X_Sample Respondent Burden Table 10 20 2015 final cleanWD rev 10-22RG

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Overview

Burden Table
Cost Assumptions
Implementation Assumptions

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Sheet 1: Burden Table

			RESPONDENTS						NON-RESPONDENTS
Affected public	Respondents type	Instrument	Sample size	Estimated number of respondents	Frequency of response	Total responses	Average time per response (hours)	Total Estimated annual burden (hours)	Estimated number of non-respondents	Frequency of response	Total responses	Average time per response (hours)	Total Estimated annual burden (hours)	Grand Total burden estimate	Hourly Wage rate**	Estimate Total Annual Cost to Respondents
Individuals/households
Individuals	Participant	Registration Document	52,852	52,852	1	52,852	0.20	10,570.40	0	0	0	0	0.00	10,570.40	$7.25	$76,635.40
	Participant	Consent Document	52,852	52,852	1	52,852	0.05	2,642.60	0	0	0	0	0.00	2,642.60	$7.25	$19,158.85
	Participant	Pretest	18	9	1	9	0.66	5.94	9	1	9	0.05	0.45	6.39	$7.25	$46.33
	Participant	Welcome Packet and Study Brochure	25,000	25,000	1	25,000	0.05	1,250.00	0	1	0	0.05	0.00	1,250.00	$7.25	$9,062.50
	Participant	Seasonal Postcard	25,000	25,000	1	25,000	0.17	4,250.00	0	1	0	0.05	0.00	4,250.00	$7.25	$30,812.50
	Participant	Survey Advance Letter (12-mon follow-up)	25,000	18,240	1	18,240	0.03	601.92	0	1	0	0.05	0.00	601.92	$7.25	$4,363.92
	Participant	Survey Reminder Letter (12-mon follow-up)	12,500	12,500	1	12,500	0.03	412.50	0	1	0	0.05	0.00	412.50	$7.25	$2,990.63
	Participant	Survey Reminder Postcard (12-mon follow-up)	12,500	12,500	1	12,500	0.02	208.75	0	1	0	0.05	0.00	208.75	$7.25	$1,513.44
	Participant	Survey Refusal Letter (12-mon follow-up)	3,750	3,750	1	3,750	0.03	123.75	0	1	0	0.05	0.00	123.75	$7.25	$897.19
	Participant	Telephone survey (12-mon follow-up)	25,000	18,240	1	18,240	0.53	9,667.20	6,760	1	6,760	0.05	338.00	10,005.20	$7.25	$72,537.70
	Participant	Seasonal Postcard	18,240	18,240	1	18,240	0.02	304.61	0	1	0	0.05	0.00	304.61	$7.25	$2,208.41
	Participant	Survey Advance Letter (36-mon follow-up)	18,240	18,240	1	18,240	0.03	601.92	0	1	0	0.05	0.00	601.92	$7.25	$4,363.92
	Participant	Survey Reminder Letter (36-mon follow-up)	9,120	9,120	1	9,120	0.03	300.96	0	1	0	0.05	0.00	300.96	$7.25	$2,181.96
	Participant	Survey Reminder Postcard (36-mon follow-up)	9,120	9,120	1	9,120	0.02	152.30	0	1	0	0.05	0.00	152.30	$7.25	$1,104.20
	Participant	Survey Refusalr Letter (36-mon follow-up)	2,736	2,736	1	2,736	0.03	90.29	0	1	0	0.05	0.00	90.29	$7.25	$654.59
	Participant	Telephone survey (36-mon follow-up)	18,240	11,090	1	11,090	0.53	5,877.70	7,150	1	7,150	0.05	357.50	6,235.20	$7.25	$45,205.20
	Participant	Focus Group Recruitment Guide	1,200	240	1	240	0.17	40.08	960	1	960	0.08	80.00	120.08	$7.25	$870.58
	Participant	Focus Group Confirmation Letter	240	240	1	240	0.03	7.92	0	1	0	0.08	0.00	7.92	$7.25	$57.42
	Participant	Focus Group & Information Survey	1,200	240	1	240	1.67	400.00	960	1	960	0.08	80.00	480.00	$7.25	$3,480.00
	Participant	Case Study	200	40	1	40	1.67	66.67	160	1	160	0.08	13.33	80.00	$7.25	$580.00
Subtotal of unique individuals/households			52,870	52,861	5.49	290,249	0.13	37,576	-*	-	15,999	-	869	38,445	-	278,725
