Appendix G ESAP Reporting Template

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Overview

Pre-Post Comparison
Cert-Recert
QC & Error Rate
Timeliness

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Sheet 1: Pre-Post Comparison

Pre-Waiver/Post-Waiver Comparison

OMB No.0584-NEW

The State will compare two groups of specific SNAP participants to assess the changes in participation

Pre-ESAP Research Cohort

Schaefer, Jill - FNS: would recommend adding specific dates before sending to State The research cohort includes all households that meet ESAP criteria and received SNAP before the ESAP is implemented. For the pre-ESAP period, the State shall identify all households comprised only of elderly and/or disabled members with no earned income who were participating in SNAP in [Month]. These households will become the research cohort for the pre-ESAP comparison period. For each case identified, the State will provide the following information in the template below for each month between [Month] and [Month]:

Note: For the Pre-ESAP cohort, we are looking for about 24-28 months of data from the time period immediately before the ESAP is implemented. Insert appropriate dates to the left and in the template.

Elderly and/or Disabled Households with No Earned Income before ESAP Implementation Template

Table A: Elderly and/or Disabled Households with No Earned Income before ESAP  Implementation

Month 1

Month 2

Month 3

Month 4

…

Final Month

Total Cases in [Month 1]:

This number would not change over time

Number of households that completed the periodic report

Number of households that left SNAP in reporting month due to:

Failure to return periodic report

Failure to recertify

Ineligibility (death)

Ineligibility (other)

Number of closed cases that return to SNAP in reporting month

Average months off program

Closure Reason for reopened cases

Failure to return periodic report

Failure to recertify

Ineligibility (other)

Number of cohort cases on SNAP in reporting month

Post Implementation ESAP Cohort

Schaefer, Jill - FNS: added the last sentence which was in the terms and conditions docx Once the ESAP is in effect, the State will identify an ESAP cohort for the post-ESAP comparison. The ESAP cohort will include all ESAP cases participating 4 months after the start of the Project. The State will collect the same monthly data points, with the exception of data about interim reporting, since this requirement is waived. In order to capture ESAP cases that close due to failure to recertify, the State will need to follow the ESAP cohort for at least 3 years after implementation.

Schaefer, Jill - FNS: added in from terms and conditions in order to remove from docx FNS recommends collecting this data for all households, not a sample of 200.

Elderly and/or Disabled Households with No Earned Income after ESAP Implementation Template

Table B: Elderly and/or Disabled Households with No Earned Income After ESAP Implementation

Month 1

Month 2

Month 3

Month 4

…

Final Month

Month 1 = 4 months after ESAP implementation

Total Cases in [insert Month that is 4 Months after ESAP Implementation]

This number would not change over time

Number of households that left SNAP in reporting month due to:

Failure to recertify

Ineligibility (death)

Ineligibility (other)

Number of closed cases that return to SNAP in reporting month

Average months off program

Closure Reason for reopened cases

Failure to recertify*

Ineligibility (other)

Number of cohort cases on SNAP in reporting month

*This data will not be available until the earliest SNAP case that was transferred to the Project comes up for renewal.

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 OMB No.0584-NEW. The time required to complete this information collection is estimated to average 81 hours per response.

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Sheet 2: Cert-Recert

Certifications/Recertification (broken out by fiscal year):					OMB No.0584-NEW
	For all Project applications, the State shall provide:
	1. Number of initial certification applications approved.
	2. Number of initial certification applications denied.
	3. Number of recertification applications approved.
	4. Number of recertification applications denied.
	5. How many of the above recertifications required an interview.
	6. The total number of ESAP participants.
	Certification/ Recertification Reporting Template
	Table 1: Certification/Recertification Data (All ESAP applications for FY)
		Approved		Denied
		Interviewed	Not Interviewed	Interviewed	Not Interviewed
	Initial Certification		NA
	Recertification
	Total
	Total Number of ESAP Participants (in fiscal year):
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 OMB No.0584-NEW. The time required to complete this information collection is estimated to average 81 hours per response.

