Appendix E Annual Burden Estimate

						Responsive					Non-Responsive
Respondent Category	Type of respondents	Instruments [a]	Appendix	Sample Size (Districts)	Sample Size (Individuals)	Number of respondents	Frequency of response	Total Annual responses	Hours per response	Annual burden (hours)	Number of Non-respondents	Frequency of response	Total Annual responses	Hours per response	Annual burden (hours)	Grand Total Annual Burden Estimate (hours)	Hourly Wage Rate	Total Annualized Cost of Respondent Burden
State Child Nutrition Agency Data Collection
State Government	State Child Nutrition Agency Staff	Site Visit Letter	A-1	NA	15	15	1	15	0.083	1.250	0	0	0	0	0	1.250	$42.33	$52.91
		Site Visit Scheduling Call	A-2	NA	15	15	1	15	0.500	7.500	0	0	0	0	0	7.500	$42.33	$317.48
		Site Visit Preparation Guide	A-2a	NA	15	15	1	15	0.250	3.750	0	0	0	0	0	3.750	$42.33	$158.74
		On-Site Interview	A-3a	NA	45	45	1	45	1	45	0	0	0	0	0	45	$42.33	$1,904.85
		On-Site Observations	A-4	NA	30	30	1	30	0.500	15	0	0	0	0	0	15	$42.33	$634.95
		Site Visit Follow-Up Telephone Interview Email	A-5	NA	15	15	1	15	0.033	0.500	0	0	0	0	0	0.500	$42.33	$21.17
		Site Visit Follow-Up Telephone Interview	A-6a	NA	15	15	1	15	1	15	0	0	0	0	0	15	$42.33	$634.95
		Administrative Records Request Email	B-1	NA	15	15	2	30	0.033	1	0	0	0	0	0	1	$42.33	$42.33
		Administrative Records Request	B-2	NA	15	15	2	30	12	360	0	0	0	0	0	360	$42.33	$15,238.80
		State Cost Data Collection Email	C-1	NA	15	15	4	60	0.033	2	0	0	0	0	0	2	$42.33	$84.66
		State Cost Data Collection Tracking Log	C-2, C-3a	NA	15	15	4	60	3	180	0	0	0	0	0	180	$42.33	$7,619.40
		State Cost Data Collection Clarification Call	C-4	NA	15	15	4	60	0.333	20	0	0	0	0	0	20	$42.33	$846.60
State Medicaid Agency Data Collection
State Government	State Medicaid Agency Staff	Site Visit Letter	A-1	NA	15	15	1	15	0.083	1.250	0	0	0	0	0	1.250	$42.33	$52.91
		Site Visit Scheduling Call	A-2	NA	15	15	1	15	0.500	7.500	0	0	0	0	0	7.500	$42.33	$317.48
		Site Visit Preparation Guide	A-2b	NA	15	15	1	15	0.250	3.750	0	0	0	0	0	3.750	$42.33	$158.74
		On-Site Interview	A-3b	NA	45	45	1	45	1	45	0	0	0	0	0	45	$42.33	$1,904.85
		On-Site Observations	A-4	NA	30	30	1	30	0.500	15	0	0	0	0	0	15	$42.33	$634.95
		Site Visit Follow-Up Telephone Interview Email	A-5	NA	15	14	1	14	0.033	0.467	1	1	1	0.033	0.033	0.500	$42.33	$21.17
		Site Visit Follow-Up Telephone Interview	A-6b	NA	15	14	1	14	1	14	1	1	1	0.167	0.167	14.167	$42.33	$599.68
		State Cost Data Collection Email	C-1	NA	15	14	4	56	0.033	1.867	1	1	1	0.033	0.033	1.900	$42.33	$80.43
		State Cost Data Collection Tracking Log	C-2, C-3b	NA	15	14	4	56	3	168	1	1	1	0.167	0.167	168.167	$42.33	$7,118.50
		State Cost Data Collection Clarification Call	C-4	NA	15	14	4	56	0.333	18.667	1	1	1	0.250	0.250	18.917	$42.33	$800.74
Other State Agency Data Collection
State Government	Other State Agency Staff	Site Visit Letter	A-1	NA	3	3	1	3	0.083	0.250	0	0	0	0	0	0.250	$42.33	$10.58
		Site Visit Scheduling Call	A-2	NA	3	3	1	3	0.500	1.500	0	0	0	0	0	1.500	$42.33	$63.50
		Site Visit Preparation Guide	A-2b	NA	3	3	1	3	0.250	0.750	0	0	0	0	0	0.750	$42.33	$31.75
		On-Site Interview	A-3b	NA	3	3	1	3	1	3	0	0	0	0	0	3	$42.33	$126.99
