Study of the Effectiveness of Efforts to Improve Supplemental Nutrition Assistance Program Access Among Medicare's Extra Help Population Pilot Projects

Forms and Documents

Document Name	Status
011613 Supplemental Responses.docx Supplementary Document	2013-01-16
OMB_SNAP Extra Help Part B.docx Supporting Statement B	2012-11-19
OMB_SNAP Extra Help Part A.docx Supporting Statement A	2012-11-19
APPENDIX E.docx Supplementary Document	2012-10-02
APPENDIX E Response to Public Comments.docx Supplementary Document	2012-10-15
Legislation.docx Supplementary Document	2012-09-06
Appendix R - NASS Review.docx Supplementary Document	2012-10-15
Appendix Q - SNAP Extra Help Full Approval letter (2).pdf Supplementary Document	2012-10-15
Appendix Q cover page.docx Supplementary Document	2012-10-15
Appendix P - SNAP IRB FINAL.docx Supplementary Document	2012-10-15
Appendix G -Pretest summary 10 12 12.docx Supplementary Document	2012-10-15

IC Document Collections

IC ID	Document Title	Status
203966	Focus Group Protocol Non-Respondent Other-Non-Respondent Place Holder	New
203965	Focus Group Protocol Other-Appendix C-Focus Group Protocol	New
203964	SNAP CATI Client Survey-Non Respondent Other-Non-Respondent Place Holder	New
203952	SNAP CATI Client Survey Other-Appendix A-SNAP Extra Help CATI Client Survey	New

ICR Details

OMB Control No: 0584-0572	ICR Reference No: 201209-0584-001
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: USDA/FNS	Agency Tracking No:
Title: Study of the Effectiveness of Efforts to Improve Supplemental Nutrition Assistance Program Access Among Medicare's Extra Help Population Pilot Projects
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 01/25/2013
	Date Received in OIRA: 11/20/2012
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2016	36 Months From Approved
Responses	6,138	0	0
Time Burden (Hours)	1,940	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The purpose of the Pilot Project collection in WA, PA, and NM is to increase SNAP participation among beneficiaries of Medicare's Extra Help.

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Authorizing Statute(s): US Code: 7 USC 2011-2036 Name of Law: The Food and Nutrition Act
  

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 48798	08/09/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 224	11/20/2012
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 4

IC Title	Form No.	Form Name
Focus Group Protocol
Focus Group Protocol Non-Respondent
SNAP CATI Client Survey
SNAP CATI Client Survey-Non Respondent

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	6,138	0	0	6,138	0	0
Annual Time Burden (Hours)	1,940	0	0	1,940	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: This is a new information collection request. This information collection will add 1,940 hours and 6,138 responses to the OMB Inventory.

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Annual Cost to Federal Government: $432,644

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: 11/20/2012

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