OMB Change Justification Memo

United States

Department of

Agriculture

Food and

Nutrition

Service

3101 Park

Center Drive

Alexandria, VA

22302-1500

DATE: August 29, 2014

TO: Julie Wise

OMB Desk Officer

THROUGH: Rachelle Ragland-Greene
Information Clearance Officer

Ruth Brown

OCIO Desk Officer

FROM: Cynthia Long
Deputy Administrator
Child Nutrition Programs

RE: Change Justification Request for Approval to Condense and Revise

HealthierUS School Challenge (HUSSC) Applications under

Approved Generic OMB Clearance No. 0584-0524

The Food and Nutrition Service (FNS) of the Department of Agriculture Food, Nutrition and Consumer Services is requesting approval to condense and revise two HealthierUS School Challenge (HUSSC) forms (FNS-779 and FNS-780) into one combined form, under the FNS Generic OMB Clearance No. 0584-0524. These forms were previously approved (0584-0524) in June 2013. FNS is requesting changes to the forms to reflect altered HUSSC criteria due to new program regulations (i.e., Nutrition Standards For All Foods Sold in Schools and Nutrition Standards in the National School Lunch and School Breakfast Programs) and initiatives to support the implementation of those regulations (i.e., use of behavioral economics in school cafeteria operations).

The target audience and the time required to complete the form will not change. Please see the following information for a detailed explanation regarding burden hours:

1. Number of Respondents: We anticipate that there will be a total of 1,000 HealthierUS School Challenge submitted applications (Attachment A) for a total of 1,000 respondents.
   
   

2. Time Needed per Response: For the application form for the HealthierUS School Challenge, approximately two hours is needed.

3. Total Burden Hours on the Public: 2,000 hours total. Each HUSSC
   applicant will complete one application form. Each form will display the OMB control number and public burden statement.

Those interested in submitting an application form can download the form from the FNS Web site and either mail, email or fax them to a designated address or fax number or submit the application and supporting documentation electronically to [email protected]. FNS reviews information submitted on the HUSSC applications to determine if the applicant meets specific criteria to qualify for an award certificate, banner and monetary incentive. The data from the form will be used for administrative purposes only.

Once OMB approves the [email protected] screen shots, the program will subsequently make those available in a revised data collection.

Attachment A Inserts:

• HealthierUS School Challenge: Smarter Lunchrooms Application (see

Attachment A)

• HealthierUS School Challenge: Smarter Lunchrooms 2014 Criteria (see

Attachment A)

• Smarter Lunchroom Scorecard (see Attachment A)

• Alliance for a Healthier Generation Smart Snacks Product Calculator
  (see Attachment A)

• HealthierUS School Challenge Bronze/Silver Application (see Attachment

A)

• HealthierUS School Challenge Gold/Gold Award of Distinction

Application (see Attachment A)

Contact Information: Questions regarding this data collection request can be directed to: Sheldon Gordon at 703-305-2893, or Ebony James at 703-305-2827.

Cynthia Long

Deputy Administrator

Child Nutrition Programs

Attachment A

3