Attachment H.5. Document Collection Guide

OMB Number: 0584-XXXX

Expiration Date: XX/XX/XXXX

SNAP Work Requirements
and Employment and Training (E&T) Data Study: Document Collection Guide

Westat is conducting the Supplemental Nutrition Assistance Program (SNAP) Work Requirements and Employment and Training (E&T) Data Study for the U.S. Department of Agriculture’s Food and Nutrition Service (FNS). This study aims to develop a framework for data that FNS can use to monitor and assess State agencies’ progress toward equity in the future. The documents you provide will inform our understanding of your State’s SNAP E&T operations and will help us draft guidance for FNS with recommendations on how to assess and monitor equity in the administration of work requirements in SNAP and SNAP E&T programs.

Instructions: The table below identifies the type of documents (i.e., Category) and examples that we would like you to provide. Document examples with an asterisk are of highest priority. Other documents listed without an asterisk are examples of what you may also upload for that category. If a document you are uploading is not listed in the table below, please write in the document type in the “other” row.

Please check the box next to the document you are uploading for each category and indicate the total number of documents you are submitting in each category. Include this document with the materials you upload to your State’s unique Box folder.

Public Burden Statement

This information is being collected to assist the Food and Nutrition Service in examining equity in SNAP work requirements and SNAP Employment and Training. This is a voluntary data collection, and FNS will use the information to understand what data are needed to assess equitable program access and outcomes in SNAP and SNAP Employment and Training. This collection does not request any personally identifiable information under the Privacy Act of 1974. According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0584-XXXX. The time required to complete this information collection is estimated to average 100 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the following address: U.S. Department of Agriculture, Food and Nutrition Service, Office of Policy Support, 1320 Braddock Place, Alexandria, VA 22314, ATTN: PRA (0584-XXXX). Do not return the completed form to this address.

Your State’s Box link and upload instructions can be found in the email sent to your SNAP State Director. If you need assistance or have questions, contact the Westat study team via email at STUDYEMAIL@westat.com or by phone at XXX.XXX.XXXX.

Document Category	Document Examples
Training material # of documents: ____________	☐Presentations and training materials* ☐Staff handbooks* ☐Checklists or ‘cheat’ sheets ☐Training scripts and protocols
Implementation guidance # of documents: ____________	☐Policy memos and communication* ☐Provider handbook* ☐County manual or handbook*
Process and operations # of documents: ____________	☐Process and operations documents, such as flow charts ☐Provider workplans and reports or reporting templates ☐County workplans and reports or reporting templates
Communication with participants # of documents: ____________	☐Outreach materials (program descriptions, marketing flyers)* ☐ Notice to participants about eligibility status* ☐ Notices to participants about E&T assignments
Codebooks, data dictionaries # of documents: ____________	☐Eligibility system codebook* ☐E&T database codebook ☐Data system documentation, user guides, training materials, manuals, flow charts
Findings, results, feedback # of documents: _____________	☐Reports, findings, or case studies other entities have written with information about a State’s SNAP E&T program* ☐Strategic plan progress tracking ☐Internal documents tracking outcomes, demographic summaries, or other program information
Financial decision making # of documents: _____________	☐Documents describing distributions of program funds* ☐Provider or county invoices or invoicing templates ☐Contracts with providers and partners
Other documents # of documents: _____________	______________________________________________ ______________________________________________ ______________________________________________ ______________________________________________

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