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pdfAPPENDIX A
NATIONAL SURVEY OF DIRECT CERTIFICATION PRACTICES
OMB No.: 0584-0529
Expiration Date: xx-xx-xxxx
National Survey of Direct Certification Practices
of the
National School Lunch Program
Direct Certification Improvement Study
ALL
If R = 1 or 2 then FILL = “65”
If R = 3 then FILL = “60”
Else FILL = “20”
Public reporting burden for this collection of information is estimated to average [FILL] 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. An agency may not conduct or sponsor, and
a person is not required to respond to, a collection of information unless it displays a currently valid OMB
control number. The OMB control number for this project is 0584-0529. Send comments regarding this burden
estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: U.S.
Department of Agriculture, Food and Nutrition Services, Office of Research and Analysis, Room 1014, Alexandria, VA
22302, ATTN: PRA (0584-0529). Do not return the completed form to this address.
Notes to the programmers:
Use the colors in the USDA FNS logo.
Respondent classification [R]:
1 = State with State-level matching
2 = State with district-level matching
3 = District selected for long survey
4 = District selected for short survey
.M = missing response
All other (specify) fields should be limited to 100 characters. The six open-ended questions
(A1F, D5E, D5F, D13, E1C, and K3) should each be programmed for 1,000 characters.
At the bottom of each page, include links to save and quit, review answers, and go back. Also
include the help desk email address and telephone number.
Login screen
Welcome to the survey for the National School Lunch Program Direct Certification Improvement
Study! To access the survey, please enter your Login Identification Number and your Password.
These were provided to you in your email invitation.
If you have trouble accessing the survey, or if you have any questions, please contact the help
desk at [EMAIL ADDRESS] or [TELEPHONE NUMBER].
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First screen after login
The study is being conducted for the U.S. Department of Agriculture, Food and Nutrition Service
(FNS). The purpose of the study is to provide FNS with a comprehensive picture of the direct
certification practices employed by States and districts and to explore the relationship between
these practices and overall direct certification performance measures. Under the Richard B.
Russell National School Lunch Act and the Child Nutrition Act of 1966, FNS has authority to
conduct this study under its responsibility for the development and implementation of national
policy for the National School Lunch Program. For more information please access the
frequently asked questions.
This survey is designed to be completed by the child nutrition or food service program director
or a designated member of your staff who has knowledge of direct certification procedures. We
encourage you to circulate the survey among appropriate staff, if necessary, to obtain all
responses. During the survey, we will ask about the following key topics:
The matching method your State or district uses for direct certification
Characteristics of the enrollment and program data used to conduct the match (e.g.,
data elements and their formats, how often the match is conducted, and the match
rules that your State or district uses)
The number of children in the program data used for your most recent match, as well
as the number of children who were directly certified
Click here to print this list of topics. You may find it helpful to gather this information before
starting the survey, but you will be able to save your progress and return at a later time if you
need to. At the end of the survey, you will also be able to return to specific sections and provide
responses to missing questions.
Your participation is voluntary. The responses that you provide will be kept private to the extent
allowed by law. Results will be reported only at the State level, and the names of participating
districts will not be revealed. It is possible that informed individuals may be able to infer the
identity of respondents at the State level from the types of information provided, but we will not
report names of respondents.
Second screen after login
Please read the following general instructions before proceeding:
Please keep a copy of your completed questionnaire for your records. You will be
able to review and print your responses at the end of the survey.
If you are returning to finishing a partially completed questionnaire, you will return to
the point where you left off.
If you are starting a new questionnaire, you will start at the beginning with the first
question.
Please do not scroll through the actual questionnaire to preview questions. This may
cause errors and we will need to contact you to collect any missing information.
Please do not use the “Enter” key to advance to the next screen. This can result in
questions being missed. When all questions on the screen have been answered,
click the “Submit Page and Continue” button on the bottom of each page.
If you are ready to begin the questionnaire, click the button below.
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Screen to display when respondents save and leave the survey
Thank you for starting the NSLP Direct Certification Improvement Study survey. Your responses
have been saved and you may return any time. When you log back in to the survey, you will
start at the first unanswered question. Please complete the survey by [DATE].
If you have questions or need assistance with the survey, please contact the help desk at
[EMAIL ADDRESS] or [TELEPHONE NUMBER].
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ALL
A. INTRODUCTION
Direct certification is the process whereby school officials determine a child’s eligibility for free
school meals in the National School Lunch Program (NSLP) based on data provided by the
State or local welfare office about participation in the Supplemental Nutrition Assistance
Program (SNAP), Temporary Assistance for Needy Families (TANF), or Food Distribution
Program on Indian Reservations (FDPIR). Direct certification is generally implemented at the
State or district level, or by mailing letters to all SNAP households in the State.
ALL
A1a
a1a
With State-level matching, a State agency (usually Child Nutrition) is
responsible for a system that matches a list of children in NSLP schools with a
list of children in SNAP households using a common identifier or identifiers.
This system can be set up in a variety of ways. Some examples include:
A State agency matches State enrollment information with a State list of
children in SNAP households. A list of students directly certified on the
basis of this match is forwarded to districts.
An initial match is conducted by a State agency. A list of matched students
is sent to districts, who then verify the matches, get further information on
students who are “potential” matches, or conduct other types of secondary
matching.
Districts upload enrollment information into a State-maintained computer
or web-based system that conducts a match to a list of children in SNAP
households. Students are directly certified on the basis of this match.
Does your State conduct matching at the State level for direct certification?
Yes .............................................................................. 1
No ................................................................................ 0
HARD CHECK: IF UNANSWERED Please select a response before proceeding.
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ALL
If R = 1 or 2 then FILL = “Do any districts in your State”
Else FILL = “Does your district”
A1b
a1b
With district-level matching, districts have primary responsibility for matching
a list of children enrolled in their schools with a list of children in SNAP
households using a common identifier or identifiers. Districts may use manual
methods or their own computer system. [Do any districts in your State/Does
your district] conduct matching at the district level for direct certification?
Yes .............................................................................. 1
No ................................................................................ 0
SOFT CHECK: IF R = 1 AND A1A = 0 You indicated your State does not conduct Statelevel matching for direct certification. With State-level matching, a State agency is
responsible for a system that matches a list of children in NSLP schools with a list of
children in SNAP households using a common identifier or identifiers. Please verify your
responses before proceeding.
IF R = 2 AND A1B = 0 You indicated your State does not conduct district-level matching
for direct certification. With district-level matching, districts have primary responsibility
for matching a list of children enrolled in their schools with a list of children in SNAP
households using a common identifier or identifiers. Please verify your responses before
proceeding.
IF (R = 3 OR 4) AND A1B = 0 You indicated your district does not conduct district-level
matching for direct certification. With district-level matching, districts have primary
responsibility for matching a list of children enrolled in their schools with a list of
children in SNAP households using a common identifier or identifiers. Please verify your
responses before proceeding.
HARD CHECK: IF UNANSWERED Please select a response before proceeding.
A1A = 1 AND A1B = 1
A1c
Which entity performs matching for direct certification first?
a1c
State ............................................................................ 1
District.......................................................................... 2
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ALL
If R = 1 or 2 then FILL = “State”
Else FILL = “district”
A1d
a1d
With the letter method, the State mails letters to all SNAP households notifying
them of their children’s eligibility for free school meals. Households who
return the letters to the school district are certified for school meal benefits
without having to fill out an application. Does your [State/district] certify
students for free school meals using the letter method?
Yes .............................................................................. 1
No ................................................................................ 0
SOFT CHECK: IF A1A = 1 AND A1B = 0 AND A1D = 1 You indicated your State uses both
State-level matching and the letter method for direct certification. Please verify your
responses before proceeding.
IF A1A = 0 AND A1B = 1 AND A1D = 1 You indicated your State uses both district-level
matching and the letter method for direct certification. Please verify your responses
before proceeding.
IF A1A = 1 AND A1B = 1 AND A1D = 1 You indicated your State uses State-level matching,
district-level matching, and the letter method for direct certification. Please verify your
responses before proceeding.
HARD CHECK: IF UNANSWERED Please select a response before proceeding.
IF A1A = 0 AND A1B = 0 AND A1D = 0
If R = 1 or 2 then FILL = “State”
Else FILL = “district”
A1e
a1e and
a1e_spec
How is direct certification conducted in your [State/district]?
Direct certification is not used ...................................... 1
Other (specify) ............................................................. 2
GO TO H2
___________________________________________
HARD CHECK: IF UNANSWERED Please select a response before proceeding.
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A1E = 1
If R = 1 or 2 then FILL = “State”
Else FILL = “district”
A1f
Why is direct certification not conducted in your [State/district]?
a1f
IF A1E = 1 GO TO H1A
ELSE IF (A1A = 0 AND A1B = 0 AND A1D = 1) GO TO A2
ELSE GO TO A3A
(R = 1 OR 2 OR 3) AND (A1D = 1)
Format as a drop-down box with digits 1 – 12.
A2
a2
As a part of directly certifying students through the letter method, in what
month does the State agency mail letters to SNAP households notifying them
of their children’s eligibility for free school meals?
|
|
| MONTH
(R = 1 OR A1A = 1) AND A1B = 1
A3a
a3a
Approximately what percentage of all school districts in your State perform
data matching for direct certification? (Please include any districts that do
matching in addition to that conducted at the State level.)
|
|
|
| % of all school districts in the State
SOFT CHECK: IF A3A LT 0 OR GT 100 Please provide a percentage between 0% and
100%.
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(R = 1 OR A1A = 1) AND A1B = 1
A3b
a3b_1
through
a3b_7_spec
What are the reasons districts perform data matching in addition to that
conducted at the State level?
MARK ALL THAT APPLY
To confirm State-level data matching
results (quality control) ................................................. 1
To determine direct certification status of students
identified by the State as “potential matches” ............... 2
District preference ........................................................ 3
Statutory requirement .................................................. 4
Additional check on new enrollments ........................... 5
State agency request ................................................... 6
Other (specify) ............................................................. 7
___________________________________________
IF A1A = 0 AND A1B = 0 GO TO C1
ELSE GO TO B1
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B. ENROLLMENT DATA CHARACTERISTICS
ALL
B1
b1 and
b1_spec
What is the primary source of student enrollment data used for direct
certification?
