SI CHI01801.003 Minnesota’s Food Support Program (RTN 408 -- 05/2007)


A. Program Description


The goal of the program is to assist low-income persons and families so they can purchase food and better meet their nutritional needs. The program is not intended to supply all of a person's or family's food needs. Instead, it supplements those needs while the person or family makes an effort to become self-supporting.


B. Funding and Operations


The United States Department of Agriculture, Food and Nutrition Services provide states with the funding needed and the policy governing the Food Support (formerly known as Food Stamps) program. Minnesota's Department of Human Services supervises the program at the state level, clarifies policies, reviews county performances, and distributes monthly benefits. In accordance with state and federal directives, county human services agencies accept client applications, determine eligibility and determine benefit levels. The Food Support program is available in all 87 Minnesota counties.


C. Participant Requirements


Monthly benefit levels are based on income and the number of persons in the household. Usually, if the household's gross income is around 130 percent of the federal poverty level or below, the household will qualify for Food Support assistance. If all the persons in the household qualify for General Assistance or the Supplemental Security Income program, they would also qualify for food support. Households exiting the Minnesota Family Investment Program (MFIP) may still qualify for food assistance from the Food Support program.


D. Monthly Benefits


Since October 1, 1998, all 87 counties are distributing food benefits through Electronic Benefit Transfer (EBT), a card system similar to a debit card. At the beginning of the month the recipient's EBT account is credited with the amount of benefits they are eligible for. During the month, the recipient uses their card to purchase food at enrolled grocery stores. The EBT card is then swiped through a "point of sale" terminal and the purchases are deducted from the account balance. If a client does not access their benefits in a 90 day period, their benefits will not be available. After the 90 day period, the client will have to contact their county financial worker to reinstate those benefits to the EBT account. If a client does not access their benefits after one year, the benefits will be expunged.


E. Coordination with MFIP


Families who receive benefits from MFIP will have their food assistance needs met through MFIP rather than the traditional Food Support program. Other adults and families that do not receive MFIP benefits will have their food needs met through the Non-Public Assistance Food Support program.


F. Food Support Questions for SSI Claimants


Two food support questions must be asked when completing either a SSI application or redetermination. The two questions are:


  • Are you currently receiving food support or has a food support application been filed for you within the past 60 days on which there has not been a decision?

  • If "No," do you wish to apply for food support?


The responses to the questions are used to help determine whether to take an application for food support, to take no further action in connection with eligibility for food support, or to refer the claimant to the county social service agency to apply for food support.


The food support questions are included on the SSA-8000BK, SSA-8203BK, and SSA-8202F6. The questions are not contained on the SSA-8202-OCR. SI 02305.809 indicates that the food support questions should not be asked when a SSA-8202-OCR is completed without SSA staff assistance. However, when a SSA-8202-OCR is completed by phone or the claimant contacts the district/branch office for assistance, use the preprinted SSA-795 (Statement of Claimant or Other Person) which contains the questions. The BMEN and BFDS screens should be completed when taking an initial claim or redetermination in MSSICS.


G. State of Minnesota Combined Application


The State of Minnesota Combined Application Form (CAF) (DHS-3469) is designed to collect information on the programs the Department of Human Services (DHS) administers. The programs included are as follows:


1. Cash Assistance

  • Minnesota Family Investment Program (MFIP)

  • Diversionary Work Program (DWP)

  • Emergency Assistance (EA)

  • General Assistance (GA)

  • Group Residential Housing (GRH)

  • IV-E Foster Care

  • Minnesota Supplemental Aid (MSA)

  • Refugee Cash Assistance (RCA)


2. Non-Cash Assistance

  • Food Support

  • Health Care


The DHS-3469 (Exhibit I) is the form, which obtains detailed information used to evaluate eligibility for the benefits covered by the application. Field offices should make sure they are using the most current version of the state Combined Application Form, since it is updated periodically. The current version can be accessed at: SSA interviewers should complete only the yellow/white portions on the DHS-3469.


Most questions on the CAF are self-explanatory and require "Yes" or "No" answers. If the applicant does not know the answer to a question, enter a question mark (?) to let the food support worker know further development is needed.


The CAF can only be completed by and/or for households eligible to file for food support at a SSA office under joint processing procedures (SI 01801.005). If a member of the public who is not eligible to file for food support in a SSA office (e.g., not a member of a pure SSI household) indicates a desire to file for food support, the individual should be referred to the local county social services office.


H. Applications/Recertificaton Process


When a SSI applicant and/or recipient files for food support in a SSA office, the SSA interviewer will complete the CAF application. Minnesota uses the same application for recertification that is used in the initial certification of food support eligibility. In completing the CAF the SSA interviewer should answer the questions as the food support applicant would if they were filling out the form. The interviewer will accept the applicant's allegation unless the information provided is questionable or verification of an item is required (SI 01801.300).


