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

APPENDIX B.2

ADMINISTRATIVE RECORDS REQUEST

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Administrative Records Data Request

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

A key component of the DCM-F/RP demonstration evaluation is an assessment of outcomes related to student certification and participation in the National School Lunch Program (NSLP) and School Breakfast Program (SBP). Therefore, we are asking each State to provide district-level administration records data on certification and participation for two school years (SY): 2017–2018 and 2018–2019.

Certification data

Certification data should be provided depending upon the date of the first DCM-F/RP match:

1. For States that implemented DCM-F/RP by the last operating day in October 2018, data should be provided (a) as of the last operating day in October 2018 AND (b) as of the last operating day in October 2017.

2. For States that implemented DCM-F/RP after the last operating day in October 2018, data should be provided (a) as of a date chosen shortly after the first DCM-F/RP match in SY 2017–18, AND (b) for the same or closest date in SY 2017–18.

Table 1 lists the data elements that should be included for each district in the certification data files. Districts report most of these data elements, as of the last operating day in October, to the State as part of the process for completing Form FNS-742.

Table 1. Data elements requested in certification file, for each district in the State

Data element	Item number on FNS-742
Total number of SFA’s schools that operate the NSLP or SBP	1-1A
Total number of SFA’s Residential Child Care Institutions (RCCIs) that operate the NSLP or SBP	1-2A
Total number of students enrolled in the SFA’s schools that operate the NSLP or SBP	1-1B
Total number of students enrolled in the SFA’s RCCIs that operate the NSLP or SBP	1-2B
Number of schools or institutions:
Operating Provision 2/3 in a base year for NSLP and SBP	2-1A
Operating Provision 2/3 in a non-base year for NSLP and SBP	2-2A
Operating the Community Eligibility Provision (CEP)	2-3A
Operating other alternatives for NSLP and SBP	2-4A
Operating an alternative provision for only NSLP or SBP	2-5A
Number of students enrolled in schools or institutions:
Operating Provision 2/3 in a base year for NSLP and SBP	2-1B
Operating Provision 2/3 in a non-base year for NSLP and SBP	2-2B
Operating CEP	2-3B
Operating other alternatives for NSLP and SBP	2-4B
Operating an alternative provision for only NSLP or SBP	2-5B
Number of students certified for free meals:
By application, based on income and household size	4-2B
By application, based on categorical eligibility	4-1B
By direct certification, based on:a
Supplemental Nutrition Assistance Program (SNAP)	3-2B
Programs other than SNAP	3-3B
Medicaid	Not reported on FNS-742 (included in 3-3B)
Temporary Assistance for Needy Families (TANF)	Not reported on FNS-742 (included in 3-3B)
Food Distribution Program on Indian Reservations (FDPIR)	Not reported on FNS-742 (included in 3-3B)
Other	Not reported on FNS-742 (included in 3-3B)
Both Medicaid and another program	Not reported on FNS-742
By SNAP letter method	3-4B
Total number of students certified for free meals	T-1
Number of students certified for reduced-price meals:
By application, based on income and household size	4-3B
Based on DCM-F/RP	Not reported on FNS-742
Total number of students certified for reduced-price meals	T-2
Average daily attendance in the district	Not reported on FNS-742
[In States where districts determine timing of match:] Date of most recent direct certification match [or indicator of whether district conducted or triggered a match after the DCM-F/RP results were available]	Not reported on FNS-742
School district name	SFA Name
Unique school district ID number	SFA ID#
Zip code	SFA Zip code

^aWe would like as much detail on the basis of direct certification as is available. If your data system does not include all the categories listed here, please provide any that are available. At a minimum, please provide the numbers for Medicaid, SNAP, and a combined number for other programs. If your data system includes other categories not listed here, please provide that information as well.

In addition to the core certification data elements listed in the table above, in States where administrative data are available on the complete results of the DCM-F/RP match and the distribution of matched students’ prior certification status and basis, that information should be included. Please provide these data as of the same point in time during SY 2018–2019 as the other certification data elements. They can be included in the same data file or in separate data files (including a common SFA identification number), if that is more convenient for the State.

Participation data

Please provide participation data for each operating month in SY 2017–2018 and SY 2018–2019. Table 2 lists the data elements that should be included for each district in the monthly participation data files. Districts report most of these data elements to the State as part of the process for generating the State-level information reported on Form FNS-10.

Table 2. Data elements requested in monthly participation files, for each district in the State

Data element	Item number on FNS-10
Number of schools and institutions participating in the NSLP	12a-F, 13a-F, 14a-Fa
Number of students enrolled in these schools and institutions	12b-F, 13b-F, 14b-Fa
Number of reimbursable lunches served, by reimbursement category:
Paid	5a-A
Free	5a-B
Reduced-price	5a-C
Total	5a-D
Average daily reimbursable lunches served	5a-E
Number of NSLP operating days	Not reported on FNS-10
Number of reimbursable lunches served that qualify district for additional paymentb	5b1-D
Number of reimbursable lunches served in districts certified for performance-based reimbursementc	5b2-D
Number of schools or institutions participating in the SBPd	12a-I, 13a-I, 14a-Ia
Number of students enrolled in these institutions	12b-I, 13b-I, 14b-Ia
Number of severe need schools or institutions	12a-J, 13a-J, 14a-Ja
Number of students enrolled in severe need institutions	12b-J, 13b-J, 14b-Ja
Number of reimbursable breakfasts served, by reimbursement category:
Paid	6-A
Free	6-B
Reduced-price	6-C
Total	6-D
Average daily reimbursable breakfasts served	6-E
Number of severe need reimbursable breakfasts served, by reimbursement category:
Paid	7-A
Free	7-B
Reduced-price	7-C
Total	7-D
Average daily severe need reimbursable breakfasts served	7-E
Number of SBP operating days	Not reported on FNS-10
School district name	Not reported on FNS-10
Unique school district ID number	Not reported on FNS-10

^aThis data element corresponds to more than one FNS-10 item. States can provide the items separately or report as a sum across the items.

^bAn SFA may receive an additional needs-based payment if at least 60 percent of its students received free or reduced-price lunches two years earlier.

^cAn SFA certified for "Performance based" reimbursement earns an additional per-lunch reimbursement of 6 cents, adjusted annually.

^dInclude severe need.

Data delivery timeline

Please provide the data files for SY 2017–2018 and the first few months of SY 2018–2019 as soon as possible after the beginning of data collection. Data for the remaining months of SY 2017–2018 should be provided as they become available.

Data delivery methods

We can accept the requested data in any standard format, but we prefer Microsoft Excel or SAS file formats. Because these files will contain only aggregate data, with no personally identifiable information on individuals, they may be transmitted via email. However, we recommend encrypting the files before sending.