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SAVES Center Data Collection for Program Improvement

ICR 202611-0970-004 · OMB 0970-0531 · Object 174614200.

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application/vnd.openxmlformats-officedocument.wordprocessingml.document
SAVES Center Data Collection for Program Improvement
Destinee Starcher
Writer
2024-08-27
2026-11-05
complete

Extracted Text

Instrument 1: Child Support Administrative Data Extract

Variable Name
CPR Expected Output
SAVES Demonstration Site Output 
Member ID 
To be used for matching cases in payment and enforcement action files (if submitted separately) 

Violence Assessment (FVI = Family Violence Indicator)
Binary (yes/no) 

CP Race 
Categorical 

NCP Race
Categorical 

CP Ethnicity
Binary or Categorical 

NCP Ethnicity
Binary or Categorical 

CP Age
Date of Birth (month/day/year)

NCP Age
Date of Birth (month/day/year)

CP Sex/gender 
Binary or categorical  

NCP Sex/gender 
Binary or categorical 

CP Zip code of residence
Categorical

NCP Zip code of residence
Categorical

Marital status on case
Categorical

Number of children on case
Total number 

Age of youngest child on case
Date of birth (month/day/year)

Number of cases CP has
Total number

Number of cases NCP has
Total number

CP Income (without CS)
Amount and frequency (ex per hour, annually etc.) 

NCP Income (without CS)
Amount and frequency (ex per hour, annually etc.)

CP Employment Status
Full-time, part-time, seasonal, self-employed, unemployed 

NCP Employment Status
Full-time, part-time, seasonal, self-employed, unemployed

County/Region
Categorical 

Case creation date
Date (month/day/year) 

Order establishment date
Date (month/day/year)

Referral source (e.g., mandatory, self)
Categorical (e.g., mandatory, self)

Order establishment method  
Categorical (admin, judicial, default, etc.)

CP attorney representation
Binary (yes/no) 

NCP attorney representation
Binary (yes/no)

Case type 
Categorical (child support, intrastate, Medicaid only, etc.) 

TANF status at establishment 
Categorical (current, former, never)

Monthly Support Obligation (MSO)
Amount of current support due per month (exclude arrears, interest, etc.) 

Arrears balance at order establishment 
Total amount 

Arrears balance at extract
Total amount 

Method of paternity establishment 
Categorical (VAP, court, etc.) 

Method of child medical coverage ordered 
Categorical (NCP, CP, Medicaid, etc.) 

Method of child medical coverage provided
Categorical (NCP, CP, Medicaid, etc.)

National Medical Support Notice (NMSN) issued to NCP Employer 
Binary (yes/no)

Verified Employer at extract 
Binary (yes/no)

Date employment verified (or previous 12 months)
Date (month/day/year)

Was good cause application made?
Binary (yes/no)

Good cause application date
Date (month/day/year) 

Good cause outcome
Categorical or binary 

Evidence of Case closure activity?
Binary (yes/no)

Case closure reason  
Categorical (interested in closure for safety) 

Case closure date 
Date (month/day/year) 

Was there a request for FVI
Binary (yes/no)

FVI Application
Date (month/day/year)

Date FVI Assigned
Date (month/day/year)

FVI Recertification  
Binary (yes/no)

FVI Recertification Date 
Date (month/day/year)

Date FVI Removed
Date (month/day/year) 

Enrolled in address confidentiality program
Yes/no/type?

Can be submitted in separate spreadsheet
Current support due (monthly for prior 12 months)
Month 1 amount due 
Month 2 amount due 
Month 3 amount due 
Month 4 amount due 
Month 5 amount due 
Month 6 amount due
Month 7 amount due 
Month 8 amount due 
Month 9 amount due 
Month 10 amount due 
Month 11 amount due 
Month 12 amount due 

Current support paid (monthly for prior 12 months)
Month 1 amount paid
Month 2 amount paid 
Month 3 amount paid
Month 4 amount paid
Month 5 amount paid
Month 6 amount paid
Month 7 amount paid
Month 8 amount paid
Month 9 amount paid
Month 10 amount paid
Month 11 amount paid
Month 12 amount paid


Was wage withholding or income assignment a method of payment in the prior 12 months? Or was the last payment in month 11 paid by wage assignment? 


Enforcement actions ever taken on case  
Type and date action taken (credit bureau, driver’s license, recreation license, passport, contempt, FIDM, etc.)