I. Exhibit I (DHS 3469)


1. Page 1 - General Information


Complete page 1 of the DHS-3469 with information regarding the applicant's household. Household members not applying for food support do not need to provide a Social Security Number. Be sure to have the applicant sign this page and include a phone number where the applicant may be reached during normal working hours. If the household does not have a residence street address, write in sufficient information to allow a food support worker to find the residence. Pages 1 and 2 of the DHS-3469 will also be used to identify cases for expedited processing.


2. Page 2 - Applicant Information


Complete all pertinent items on this page. This page focuses on the Expedited Food Support questions and other emergency help questions. It also contains general procedural information.


3. Pages i and ii - Important Information - Tear-off Pages


These pages give information about Social Security numbers, Interim aid programs, the Food Support Nutrition Education Program, Minnesota’s Workforce centers, liens and estate claims, denial or changes, family cap information, important information for non-citizen applicants, proof of citizenship or national status and immigration.


4. Pages iii and iv - Your Responsibilities and Rights


These are tear-off pages that give applicants their Rights and Responsibilities.


5. Page 3 - Statement of Need


The applicant’s name, phone number, street address, city, state and zip code need to be completed in the white section of this page.


6. Page 4 - Designating Authorized Representatives


This page provides more detailed information on the authorized representative, designation of the Food support principal Wage Earner, and questions about legal guardians.


7. Fold out Page


Each household member is listed on the fold out page.


8. Page 5 – What Kind of Help Do You Need?


This page asks about any help or referrals the applicant needs.

9. Page 6 – Assistance


The applicant is to indicate what type of assistance they and the rest of the household members are applying for. It also contains demographic information.


10. Pages 7 – 9 - Eligibility Questions (Questions 9 – 28)


This section captures information about household composition, citizenship, buying, fixing and preparing food, school, disability, income type, accidents, etc.


11. Pages 10 – 11 - Assets (Questions 29 – 30)


Resources must be identified on the CAF in sufficient detail to permit verification by the county agency. Resources available to the household during the entire month may be used to determine eligibility.


12. Pages 11 – 13 - Income (Questions 31 – 35)


All sources of income must be listed on the CAF. Request that the applicant submit verification of all monthly income. It is not necessary to send copies of documents that are available in SSA files to the food support office. Annotating the SSA-4233 (Social Security Administration Transmittal for


Food Support Applications) (SI 01801.310) that evidence is in SSA files will satisfy the documentation requirement.


13. Pages 14 – 15 - Household Expenses (Questions 36 – 40)


  1. A. 


    When determining the household's monthly income, certain deductions are made for shelter expenses. Deductible expenses include rent or mortgage payments, taxes, and homeowners insurance.

  2. B. 

    Utility Expenses

    When completing the utility section of the application, check all utility expenses that the applicant alleges paying. The household has the option of using the utility standards or actual utility expenses (Exhibit II).

    • Households that incur heating and/or cooling expenses may use the single utility standard. The standard includes heating, cooling, electricity, water, sewer, garbage, and phone.

    • Households that are responsible for electricity but not heating or cooling costs may use the electricity standard.

    • There are no water/sewer or garbage/trash collection standards. Households ineligible for the single utility standard that incur cooking gas, water, sewer or garbage collection expenses must submit verification of actual expenses before a deduction may be allowed.

    • A household that incurs a telephone expense and is not eligible for the single utility standard should be allowed the telephone standard. Never allow actual telephone expenses. The cost of a telephone is included in the single utility standard.

    If the applicant wants the food support office to use the state utility standards to compute their food support benefits, the amounts of the most recent bills need not be shown. If the utility bills are higher than the utility standards, the actual amount should be shown and the interviewer should request any available verification the applicant may have at the time of the interview. If actual expenses are lower than the utility standards, no verification of expenses is required.


14. Page 16 - Medical Expenses (Questions 41 – 45b)


These questions determine if any household members have medical expenses, the nature of the expenses and whether anyone in the household has private health or hospital insurance.


15. Pages 17 – 18 - Assignments, Penalty and Warnings


The applicant must assign all rights to support to the State of Minnesota. They must also assign to the State of Minnesota any medical care payments that they have a right to under automobile or health care insurance. This page also addresses penalty warnings and qualification questions.


16. Page 19 - Employment Services Registration, Perjury and General Declarations and Signature


The applicant or authorized representative should read the release and explanation section prior to signing the application in the appropriate block(s).


J. Minnesota Utility Standards – Exhibit II


The following standard amounts should be allowed for households not electing to claim actual utility expenses:


Single Utility Standard


(to be allowed if heating or cooling costs are incurred)

Electric Standard


(to be allowed when electric but not heating or cooling costs are incurred)

Telephone Standard


(to be allowed when telephone expenses are incurred by a household not entitled to the single utility standard or for households claiming actual expenses)


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SI CHI01801.003 - Minnesota’s Food Support Program (RTN 408 -- 05/2007) - 10/05/2022
Batch run: 06/06/2023