MARK ONE ONLY
Statewide Student Information System (SSIS) ............. 1
GO TO B3a
Electronic files maintained at district ............................ 2
Hard-copy files ............................................................. 3
Other (specify) ............................................................. 4
___________________________________________
(R = 1 OR 2) AND B1 ^=1
B2a
Does your State have or plan to have a Statewide Student Information System?
b2a
MARK ONE ONLY
Yes, SSIS currently in place ......................................... 1
Yes, SSIS planned ....................................................... 2
No ................................................................................ 0
(R = 1 OR 2) AND B1 ^=1
B2b
b2b
Does your agency expect to use the Statewide Student Information System for
NSLP direct certification in the future?
MARK ONE ONLY
No plans at the current time ......................................... 1
Yes, within the next 2 years ......................................... 2
Yes, within 3 to 4 years ................................................ 3
Yes, within 5 or more years .......................................... 4
Yes, but time frame is uncertain ................................... 5
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IF B2A = 1 GO TO B3A
ELSE GO TO B8
R = 1 OR 2
B3a
Does the Statewide Student Information System assign each student a unique
statewide student ID, distinct from the Social Security number (SSN)?
b3a
Yes .............................................................................. 1
GO TO B4a
No ................................................................................ 0
(R = 1 OR 2) AND (B3A = 0 OR .M)
B3b
b3b
Are there plans to implement a unique statewide student ID into the Statewide
Student Information System?
MARK ONE ONLY
No plans ...................................................................... 1
Yes, for school year 2012–2013................................... 2
Yes, after school year 2012–2013 ................................ 3
Yes, but no date set ..................................................... 4
Don’t know ................................................................... d
R = 1 OR 2
B4a
b4a
Of the total school districts in your State, what percentage is included in the
Statewide Student Information System?
|
|
|
| % of all school districts in the State
SOFT CHECK: IF B4A LT 0 OR GT 100 Please provide a percentage between 0% and
100%.
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R = 1 OR 2
B4b
b4b
Of the total public school students in your State, what percentage is included
in the Statewide Student Information System?
|
|
|
| % of total public school students in the State
SOFT CHECK: IF B4B LT 0 OR GT 100 Please provide a percentage between 0% and
100%.
R = 1 OR 2
B4c
b4c
Of the total private school students in your State, what percentage is included
in the Statewide Student Information System?
|
|
|
| % of total private school students in the State
SOFT CHECK: IF B4C LT 0 OR GT 100 Please provide a percentage between 0% and
100%.
R = 1 OR 2
B4d
b4d
Of the total charter school students in your State, what percentage is included
in the Statewide Student Information System?
|
|
|
| % of total charter school students in the State
SOFT CHECK: IF B4D LT 0 OR GT 100 Please provide a percentage between 0% and
100%.
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R = 1 OR 2 OR 3
B5
What type of database is used for the Statewide Student Information System?
MARK ONE ONLY
b5 and
b5_spec
Microsoft SQL .............................................................. 1
Oracle .......................................................................... 2
Microsoft Access .......................................................... 3
SAS ............................................................................. 4
DB2.............................................................................. 5
Other (specify) ............................................................. 6
___________________________________________
R = 1 OR 2 OR 3
B6a
How are data entered into the SSIS?
b6a_1
through
b6a_4_spec
MARK ALL THAT APPLY
Manual data entry ........................................................ 1
District staff upload enrollment files into system ........... 2
Automatic process loads enrollment data into system .. 3
Other (specify) ............................................................. 4
___________________________________________
R = 1 OR 2
B6b
Does your agency perform data quality checks on the data that are entered
into the Statewide Student Information System?
b6b
Yes .............................................................................. 1
No ................................................................................ 0
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GO TO B7
(R = 1 OR 2) AND (B6B = 1 OR .M)
B6c
b6c_1
through
b6c_spec
What data quality checks are performed on the data that are entered into the
Statewide Student Information System?
MARK ALL THAT APPLY
System has a set of validation rules and edit checks
that are applied to data entered into the system ........... 1
Random sample audit checks of data are performed
each year ..................................................................... 2
Follow-up with districts is routine for questionable
data.............................................................................. 3
Audit checks are performed on randomly selected
districts in the state ...................................................... 4
An outside contractor performs data quality audits ....... 5
Other (specify) ............................................................. 6
___________________________________________
R = 1 OR 2 OR 3
IF R =1 OR 2 FILL = “If districts or schools can choose when to update their data, please give
the minimum frequency at which they are required to do so.”
Else FILL ““
B7
b7 and
b7_spec
How often are data from the Statewide Student Information System refreshed
(updated) during the school year? [If districts or schools can choose when to
update their data, please give the minimum frequency at which they are
required to do so. / ““]
MARK ONE ONLY
Ongoing, real-time updates .......................................... 1
Weekly ......................................................................... 2
Monthly ........................................................................ 3
Quarterly ...................................................................... 4
Three times per year .................................................... 5
Twice per year ............................................................. 6
Once per year .............................................................. 7
Other (specify) ............................................................. 8
___________________________________________
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R = 1 OR 2 OR 3
B8
How are the student enrollment data transferred to the entity that conducts
matching for direct certification?
b8_1
through
b8_8_spec
MARK ALL THAT APPLY
No transfer necessary; student enrollment data are
housed at the entity that conducts matching ................ 1
Hard-copy lists are sent via mail .................................. 2
Data disks are sent via mail ......................................... 3
Electronic files are sent via email ................................. 4
Electronic files are uploaded via Internet...................... 5
Electronic files are uploaded via automatic process ..... 6
Data are entered through web browser ........................ 7
Other (specify) ............................................................. 8
___________________________________________
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C. PROGRAM DATA QUESTIONS
R = 1 OR 2
C1
c1_1
through
c1_5_spec
Aside from SNAP, which program data are currently used to conduct direct
certification in your State?
MARK ALL THAT APPLY
Temporary Assistance to Needy Families (TANF)........ 1
Food Distribution Program on Indian
Reservations (FDPIR) .................................................. 2
Medicaid ...................................................................... 3
Foster care system ...................................................... 4
Other (specify) ............................................................. 5
___________________________________________
No other program data are used to conduct direct
certification................................................................... 0
HARD CHECK: IF C1_1 THROUGH C1_5_SPEC UNANSWERED Please indicate which
program data, aside from SNAP, are currently used to conduct direct certification in your
State.
IF A1A = 0 AND A1B= 0 GO TO E1
ELSE GO TO C2
R = 1 OR 2
C2
c2
For purposes of direct certification, does the State child nutrition agency have
a formal data sharing agreement and/or contract with the other agencies
whose data are used in direct certification?
Yes .............................................................................. 1
No ................................................................................ 0
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R = 1 OR 2
C3a
c3a and
c3a_spec
How often does your agency get program data from SNAP for direct
certification during the school year?
MARK ONE ONLY
Ongoing, real-time updates .......................................... 1
Weekly ......................................................................... 2
Monthly ........................................................................ 3
Quarterly ...................................................................... 4
Three times per year .................................................... 5
Twice per year ............................................................. 6
Once per year .............................................................. 7
Other (specify) ............................................................. 8
___________________________________________
(R = 1 OR 2) AND C1_1 = 1
C3b
c3b and
c3b_spec
How often does your agency get program data from TANF for direct
certification during the school year?
MARK ONE ONLY
Ongoing, real-time updates .......................................... 1
Weekly ......................................................................... 2
Monthly ........................................................................ 3
Quarterly ...................................................................... 4
Three times per year .................................................... 5
Twice per year ............................................................. 6
Once per year .............................................................. 7
Other (specify) ............................................................. 8
___________________________________________
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(R = 1 OR 2) AND C1_2 = 1
C3c
c3c and
c3c_spec
How often does your agency get program data from FDPIR for direct
certification during the school year?
MARK ONE ONLY
Ongoing, real-time updates .......................................... 1
Weekly ......................................................................... 2
Monthly ........................................................................ 3
Quarterly ...................................................................... 4
Three times per year .................................................... 5
Twice per year ............................................................. 6
Once per year .............................................................. 7
Other (specify) ............................................................. 8
___________________________________________
(R = 1 OR 2) AND C1_3 = 1
C3d
c3d and
c3d_spec
How often does your agency get program data from Medicaid for direct
certification during the school year?
MARK ONE ONLY
Ongoing, real-time updates .......................................... 1
Weekly ......................................................................... 2
Monthly ........................................................................ 3
Quarterly ...................................................................... 4
Three times per year .................................................... 5
Twice per year ............................................................. 6
Once per year .............................................................. 7
Other (specify) ............................................................. 8
___________________________________________
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(R = 1 OR 2) AND C1_4 = 1
C3e
c3e and
c3e_spec
How often does your agency get program data from the foster care system for
direct certification during the school year?
MARK ONE ONLY
Ongoing, real-time updates .......................................... 1
Weekly ......................................................................... 2
Monthly ........................................................................ 3
Quarterly ...................................................................... 4
Three times per year .................................................... 5
Twice per year ............................................................. 6
Once per year .............................................................. 7
Other (specify) ............................................................. 8
___________________________________________
(R = 1 OR 2) AND C1_5 = 1
FILL = C1_5_SPEC
C3f
c3f and
c3f_spec
How often does your agency get program data from [FILL FROM C1 OTHER
SPECIFY] for direct certification during the school year?
MARK ONE ONLY
Ongoing, real-time updates .......................................... 1
Weekly ......................................................................... 2
Monthly ........................................................................ 3
Quarterly ...................................................................... 4
Three times per year .................................................... 5
Twice per year ............................................................. 6
Once per year .............................................................. 7
Other (specify) ............................................................. 8
___________________________________________
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R = 1 OR 2
C4a_1
c4a_1a
through
c4a_1u
For each SNAP data element listed below, please indicate whether it is used
for matching.
