Appendix F.3 Screen Shots
Appendix F.3 (5-20-13).docx
The Evaluation of Demonstrations of NSLP/SBP Direct Certification of Children Receiving Medicaid Benefits
Appendix F.3 Screen Shots
OMB: 0584-0586
Appendix F.3: District Cost Survey Preliminary Web Shots
Welcome
to the |
|
OMB #: 0584-xxxx
Expiration Date: xx/xx/20xx
The District Cost Survey for the NSLP/SBP
Direct Certification of Children Receiving Medicaid Benefits (DC-M)
Demonstration is sponsored by the Food and Nutrition Service (FNS) in
the U.S. Department of Agriculture (USDA). FNS has contracted with
Mathematica Policy Research to conduct this evaluation.
Please
refer to the instructions you received in the mail or by email to
find your Username and Password.
To begin the survey, enter your
Username and Password in the fields below and then click
continue.
If you do not have your Username and Password,
or have other problems accessing the survey, please contact the DC-M
Helpdesk toll-free at: 1-877-xxx-xxxx,
or email dc-m@mathematica-mpr.com.
Username:
Password:
Information about this survey
OMB #: 0584-xxxx
Expiration Date: xx/xx/20xx
The information collected in this survey is solicited under the authority of Section 103 of Public Law 111-296, the Healthy, Hunger-Free Kids Act of 2010 (HHFKA). HHFKA amended the National School Lunch Act (NSLA) to authorize FNS to conduct and evaluate multi-year demonstration projects beginning in July 2012 in selected States and districts to test the effectiveness of direct certification with the Medicaid program in determining eligibility for free school meals. It also provides access to data for the purposes of conducting program monitoring, evaluations and performance measurements of States and districts participating in the Child Nutrition Program and mandates the cooperation of relevant State and local agencies in Department of Agriculture studies and evaluations related to Programs authorized under the NSLA and the CAN. Participants in this study will be subject to safeguards as provided by the Privacy Act of 1974 (5 USC 552a), which requires the safeguarding of individuals against invasion of privacy. The Privacy Act also provides for the confidential treatment of records maintained by a Federal agency according to either the individual’s name or some other identifier. The information you provide will be used only for research and statistical purposes by the survey sponsor, their contractors, and collaborating researchers for the purpose of analyzing data and preparing scientific reports and articles. Any information publicly released (such as statistical summaries) will be in a form that does not personally identify you or your district.
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 survey is 0584-xxxx.
Actual time to complete the questionnaire may vary depending upon your circumstances, but on average it will take about 45 minutes.
Please click one of the buttons below to begin or exit the survey.
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Frequently Asked Questions
What is the District Survey of NSLP/SBP Direct Certification of Children Receiving Medicaid (DC-M) Demonstrations?
This web-based survey collects information on costs of certifying students for free and reduced-price meals in your district, including conducting direct certification and certification by application. Most of these costs are labor costs, so most of the questions are about which staff perform specific steps in the certification process, and on how many hours they spend on each task. At the end of the survey, we will ask you for average salary and benefits paid to each category of staff.
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Why should I complete this survey?
This demonstration will provide important information on the benefits and costs of using Medicaid eligibility data to directly certify schoolchildren for free school meals. The goal of DC-M is to increase the number of low-income students directly certified for free meals and to reduce the number of certifications by application. The study is testing the idea that the savings from reduced numbers of applications to process will outweigh the increased costs of direct certification using Medicaid data. Regardless whether your district is in the group implementing DC-M or in the control group, your input is critical in accurately assessing how DC-M affects certification costs.
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What is FNS?
FNS is the abbreviation for the Food and Nutrition Service, part of the U.S. Department of Agriculture. It is the federal agency that funds the NSLP and SBP programs and sets the regulations that apply to these programs.
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What is Mathematica Policy Research?
Mathematica Policy Research is a nonpartisan employee-owned company that works across the country and around the globe, serving federal agencies, state and local governments, foundations, universities, professional associations, and businesses. Our studies and analysis have yielded information to guide decisions in wide-ranging policy areas, from health, education, early childhood, and family support to nutrition, employment, disability, and international development. The company has been at the forefront of assessing the effectiveness of policies and programs since 1968.
Insight Policy Research is a certified 8(a), woman-owned, small business focused on rigorous, high-quality research. Insight brings specific expertise in the areas of health, education, food and nutrition, and social welfare. Since its inception over a decade ago, it has focused on issues impacting at-risk and vulnerable populations.
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How frequently will this survey be conducted?
The survey will be conducted in Summer 2013, looking back retrospectively at the 2012-2013 school year, for those participating in the demonstrations at that time. For the 2013-2014 school year, we will ask you to complete the survey five times, starting in September, and responding for the previous two calendar months. The survey will be set up so you can see some of your previous responses and make updates to the information that has changed, where applicable.
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If I complete the survey, will I be compensated for my time?
FNS has not authorized any incentive payments for completion of the survey, as they see it as part of ongoing obligations to report data on federal programs. However, your participation is very important in assessing whether direct certification via Medicaid is a cost-effective addition to current direct certification data sources.
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Who is participating in this study?
The participants are school districts offering NSLP in states that applied to conduct DC-M and were selected by FNS. In school year 2012-2013, six states (Alaska, Florida, Illinois, Kentucky, New York, and Pennsylvania) are testing DC-M, with two states implementing DC-M statewide and districts in four states being randomly selected to conduct DC-M or to be in a control group that uses current direct certification procedures.
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Why was my district chosen for this survey?
[DC-M1 states:] Your district was included in your State’s application for DC-M. Although some of the districts listed in the application were randomly selected for the demonstration and others for the control group, both groups are included in the survey.
[DC-M2 states:] Your district was randomly selected for the survey.
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How was I chosen for this survey?
In each district, we are sending the survey first to the School Food Authority, identified by the State child nutrition agency. We encourage the SFA Director to involve other staff in completion of the web survey. The survey can be partially completed and then resumed at a later point, and at that point someone else can take over (if given the district’s password) and complete the sections they have more knowledge of.
You can delegate completion of the survey to another staff member knowledgeable about the certification process. We ask you to let us know if the primary contact for the survey should be someone else, by sending the information to....
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How is this information used?
We will calculate the estimated costs of direct certification and estimated costs of certification by application for each district, as well as the costs per certified student. These data will be combined with data from approximately ([IN SY 2012-2013] 700, [IN SY 2013-2014] 1,200) other districts to analyze how DC-M affects certification costs.
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Where can I find the survey results?
The survey results will be published in a study report that estimated to be available on the FNS website in September 2014.
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Will my information be kept private?
Participants in this study will be subject to safeguards as provided by the Privacy Act of 1974 (5 USC 552a), which requires the safeguarding of individuals against invasion of privacy. The Privacy Act also provides for the confidential treatment of records maintained by a Federal agency according to either the individual’s name or some other identifier. The information you provide will be used only for research and statistical purposes by the survey sponsor, their contractors, and collaborating researchers for the purpose of analyzing data and preparing scientific reports and articles. Any information publicly released (such as statistical summaries) will be in a form that does not personally identify you or your district. [Top]
How can I find out more about the study?
A summary of the study is available here. [LINK TO STUDY SUMMARY].
If you have additional questions, you can contact the DC-M Helpdesk toll-free at: 1-877-xxx-xxxx, or email dc-m@mathematica-mpr.com
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| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | DPatterson |
| File Modified | 0000-00-00 |
| File Created | 2021-01-29 |
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