SR 16-15 Dated 06/16

STATE OF NEW HAMPSHIRE

INTER-DEPARTMENT COMMUNICATION – Division of Family Assistance (DFA)

SUMMARY

This SR releases revisions to the following forms and their associated Spanish and Nepali versions to respond to certain US Department of Agriculture (USDA) Food and Nutrition Services (FNS) findings:

·  DFA Form 800, Application for Assistance; and

·  DFA Form 811R: Application: Your Rights and Responsibilities.

DESCRIPTION OF REVISIONS MADE TO FORMS

DFA Form 800, Application for Assistance, is now six back-to-back pages:

·  Pages 1-4 of DFA Form 800, the first two back-to-back pages of the form, contain Information related to DFA programs and services followed by what is considered the actual application containing eligibility-related questions for all programs and services;

·  Pages 5-6 of DFA Form 800, the next back-to-back page in the form, contains the rights and responsibilities section which must be provided at application per RSA 167:87, 7 CFR 272.5(b)(1), and 7 CFR 273.2(a)(1). This section is also offered independently as DFA Form 811R, Application: Your Rights and Responsibilities;

·  Pages 7-8 of DFA Form 800 contains the statements of understanding section. This section is also offered independently as DFA Form 811S, Application: Statements of Understanding;

·  Pages 9-10 of DFA Form 800 contain the Food Stamp program non-discrimination notice with the information provided in English on page 9 and in Spanish on page 10. This information must be included in the application as directed by FNS per 273.2(b)(1)(viii); and

·  Pages 11-12 of DFA Form 800, the final back-to-back sheet In the form, contains the text of DFA Form 77u, It Takes a Village. This information is now being included in the application for two reasons:

    -  to begin to alter the current process DFA is using to satisfy the TANF-related service requirement associated with implementing expanded Food Stamp categorical eligibility. The information provided in DFA Form 77u to all food stamp households may be used to fulfill the requirements at 7 CFR 273.2(j)(2)(ii)(A) and (B); and

    - to increase the size of the application to 12 pages (six back-to-back pages), which allows Graphic Services to print the application in a more cost-effective and resource-friendly manner.

Changes to DFA Form 800, Application for Assistance, and DFA Form 811R, Application: Your Rights and Responsibilities

·   A statement found under the “Social Security Numbers (SSN)” header on page 1 of DFA Form 800 was altered to address what FNS indicated was a repeat finding based upon 7 CFR 273.2(b)(4)(i). FNS was incorrect in identifying this as a repeat finding as a) FNS had not presented NH with a finding in previous years that this text was incorrect and b) FNS has not yet updated their CFRs to indicate the new language that they would like states to now use (and upon which FNS based their finding), therefore the current language in the application does correctly match 7 CFR 273.2(b)(4)(i) as the CFR currently reads. However, the text was altered as follows to address this finding (colored text delineates the changes made): Food Stamps: RSA 167:4-c, Food Stampand Nutrition Act of 19772008 (formerly Food Stamp Act), as amended, 7 USC 2011-2036, 7 CFR 273.2(b)(4)(i), & 7 CFR 273.6.

·  The following new text was added to the end of the paragraph in the “Attention” box of page 6 of DFA Form 800 (which is the 2^nd page of DFA Form 811R where the change was also made) to address an FNS finding based upon 7 CFR 271.5(b): If you are convicted, the court may also bar you from participating in the program for another 18 months, in addition to the sentence you receive.

·  A new statement was added under the “Do Not” header on page 6 of DFA Form 800 (which is the 2^nd page of DFA Form 811R where the change was also made), to address what FNS indicated was a repeat finding based upon 7 CFR 273.16(d). FNS was incorrect to state this was a repeat finding because FNS has repeatedly cited an incorrect CFR to support their finding, and the CFR FNS cites is adequately addressed on the application. However, now that FNS has indicated the correct citation of 7 CFR 274.7(b) associated with the prohibition on purchasing food with an EBT card on credit, the following statement was added under this header to address the newly correctly cite and the missing information in the application: Do not try to buy food with your FS benefits unless you have your EBT card with you at the time you buy the food. You may not buy food on 1 day and pay for it with your EBT FS benefits on another day.

·  The following new text was added under the header “Trafficking Food Stamp (FS) Benefits” on page 6 of DFA Form 800 (which is the 2^nd page of DFA Form 811R where the change was also made), to include missing information found in Section 6(b)(1) of the Food and Nutrition Act of 2008 [7 USC 2015(b)(1)] (italicized text delineates new text): Any person who is found guilty in a court of law for buying or selling FS benefits will be suspended from the FS Program for 1 year for the 1^st offense, 2 years for the 2^nd offense, and permanently for the 3^rd.

The following additional changes unrelated to any FNS findings were also made to DFA Form 800:

·  The Spanish translation of the FNS non-discrimination notice was added to the back-side of the English text that is provided in the DFA Form 800; and

·  The text from DFA Form 77u was added to the final pages of the application. The addition of the text from DFA Form 77u to the final pages of DFA Form 800:

    -   allows DHHS to explore a new method of fulfilling the requirements at 7 CFR 273.2(j)(2)(ii)(A) and (B) which must be met because DHHS has opted to offer expanded Food Stamp categorical eligibility; and

    -  increases the size of the paper application to 6 back-to-back pages, which allows Graphic Services to print the application in a more cost-effective and resource-friendly manner.