Used to Match?
Yes
Student data elements:
SSN
No/Not
available
1
0
First name
1
0
Middle name / initial
1
0
Last name
1
0
Date of birth
1
0
Gender
1
0
Street address
1
0
City
1
0
County code
1
0
Zip code
1
0
Phone number
1
0
School name / ID
1
0
SNAP or other program ID
1
0
SSN
1
0
First name
1
0
Middle name / initial
1
0
Last name
1
0
Date of birth
1
0
Student, parent, or other
data elements (specify):
__________________
1
0
__________________
1
0
__________________
1
0
Parent data elements:
SOFT CHECK: IF ANY OF C4A_1A THROUGH C4A_1U UNANSWERED For each SNAP
data element, please indicate whether it is used for matching.
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R = 1 OR 2 AND (C4A_1A ^=0 OR C4A_1B ^=0 OR … OR C4A_1U ^=0)
C4a_2
c4a_2a
through
c4a_3u
For each SNAP data element used for matching, please indicate its format and
whether missing values are allowed.
C4a_3:
Missing
Values
Allowed?
C4a_2: Format?
Yes
No
1
0
First name
1
0
Middle name / initial
1
0
Last name
1
0
1, 2, 4-10
1
0
Gender
1-3
1
0
Street address
1, 2
1
0
1
0
Student data elements:
SSN
Date of birth
1, 2
City
County code
1-3
1
0
Zip code
1, 2
1
0
Phone number
1, 2
1
0
School name / ID
1-3
1
0
SNAP or other program ID
1, 2
1
0
1, 2
1
0
First name
1
0
Middle name / initial
1
0
Last name
1
0
1, 2, 4-10
1
0
Student, parent, or other
data elements (specify):
__________________
1-10
1
0
__________________
1-10
1
0
__________________
1-10
1
0
Parent data elements:
SSN
Date of birth
SOFT CHECK: IF ANY OF C4A_2A THROUGH C4A_3U UNANSWERED For each SNAP
data element, used for matching, please indicate its format and whether missing values
are allowed.
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These response options will be listed in drop-down boxes. Not all options will be listed for each
data element. These options will be repeated in each similar question (C4a_2 through C4e_2).
Numeric (for example, 3, 28, or 5004) ........................... 1
Character or text (for example, Smith or street) ............ 2
Binary (for example, Y/N or 0=male/1=female) ............. 3
Date/Time: MMDDYYYY ............................................... 4
Date/Time: MM/DD/YYYY ............................................. 5
Date/Time: YYYYMMDD ............................................... 6
Date/Time: Long Date (for example,
Monday, June 15, 2009) ............................................... 7
Date/Time: Universal Sortable Date/Time
Pattern (YYYY-MM-DD) ................................................ 8
Other Date/Time format ................................................ 9
Other date format ......................................................... 10
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(R = 1 OR 2) AND C1_1 = 1
C4b_1
c4b1 and
c4b_1a
through
c4b_1u
For each TANF data element listed below, please indicate whether it is used for
matching.
TANF data elements are identical to those
used with SNAP ............................................................ 1
GO TO C4B_2
Used to Match?
Yes
Student data elements:
SSN
No/Not
available
1
0
First name
1
0
Middle name / initial
1
0
Last name
1
0
Date of birth
1
0
Gender
1
0
Street address
1
0
City
1
0
County code
1
0
Zip code
1
0
Phone number
1
0
School name / ID
1
0
SNAP or other program ID
1
0
SSN
1
0
First name
1
0
Middle name / initial
1
0
Last name
1
0
Date of birth
1
0
Student, parent, or other
data elements (specify):
__________________
1
0
__________________
1
0
__________________
1
0
Parent data elements:
SOFT CHECK: IF ANY OF C4B_1A THROUGH C4B_1U UNANSWERED For each TANF data
element, please indicate whether it is used for matching.
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(R = 1 OR 2) AND [C1_1 = 1 AND (C4B_1A ^=0 OR C4B_1B ^=0 OR … OR C4B_1U ^=0)] OR
C4B1 = 1
C4b_2
c4b2 and
c4b_2a
through
c4b_3u
For each TANF data element used for matching, please indicate its format and
whether missing values are allowed.
TANF data formats and missing value rules are
both identical to those used with SNAP ......................... 1
GO TO C4C_1
C4b_3: Missing
Values Allowed?
C4b_2: Format?
Yes
No
1
0
First name
1
0
Middle name / initial
1
0
Last name
1
0
1, 2, 4-10
1
0
Gender
1-3
1
0
Street address
1, 2
1
0
1
0
Student data elements:
SSN
Date of birth
1, 2
City
County code
1-3
1
0
Zip code
1, 2
1
0
Phone number
1, 2
1
0
School name / ID
1-3
1
0
SNAP or other program ID
1, 2
1
0
1, 2
1
0
First name
1
0
Middle name / initial
1
0
Last name
1
0
1, 2, 4-10
1
0
Student, parent, or other
data elements (specify):
__________________
1-10
1
0
__________________
1-10
1
0
__________________
1-10
1
0
Parent data elements:
SSN
Date of birth
SOFT CHECK: IF ANY OF C4B_2A THROUGH C4B_3U UNANSWERED For each TANF data
element, used for matching, please indicate its format and whether missing values are
allowed.
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23
(R = 1 OR 2) AND C1_2 = 1
C4c_1
c4c1 and
c4c_1a
through
c4c_1u
For each FDPIR data element listed below, please indicate whether it is used
for matching.
FDPIR data elements are identical to those
used with SNAP ............................................................ 1
GO TO C4C_2
Used to Match?
Yes
Student data elements:
SSN
No/Not
available
1
0
First name
1
0
Middle name / initial
1
0
Last name
1
0
Date of birth
1
0
Gender
1
0
Street address
1
0
City
1
0
County code
1
0
Zip code
1
0
Phone number
1
0
School name / ID
1
0
SNAP or other program ID
1
0
SSN
1
0
First name
1
0
Middle name / initial
1
0
Last name
1
0
Date of birth
1
0
Student, parent, or other
data elements (specify):
__________________
1
0
__________________
1
0
__________________
1
0
Parent data elements:
SOFT CHECK: IF ANY OF C4C_1A THROUGH C4C_1U UNANSWERED For each FDPIR
data element, please indicate whether it is used for matching.
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24
(R = 1 OR 2) AND C1_2 = 1 AND (C4C_1A ^=0 OR C4C_1B ^=0 OR … OR C4C_1U ^=0)] OR
C4C1 = 1
C4c_2
c4c2 and
c4c_2a
through
c4c_3u
For each FDPIR data element used for matching, please indicate its format and
whether missing values are allowed.
FDPIR data formats and missing value rules are
both identical to those used with SNAP ......................... 1
GO TO C4D_1
C4c_3: Missing
Values Allowed?
C4c_2: Format?
Yes
No
1
0
First name
1
0
Middle name / initial
1
0
Last name
1
0
1, 2, 4-10
1
0
Gender
1-3
1
0
Street address
1, 2
1
0
1
0
Student data elements:
SSN
Date of birth
1, 2
City
County code
1-3
1
0
Zip code
1, 2
1
0
Phone number
1, 2
1
0
School name / ID
1-3
1
0
SNAP or other program ID
1, 2
1
0
1, 2
1
0
First name
1
0
Middle name / initial
1
0
Last name
1
0
1, 2, 4-10
1
0
Student, parent, or other
data elements (specify):
__________________
1-10
1
0
__________________
1-10
1
0
__________________
1-10
1
0
Parent data elements:
SSN
Date of birth
SOFT CHECK: IF ANY OF C4C_2A THROUGH C4C_3U UNANSWERED For each FDPIR
data element, used for matching, please indicate its format and whether missing values
are allowed.
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25
(R = 1 OR 2) AND C1_3 = 1
C4d_1
c4d1 and
c4d_1a
through
c4d_1u
For each Medicaid data element listed below, please indicate whether it is used
for matching.
Medicaid data elements are identical to those
used with SNAP ............................................................ 1
GO TO C4D_2
Used to Match?
Yes
Student data elements:
SSN
No/Not
available
1
0
First name
1
0
Middle name / initial
1
0
Last name
1
0
Date of birth
1
0
Gender
1
0
Street address
1
0
City
1
0
County code
1
0
Zip code
1
0
Phone number
1
0
School name / ID
1
0
SNAP or other program ID
1
0
SSN
1
0
First name
1
0
Middle name / initial
1
0
Last name
1
0
Date of birth
1
0
Student, parent, or other
data elements (specify):
__________________
1
0
__________________
1
0
__________________
1
0
Parent data elements:
SOFT CHECK: IF ANY OF C4D_1A THROUGH C4D_1U UNANSWERED For each Medicaid
data element, please indicate whether it is used for matching.
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26
(R = 1 OR 2) AND C1_3 = 1 AND (C4D_1A ^=0 OR C4D_1B ^=0 OR … OR C4D_1U ^=0)] OR
C4D1 = 1
C4d_2
c4d2 and
c4d_2a
through
c4d_3u
For each Medicaid data element used for matching, please indicate its format
and whether missing values are allowed.
Medicaid data formats and missing value rules are
both identical to those used with SNAP ......................... 1
GO TO C4E_1
C4d_3: Missing
Values Allowed?
C4d_2: Format?
Yes
No
1
0
First name
1
0
Middle name / initial
1
0
Last name
1
0
1, 2, 4-10
1
0
Gender
1-3
1
0
Street address
1, 2
1
0
1
0
Student data elements:
SSN
Date of birth
1, 2
City
County code
1-3
1
0
Zip code
1, 2
1
0
Phone number
1, 2
1
0
School name / ID
1-3
1
0
SNAP or other program ID
1, 2
1
0
1, 2
1
0
First name
1
0
Middle name / initial
1
0
Last name
1
0
1, 2, 4-10
1
0
Student, parent, or other
data elements (specify):
__________________
1-10
1
0
__________________
1-10
1
0
__________________
1-10
1
0
Parent data elements:
SSN
Date of birth
SOFT CHECK: IF ANY OF C4D_2A THROUGH C4D_3U UNANSWERED For each Medicaid
data element, used for matching, please indicate its format and whether missing values
are allowed.
