Use the following procedure when an individual in a public institution:
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wishes to file for food stamps, and
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upon release, will not live in a cashout State (i.e., California), a commercial boarding
house, or an institution where food stamp eligibility is precluded.
When obtaining an SSI application under prerelease procedure and the answer to question
38(b) of the SSA-8000-BK is "yes," complete a food stamp (FS) application. Write the
word, "PRERELEASE," in red across the top of the first page of the food stamp application.
Use the FS application provided by the State agency and send it per instructions in
SI DAL01801.040B.4. The household composition of the expected residency has to be an all SSI household
as defined in SI 01801.060.
NOTE: The individual does not have to meet the criteria of living in a pure SSI household
at the time of filing.
The food stamp application should be signed by the SSI claimant even if the SSI application is signed by a representative payee.
1. Completion of the SSA Transmittal for Food Stamp Applications, SSA-4233
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a.
Complete Sections I through V with information on the household members for the anticipated
residence upon release of the SSI applicant. Provide as much information as is available.
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b.
Annotate "Unknown" if information cannot be obtained from the SSI claimant or the
institution. Retain a copy of the SSA-4233 in the SSI file for a subsequent contact
with the FS agency discussed in SI DAL01801.040B.3.
2. Additional information to be added to the Transmittal Sheet, SSA-4233
The FS agency will require the address of the anticipated residence after release
to be able to adjudicate the FS application under prerelease procedures. Add the address
to form SSA-4233 in the Remarks section.
3. Informal notice to FS agency of decision
The FS agency will hold the FS application until it is notified by SSA of our decision.
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a.
If the SSI claim will be denied for either non- disability or disability reasons,
informally notify the FS agency at the same time the informal notice is provided to
the institution. The informal notice may be by:
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with a copy of the SSA-4233
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b.
If the SSI claim will be allowed (i.e., a disability established and non-disability
requirements are met), use a copy of the SSA-4233 and provide the FS agency with the
following information.
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The expected release date as provided by the institution or the reason the applicant
will not be released as previously expected.
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The address of anticipated residency, if different from the original SSA-4233.
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Any changes in income or resources, if different from the original SSA-4233
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A finding of incapability either by the DDS or the FO.
Provide the name and address of the representative payee, if available.
4. Routing instructions for FS applications and SSA- 4233
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a.
Mail, or fax (preferred) per local arrangement as appropriate, the FS application
and the SSA-4233 (original and subsequent copy) to the FS office servicing the expected resident address of the applicant upon release. See SI DAL01801.010 for Texas resident procedures.
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b.
If the institution is in one State and the expected residency is in a different State
in the Dallas Region, follow the instructions in SI DAL01801.040B.4.a and SI DAL01801.040B.4.d for the expected residency.
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c.
If the expected residency is out of the Region, send the FS application to the SSA
FO servicing the expected residency, and request that they forward the FS application
to the proper FS office based on established procedures for their region.
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d.
If the expected residency is anywhere in Texas, FAX the FS application and SSA-4233(s)
per SI DAL01801.010.
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e.
If neither the SSI claimant nor the institution can provide an expected residency,
hold the FS application until the earlier of the following events:
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expected residency is provided to SSA, or
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If the claim is denied, Texas field offices should send the FS application to the
centralized location per instructions in SI
DAL01801.010.