The Spanish and Nepali translations of DFA Forms 800 and 811R have been updated accordingly. Since there are no changes associated with the use of these forms, their associated instructions have not been re-released with this SR.

The current English version of these forms must be used until the supply is exhausted, at which point the new versions will be printed. The English version of these forms continue to be available in the DHHS Warehouse and can be ordered using current forms reordering procedures, via the Quarterly Forms Order (QFO). All the forms are available electronically, for Department staff only, on the Lotus Notes Family Services Database and on the website at. http://www.dhhs.nh.gov/dfa/apply.htm and http://www.dhhs.nh.gov/dfa/forms.htm. The Spanish and Nepali translations can be printed in small supplies from the Family Services Database, as needed, or if larger quantities are required, by contacting the Supervisor of the Policy Development Unit.

FNS Findings That Were Not Addressed Via Changes to DFA Form 800 or DFA Form 811R

According to FNS:

·  NH was cited as out of compliance with section 115 of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), in which Food Stamp benefits are disallowed for individuals with a drug-related conviction. NH did not make any changes to the application or application process to respond to this finding because NH has opted out of this mandate via RSA 167:81-a, and as permitted by 7 CFR 273.11(m). NH has indicated this to FNS on several occasions over several years.

·  NH was cited as out of compliance with Section 6(b)(1) of the Food and Nutrition Act of 2008 [7 USC 2015(b)(1)], as FNS indicated that information about the prohibition of trading Food Stamp benefits for drugs was not located in the application. NH did not make any changes to the application as this information is already displayed on page of 6 of DFA Form 800 under the “Trafficking Food Stamp (FS) Benefits” header (which is the 2^nd page of DFA Form 811R).

·  NH was cited as out of compliance with Section 6(j) of the Food and Nutrition Act of 2008 [7 USC 2015(j)], as FNS indicated that information about the prohibition of receiving duplicate benefits was not located in the application. NH did not make any changes to the application as this information is already displayed on page 6 of DFA Form 800 under the “Identity & Residence” header (which is the 2^nd page of DFA Form 811R).

·  NH was cited as out of compliance with Section 13942 of PL 103-66 [7 USC 2015(b)(1)], as FNS indicated that information about the prohibition of trading Food Stamp benefits for guns was not located in the application. NH did not make any changes to the application as this information is already displayed on page of 6 of DFA Form 800 under the “Trafficking Food Stamp (FS) Benefits” header (which is the 2^nd page of DFA Form 811R).

·  NH was cited on what is alleged to be a repeat finding for being out of compliance with 7 CFR 273.2(b)(3) which states:

    -   that If a state has a procedure that allows applicants to apply for Food Stamps and another program at the same time, the state must notify applicants that they may file a joint application for more than one program or they may file a separate application for food stamps independent of their application for benefits from any other program. NH did not make any changes to the application because:

       a)    in the very first paragraph of DFA Form 800, the application notifies clients of the following: If you only want Food Stamp benefits and are completing the full Application, please complete every Section except Section I; and

       b)    the eligibility questions on the application that do not apply to the Food Stamp program are clearly identified in Section I on page 4 of DFA Form 800.

    -   that all food stamp applications, regardless of whether they are joint applications or separate applications, must be processed for food stamp purposes in accordance with food stamp procedural, timeliness, notice, and fair hearing requirements. No household shall have its food stamp benefits denied solely on the basis that its application to participate in another program has been denied or its benefits under another program have been terminated without a separate determination by the State agency that the household failed to satisfy a food stamp eligibility requirement. Households that file a joint application for food stamps and another program and are denied benefits for the other program shall not be required to resubmit the joint application or to file another application for food stamps but shall have its food stamp eligibility determined based on the joint application in accordance with the food stamp processing time frames from the date the joint application was initially accepted by the State agency. NH did not make any changes to the application because this text applies to how states must process Food Stamp cases, and is not client-required information needed on the application.

NEW HEIGHTS SYSTEMS PROCEDURES AND IMPLEMENTATION

New HEIGHTS and DFA are coordinating any needed systems changes.

POLICY MANUAL REVISIONS

Revised Food Stamp Manual Topics

Section 701.01    The Purpose and Uses for Food Stamp Benefits

Section 711.03    Definition of Trafficking Food Stamp Benefits

Section 713.03    Disqualification Periods

IMPLEMENTATION

The paper form changes released in this SR are effective as of June 1, 2016, but the forms will not be printed with the changes released in this SR until the current supply has been exhausted. The corresponding changes that were made in New HEIGHTS and NH EASY will be available according to the timelines described in the NEW HEIGHTS SYSTEMS PROCEDURES AND IMPLEMENTATION section above.

CLIENT NOTIFICATION

No special client notification is planned or needed.

TRAINING

No special training is planned or needed.

FORMS MANUAL POSTING INSTRUCTIONS

DISPOSITION

This SR may be destroyed or deleted after its contents have been noted and the revised manual topics released by this SR have been posted to the On-line manuals.

DISTRIBUTION

This SR will be distributed according to the e-distribution list for DFA policy releases. This SR and revised On-Line Manuals will be available for agency staff and for public access on the Internet at www.dhhs.nh.gov/DFA/publications.htm, effective June 27, 2016. Additionally, this SR and printed pages with posting instructions will be distributed under separate cover to all internal hard copy holders of the Food Stamp and Forms Manuals.

DFA/JBV:s