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27
(R = 1 OR 2) AND C1_4 = 1
C4e_1
c4e1 and
c4e_1a
through
c4e_1u
For each foster care system data element listed below, please indicate whether
it is used for matching.
Foster care system data elements are identical
to those used with SNAP .............................................. 1
GO TO C4E_2
C4e_1: Used to
Match?
Yes
Student data elements:
SSN
No/Not
available
1
0
First name
1
0
Middle name / initial
1
0
Last name
1
0
Date of birth
1
0
Gender
1
0
Street address
1
0
City
1
0
County code
1
0
Zip code
1
0
Phone number
1
0
School name / ID
1
0
SNAP or other program ID
1
0
SSN
1
0
First name
1
0
Middle name / initial
1
0
Last name
1
0
Date of birth
1
0
Student, parent, or other
data elements (specify):
__________________
1
0
__________________
1
0
__________________
1
0
Parent data elements:
SOFT CHECK: IF ANY OF C4E_1A THROUGH C4E_1U UNANSWERED For each foster
care system data element, please indicate whether it is used for matching.
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28
(R = 1 OR 2) AND C1_4 = 1 AND (C4E_1A ^=0 OR C4E_1B ^=0 OR … OR C4E_1U ^=0)] OR
C4E1 = 1
C4e_2
c4e2 and
c43_2a
through
c4e_3u
For each foster care system data element used for matching, please indicate
its format and whether missing values are allowed.
Foster care system data formats and missing value
rules are both identical to those used with SNAP .......... 1
GO TO C4F_1
C4e_3: Missing
Values Allowed?
C4e_2: Format?
Yes
No
1
0
First name
1
0
Middle name / initial
1
0
Last name
1
0
1, 2, 4-10
1
0
Gender
1-3
1
0
Street address
1, 2
1
0
1
0
Student data elements:
SSN
Date of birth
1, 2
City
County code
1-3
1
0
Zip code
1, 2
1
0
Phone number
1, 2
1
0
School name / ID
1-3
1
0
SNAP or other program ID
1, 2
1
0
1, 2
1
0
First name
1
0
Middle name / initial
1
0
Last name
1
0
1, 2, 4-10
1
0
Student, parent, or other
data elements (specify):
__________________
1-10
1
0
__________________
1-10
1
0
__________________
1-10
1
0
Parent data elements:
SSN
Date of birth
SOFT CHECK: IF ANY OF C4E_2A THROUGH C4E_3U UNANSWERED For each foster
care system data element, used for matching, please indicate its format and whether
missing values are allowed.
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29
(R = 1 OR 2) AND C1_5 = 1
FILL = C1_5_SPEC
C4f_1
c4f1
and
c4f_1a
through
c4f_1u
For each [FILL FROM C1 OTHER SPECIFY] data element listed below, please
indicate whether it is used for matching.
[FILL FROM C1 OTHER SPECIFY] data elements
are identical to those used with SNAP .......................... 1
GO TO C4F_2
Used to Match?
Yes
Student data elements:
SSN
No/Not
available
1
0
First name
1
0
Middle name / initial
1
0
Last name
1
0
Date of birth
1
0
Gender
1
0
Street address
1
0
City
1
0
County code
1
0
Zip code
1
0
Phone number
1
0
School name / ID
1
0
SNAP or other program ID
1
0
SSN
1
0
First name
1
0
Middle name / initial
1
0
Last name
1
0
Date of birth
1
0
Student, parent, or other
data elements (specify):
__________________
1
0
__________________
1
0
__________________
1
0
Parent data elements:
SOFT CHECK: IF ANY OF C4F_1A THROUGH C4F_1U UNANSWERED For each data
element, please indicate whether it is used for matching.
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30
(R = 1 OR 2) AND C1_5 = 1 AND (C4F_1A ^=0 OR C4F_1B ^=0 OR … OR C4F_1U ^=0)] OR
C4F1 = 1
FILL = C1_5_SPEC
C4f_2
c4f2
and
c4f_2a
through
c4f_3u
For each [FILL FROM C1 OTHER SPECIFY] data element used for matching,
please indicate its format and whether missing values are allowed.
[FILL FROM C1 OTHER SPECIFY] data formats and
missing value rules are both identical
to those used with SNAP .............................................. 1
GO TO D1
C4f_3: Missing
Values Allowed?
C4f_2: Format?
Yes
No
1
0
First name
1
0
Middle name / initial
1
0
Last name
1
0
1, 2, 4-10
1
0
Gender
1-3
1
0
Street address
1, 2
1
0
1
0
Student data elements:
SSN
Date of birth
1, 2
City
County code
1-3
1
0
Zip code
1, 2
1
0
Phone number
1, 2
1
0
School name / ID
1-3
1
0
SNAP or other program ID
1, 2
1
0
1, 2
1
0
First name
1
0
Middle name / initial
1
0
Last name
1
0
1, 2, 4-10
1
0
Student, parent, or other
data elements (specify):
__________________
1-10
1
0
__________________
1-10
1
0
__________________
1-10
1
0
Parent data elements:
SSN
Date of birth
SOFT CHECK: IF ANY OF C4F_2A THROUGH C4F_3U UNANSWERED For each data
element, used for matching, please indicate its format and whether missing values are
allowed.
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31
D. DATA-MATCHING CHARACTERISTICS
R = 1 OR 2 OR 3
If R = 1 or 2 then FILL = “do most districts in your state”
Else FILL = “does your district”
Format as a drop-down box with digits 1 – 12.
D1
d1
During which month [do most districts in your State/does your district] start
the school year?
|
|
|
(R = 1 OR 3 OR 4) OR (R = 2 AND A1A = 1)
D2a
When did or when will the initial match of student enrollment data against the
program data for SY 2011–2012 be performed?
d2a
Before the start of the current school year ................... 1
During the current school year ..................................... 2
(R = 1 OR 3 OR 4) OR (R = 2 AND A1A = 1)
Format as a drop-down box with digits 1 – 12.
D2b
d2b
When was or when will be the month of the initial match?
|
|
|
(R = 1 OR 3 OR 4) OR (R = 2 AND A1A = 1)
D3
Does this initial match include students who are newly enrolled since the
previous school year?
d3
Yes .............................................................................. 1
No ................................................................................ 0
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32
(R = 1 OR 3 OR 4) OR (R=2 AND A1A = 1)
D4
d4
Does the initial match for direct certification involve a computer match or a
manual match?
MARK ONLY ONE
Manual match .............................................................. 1
Computer match .......................................................... 2
HARD CHECK: IF UNANSWERED Please select a response before proceeding.
(R = 1 OR 3 OR 4) OR (R = 2 AND A1A = 1)
D5a_1
d5a_1_1
through
d5a_1_27
Some States or districts apply matching rules in a series of steps, whereas
others apply only one set of rules. The following grid allows you to indicate
whether certain data elements are required or allowed to be included under the
first matching rule. For example, if your agency requires an exact match on
SSN plus exact matches on two additional elements, SSN should be marked as
“must be used in match,” while all additional elements should be marked as
“might be used in match.” (Later, we will ask about the minimum number of
elements required for a match. We will also ask about any additional
combinations of data elements used for matching.)
If your agency bases direct certification on a score that indicates how likely
the match is to be accurate – sometimes called probabilistic matching – mark
all items included in the score as “must be used in match.” (We will ask about
creating match scores later.)
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33
First Set of Data Elements
(Primary Identifiers)
Must Be
Used in
Match
Might Be
Used in
Match
Not
Used/Not
Available
Student data elements:
SSN
2
1
0
First name
2
1
0
Partial or phonetic first name
2
1
0
Middle name / initial
2
1
0
Partial or phonetic middle name
2
1
0
Last name
2
1
0
Partial or phonetic last name
2
1
0
Date of birth
2
1
0
Gender
2
1
0
Street address
2
1
0
City
2
1
0
County code
2
1
0
Zip code
2
1
0
Phone number
2
1
0
School name / ID
2
1
0
SNAP or other program ID
2
1
0
SSN
2
1
0
First name
2
1
0
Partial or phonetic first name
2
1
0
Middle name / initial
2
1
0
Partial or phonetic middle name
2
1
0
Last name
2
1
0
Partial or phonetic last name
2
1
0
Date of birth
2
1
0
_________________
2
1
0
_________________
2
1
0
_________________
2
1
0
Parent data elements:
Student, parent, or other data elements
(specify):
SOFT CHECK: IF D5A_1_1 THROUGH D5A_1_24 UNANSWERED For each element, please
indicate whether it must or might be used as a primary identifier, or whether it is not
used/not available.
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34
[(R = 1 OR 3 OR 4) OR (R = 2 AND A1A = 1)] AND (D5A_1_1 ^= 0 OR D5A_1_2 ^=0 OR … OR
D5A_1_25 = 1 OR 2 OR D5A_1_26 = 1 OR 2 OR D5A_1_27 = 1 OR 2)
D5a_2
d5a_2_1
through
d5a_2_27
For each data element that is required or allowed to be included under the first
matching rule, please indicate whether an exact match is required or if a near
match is allowed. If your agency bases direct certification on probabilistic
matching, mark all items included in the score as “inexact match allowed.”
Prepared by Mathematica Policy Research
35
Exact
Match
Required
Inexact or Near
Match Allowed
Student data elements:
SSN
0
1
First name
0
1
Partial or phonetic first name
0
1
Middle name / initial
0
1
Partial or phonetic middle name
0
1
Last name
0
1
Partial or phonetic last name
0
1
Date of birth
0
1
Gender
0
1
Street address
0
1
City
0
1
County code
0
1
Zip code
0
1
Phone number
0
1
School name / ID
0
1
SNAP or other program ID
0
1
SSN
0
1
First name
0
1
Partial or phonetic first name
0
1
Middle name / initial
0
1
Partial or phonetic middle name
0
1
Last name
0
1
Partial or phonetic last name
0
1
Date of birth
0
1
_________________
0
1
_________________
0
1
_________________
0
1
Parent data elements:
Student, parent, or other data elements
(specify):
SOFT CHECK: IF D5A_2_1 THROUGH D5A_2_24 UNANSWERED For each element used
as a primary identifier, please indicate whether an exact match is required or an inexact
match is allowed.
