Eligibility

Summer Food Service Program

Procedure for Approval/Denial of Household Income Statements

These are the main steps for a Summer Food Service Program (SFSP) sponsoring organization to review, and approve or deny, Household Income Statement (HIS) forms.

Step 1: Check the Submitted HIS Form for Completeness

The sections of the HIS that the household is required to complete depends on whether the HIS reports information on (1) incomes of household members or (2) assistance number of any household member or (3) children in foster care.

Section of HIS

Information

Required for HIS based on Household Incomes

Required for HIS based on Assistance Number

Required for HIS based on Foster Care Status

1

Children names

X

X

X

1

Indication of foster status

   

X

2

Assistance number

 

X

 

3

Adults’ names/incomes

X

   

4

Signature

X

X

X

4

Last four digits of Social Security number (or indication of no SSN)

X

   

If any required information is missing, the HIS cannot be approved. The household may be asked to resubmit the form with complete information.

Step 2: Approve or Deny the HIS Form

Approve or deny complete HISs submitted from households.

HIS with Household Incomes:

- Determine the total number of household members and the total household income and record in the section at the bottom of the form. If there are incomes with different frequencies, convert each income to an annual income and add the annual incomes together for total annual household income. To convert to annual income, multiply a weekly income by 52, a bi-weekly income (every other week) by 26, a twice-per-month income by 24 or a monthly income by 12.

- Refer to the table of current SFSP Household Income Guidelines, which are on the Household Letter that is attached to the HIS form.

- Approve SFSP meal benefits if the household’s total income is within SFSP income guidelines for the household size. Deny SFSP meal benefits if total household income is too high. Document the approval or denial in the section at the bottom of the HIS form with your signature and date.

HIS with Assistance Number:

Approve SFSP meal benefits if the completed form shows an assistance number from the Minnesota Family Investment Program (MFIP), Supplemental Nutrition Assistance Program (SNAP), or Food Distribution Program on Indian Reservations (FDPIR). A Medical Assistance number or WIC number does not qualify. MFIP and SNAP case numbers are up to eight digits with no letters. FDPIR uses the Social Security number. The form must be signed by an adult household member however the last four digits of their Social Security number are not needed. Document the approval or denial in the section at the bottom of the form with your signature and date.

HIS for Foster Child/ren:

Approve a foster child for SFSP meal benefits if the column is checked that the child is a foster child (child whose care and placement is the responsibility of the state or who is placed by a court with a caretaker household). The form must be signed by an adult household member, however the last four digits of their Social Security number are not needed. Document the approval or denial in the section at the bottom of the form with your signature and date.

HIS with combined Household Income and Foster Child information: If an HIS is submitted for a household that has a combination of foster children and other children, the HIS must be separately approved or denied for the foster children and the other children. Approval of foster children – follow guidelines in the paragraph above. Approval for other (non-foster) children – follow guidelines above for HIS with Household Incomes (foster children may be included in total household size).