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Sheet 3: QC & Error Rate

Quality Control and Error Rates: (broken out by fiscal year)							OMB No.0584-NEW
Please note: When submitting reports to FNS, do NOT include clients’ Personally Identifiable Information (PII).
	1. The State will randomly sample 200 active ESAP cases. The State will review the applications for payment accuracy.
	2. The State will randomly sample 100 denied and terminated ESAP applications, and review the applications for the negative error rate.
	3. The State shall perform a full quality control review based on the Quality Control 310 Handbook.
	4. For active error rates, the State will provide payment accuracy information with a brief description of the source of the error.
	Schaefer, Jill - FNS: updated error threshold for FY2019 5. The State will also provide information on all active cases where a variance in payment was discovered in the below payment variance spreadsheet. Unlike the error threshold (FY 2019 = $37) used in the calculation of the active error rate, payment variance is any amount over or under the true benefit the household should have received. Additional rows may be added, if needed.
	6. For negative cases, the State will provide the CAPER rate, and the reason for denial, as either procedural (e.g. failure to provide verification or additional information) or client ineligibility (due to income, fleeing felon, drug convict, alien status, and self-reported resources).
	7. The State may conduct these reviews via telephone.
	8. The State should report on all errors by case.
	Error Rate Reporting Template
	Table 2: Active Error Rate (n = 200 active cases)
	Active Cases	Overpayment (Based on error threshold)		Underpayment (Based on error threshold)				Total Payment Error (Based on error threshold)
		Number of Cases	Average $ Amount	Number of Cases		Average $ Amount		Number of Cases	Average $ Amount
	Value
	Cause of Error	Overpayment (Number of Cases)		Underpayment (Number of Cases)				Total Errors (Number of Cases)
	Household Composition
	Medical Deduction Error
	Shelter Deduction Error
	Earned Income*
	Unearned Income
	Total Number of Errors
	* Also ineligible for Project, error calculated according to normal program rules.
	Schaefer, Jill - FNS: added to template 9/20. Barb reviewed VT ESAP with this line in it and gave the OK Payment Error Rate for ESAP cases (in fiscal year):
	CAPER Rate for ESAP cases (in fiscal year):
	Quality Control Reporting Template
	Table 3: Quality Control Summary (n = 100 negative cases)
	Cases Denied & Terminated	New Certification (Number of Cases)		Recertification (Number of Cases)				Periodic Report (Number of Cases)		Outside of Cert/Recert/Periodic Report (Number of Cases)	Total
	Procedural Denial
	Incomplete Application
	Failure to Provide Verification
	Ineligibility Denial
	Income
	Fleeing Felon
	Drug Felony
	Lottery/Gambling Winnings
	Resources
	Client Request
	Alien Status
	ESAP Ineligible (e.g. not a senior, has earned income)*
	* Number of ESAP ineligible cases which were then processed under “normal” program rules:
	Payment Variance Worksheet
	Payment Variance Worksheet Include any case where the client received an over or underpayment of any amount.
	Client	Type of Case	Client Contact	Overpayment or Underpayment		Cause of Error (Check all that apply)
		Certification or Recertification C/R	Interviewed Y/N	Over or Under	Dollar Amount	Household Composition	Medical Deduction Error	Shelter Deduction Error	Earned Income	Unearned Income
	1
	2
	3
	4
	5
	6
	7
	8
	9
	10
	Notes on Variance Worksheet:
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 OMB No.0584-NEW. The time required to complete this information collection is estimated to average 81 hours per response.

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Sheet 4: Timeliness

Timeliness: (broken out by fiscal year)		OMB No.0584-NEW Expiration Date xx-xx-xxxx
Please note: When submitting reports to FNS, do NOT include clients’ Personally Identifiable Information (PII).
	For the 200 active cases:
	1. The State should differentiate between expedited and regular 30-day applications and indicate the number of each type of application processed within the statutory requirements for application processing.
	2. The State should report the percent of all Project participants processed within current timeliness standards.
	Timeliness Reporting Template
	Table 4: Initial Timeliness (n = 100)
	Number of normal applications process within 30 days
	Number of expedited application processed within 7 days
	Percent of all cases processed within statutory timeframes (APT rate for ESAP cases)
	Table 5: Recertification Timeliness (n = 100)
	Number of normal applications process within 30 days
	Number of expedited application processed within 7 days
	Percent of all cases processed within statutory timeframes (APT rate for ESAP cases)
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 OMB No.0584-NEW. The time required to complete this information collection is estimated to average 81 hours per response.