Ap A_Administrative Data Elements (Approved under 0584-0512)

Ap A_Administrative Data Elements.docx

Assessment of the Contribution of an Interview to SNAP Program Eligibility and Benefit Determination Study

Ap A_Administrative Data Elements (Approved under 0584-0512)

OMB: 0584-0582

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APPENDIX A – ADMINISTRATIVE DATA ELEMENTS

LIST OF REQUIRED DATA ELEMENTS FOR The Assessment of Contributions of an Interview to SNAP Eligibility and Benefit Determinations Study

A. Case/Unit-Level Data

1. Case/Unit ID1

2. County name

3. Name or ID number of the office servicing the case

4. Zip code

5. Number of members in the SNAP unit

6. Date application was received

7. Origin location of the application (such as the SNAP office, partner organization, from home, etc)

8. Method of application (such as walk-in, fax, mail, online, telephone, etc.)

9. Reason for the application (lost a job, etc)

10. Application status (pending, approved, denied, etc)

11. Application status date/eligibility determination date (the date that eligibility was determined, or the date the application status became effective)

12. Reason for denial

13. Whether anyone assisted the applicant, what their role was (for example, as a contact, authorized representative or payee, interpreter, or other role; whether they are related or unrelated to the applicant, etc), and an identifier if assistance was at a community agency

14. Whether an authorized representative submitted the application

15. Language used to fill out the application (English, Spanish, etc)

16. Whether the case received expedited service at last opening

17. Date case was opened

18. Date case was last recertified


19. Length of current certification period

20. Benefit amount for most recent payment period

21. Unit’s total gross income for the month

22. Unit’s total net income for the month

23. Unit’s total gross earned income for the month

24. Unit’s total income from Social Security and SSI for the month

25. Unit’s total assets

26. Unit’s shelter deduction

27. Unit’s medical deduction

28. Indicator of whether the case was opened under disaster food stamps or other emergency program

29. Indicator of current TANF receipt

30. Indicator of current receipt of Property Tax and Rent Rebate

31. Indicator of current receipt of Low-Income Subsidy

32. Indicator of current Medicaid participation

33. Indicator of current participation in State prescription benefits plan

B. Individual-Level Data (for Each Person Within Each Case/Unit)

1. Person ID and Case/Unit ID2

2. Date of birth

3. Gender

4. Race/ethnicity

5. Disability status

6. Citizenship and country of citizenship

7. Relationship of this person to the applicant/grantee


1 The primary purpose of the case ID will be to link data from multiple files over time. It will also enable us to explore particular cases with you about which we have questions.

2 The purpose of these IDs will be to link individuals to units.

A.3

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorSharon D. Clark
File Modified0000-00-00
File Created2021-01-28

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