State, local, and Tribal government
State, local, and Tribal government	State, local, or Tribal agency director/manager	In-person interview (round 1) and Cost/benefit interivews	170	170	1	170	1.00	170.00	0	0	0	0	0.00	170.00	$54.08	$9,193.60
	State, local, or Tribal agency director/manager	In-person interview (round 2)	150	150	1	150	1.00	150.00	0	0	0	0	0.00	150.00	$54.08	$8,112.00
	State, local, or Tribal agency direct service staff	In-person interview (round 3)	150	150	1	150	1.00	150.00	0	0	0	0	0.00	150.00	$21.79	$3,268.50
	State, local, or Tribal agency direct service staff	Case Study	10	10	1	10	1.00	10.00	0	0	0	0	0.00	10.00	$21.79	$217.90
	State, local, or Tribal agency direct service staff	Provide documents for review	10	10	4	40	0.25	10.00	0	0	0	0	0.00	10.00	$21.79	$217.90
	State, local, or Tribal agency direct service staff	Complete MOU	10	10	1	10	1.00	10.00	0	0	0	0	0.00	10.00	$21.79	$217.90
	State, local, or Tribal agency director/manager	Provide wage data	10	10	5	50	2.50	125.00	0	0	0	0	0.00	125.00	$54.08	$6,760.00
	State, local, or Tribal agency director/manager	Provide SNAP/Medicaid/TANF data	10	10	20	200	2.50	500.00	0	0	0	0	0.00	500.00	$54.08	$27,040.00
	State, local, or Tribal agency director/manager	Provide entry effects data	10	10	2	20	2.50	50.00	0	0	0	0	0.00	50.00	$54.08	$2,704.00
	State, local, or Tribal agency director/manager	Cost/benefit interviews (after visit 1)	10	10	19	190	1.00	190.00	0	0	0	0	0.00	190.00	$54.08	$10,275.20
	State, local, or Tribal agency director/manager	Provide cost data	10	10	11	110	2.00	220.00	0	0	0	0	0.00	220.00	$54.08	$11,897.60
Subtotal unique State, local, and Tribal government			190	190	5.79	1,100	1.44	1,585.00	0	-	0	-	0.00	1,585.00		79,905
Business for-not-for profit
Private sector	Private sector for-profit business director/manager	In-person interview (round 1)	75	75	1	75	1.00	75.00	0	0	0	0	0.00	75.00	$54.08	$4,056.00
	Private sector for-profit business director/manager	In-person interview (round 2)	75	75	1	75	1.00	75.00	0	0	0	0	0.00	75.00	$54.08	$4,056.00
	Private sector for-profit business director/manager	In-person interview (round 3)	75	75	1	75	1.00	75.00	0	0	0	0	0.00	75.00	$54.08	$4,056.00
	Private sector for-profit business director/manager	Case Study	55	55	1	55	1.00	55.00	0	0	0	0	0.00	55.00	$54.08	$2,974.40
	Private sector for-profit business director/manager	Provide administrative data	50	50	12	600	4.00	2,400.00	0	0	0	0	0.00	2,400.00	$54.08	$129,792.00
	Private sector for-profit business director/manager	Cost/benefit interviews	100	100	20	2,000	0.50	1,000.00	0	0	0	0	0.00	1,000.00	$54.08	$54,080.00
	Private sector for-profit business director/manager	Provide cost data	10	100	11	1,100	1.00	1,100.00	0	0	0	0	0.00	1,100.00	$54.08	$59,488.00
	Private sector for-profit direct service staff	Time Use Survey Initial Email	80	80	3	240	0.02	4.01	0	0	0	0	0.00	4.01	$21.03	$84.29
	Private sector for-profit direct service staff	Time Use Survey Reminder Letter	40	40	3	120	0.03	3.96	0	0	0	0	0.00	3.96	$21.03	$83.28
	Private sector for-profit direct service staff	Time Use Survey	80	80	3	240	0.33	79.20	0	0	0	0	0.00	79.20	$21.03	$1,665.58
