State, Local, and Tribal Government (CN Agency Staff, State Medicaid Agency Staff, Other State Agency Staff, and School District Staff)

APPENDIX A.6a

DETAILED FOLLOW-UP TELEPHONE INTERVIEW PROTOCOL:
STATE CHILD NUTRITION AGENCY STAFF

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Detailed Follow-Up Interview Protocol: State Child Nutrition Agency Staff

Evaluation of Demonstrations of Direct Certification with Medicaid for Free and Reduced-Price Meals (DCM-F/RP)

State:	Date:
Interviewee(s)/position(s):	Start time:
	End time:
Permission to record:	Interviewer:

Introduction

We spoke with you during the site visit in [month] about your experiences with DCM-F/RP, the demonstration of direct certification for free and reduced-price meals using Medicaid data. In this interview, we’ll discuss your experiences and progress since the last time we talked and your overall assessment of the demonstration this year. This interview will last approximately one hour.

The information that we collect in this interview will be used to describe the experiences of States participating in the demonstration. Because each State’s project is unique, description of a particular State’s experiences can identify that State. We will not use your name in our reports, but your identity might be inferred from the identity of your State and the nature of the information that you provide. If there is something that you want to say in confidence that you would not otherwise mention, let us know and we’ll use it to enhance our understanding, but we will keep the details private. Although participation in the data collection is a requirement of the demonstration, your individual participation in this interview is voluntary, and you do not have to answer any questions you don’t want to answer.

With your permission, we’d like to make an audio recording of the interview to fill in gaps in our notes. Do I have your permission to record the interview?

[If yes:] Thank you.

[If no:] You have my assurance that we will keep anything private that you wish. If you’d prefer, we will not cite anything that you say verbatim from the recording. Wait for response; if yes, record: Thank you. If no: That’s OK. Just bear with us/me as I take detailed notes.

[Moderator note: If you did not have time to cover all of the questions in the site visit protocol, ask them during this follow-up interview. If you need the respondent to clarify any earlier answers to the site visit protocol, please do so during this follow-up interview.]

Implementation process

The last time we spoke, we discussed your direct certification process in detail.

1. Have any changes occurred in your DCM-F/RP process since we last spoke? If so, what changed?

   1. What are the reasons for these changes?

2. Have any changes been made to your overall direct certification process (not specific to DCM-F/RP)? If so, what changed?

   1. What are the reasons for these changes?

3. [If local-level matching State, ask:] To your knowledge, have your districts (or their point-of-sale vendors) made any changes to their DCM-F/RP processes since we last spoke? If so, what changed?

   1. What are the reasons for these changes?

4. How has the level of effort involved in the DCM-F/RP process changed since the first DCM-F/RP match?

   1. [If changed, ask:] What are the reasons for this [increase/decrease]?

Outcomes

During our site visit, we discussed early outcomes of the demonstration. [For States that have conducted more than one round of DCM-F/RP matching:] Now that you/your districts have conducted additional rounds of DCM-F/RP matching, I’d like to revisit these numbers.

5. Approximately, how many children were on the DCM-F/RP lists provided to you by the [Medicaid agency]? Roughly what proportion of these cases was successfully matched?

   1. How does this compare to the proportion of SNAP cases successfully matched from the list of SNAP recipients?

      1. [Probe, if applicable:] What are some reasons you think that the DCM-F/RP match was more/less successful than the DC-SNAP match?

6. Has DCM-F/RP matching success varied by student or household characteristics?

   1. Are there any differences by:

      1. Race/ethnicity?

      2. Family/household size?

      3. Family/household composition?

      4. Families/households with name differences?

      5. Split households (refers to children who live in two separate households if divorced parents split custody)?

      6. Grade level?

      7. Medicaid eligibility category (e.g., children who qualify for Medicaid based on MAGI income versus other children, such as those with disabilities, who qualify based on non-MAGI income)?

      8. Other student or household characteristics?

7. Has DCM-F/RP matching success varied by district characteristics?

   1. Are there any differences by:

      1. Urban/rural?

      2. Large/small?

      3. Public/private?

      4. Districts with a high versus low percentage of free/reduced-price students (or other economic indicators)?

      5. Levels of DC-SNAP as a percentage of direct certifications?

      6. [Local-level matching, ask:] Local data systems or point-of-sale vendors?

      7. Other district characteristics?

Challenges and resolutions

8. During the site visit, you told us about challenges related to [fill in from site visit notes]. What steps have been taken to address these challenges?

1. To what extent have you been successful in resolving these issues?

9. Have any new challenges arisen since we last spoke? If so, what are they?

   1. What steps are being taken to resolve these new challenges? To what extent have these steps been successful?

10. During our site visit, we also discussed challenges your districts encountered, including [fill in from site visit notes]. What steps have you or the districts taken to address these challenges?
    
    
    

11. Have your districts reported any new challenges since we last spoke?

    1. Are these challenges common or unique to certain types of districts (e.g., large versus small/medium, private versus public, etc.)?

    2. What consequences have these challenges caused?

    3. How did you and/or the districts resolve these new challenges, or how are you attempting to resolve them?

Best practices and lessons learned

Let’s talk about some of the lessons learned from conducting DCM-F/RP this year.

12. Given everything you now know about the demonstration, is there anything you would have done differently? If so, what?

    1. Is there any information you wish you had known earlier? Please explain.

13. Is there anything that worked particularly well in your State or districts that you would recommend to others?
    [Probe:] Are there certain technologies, trainings, resources, or communication strategies that worked well?

14. Are any changes to the DCM-F/RP process planned for next school year? If so, what?

    1. [If yes, ask:] What are the reasons for these changes?

    2. [If no, ask:] Are there any changes you would like to make to improve matching success, but cannot at the moment? Please describe.

15. Based on your experiences with implementing DCM-F/RP and the outcomes you’ve seen thus far, would you recommend the demonstration to other States? Please explain.

Closing

16. Is there anything else you would like to add about your experience in implementing DCM‑F/RP?

That concludes our interview. Thank you for speaking with me again.