PURPOSE: This form is used to request information from the Research and Evaluation (R&E) Unit within the Department of Social Services.
NUMBER OF COPIES AND DISPOSITION: The original is completed electronically. After completion, the form is emailed to Rachel.E.Traver@dss.mo.gov. IMP&P staff will determine if the data is already available online or in existing reports. If the information is not already available, the request will be assigned a priority level, logged into a database for tracking, and submitted to R&E.
INSTRUCTIONS FOR COMPLETION: Complete this form electronically or print the form, complete, and scan as an electronic document.
Priority: IMP&P Unit staff enter the priority level for the request. This is not completed by the requestor. The options are H (high), M (medium), L (low), and FN (fiscal note).
Individual Requesting the Information: Enter the name of the individual (requestor) requesting the information.
Date: Enter the date the information is requested.
Email Address: Enter the email address of the requestor.
County Office, Region, or Program: Enter the county office to which the requestor is assigned, the region to which the requestor is assigned, or the program for which the requestor works if not in a county office or region.
Mailing Address, if needed: Enter the mailing address of the requestor if the information is to be mailed to the requestor upon completion.
Detailed Information on Request: Enter detailed information about what is needed. This should include where the information can be found in the case information, if it is limited to certain program categories, what is meant by certain terms (i.e. children – under age 19, under age 18, etc.), etc.
Additional Information Needed: Complete each of the boxes listed below, as applicable.
Timeframe for Completion: Enter by what date this information is needed, giving R&E as much lead time as possible.
Contact Person/Email – Who can provide additional clarification or answer questions about the request: Enter the name and email address of any individual who can provide additional clarification or answer questions, if other than the requestor.
Time Period the Request Should Cover (Calendar Year (CY), State Fiscal Year (SFY), Federal Fiscal Year (FFY), Month/Year): Enter the time period the request should cover. Calendar year is January – December, state fiscal year is July – June, and federal fiscal year is October – September. If the information needed is just for a month in time or a date in time, enter the month and year or specific date.
How will this data be used? If the request is from a second or third party, enclose a copy of the original request: Enter how the data will be used. This information often helps R&E understand exactly what data is needed and perhaps suggests a better way of answering the question or providing the data.
How the Data Should Be Displayed (by month, county, region, program, ES, etc.): Enter how the data should be displayed.
If a Count is Requested, Is It For a Particular Point in Time or During the Entire Time Period? (i.e. eligible at the end of the month or eligible at any time during the month): Enter the point in time for which the request is being made, if applicable. This is used when asking for monthly data. The requestor indicates if the data should be as of a specific day (15th of the month or date report run), active on the first day of the month, eligible at any point in the month, or eligible/active on the last day of the month.
If the Request Is For an Update to a Previous Report, Include the Identifying information from the Report (which research analyst completed the report, last date report run, the report name, etc.): Enter any information identifying the previous report. The information is typically in the lower corner of the report. For example, the ABAWD report previously run each month for State Office has the following in the lower left corner: DSS R&E/COMBS JOB NAME – FSMTHLY RUN DATE: 11/04/09. The report name is FOOD STAMP RECIPIENTS AGE 18 TO 49 WITH NO DEPENDENTS UNDER 18. If the report needs to be run again in the future, the information in CAPS above would be entered in this field to help R&E identify the report.
In What Form Should Data Be Supplied? (paper, Excel, computer file, dataset, etc.): Enter the preferred method to receive the data.
Name, Email Address and/or Mailing Address of Person Who Should Receive the Data When Completed: Enter the name, email address and/or mailing address of the individual who should receive the data if other than the requestor.