Eval Design & Study Plan.pdf	Supplementary Document	Uploaded 2011-05-06	Available
Appendix I3 - IRB and confidentiality.doc	Supplementary Document	Uploaded 2011-05-06	Available
Appendix I2 - IRB Approval Letter.pdf	Supplementary Document	Uploaded 2011-05-06	Available
Appendix I1 - Abt-Westat IAA.pdf	Supplementary Document	Uploaded 2011-05-06	Available
Appendix G2 - NASS comments.doc	Supplementary Document	Uploaded 2011-05-05	Available
HIP_OMB_SSB 11-5-24.docx	Supporting Statement B	Uploaded 2011-05-24	Available
HIP_OMB_SSA 11-5-24.doc	Supporting Statement A	Uploaded 2011-05-24	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
197621	State and Local Agencies	Other-Round 2 DTA Technical Team HIP Interview Guide	Unchanged
197619	Business (For- and Not-for-Profit)	Other-Round 1 EBT Contractor (ACS) Interview Guide	Unchanged
197618	Non-Responders (Business-for and not-for Profit)	Other-Non-responses	Unchanged
197617	Non-Responders (State Agencies)	Other-Non-responses	Unchanged
197616	Non Responders (Individual/Households)	Other-Non Responders	Unchanged
197607	Parents-Minor Surveys	Other-Survey- Attachment 5 QRE with Added Cell Question 1-19-12	Modified

ICR Details

OMB Control No: 0584-0561	ICR Reference No: 201201-0584-006
Status: Historical Active	Previous ICR Reference No: 201105-0584-001
Agency/Subagency: USDA/FNS	Agency Tracking No:
Title: Healthy Incentives Pilot Evaluation
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 02/21/2012
	Date Received in OIRA: 02/09/2012
Terms of Clearance: FNS will report the impact on response rates as a result of this change to OMB. This is not an indication that similar incentive increases will be approved in the future for this collection nor should it be viewed as setting a precedent for other collection requests.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2014	08/31/2014	08/31/2014
Responses	8,257	0	8,257
Time Burden (Hours)	4,832	0	4,832
Cost Burden (Dollars)	0	0	0

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Abstract: Healthy Incentives Pilot (HIP) will provide financial incentives to SNAP households to encourage their purchase and consumption of 'targeted' fruits and vegetables. The targeted fruits and vegetables are the same foods that are eligible under the national definition for WIC fruit and vegetable cash value vouchers. The intention of this incentive is to increase fruit and vegetable consumption both through the standard economic pathway of lower prices and through the implicit message of the importance of fruit and vegetable consumption that is sent by the incentive itself.

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Authorizing Statute(s): PL: Pub.L. 110 - 246 Section 4141(K)(3)(E) Name of Law: The Food, Conservation, and Energy Act of 2008 (2008 Farm Bill)
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 6597	02/07/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 105	06/01/2011
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 6

table that charts list of burden

IC Title	Form No.	Form Name
Non Responders (Individual/Households)
Non-Responders (State Agencies)
Non-Responders (Business-for and not-for Profit)
Business (For- and Not-for-Profit)
Parents-Minor Surveys
State and Local Agencies

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	8,257	8,257	0	0	0	0
Annual Time Burden (Hours)	4,832	4,832	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $2,993,504

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 02/09/2012

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