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36
ALL
D5b
d5b
Must a minimum number of elements be matched in order for a student to be
directly certified?
MARK ONLY ONE
No ................................................................................ 0
Yes, minimum of 2 elements ........................................ 1
Yes, minimum of 3 elements ........................................ 2
Yes, minimum greater than 3 elements ........................ 3
(R = 1 OR 3 OR 4) OR (R = 2 AND A1A = 1)
D5c
d5c
Does your agency create a number or score indicating either the strength of
the match or how likely the match is to be accurate? This type of score is
sometimes referred to as probabilistic matching.
MARK ONLY ONE
Yes .............................................................................. 1
No ................................................................................ 0
Prepared by Mathematica Policy Research
37
GO TO D6A
(R = 1 OR 2 OR 3) AND (D5C=1 OR .M)
D5d
d5d_1 and
d5d_2
How do you use the score indicating the strength of the match or how likely
the match is to be accurate (probabilistic matching)?
MARK ALL THAT APPLY
Students are directly certified if scores are
above a certain threshold ............................................ 1
Students are classified as potential matches to be
examined further if scores are above a certain
threshold ...................................................................... 2
(R = 1 OR 2) AND (D5D_1=1 OR .M)
IF D5D_1 = 1 AND D5D_2 = 1, PLEASE DISPLAY D5E AND D5F ON THE SAME SCREEN
D5e
d5e
Please describe how you use the score indicating how likely the match is to be
accurate (probabilistic matching) to directly certify students.
(R = 1 OR 2) AND D5D_2=1
IF D5D_1=1 AND D5D_2=1, PLEASE DISPLAY D5E AND D5F ON THE SAME SCREEN
D5f
d5f
Please describe how you use the score indicating how likely the match is to be
accurate (probabilistic matching) to generate a list of potential matches.
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38
(R = 1 OR 3) OR (R = 2 AND A1A = 1)
If R = 1 or (R = 2 AND A1A = 1) then SHOW = “Yes, further examination of potential matches is
conducted by State staff”
D6a
d6a and
d6a_spec
Some matching systems identify a list of potential matches between students
and program records. These potential matches typically do not meet the
criteria for identifying a definite match, but do have some common identifiers.
Do you have a process for identifying and investigating potential, but not
definite, matches between students and program records?
MARK ONLY ONE
No, the matching process does not generate a list of
potential matches ......................................................... 1
[Yes, further examination of potential matches is
conducted by State staff............................................... 2]
Yes, further examination of potential matches is
conducted by district staff............................................. 3
Other (specify) ............................................................. 4
___________________________________________
(R = 1 OR 3 OR 4) OR (R = 2 AND A1A = 1)
D6b
d6b
When there are children in the program data who, based on the primary
identifiers you indicated earlier, do not match the student enrollment data, do
you conduct further matching based on additional combinations of data
elements?
MARK ONLY ONE
Yes .............................................................................. 1
No ................................................................................ 0
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39
GO TO D6e
[(R = 1 OR 3 OR 4) OR (R=2 AND A1A = 1)] AND (D6B = 1 OR .M)
D6c
Does the process for matching additional combinations of data elements use a
manual match, computer match, or both?
d6c_1 and
d6c_2
MARK ALL THAT APPLY
Manual match .............................................................. 1
Computer match .......................................................... 2
[(R = 1 OR 3 OR 4) OR (R = 2 AND A1A = 1)] AND (D6B = 1 OR .M)
D6d_1
d6d_1_1
through
d6d_1_27
What additional combinations of data elements (secondary identifiers) are
used for children not directly certified with the first set of data elements
(primary identifiers)? If multiple sets of data elements are used in separate
steps, please mark all of the elements used in any combination.
Prepared by Mathematica Policy Research
40
Additional Combination of Data
Elements (Secondary Identifiers)
Must Be
Used in
Match
Might Be
Used in
Match
Not
Used/Not
Available
Student data elements:
SSN
2
1
0
First name
2
1
0
Partial or phonetic first name
2
1
0
Middle name / initial
2
1
0
Partial or phonetic middle name
2
1
0
Last name
2
1
0
Partial or phonetic last name
2
1
0
Date of birth
2
1
0
Gender
2
1
0
Street address
2
1
0
City
2
1
0
County code
2
1
0
Zip code
2
1
0
Phone number
2
1
0
School name / ID
2
1
0
SNAP or other program ID
2
1
0
SSN
2
1
0
First name
2
1
0
Partial or phonetic first name
2
1
0
Middle name / initial
2
1
0
Partial or phonetic middle name
2
1
0
Last name
2
1
0
Partial or phonetic last name
2
1
0
Date of birth
2
1
0
_________________
2
1
0
_________________
2
1
0
_________________
2
1
0
Parent data elements:
Student, parent, or other data elements
(specify):
SOFT CHECK: IF D6D_1_1 THROUGH D6D_1_24 UNANSWERED For each element, please
indicate whether it must or might be used as a secondary identifier, or whether it is not
used/not available.
Prepared by Mathematica Policy Research
41
[(R = 1 OR 3 OR 4) OR (R = 2 AND A1A = 1)] AND (D6B = 1 OR .M) AND (D6D_1_1 ^= 0 OR
D6D_1_2 ^=0 OR … OR D6D_1_25 = 1 OR 2 OR D6D_1_26 = 1 OR 2 OR D6D_1_27 = 1 OR
2)
D6d_2
d6d_2_1
through
d6d_2_27
For each data element used as a secondary identifier, please indicate whether
an exact match is required or if an inexact match is allowed.
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Exact
Match
Required
Inexact or Near
Match Allowed
Student data elements:
SSN
0
1
First name
0
1
Partial or phonetic first name
0
1
Middle name / initial
0
1
Partial or phonetic middle name
0
1
Last name
0
1
Partial or phonetic last name
0
1
Date of birth
0
1
Gender
0
1
Street address
0
1
City
0
1
County code
0
1
Zip code
0
1
Phone number
0
1
School name / ID
0
1
SNAP or other program ID
0
1
SSN
0
1
First name
0
1
Partial or phonetic first name
0
1
Middle name / initial
0
1
Partial or phonetic middle name
0
1
Last name
0
1
Partial or phonetic last name
0
1
Date of birth
0
1
_________________
0
1
_________________
0
1
_________________
0
1
Parent data elements:
Student, parent, or other data elements
(specify):
SOFT CHECK: IF D6D_2_1 THROUGH D6D_2_24 UNANSWERED For each secondary
identifier, please indicate whether an exact match is required or if an inexact match is
allowed.
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[(R = 1 OR 3 OR 4) OR (R = 2 AND A1A = 1)] AND D6B = 0
D6e
d6e_1
through
d6e_3_spec
What process is used when there are children in the program data who do not
match the student enrollment data based on any data elements used for
matching?
MARK ALL THAT APPLY
No additional steps taken ............................................. 1
Letter is sent to parent(s) of unmatched children in
the program data.......................................................... 2
Other (specify) ............................................................. 3
___________________________________________
(R = 1 OR 3 OR 4) OR (R = 2 AND A1A = 1)
D7a
d7a_1
through
d7a_6_spec
What process is used when there are two or more children in the student
enrollment data that match one child in the program data (that is, duplicate
matches)?
MARK ALL THAT APPLY
Identify both/all students as matches ........................... 1
GO TO D8a
Identify none of the students as matches ..................... 2
GO TO D8a
Send letter to students’ parents.................................... 3
GO TO D8a
Use additional information to determine which
student matches the program data............................... 4
Duplicate matches do not occur ................................... 5
GO TO D8a
Other (specify) ............................................................. 6
GO TO D8a
___________________________________________
[(R = 1 OR 3 OR 4) OR (R = 2 AND A1A = 1)] AND (D7A = 4 OR .M)
D7b_1
d7b_1_1
through
d7b_1_27
Please indicate the additional set of data elements that are used to determine
which student matches the program data in cases in which there are two or
more children in the student enrollment data that match one child in the
program data (that is, duplicate matches).
Prepared by Mathematica Policy Research
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Additional Set of Data Elements
(Duplicate Identifiers)
Must Be
Used in
Match
Might Be
Used in
Match
Not
Used/Not
Available
Student data elements:
SSN
First name
Partial or phonetic first name
Middle name / initial
Partial or phonetic middle name
Last name
Partial or phonetic last name
Date of birth
Gender
Street address
City
County code
Zip code
Phone number
School name / ID
SNAP or other program ID
2
1
0
2
1
0
2
1
0
2
1
0
2
1
0
2
1
0
2
1
0
2
1
0
2
1
0
2
1
0
2
1
0
2
1
0
2
1
0
2
1
0
2
1
0
2
1
0
2
1
0
2
1
0
2
1
0
2
1
0
2
1
0
2
1
0
2
1
0
2
1
0
2
1
0
2
1
0
2
1
0
Parent data elements:
SSN
First name
Partial or phonetic first name
Middle name / initial
Partial or phonetic middle name
Last name
Partial or phonetic last name
Date of birth
Student, parent, or other data elements
(specify):
_________________
_________________
_________________
SOFT CHECK: IF D7B_1_1 THROUGH D7B_1_24 UNANSWERED For each element, please indicate
whether it must or might be used to match duplicate records, or whether it is not used/not available.
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[(R = 1 OR 3 OR 4) OR (R = 2 AND A1A = 1)] AND (D7A = 4 OR .M) AND (D7A_1_1 ^= 0 OR
D7A_1_2 ^=0 OR … OR D7A_1_25 = 1 OR 2 OR D7A_1_26 = 1 OR 2 OR D7A_1_27 = 1 OR
2)
D7b_2
d7b_2_1
through
d7b_2_27
For each data element used for duplicate matches, please indicate whether an
exact match is required or if an inexact match is allowed.
