Improving Coordination Between SNAP and Medicaid in State Agencies (New)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
SNAP Medicaid Revised OMB Package_Part A_clean.docx	Supporting Statement A	Uploaded 2023-11-30	Repair queued
Appendix N. Burden Table.xlsx	Supplementary Document	Uploaded 2023-11-30	Repair queued
Appendix AG. FNS-10 USDA FNS Persons Doing Business with the Food and Nutrition Service.pdf	Supplementary Document	Uploaded 2023-11-29	Repair queued
Appendix AF. FNS-8 USDA_FNS Studies and Reports.pdf	Supplementary Document	Uploaded 2023-11-29	Missing upstream
Appendix O. Confidentiality Agreement.docx	Supplementary Document	Uploaded 2023-11-28	Repair queued
Appendix M. Pretest Results Memorandum.docx	Supplementary Document	Uploaded 2023-11-28	Repair queued
Appendix L. Project Description.docx	Supplementary Document	Uploaded 2023-11-28	Repair queued
Appendix H. Case Study Recruitment Email from FNS to Regional Office.docx	Supplementary Document	Uploaded 2023-11-28	Repair queued
Appendix AD. IRB Approval Letter.pdf	Supplementary Document	Uploaded 2023-11-28	Repair queued
A. Legal Authority.pdf	Supplementary Document	Uploaded 2023-11-28	Repair queued
SNAP Medicaid Revised OMB Package_Part B.docx	Supporting Statement B	Uploaded 2023-11-28	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
263711	Businesses Non-Respondents	Other-NON RESPONDENT PLACE HOLDER	New
263710	Businesses Respondents	Other-Appendix AE. Case Study Recruitment Email from Project Tea	New
263709	State and Local Government Non-Respondents	Other-NON RESPONDENT PLACE HOLDER	New
263708	State and Local Government Respondents	Other-Appendix B. State Administrator Interview Guide	New

ICR Details

OMB Control No: 0584-0694	ICR Reference No: 202311-0584-006
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: USDA/FNS	Agency Tracking No:
Title: Improving Coordination Between SNAP and Medicaid in State Agencies (New)
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 02/21/2024
Retrieve Notice of Action (NOA)	Date Received in OIRA: 01/11/2024
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2027	36 Months From Approved
Responses	355	0	0
Time Burden (Hours)	184	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The purpose of the data collection is to understand how States coordinate between SNAP and Medicaid and identify barriers and facilitators to program coordination in State SNAP and Medicaid agencies.

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Authorizing Statute(s): PL: Pub.L. 116 - 94 17 Name of Law: The Food and Nutrition Act of 2008
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 19903	04/04/2023
30-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 1875	01/11/2024
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 4

table that charts list of burden

IC Title	Form No.	Form Name
Businesses Non-Respondents
Businesses Respondents
State and Local Government Non-Respondents
State and Local Government Respondents

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	355	0	0	355	0	0
Annual Time Burden (Hours)	184	0	0	184	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a new information collection that will add 184.34 burden hours (162.86 response hours plus 21.31 nonresponse hours) and 355 annual responses (300 responses plus 55 nonresponses) to the OMB information collection inventory.

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Annual Cost to Federal Government: $220,921

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 01/11/2024

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