The Evaluation of Demonstrations of NSLP/SBP Direct Certification of Children Receiving Medicaid Benefits

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Appendix L.2c.pdf	Supplementary Document	Uploaded 2013-05-23	Available
Appendix L.2b.pdf	Supplementary Document	Uploaded 2013-05-23	Available
Appendix L.2a.pdf	Supplementary Document	Uploaded 2013-05-23	Available
Appendix M (5-10-13).docx	Supplementary Document	Uploaded 2013-05-23	Available
Appendix K (5-6-13).docx	Supplementary Document	Uploaded 2013-05-23	Available
Appendix J (5-10-13).docx	Supplementary Document	Uploaded 2013-05-23	Available
DC-M_OMB PART A (6-24-13).docx	Supporting Statement A	Uploaded 2013-06-24	Available
DC-M_OMB PART B (5-21-13).clean.docx	Supporting Statement B	Uploaded 2013-05-23	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
206970	Non-Respondents	Other-Non-Respondent Place Holder	New
206968	State and Local Governments	Other-CERTIFICATION AND PARTICIPATION DATA REQUEST	New

ICR Details

OMB Control No: 0584-0586	ICR Reference No: 201305-0584-004
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: USDA/FNS	Agency Tracking No:
Title: The Evaluation of Demonstrations of NSLP/SBP Direct Certification of Children Receiving Medicaid Benefits
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 without change	Conclusion Date: 08/19/2013
Retrieve Notice of Action (NOA)	Date Received in OIRA: 07/02/2013
Terms of Clearance: Full documentation included in submission.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2016	36 Months From Approved
Responses	7,048	0	0
Time Burden (Hours)	3,162	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The overall aim of this evaluation is to estimate the effect of direct certification using Medicaid (DC-M) on meal program access, costs, and participation. Although the process of matching student enrollment records to Medicaid data will likely increase direct certification costs for States and some school districts, DC-M can generate cost savings for districts if it leads fewer families to submit applications for school meals. DC-M will also have an impact on Federal costs if it leads to an increase in students certified for free meals and therefore, an increase in Federal funds to school districts to cover the meals of the additional certified students.

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Authorizing Statute(s): PL: Pub.L. 108 - 265 104 Name of Law: Child Nutrition and WIC Reauthorization Act of 2004
   PL: Pub.L. 111 - 296 103 Name of Law: Healthy, Hunger-Free Kids Act of 2010
  

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:
	78 FR 10593	02/14/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 125	06/28/2013
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
Non-Respondents
State and Local Governments

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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	7,048	0	0	7,048	0	0
Annual Time Burden (Hours)	3,162	0	0	3,162	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 collection of information resulting in a program change of 3,163 hours.

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Annual Cost to Federal Government: $1,128,886

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: 07/02/2013

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