State Supplementation Provisions: Agreement; Payment

Forms and Documents

Document Name	Status
Supporting Statement--0240.doc Supporting Statement A	2006-11-01

IC Document Collections

IC ID	Document Title	Status
9161	Total Expenditures Other-Regulation	Modified
45281	Maintenance of Payment Levels Other-Regulation	New

ICR Details

OMB Control No: 0960-0240	ICR Reference No: 200609-0960-027
Status: Historical Active	Previous ICR Reference No: 200311-0960-001
Agency/Subagency: SSA	Agency Tracking No:
Title: State Supplementation Provisions: Agreement; Payment
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 01/11/2007
	Date Received in OIRA: 11/01/2006
Terms of Clearance: Because the burden fluctuates from year to year depending on which of the 2 methods states choose to use, as discussed in the supporting statement, SSA agrees to keep track of which of the 2 methods states choose to use and, on next submission, will use the average over the past 3 years to derive burden estimates unless SSA has reason to believe--and can explain why--such an estimate would be inaccurate.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2010	36 Months From Approved	01/31/2007
Responses	51	0	26
Time Burden (Hours)	51	0	71
Cost Burden (Dollars)	0	0	0

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Abstract: Section 1618 of the Social Security Act contains pass-along provisions of the Social Security amendments. These provisions require States which supplement the Federal Supplemental Security Income payments also pass along Federal cost-of-living increases to individuals who are eligible for State supplemental payments. If a State fails to keep payments at the required level, it becomes ineligible for Medicaid reimbursement under Title XIX of the Social Security Act. Respondents are State agencies administering supplemental programs.

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Authorizing Statute(s): US Code: 42 USC 1382g Name of Law: null
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	71 FR 43270	07/31/2006
30-day Notice:	Federal Register Citation:	Citation Date:
	71 FR 61821	10/19/2006
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
Total Expenditures
Maintenance of Payment Levels

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	51	26	0	0	25	0
Annual Time Burden (Hours)	51	71	0	0	-20	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The estimated public reporting burden has decreased from 71 to 51 because the number of States electing to comply by the total-expenditures method (quarterly reporting) has decreased from 15 to 7, while the number of States electing to comply by the maintenance-of-payment-levels method (annual reporting) has increased from 11 to 23. The actual number of responses can vary from year to year, because States annually elect to use either the total-expenditures method or the maintenance-of-payment-levels method for the upcoming year. States also can change from direct administration of their supplementary payments to federal administration (or vice versa).

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Annual Cost to Federal Government: $7,000

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 11/01/2006

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