		State Cost Data Collection Email	C-1	NA	3	3	4	12	0.033	0.400	0	0	0	0	0	0.400	$42.33	$16.93
		State Cost Data Collection Tracking Log	C-2, C-3b	NA	3	3	4	12	3	36	0	0	0	0	0	36	$42.33	$1,523.88
		State Cost Data Collection Clarification Call	C-4	NA	3	3	4	12	0.333	4	0	0	0	0	0	4	$42.33	$169.32
School District Data Collection
Local Government	School District Staff	Site Visit Letter	A-1	34	34	34	1	34	0.083	2.833	0	0	0	0	0	2.833	$41.86	$118.60
		Site Visit Scheduling Call	A-2	34	34	34	1	34	0.500	17	0	0	0	0	0	17	$41.86	$711.62
		Site Visit Preparation Guide	A-2c	34	34	34	1	34	0.250	8.500	0	0	0	0	0	8.500	$41.86	$355.81
		On-Site Interview	A-3c	34	102	102	1	102	1	102	0	0	0	0	0	102	$41.86	$4,269.72
		On-Site Observations	A-4	34	68	68	1	68	0.500	34	0	0	0	0	0	34	$41.86	$1,423.24
		Site Visit Follow-Up Telephone Interview Email	A-5	34	34	31	1	31	0.033	1.033	3	1	3	0.033	0.100	1.133	$41.86	$47.44
		Site Visit Follow-Up Telephone Interview	A-6c	34	34	31	1	31	1	31	3	1	3	0.167	0.500	31.500	$41.86	$1,318.59
State/Local Government Sub-Total				34	195	195	5.58	1,088	1.074	1,169	4	2.75	11	0.114	1.250	1170.02	-	$49,434.23
Vendor Data Collection
Business	Vendor Staff	Telephone Interview Email	A-2d	NA	2	2	1	2	0.033	0.067	0	0	0	0	0	0.067	$42.25	$2.82
		On-Site or telephone Interview	A-3a/b	NA	4	4	1	4	1	4	0	0	0	0	0	4	$42.25	$169.00
Business Sub-Total				NA	4	4	1.50	6	0.678	4.067	0	0	0	0	0	4.067	$42.25	$171.82
	GRAND TOTAL [c]			34	199	199	5.497	1,094	1.072	1,173	4	2.750	11	0.114	1.250	1,174	-	$49,606.05
Notes:	NA = Not applicable.
	Due to rounding of the data in this table, the individual components may not appear to sum exactly to the totals.
[a] Data collection instruments for Child Nutrition, Medicaid, and school district staff are included in appendices. In States where staff of State Agency vendors or third State Agencies play key roles in the DCM-F /RP process, the protocol for Child Nutrition Agency staff or Medicaid Agency staff—depending on which role is most similar—would be tailored for use in interviewing those respondents.
[b] For State government respondents, we used North American Industry Classification System (NAICS) 999200: State Government (SOC Code 11-000) mean wage = $42.33 per hour in computing the cost of respondent burden. For local government respondents, we used NAICS 999300: Local Government (SOC Code 11-000) mean wage = $41.86 per hour. For Business respondents, we used SOC Code 15-0000 (Computer and Mathematical Occupations) mean wage $42.25 per hour in computing the cost of respondent burden. Source: Bureau of Labor Statistics, Occupational Employment Statistics Survey, May 2016. (http://www.bls.gov/oes/current/naics3_999000.htm; https://www.bls.gov/oes/current/oes150000.htm)
[c] State Child Nutrition Agency, State Medicaid Agency, other State Agency, and school district staff are all expected to participate in multiple data collection activities, including the site visits, follow-up interviews, and the completion of cost tracking logs and administrative records requests, where applicable. Each individual is counted only once in the total.