	Private sector not-for-profit agency director/manager	In-person interview (round 1)	75	75	1	75	1.00	75.00	0	0	0	0	0.00	75.00	$32.56	$2,442.00
	Private sector not-for-profit agency director/manager	In-person interview (round 2)	75	75	1	75	1.00	75.00	0	0	0	0	0.00	75.00	$32.56	$2,442.00
	Private sector not-for-profit agency director/manager	In-person interview (round 3)	75	75	1	75	1.00	75.00	0	0	0	0	0.00	75.00	$32.56	$2,442.00
	Private sector not-for-profit agency director/manager	Case Study	55	55	1	55	1.00	55.00	0	0	0	0	0.00	55.00	$32.56	$1,790.80
	Private sector not-for-profit agency director/manager	Provide administrative data	50	50	12	600	4.00	2,400.00	0	0	0	0	0.00	2,400.00	$32.56	$78,144.00
	Private sector not-for-profit agency director/manager	Cost/benefit interviews	100	100	20	2,000	0.50	1,000.00	0	0	0	0	0.00	1,000.00	$32.56	$32,560.00
	Private sector not-for-profit agency director/manager	Provide cost data	100	100	11	1,100	1.00	1,100.00	0	0	0	0	0.00	1,100.00	$32.56	$35,816.00
	Private sector for-profit direct service staff	Time Use Survey Initial Email	80	80	3	240	0.02	4.01	0	0	0	0	0.00	4.01	$21.03	$84.29
	Private sector for-profit direct service staff	Time Use Survey Reminder Letter	40	40	3	120	0.03	3.96	0	0	0	0	0.00	3.96	$21.03	$83.28
	Private sector not-for-profit agency director/manager	Time Use Survey	80	80	3	240	0.33	79.20	0	0	0	0	0.00	79.20	$32.56	$2,578.75
	Private sector not-for-profit employer training supervisor	Focus Group Recruitment Email	200	120	1	120	0.02	2.00	80	1	80	0.05	4.00	6.00	$21.03	$126.26
	Private sector not-for-profit employer training supervisor	Focus Group Confirmation Letter	200	120	1	120	0.03	3.96	80	1	80	0.05	4.00	7.96	$21.03	$167.40
	Private sector not-for-profit employer training supervisor	Focus Group	200	120	1	120	1.58	190.00	80	1	80	0.05	4.00	194.00	$21.03	$4,079.82
Subtotal unique private/business sector			770	690	13.80	9,520	1.04	9,930	240	-	240	-	12	9,942.30	-	$423,092.15
	Grand total		53,830	53,741	5.60	300,869	0.16	49,090.81	- *	1.00	16,239	0.05	881.28	49,972.09		$781,721.47
* Nonrespondents are part of the total individuals who completed the registration document.
** Sources: Department of Labor Wage and Hour Division (http://www.dol.gov/whd/minimumwage.htm). Bureau of Labor Statistics, Occupational Employment Statistics Survey, May 2014. (http://www.bls.gov/oes/current/oes_nat.htm) Individuals/Participant: Federal minimum wage. State, local, or Tribal agency director/manager: Average hourly earnings of workers in management occupations; State, local, or Tribal agency direct service staff: Average hourly earnings of workers in community and social services occupations; Private sector for-profit business director/manager: Average hourly earnings of workers in management occupations; Private sector not-for-profit agency director/manager: Average hourly earnings of social and community services managers; Private sector not-for-profit direct service staff : Average hourly earnings of community and social service specialists;
			total # of respondents (including participants and non)					53741
			total # of annual reponses (including participants and non)					317108
			total annual burden estimates (including participants and non)					49972.09

