State Agency (aka Key Informants)

Cost Instrument - Short (State Grantees)

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OMB Control # 0584-NEW

Expiration Date: xx/xx/20xx

Public reporting burden for this collection of information is estimated to average 30 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: U.S. Department of Agriculture, Food and Nutrition Services, Office of Research and Analysis, 3101 Park Center Drive, Room 1014, Alexandria, VA 22302 ATTN: PRA (0584-xxxx*). Do not return the completed form to this address.

INTRODUCTORY REMARKS

Good morning/afternoon. Thank you for taking the time to talk with us today. My name is [interviewer’s name]. I work for Westat, a private research company in Rockville, Maryland.

As you know, the US Department of Agriculture, Food and Nutrition Services (FNS) is funding demonstration projects to test ideas for reaching greater numbers of children in the summer and making sure that they do not go hungry. FNS has asked Westat to conduct an evaluation of these demonstrations to understand how these ideas are working and how they are carried out. All of the information we collect is meant to provide FNS with valid and objective findings to help them with their policymaking on Federal summer programs.

One of the objectives of this evaluation is to determine and document the total and component costs of implementing and operating the demonstrations, including information on administrative startup costs, ongoing administrative costs of operation, and benefit costs.

As the state agency that holds the FNS grant and you as the [position/title], you are an important source of information regarding the state level costs of this demonstration. We have some specific questions to ask you about the cost items and sources of funding for these expenses. The interview should last no more than an hour.

Initial set-up Costs

Before most projects begin, there is usually an investment in start-up costs. These costs (e.g., preprogram advertising, initial training costs, recruiting and hiring personnel, etc.) are paid just one time and do not include your normal monthly expense.

1. Please tell us all expenditures and sources of funding related to resources and staff hours required to set-up the summer demonstration project.

Type of cost	Expenditures	Funding source

Ongoing Costs

We also would like to find out about your ongoing costs. Ongoing costs refer to expenses related to administering SFSP enhancement demonstration projects, providing oversight and monitoring, providing technical assistance and training, managing reporting and data collection requirements, processing reimbursement requests and communicating with sponsors.

1. Personnel expenditures

Tell us all salaried personnel paid by the funds received from this demonstration grant; include percentage of time devoted to the operations of this grant and monthly salary. Is there any other staff involved in this project but are receiving funding from other sources? Tell us their percentage of time devoted to this project and monthly salary.

Staff (position)	Monthly salary	Percent of time devoted to demonstration project	Funding source

2. Cost of Contracted Services

Tell us about all expenses paid by this grant funding for contracted services such as advertising, consultants, and any other services needed to administer this program. Also, tell us about contracted services paid by other funds and/or in-kind resources.

Type of expense	Amount	Funding source	In kind (yes/no)
Advertising
Consultants

3. Building and facilities

Tell us about the lease/rent expenses for the office spaces used by staff administering the summer demonstration project. If the facilities are owned, provide estimated fair market lease or rental price.

Lease/rent expenses:
Facility owned – Fair market lease or rental price:

4. Other Equipment/supplies/materials

Tell us about expenses and source of funding for purchased/leased/rented equipments, supplies (e.g., office supplies, etc.) and materials. Provide market value of supplies and materials that were donated or received free of charge.

Type of expense	Amount or value	Funding source	Donations (yes/no)
Materials
Equipment

5. Administrative and operational overhead

Tell us about the administrative and operational overhead for the resources used to administer the summer demonstration project. If you are not able to itemize and/or provide dollar value for the overhead expenditures, you can also provide the rate for overhead expenses as a percentage of all other expenses

List all expenses and source of funding for expenses related to administrative and operational overhead, (e.g., electricity, gas, oil, water and sewer, garbage, insurance, licenses, taxes, telephone, books, subscriptions, regulation fees, travel and other miscellaneous items)

Administrative and operational	Expenditures	Source of funding

If you are not able to itemize and/or provide dollar value for the overhead expenditures, you can also provide the rate for overhead expenses as a percentage of all other expenses.

Administrative and operational	% of all other expenses	Source of funding

6. Other costs

Tell us about all other expenses and source of funding for resources and miscellaneous items that are not included in items 1 through 6 above.

Type of expense	Amount or value	Funding source	Donations (yes/no)