Prepared by Mathematica Policy Research
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Exact
Match
Required
Inexact or Near
Match Allowed
Student data elements:
SSN
First name
Partial or phonetic first name
Middle name / initial
Partial or phonetic middle name
Last name
Partial or phonetic last name
Date of birth
Gender
Street address
City
County code
Zip code
Phone number
School name / ID
SNAP or other program ID
Parent data elements:
SSN
First name
Partial or phonetic first name
Middle name / initial
Partial or phonetic middle name
Last name
Partial or phonetic last name
Date of birth
0
1
0
1
0
1
0
1
0
1
0
1
0
1
0
1
0
1
0
1
0
1
0
1
0
1
0
1
0
1
0
1
0
1
0
1
0
1
0
1
0
1
0
1
0
1
0
1
0
1
0
1
0
1
Student, parent, or other data elements
(specify):
_________________
_________________
_________________
SOFT CHECK: IF D7B_2_1 THROUGH D7B_2_24 UNANSWERED For each element used to match
duplicate records, please indicate whether an exact match is required or if an inexact match is
allowed.
Prepared by Mathematica Policy Research
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(R = 1 OR 3 OR 4) OR (R = 2 AND A1A = 1)
D8a
d8a
Does direct certification matching of student enrollment data with program
data take place more than once during the school year?
Yes .............................................................................. 1
No ................................................................................ 0
GO TO D9
D8A = 1 OR .M
D8b
After the initial match, how frequently are subsequent matches performed?
d8b and
d8b_spec
MARK ONLY ONE
Ongoing, real-time updates .......................................... 1
Weekly ......................................................................... 2
Monthly ........................................................................ 3
Quarterly ...................................................................... 4
Three times per year .................................................... 5
Twice per year ............................................................. 6
Once per year .............................................................. 7
Other (specify) ............................................................. 8
___________________________________________
D8A = 1 OR .M
D8c
d8c_1 through
d8c_5_spec
For subsequent matches, what student enrollment data are matched against
the program data provided by the State?
MARK ALL THAT APPLY
Data on students newly enrolled since last data
match via individual look-up ......................................... 1
Data on students newly enrolled since last data
match via batch process .............................................. 2
All student enrollment data via batch process .............. 3
Enrollment data for all students not previously
certified via batch process ............................................ 4
Other (specify) ............................................................. 5
___________________________________________
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D8A = 1 OR .M
D8d
Are subsequent matches based on the same data elements and matching rules
that are used for the first match?
d8d
Yes .............................................................................. 1
No ................................................................................ 0
[R = 1 OR (R = 2 AND A1A = 1)] AND (D8A = 1 OR .M)
D8e
Who has primary responsibility for performing the subsequent matches?
d8e
State ............................................................................ 1
District.......................................................................... 2
R = 1 OR (R = 2 AND A1A = 1)
D9
How are direct certification match results communicated to districts?
d9_1
through
d9_5_spec
MARK ALL THAT APPLY
Hard-copy lists are sent via mail .................................. 1
Data disks are sent via mail ......................................... 2
Electronic files are sent via email ................................. 3
Results are posted on the Internet for download .......... 4
Other (specify) ............................................................. 5
___________________________________________
(R = 1 OR 3) OR (R = 2 AND A1A = 1)
D10
d10_1 and
d10_2
How many children were directly certified in the initial match for school year
2011-2012?
|
|
|
|
|
|
|
| NUMBER
Initial match for 2011-2012 has not yet been
performed .................................................................... 1
This information is not collected ................................... 2
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(R = 1 OR 3) OR (R = 2 AND A1A = 1)
If R = 1 or 2 then FILL = “agency”
Else FILL = “district”
D11a
d11a
Does your [agency/district] calculate a direct certification match rate (that is,
the percentage of children participating in eligible programs who were directly
certified)?
Yes .............................................................................. 1
No ................................................................................ 0
GO TO D12
D10_1 ≥ 0 AND (D11A = 1 OR .M)
If R = 1 or 2 then FILL1 = “States” and FILL2 = “State’s”
Else FILL1 = “districts” and FILL2 = “district’s”
D11b
d11b_1
through
d11b_4_spec
ec
When calculating match rates for direct certification, [States/districts] may
have different age ranges in the program data that they use. For example,
some might have only school-age children, some might have ages from birth
to 21, and others might have people of all ages. Which of the following age
groups are included in the program data used to calculate your [State’s /
district’s] match rate?
Included in
Data to
Calculate
Match Rate
Ages from birth up to school entry
Ages from school entry up to high school graduation
Ages from high school graduation and older
Other (specify)
__________________________________________
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Not Included
in Data to
Calculate
Match Rate
1
0
1
0
1
0
1
0
D10_1 ≥ 0 AND (D11A = 1 OR .M)
D11c
d11c
How many children were in the program data used for the initial match for
school year 2011-2012? This would be the number used to calculate the direct
certification match rate. (If children were included in the data from more than
one program, only count each child once.)
|
|
|
|
|
|
|
| NUMBER
SOFT CHECK: IF LT D10_1 You reported directly certifying more children than were in the
program data. Please verify your responses.
(R = 1 OR 2) AND D10_1 ≥ 0 AND (D11A = 1 OR .M)
D12
d12
How does the direct certification match rate you calculate typically compare to
the direct certification performance measure reported in the FNS report to
Congress called Direct Certification in the National School Lunch Program:
State Implementation Progress?
Performance measure is typically about the same
as the direct certification match rate ............................. 1
Performance measure is typically higher than the
direct certification match rate ....................................... 2
Performance measure is typically lower than the
direct certification match rate ....................................... 3
Performance measure is sometimes higher and
sometimes lower than the direct certification
match rate .................................................................... 4
Don’t know ................................................................... d
(R = 1 OR 3) OR (R = 2 AND A1A = 1)
D13
d13
Is there anything else you would like to share about your direct certification
matching process?
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E. METHODS OF LINKING CHILDREN IN THE SAME HOUSEHOLD
(R = 1 OR 3 OR 4) OR (R = 2 AND A1A = 1)
E1a
e1a_1
through
e1a_5
Please indicate how the direct certification process is identifying additional
children in a household and directly certifying them in accordance with FNS’
policy, “Extending Categorical Eligibility to Additional Children in a
Household,” effective for SY 2009–2010.
MARK ALL THAT APPLY
Notification letters have been modified to inform
parents about eligibility of other children ...................... 1
All students with same parent’s name as a
categorically eligible child are directly certified ............. 2
All students with same address as a categorically
eligible child are directly certified.................................. 3
Other (specify) ............................................................. 4
___________________________________________
No changes have been made to extend categorical
eligibility ....................................................................... 5
GO TO E2a
[(R = 1 OR 3) OR (R = 2 AND A1A = 1] AND (E1A ^= 5)
E1b
e1b_1 to
e1b_5
What barriers or challenges were faced in implementing the policy to extend
categorical eligibility to additional children in a household?
MARK ALL THAT APPLY
Interpreting the eligibility policy .................................... 1
Developing a process for identifying children in the
same household .......................................................... 2
Lack of technological resources available to allow
for electronic identifying of children in the same
household .................................................................... 3
Other (specify) ............................................................. 4
___________________________________________
No barriers or challenges to implementation ................ 0
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GO TO E2a
[(R = 1 OR 3) OR (R = 2 AND A1A = 1)] AND (E1B ^= 0)
E1c
What measures were taken to overcome those barriers?
e1c
(R = 1 OR 3 OR 4) OR (R = 2 AND A1A = 1)
If E1a = 5 or then FILL = “”
Else FILL = “additional”
E2a
e2a
Are there plans to make any [additional] changes to extend categorical
eligibility to all children in a household?
MARK ONLY ONE
No plans ...................................................................... 1
GO TO F1
Yes, for school year 2012-2013 ................................... 2
Yes, after school year 2012-2013 ................................ 3
Yes, but no date set ..................................................... 4
Don’t know ................................................................... d
GO TO F1
[(R = 1 OR 3) OR (R = 2 AND A1A = 1)] AND (E2A ^= 1 OR D)
E2b
e2b_1
through
e2b_4_spec
What changes are planned to make to extend categorical eligibility to all
children in a household?
MARK ALL THAT APPLY
Develop a notification process to inform parents
about eligibility of other children ................................... 1
Directly certify all students with same parent’s
name as a categorically eligible child ........................... 2
Directly certify all children at the same address at
which at least one child is categorically eligible ............ 3
Other (specify) ............................................................. 4
___________________________________________
Prepared by Mathematica Policy Research
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F. NON-PUBLIC SCHOOLS
R = 1 OR 2 OR 3
F1a
Do charter schools participate in the direct certification process?
f1a
MARK ONLY ONE
Yes, all charter schools ................................................ 1
Yes, some charter schools ........................................... 2
No, charter schools do not participate .......................... 3
No, there are no charter schools .................................. 4
R = 1 OR 2 OR 3
If R = 3 then SHOW “No, there are no private schools”
F1b
Do private schools participate in your direct certification process?
f1b
MARK ONLY ONE
Yes, all private schools ................................................ 1
Yes, some private schools ........................................... 2
No, private schools do not participate .......................... 3
[No, there are no private schools ................................. 4]
(R = 1 OR 2 OR 3) AND [(F1A = 2 OR 3 OR .M) OR (F1B = 2 OR 3 OR .M)]
F1c
f1c_1 through
f1c_spec
Why don’t all non-public schools (NPSs) participate in the direct certification
process?
MARK ALL THAT APPLY
No access to non-public
school student enrollment data .................................... 1
State does not require non-public schools to
participate in direct certification .................................... 2
Too few non-public school students likely to be
eligible ......................................................................... 3
Other (specify) ............................................................. 4
___________________________________________
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(R = 1 OR 2 OR 3) AND (F1A = 1 OR 2 OR .M)
F2a
f2a_1
through
f2a_6_spec
What is the direct certification process for charter schools that participate in
direct certification?