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Sheet 2: Cost Assumptions

Respondent Type	Instrument	Sample size [# of pilots]	Estimated number of respondents [per pilot]	Frequency of response	Total responses	Average time per response (minutes)	Average time per response (hours)	Total Estimated annual burden (hours)		Notes
A. Start-Up Interviews (Site Visit #1)
1. Pilot Director & Manager	In-person interview	10	1	1	10	60	1	10		First site visit: conduct cost interviews with (a) grantee pilot lead ("Pilot Director"), grantee pilot manager who oversees day-to-day at grantee-level ("Pilot Manager"), designed liaison to the cost study (typically a finance/accounting person, "Grantee Cost Liaison"), and the managers of each partner/provider agency (assume an average of 20 / grantee (10 of each kind), "Partner Managers").
2. Pilot Manager	In-person interview	10	1	1	10	60	1	10
3. Grantee Cost Liaison	In-person interview	10	1	1	10	90	1.5	15
4a. Partner Managers [for-profit]	In-person interview	10	10	1	100	45	0.75	75
4b. Partner Managers [not-for-profit]	In-person interview	10	10	1	100	45	0.75	75
B. Data Worksheet Prep
1. Grantee Cost Liaison	telephone discussion	10	1	6	60	30	0.5	30		Calls prior to sending worksheets for cost data collection (document important changes, review how to complete worksheets etc.); assume twice / year / respondent / grantee; first of these calls happens after site visit and before sending worksheets for the first time.
2a. Partner Managers [for-profit]	telephone discussion	10	10	6	600	30	0.5	300
2b. Partner Managers [not-for-profit]	telephone discussion	10	10	6	600	30	0.5	300
C. Data Worksheet Completion
1a. Grantee Cost Liaison (1st contact)	provide cost data	10	1	1	10	180	3	30		Time to coordinate completion of worksheets for Grantee Cost Liaison and time to complete worksheets for Provider Managers. Assume that all will take longer the first time, then require less burden thereafter. Collect data quarterly (4 / year for 3 years), for a total of 12 times.
1b. Grantee Cost Liaison (subsequent contacts)	provide cost data	10	1	11	110	120	2	220
2a1. Partner Managers (1st contact) [for-profit]	provide cost data	10	10	1	100	90	1.5	150
2a2. Partner Managers (1st contact) [not-for-profit]	provide cost data	10	10	1	100	90	1.5	150
2b1. Partner Managers (subsequent contacts) [for-profit]	provide cost data	10	10	11	1100	60	1	1100
2b2. Partner Managers (subsequent contacts) [not-for-profit]	provide cost data	10	10	11	1100	60	1	1100
D. Data Worksheet Follow-Up
1. Grantee Cost Liaison	telephone discussion	10	1	12	120	60	1	120		Calls after receiving worksheets; follow-up for clarification, correct errors, etc.
2a. Partner Managers [for-profit]	telephone discussion	10	10	12	1200	30	0.5	600
2b. Partner Managers [not-for-profit]	telephone discussion	10	10	12	1200	30	0.5	600
E. Time Use Survey
1. [Government] Frontline Staff	provide time-use data	10	10	3	300	20	0.333333333333333	100		Conduct time use surveys once / year for 3 years, for a total of 3 times. Collect time use data from a random sample of 10 SNAP line staff per grantee (responsible for recruitment, eligibility determination, intake, etc,; "[Government] Frontline Staff") and a random sample of 16 partner line staff per grantee (responsible for case management, etc.; "Parnter Frontline Staff").
2a. Partner Frontline Staff [for-profit]	provide time-use data	10	8	3	240	20	0.333333333333333	80
2b. Partner Frontline Staff [not-for-profit]	provide time-use data	10	8	3	240	20	0.333333333333333	80
							Total Burden by Respondent Type (Hours)
							Pilot Director	10
							Pilot Manager	10
							Grantee Cost Liaison	415
							Partner Managers [for-profit]	2225
							Partner Managers [not-for-profit]	2225
							[Government] Frontline Staff	100
							Partner Frontline Staff [for-profit]	80
							Partner Frontline Staff [not-for-profit]	80

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Sheet 3: Implementation Assumptions

Implemenation Study Assumptions

Implementation Interviews:

Assume: 7 grantee staff (state) and 8 local office staff across 2-3 offices

Assume: 2-3 staff at 5 providers during each visit--15 per site or 150; split evenly between for profit and non profit

Admin Data:

Assume: quarterly collection over three year (12 times); one day per site for admin and a half day per site for providers--each period

Assume most data will be part of MIS, but will need to collect some from providers are few sites--estimate no more than 100 providers across the 10 sites will provide us data directly

Focus Group: Maximum hours for each type

Assume 2 client foucs group per site (12 people max per group); 240 particpants for 90 minutes plus 10 for recruiting; 5 minutes for nonparticipants (960)

Assume 1 employer focus group per site (12 people max per group); 120 particpants for 90 minutes plus 5 for recruiting; 3 minutes for nonparticipants (80)

Assume 4 case studies per site; 40 participants 120 minutes plus 10 minutes for recruiting; 3 local office staff or provider staff per participant (120) for 60 minutes ; 5 minutes for nonrespondents (160)