Fast Track Submission - WIC Eligibility Customer Experience Survey

Request for Approval under the “FNS Fast Track Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 0584-0611)

TITLE OF INFORMATION COLLECTION:

WIC Eligibility Customer Experience Survey

PURPOSE: The Food and Nutrition Service (FNS) of the United States Department of Agriculture (USDA) is committed to continuous improvement to the services delivered to the American public. The purpose of this collection is to learn about the public’s experience with the WIC Prescreening/Eligibility Tool in order to improve the service.

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides supplemental food, nutrition education, and referrals to health and social services to pregnant and postpartum women, infants, and children up to age 5 years who are living in low-income households and who are at nutritional risk. WIC is administered by 89 WIC State agencies and serves more than 6 million individuals.

In December 2021, President Biden signed Executive Order 14058 on Transforming Federal Customer Experience and Service Delivery to Rebuild Trust in Government. The Executive Order requires “High Impact Service Providers” (HISPs) or those agencies that provide or fund customer-facing services that have a high impact on the public to comply by measuring and managing customer experience. USDA FNS is considered a HISP and this information collection will contribute to FNS’ goal to collect feedback on the WIC services of highest-impact and report the findings back to the Office of Management and Budget (OMB) in accordance with OMB Circular No. A-11 (2020), Section 280.

DESCRIPTION OF RESPONDENTS: Individuals who visit the USDA FNS website and complete the WIC Prescreening/Eligibility Tool will be surveyed. All those who complete the Tool will be presented with the opportunity to complete the survey.

TYPE OF COLLECTION: (Check one)

[ ] Customer Comment Card/Complaint Form [x] Customer Satisfaction Survey

[ ] Usability Testing (e.g., Website or Software) [ ] Small Discussion Group

[ ] Focus Group [ ] Other: ______________________

[ ] Quick census or surveys

CERTIFICATION:

I certify the following to be true:

1. The collection is voluntary.

2. The collection is low-burden for respondents and low-cost for the Federal Government.

3. The collection is non-controversial and does not raise issues of concern to other Federal agencies.

4. The results are not intended to be disseminated to the public.

5. Information gathered will not be used for the purpose of substantially informing influential policy decisions.

6. The collection is targeted to the solicitation of opinions from respondents who have experience with the program or may have experience with the program in the future.

To assist review, please provide answers to the following question:

Personally Identifiable Information:

1. Is personally identifiable information (PII) collected? [ ] Yes [x] No

2. If Yes, will any information that is collected be included in records that are subject to the Privacy Act of 1974? [ ] Yes [ ] No [X] N/A

3. If Yes, has an up-to-date System of Records Notice (SORN) been published? [ ] Yes [ ] No [X] N/A

Sensitive Information:

1. Will sensitive information, such as demographic characteristics, be collected from respondents?

[ ] Yes [x] No

2. If yes, explain the necessity of such information to the programmatic objective(s)?

Gifts or Payments:

Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to participants? [ ] Yes [x] No

BURDEN HOURS

Category of Respondent	No. of Respondents	Participation Time	Burden
Individuals interested in learning about their WIC eligibility status	22,500	5 minutes	1875 hours
Total	22,500		1875

FEDERAL COST: The estimated annual cost to the Federal government is $1,503.42

· FNS staff time: $1,503.42 annually

o GS-13, Step 1 working 20 hours a year at a rate of $56.52/hour based on the 2024 General Schedule for the Washington/Baltimore/Arlington locality; estimated cost plus 33% fully loaded wage rate is $1,503.43 (1130.40 + 373.03).

If you are conducting a focus group, survey, or plan to employ statistical methods, please provide answers to the following questions:

The selection of your targeted respondents

1. Do you have a customer list or something similar that defines the universe of potential respondents and do you have a sampling plan for selecting from this universe?

[ ] Yes [x] No

2. If the answer is yes, please provide a description of both below (or attach the sampling plan)? If the answer is no, please provide a description of how you plan to identify your potential group of respondents and how you will select them?

All those who complete the WIC eligibility screening will be offered the option to complete the survey.

Administration of the Instrument

1. How will you collect the information? (Check all that apply)

[ x] Web-based or other forms of Social Media

[ ] Telephone

[ ] In-person

[ ] Mail

[ ] Other

2. Will interviewers or facilitators be used? [ ] Yes [x] No

Instructions for completing Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback”

TITLE OF INFORMATION COLLECTION: Provide the name of the collection that is the subject of the request. (e.g. Comment card for soliciting feedback on xxxx)

PURPOSE: Provide a brief description of the purpose of this collection and how it will be used. If this is part of a larger study or effort, please include this in your explanation.

DESCRIPTION OF RESPONDENTS: Provide a brief description of the targeted group or groups for this collection of information. These groups must have experience with the program.

TYPE OF COLLECTION: Check one box. If you are requesting approval of other instruments under the generic, you must complete a form for each instrument.

CERTIFICATION: Please read the certification carefully. If you incorrectly certify, the collection will be returned as improperly submitted or it will be disapproved.

PERSONALLY IDENTIFIABLE INFORMATION: Provide answers to the questions. Note: Agencies should only collect PII to the extent necessary, and they should only retain PII for the period of time that is necessary to achieve a specific objective.

GIFTS OR PAYMENTS: If you answer yes to the question, please describe the incentive and provide a justification for the amount.

SENSITIVE INFORMATION: If you answer yes to the question, please describe the nature of the sensitive information being collected (e.g., race, sexual behavior or attitudes, religious beliefs, and other matters that are commonly considered private) and provide a justification for its use.

BURDEN HOURS:

Category of Respondents: Identify who you expect the respondents to be in terms of the following categories: (1) Individuals or Households; (2) Businesses (i.e., Profit, Not for Profit, and/or Farms); (3) State, local, or tribal governments; or (4) Federal Government. Only one type of respondent can be selected per row.

No. of Respondents: Provide an estimate of the Number of respondents.

Participation Time: Provide an estimate of the amount of time required for a respondent to participate (e.g., fill out a survey or participate in a focus group)

Burden: Provide the Annual burden hours: Multiply the Number of responses and the participation time and divide by 60.

FEDERAL COST: Provide an estimate of the annual cost to the Federal government.

If you are conducting a focus group, survey, or plan to employ statistical methods, please provide answers to the following questions:

The selection of your targeted respondents. Please provide a description of how you plan to identify your potential group of respondents and how you will select them. If the answer is yes, to the first question, you may provide the sampling plan in an attachment.

Administration of the Instrument: Identify how the information will be collected. More than one box may be checked. Indicate whether there will be interviewers (e.g. for surveys) or facilitators (e.g., for focus groups) used.

Submit all instruments, instructions, and scripts are submitted with the request.

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