MARK ALL THAT APPLY
Charter schools submit student enrollment data to
State for data matching ................................................ 1
Charter schools use a State-maintained web-based
individual student look-up system ................................ 2
Charter schools submit data to nearby districts for
data matching .............................................................. 3
Charter schools access statewide program data
and perform data match themselves ............................ 4
GO TO F3a
Charter schools access local program data
and perform data match themselves ............................ 5
GO TO F3a
Other (specify) ............................................................. 6
___________________________________________
(R = 1 OR 2) AND (F2A_4 ^=1 OR F2A_5 ^= 1)
F2b
f2b
Are the matching criteria for direct certification the same for charter schools
as for public school districts?
MARK ONLY ONE
Yes .............................................................................. 1
No ................................................................................ 0
Varies by district........................................................... 2
Prepared by Mathematica Policy Research
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(R = 1 OR 2 OR 3) AND (F1B = 1 OR 2 OR .M)
F3a
f3a_1
through
f3a_6_spec
What is the direct certification process for private schools that participate in
direct certification?
MARK ALL THAT APPLY
Private schools submit student enrollment data to
State for data matching ................................................ 1
Private schools use a State-maintained web-based
individual student look-up system ................................ 2
Private schools submit data to nearby districts for
data matching .............................................................. 3
Private schools access statewide program data
and perform data match themselves ............................ 4
GO TO G1a
Private schools access local program data
and perform data match themselves ............................ 5
GO TO G1a
Other (specify) ............................................................. 6
___________________________________________
(R = 1 OR 2) AND (F3A_4 ^= 1 OR F3A_5 ^= 1)
F3b
f3b
Are the matching criteria for direct certification the same for private schools as
for public school districts?
MARK ONLY ONE
Yes .............................................................................. 1
No ................................................................................ 0
Varies by district........................................................... 2
IF (R = 2 AND A1B = 1) OR D4 = 1 GO TO H1A
ELSE GO TO G1A
Prepared by Mathematica Policy Research
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G. DATA MATCH SYSTEM
[(R = 1 OR 3) OR (R = 2 AND A1A = 1)] AND D4 = 2
G1a
Who developed the software and data systems used for direct certification?
g1a_1
through
g1a_7_spec
MARK ALL THAT APPLY
State child nutrition information technology (IT) staff .... 1
State IT staff from agencies other than child nutrition ... 2
Other State staff ........................................................... 3
District IT staff .............................................................. 4
Other district staff ......................................................... 5
Outside contractor........................................................ 6
Other (specify) ............................................................. 7
___________________________________________
[(R = 1 OR 3) OR (R = 2 AND A1A = 1)] AND D4 = 2
If R = 1 or 2 then FILL1 = “your agency’s”
Else FILL1 = “your district’s”
G1b
g1b_1
through
g1b_6_spec
What was the funding source for developing your [agency’s/district’s] current
direct certification system?
MARK ALL THAT APPLY
Federal grant ............................................................... 1
Other grant................................................................... 2
State child nutrition operating funds ............................. 3
Other State funds ......................................................... 4
District funds ................................................................ 5
Other (specify) ............................................................. 6
___________________________________________
Prepared by Mathematica Policy Research
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[(R = 1 OR 3) OR (R = 2 AND A1A = 1] AND D4 = 2
If R = 1 or 2 then FILL = “agency’s”
Else FILL = “district’s”
If R = 1 or 2 then SHOW = “State child nutrition staff”
If R = 1 or 2 then SHOW = “State education agency staff”
If R = 1 or 2 then SHOW = “Other State staff”
If R = 3 then SHOW = “District staff”
G2a
g2a
Who maintains your [agency’s/district’s] direct certification software/system
tool and performs data matching?
MARK ONLY ONE
[State child nutrition staff .............................................. 1]
[State education agency staff ....................................... 2]
[Other State staff .......................................................... 3]
[District staff ................................................................. 4]
Outside contractor........................................................ 5
[(R = 1 OR 3) OR (R = 2 AND A1A = 1] AND D4 = 2
G2b
What software do you use to perform computer data matching?
g2b and
g2b_spec
MARK ONLY ONE
Commercial, off-the-shelf data-matching software
(SAS, other data profiling tools) ................................... 1
Third-party software developed specifically for
direct certification ......................................................... 2
Software developed in-house specifically for
direct certification ......................................................... 3
Microsoft Office tools (Access or Excel) ....................... 4
Other (specify) ............................................................. 5
___________________________________________
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H. FEASIBILITY/EFFECTIVENESS OF DATA-MATCHING SYSTEMS
R = 1 OR 2
H1a
Has any analysis been conducted on the costs and effectiveness of computer
matching for direct certification in your State?
h1a
Yes .............................................................................. 1
No ................................................................................ 0
GO TO H2
(R = 1 AND D4 = 1 AND H1A ^= 0) OR (R = 2 AND H1A ^= 0)
H1b
Did this analysis determine that computer matching was not cost effective in
your State?
h1b
Yes .............................................................................. 1
No ................................................................................ 0
R = 1 OR 2 OR 3
If R = 1 or 2 then FILL1 = “agency”
Else FILL1 = “district”
If R = 1 or 2 then SHOW “Other State agencies”
If R = 3 then SHOW “State child nutrition agency”
H2
h2_1
through
h2_7
With which of the following organizations has your [agency/district] talked
regarding the technical and logistical requirements of computer matching for
direct certification?
MARK ALL THAT APPLY
[Other State agencies .................................................. 1]
[State child nutrition agency ......................................... 2]
Contractors .................................................................. 3
IT staff.......................................................................... 4
Regional office ............................................................. 5
Other districts............................................................... 6
None of the above........................................................ 0
IF (A1E = 1 OR 2) GO TO I1A
Prepared by Mathematica Policy Research
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R = 1 OR 2
H3
Have any other States contacted your agency about adopting elements of your
State’s direct certification practices?
h3
Yes .............................................................................. 1
No ................................................................................ 0
Prepared by Mathematica Policy Research
60
I. BARRIERS
R = 1 OR 2 OR 3
If R = 1 or 2 then FILL = “State”
Else FILL = “district”
I1a
i1a_1
through
i1a_7_spec
In your opinion, what issues related to enrollment records are barriers to
improving the use of data matching for direct certification in your
[State/district]?
MARK ALL THAT APPLY
No barriers related to enrollment records ..................... 1
The State agency does not maintain a database
of students ................................................................... 2
The State’s database of students does not have
sufficient information to support computer matching
(for example, no SSNs) ................................................ 3
The State’s database of students is not updated with
fall enrollment data in time for direct certification .......... 4
It takes too long to obtain student enrollment data
files from all districts ..................................................... 5
Naming conventions in enrollment database are not
consistent with data in other systems ........................... 6
Other barrier related to enrollment records (specify) .... 7
___________________________________________
Prepared by Mathematica Policy Research
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R = 1 OR 2 OR 3
If R = 1 or 2 then FILL1 = “State”
Else FILL1 = “district”
If R = 1 or 2 then FILL2 = “agency” and FILL3 = “agency” and FILL4 = “agency”
Else FILL2 = “district” and FILL3 = “district” and FILL4 = “district”
If C1_1 = 1 then SHOW “The TANF agency does not keep records in a manner that makes it
cost-effective for your [agency/district] to use computer matching”
If C1_1 = 1 then SHOW “It’s too difficult to get data files from the TANF agency”
If C1_1 = 1 then SHOW “The TANF agency won’t agree to perform the match”
I1b
i1b_1
through
i1b_11_spec
In your opinion, what issues related to program participation are barriers to
improving the use of data matching for direct certification in your
[State/district]?
MARK ALL THAT APPLY
No barriers related to program participation ................. 1
The SNAP agency does not keep records in a
manner that makes it cost-effective for your
[agency/district] to use computer matching .................. 2
[The TANF agency does not keep records in a
manner that makes it cost-effective for your
[agency/district] to use computer matching .................. 3]
Agencies other than SNAP with relevant program
data do not keep records in a manner that
makes it cost-effective for your [agency/district] to
use computer matching ................................................ 4
It’s too difficult to get data files from the SNAP
agency ......................................................................... 5
[It’s too difficult to get data files from the TANF
agency ......................................................................... 6]
It’s too difficult to get data files from agencies with
relevant program data other than SNAP ...................... 7
The SNAP agency won’t agree to perform the match ... 8
[The TANF agency won’t agree to perform the match .. 9]
Agencies other than SNAP with relevant program
data won’t agree to perform the match ......................... 10
Other barrier related to program
participation (specify) ................................................... 11
___________________________________________
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R = 1 OR 2 OR 3
If R = 1 or 2 then FILL = “State”
Else FILL = “district”
I1c
i1c_1
through
i1c_8_spec
In your opinion, what issues related to resources or other factors are barriers
to improving the use of data matching for direct certification in your
[State/district]?
MARK ALL THAT APPLY
No barriers related to resources or other factors .......... 1
Staff not available at the State level to perform the
work required for computer matching for direct
certification................................................................... 2
Funds are not available to pay to train State staff to
do the work required for computer matching ................ 3
Computer resources not available at the State level to
conduct the computer matching process ...................... 4
Concerned about how State-level computer matching
would compromise student confidentiality .................... 5
Percentage of students eligible for free meals is too
small to make computer matching for direct
certification worthwhile ................................................. 6
State regulations prohibit use of student records for
this purpose ................................................................. 7
Other barrier related to resources or other
factors(specify) ............................................................ 8
___________________________________________
IF (A1E = 1 OR 2) GO TO K1
Prepared by Mathematica Policy Research
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R = 1 OR 2 OR 3
If R = 1 OR A1A = 1 then FILL = “improving”
Else FILL = “greater use of district-level“
I2a
i2a_a
through
i2a_e_spec
To what extent are the following barriers to [improving / greater use of districtlevel] computer matching for direct certification of public school students?
A
SIGNIFICANT
BARRIER
NOT AT ALL
A BARRIER
a
Cost of computer software....
1
2
3
4
5
b
Lack of technical expertise ...
1
2
3
4
5
c
Student enrollment data are
not suitable for computer
matching ..............................
1
2
3
4
5
No perceived need for
computer matching ...............
1
2
3
4
5
1
2
3
4
5
d
e
Other (specify):
____________________
R = 1 OR 2 OR 3
If R = 1 OR A1A = 1 then FILL = “improving”
Else FILL = “greater use of district level“
I2b
i2b_a
through
i2b_e_spec
To what extent are the following barriers to [improving / greater use of districtlevel] computer matching for direct certification of non-public school
students?
A
SIGNIFICANT
BARRIER
NOT AT ALL
A BARRIER
a
Cost of computer software....
1
2
3
4
5
b
Lack of technical expertise ...
1
2
3
4
5
c
Student enrollment data are
not suitable for computer
matching ..............................
1
2
3
4
5
No perceived need for
computer matching ...............
1
2
3
4
5
1
2
3
4
5
d
e
Other (specify):
____________________
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R = 1 OR 2 OR 3
If R = 1 or 2 then FILL = “districts”
Else FILL = “your district”
I3
Did [districts/your district] have to implement any technology upgrades to use
direct certification?
i3
Yes .............................................................................. 1
No ................................................................................ 0
R = 1 OR 2 OR 3
I4
Did district staff have to undergo any additional training to use direct
certification?
i4
Yes .............................................................................. 1
No ................................................................................ 0
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J. DIRECT CERTIFICATION GRANTS
R = 1 OR 2
J1a
Did your State receive a direct certification grant awarded by the Food and
Nutrition Service?
j1a
Yes .............................................................................. 1
No ................................................................................ 0
GO TO K1
J1A ^= 0
J1b
j1b
In what year was the direct certification grant awarded? (If your State has
received more than one direct certification grant, please report the most recent
one.)
ENTER 4-DIGIT YEAR
|
|
|
|
|
SOFT CHECK: IF J1B LT 1990 OR GT 2011 Please check your response.
J1A ^= 0
J1c
j1c_1
through
j1c_8_spec
What specific changes to your agency’s direct certification process have been
made or are currently underway as a result of the direct certification grant?
MARK ALL THAT APPLY
Upgraded the State information systems ..................... 1
Obtained data from other programs in addition
to SNAP ....................................................................... 2
Implemented a new computer matching system .......... 3
Increased the frequency of data matching ................... 4
Added more elements for data matching ...................... 5
Upgraded matching system algorithm to incorporate
probabilistic matching techniques ................................ 6
Created a web-based look-up system .......................... 7
Other (specify) ............................................................. 8
___________________________________________
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J1A ^= 0
J1d
j1d_1
through
j1d_8_spec
What additional changes are planned as a result of the direct certification
grant?
MARK ALL THAT APPLY
No additional changes planned .................................... 0
Upgrade the State information systems ....................... 1
Obtain data from other programs in addition to SNAP .. 2
Implement a new computer matching system .............. 3
Increase the frequency of data matching ..................... 4
Add more elements for data matching.......................... 5
Upgrade matching system algorithm to incorporate
probabilistic matching techniques ................................ 6
Create a web-based look-up system ............................ 7
Other (specify) ............................................................. 8
___________________________________________
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K. PLANNED CHANGES/EMERGING APPROACHES
R = 1 OR (R = 2 AND A1B = 0)
If J1a = 0 then FILL = “”
Else FILL = “additional”
If A1B = 1 or A1C = 1 then SHOW “Increase the frequency of sending program data”
If A1A = 1 then SHOW “Implement computer matching system”
If A1A = 1 then SHOW “Increase the frequency of data matching”
If A1A = 1 then SHOW “Upgrade matching system algorithm to incorporate probabilistic
matching techniques”
K1
k1_1
through
k1_12
What [/additional] changes, if any, does your agency plan to make to current
procedures for direct certification?
MARK ALL THAT APPLY
Upgrade your State information systems ...................... 1
Obtain program participation data in addition to the
program data currently used for matching ..................... 2
[Increase the frequency of sending program data ......... 3]
[Implement a new computer matching system .............. 4]
[Increase the frequency of data matching ..................... 5]
Add more elements for data matching........................... 6
[Upgrade matching system algorithm to incorporate
probabilistic matching techniques ................................. 7]
Implement a process to resolve unmatched records ..... 8
Create a web-based look-up system ............................. 9
Implement a process to extend categorical eligibility
to other children in a household ................................... 10
Other (specify) ............................................................. 11
___________________________________________
No changes planned .................................................... 12
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(R = 1 OR 2) AND A1A = 0
K2
k2
Do you have any plans to implement State-level matching for direct
certification in the future?
Yes .............................................................................. 1
No ................................................................................ 0
Don’t know ................................................................... d
ALL
K3
k3
If you could change anything, how would you improve your direct certification
procedures to match a greater number of children for free school meals?
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L. POTENTIAL/FEASIBILITY OF USE OF MEDICAID DATA FOR DIRECT CERTIFICATION
R = 1 OR 2
L1
l1
SNAP data can be used for direct certification because SNAP income eligibility
criteria are the same as those for free school meals. Income eligibility for
Medicaid varies from State to State. In your State, would all children eligible for
Medicaid also be eligible for free school meals?
Yes .............................................................................. 1
No ................................................................................ 0
Don’t know ................................................................... d
R = 1 OR 2 OR 3
If R = 1 or 2 then FILL = “agency”
Else FILL = “district”
L2a
Will your [agency/district] use Medicaid data to verify NSLP income
applications for school year 2011–2012? (NSLP income applications contain
information about household membership and income sources.)
l2a
Yes .............................................................................. 1
No ................................................................................ 0
GO TO L3a
(R = 1 OR 2 OR 3) AND L2A ^= 0
If R = 1 or 2 then FILL = “agency”
Else FILL = “district”
L2b
Does your [agency/district] use computer matching of Medicaid electronic data
to verify NSLP income applications?
l2b
Yes .............................................................................. 1
No ................................................................................ 0
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GO TO L3a
(R = 1 OR 2 OR 3) AND L2B ^= 1
If R = 1 or 2 then FILL = “agency”
Else FILL = “district”
L2c
Has your [agency/district] investigated the feasibility of using computer
matching with Medicaid data to verify NSLP eligibility?
l2c
Yes .............................................................................. 1
No ................................................................................ 0
R = 1 OR 2 OR 3
If R = 1 or 2 then FILL = “agency”
Else FILL = “district”
L3a
Does your [agency/district] provide data on NSLP certifications for referrals to
the Medicaid or State Children’s Health Insurance Program?
l3a
Yes .............................................................................. 1
No ................................................................................ 0
Don’t know ................................................................... d
R = 1 OR 2 OR 3
If R = 1 or 2 then SHOW = “Varies by district” and “Don’t know”
L3b
l3b
Does Medicaid participate in a data-matching program of individual records to
determine Medicaid reimbursements to school districts?
MARK ONLY ONE
Yes .............................................................................. 1
No ................................................................................ 2
END
[Varies by district ......................................................... 3
END]
[Don’t know .................................................................. d
END]
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(R = 1 OR 2 OR 3) AND (L3B = 1 OR .M)
L3c
Please indicate the Medicaid data elements that are used for matching to
determine Medicaid reimbursements to school districts.
l3c_1
through
Not Used for
l3c_21
Used for
Matching/Not
Match elements
Matching
Available
Student data elements:
SSN
1
0
First name
1
0
Middle name / initial
1
0
Last name
1
0
Date of birth
1
0
Gender
1
0
Street address
1
0
City
1
0
County code
1
0
Zip code
1
0
Phone number
1
0
School name / ID
1
0
Medicaid ID
1
0
SSN
1
0
First name
1
0
Middle name / initial
1
0
Last name
1
0
Date of birth
1
0
__________________
1
0
__________________
1
0
__________________
1
0
Parent data elements:
Student, parent, or other data elements (specify):
SOFT CHECK: IF L3C_1 THROUGH L3C_18 UNANSWERED For each element, please
indicate whether it is used for matching to determine Medicaid reimbursements to school
districts.
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End screen
Thank you for completing the survey. Please click on the review missing data button below to
see questions with missing responses. You will be able to answer additional questions in each
survey section.
A. Introduction
B. Enrollment Data Characteristics
C. Program Data Questions
D. Data-Matching Characteristics
E. Methods of Linking Children in the Same Household
F. Non-Public Schools
G. Data Match System
H. Feasibility/Effectiveness of Data-Match Systems
I. Barriers
J. Direct Certification Grants
K. Planned Changes/Emerging Approaches
L. Potential/Feasibility of Use of Medicaid Data for Direct Certification
Once you have gone through your missing responses, please click the review responses button
below. You may review and all of your responses and make any final corrections before
submitting your survey.
Submit screen
Thank you for completing the survey. In case we need to follow up with your agency on any of
your responses, please provide the name and contact information of the primary person who
completed this survey. All contact information will remain confidential and will not be used for
any other purposes.
(STRING 20)
FIRST NAME
(STRING 20)
LAST NAME
(STRING 40)
TITLE
(STRING 40)
EMAIL ADDRESS
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TELEPHONE NUMBER
REFUSED.................................................................... r
If you are satisfied with your responses, please click on the submit button below. Once you
submit your survey, you will not be able to make any additional changes. If you need to correct
anything, please contact the help desk at [EMAIL ADDRESS] or [TELEPHONE NUMBER] for
assistance.
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If someone tries to log in to a completed survey:
Thank you for your interest in completing this survey for the NSLP Direct Certification
Improvement Study. Someone from your agency submitted responses on [DATE]. If you believe
you are getting this message in error, please contact the help desk at [EMAIL ADDRESS] or
[TELEPHONE NUMBER] for assistance.
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File Type | application/pdf |
Author | Dawn Patterson |
File Modified | 2012-02-02 |
File Created | 2012-02-02 |