Background: The Food and Nutrition Act
of 2008 provides a State option for Supplemental Nutrition Assistance Program
(SNAP) applicants to submit and sign their applications over the telephone. In order to implement this process, the Ohio
Department of Job and Family Services (ODJFS) established procedures for
accepting applications and signatures over the phone that ensures the necessary
protections and compliance with the Act.
Procedure: Effective February 1, 2017, a
county agency, with approval from ODJFS, could opt into accepting a telephonic
signature as part of an initial application or recertification. Telephonic signatures cannot be required by a
county agency; thereby an applicant’s right to apply in writing or online must
always remain available.
Update: Previous
guidance stated that county agencies must capture the SNAP applicants name,
address and signature in order for it to constitute a telephonic signature.
This meant that an interview could be done after the telephonic signature was
recorded. Recently, the United States Department of Agriculture, Food and
Nutrition Services (FNS) provided guidance that stated a telephonic signature
must be recorded after the client has been interviewed, and the recording must
include a summary of the information to which the household assents.
Additionally, the below
script has been updated to include language for the dynamic, or “combined”,
audio signature of SNAP, cash assistance programs and medical assistance. The
County Shared Services Finesse System has been updated for the Agent Script/Companion
guide to display in order to enable the county agency worker to read through
the script and follow along with the recording.
Use of Standardized Scripts
ODJFS has developed standardized scripts for county agencies to
accept initial applications and recertifications by phone.
The scripts specifically indicate what information has to be
recorded during the application process and concludes the process by capturing
the audio signature and submitting the valid application. The phone interview
immediately preceding the submission of the application should be conducted in
the same manner as a scheduled phone interview would otherwise be conducted had
a paper application been received.
Retrievable Audio Recording
The county agency must ensure there is access upon demand to the
audio file containing the verbal assent of the applicant and that the audio
file is retrievable and complies with federal record retention requirements in
7 CFR 272.1(f). The county agency must
also ensure that there is a direct link between the audio and case files.
Safeguarding
In order to meet the requirements of the Act, steps must be
taken to prevent impersonation, identity theft, and invasions of privacy by
individuals attempting to apply or reapply over the phone. The county agency must take steps to ensure an
individual applying over the phone is who they claim to be. For current or former public assistance
recipients, this information could be verified based on details in their
current or former case; but for individuals never known to have received public
assistance, the county agency must review information from a reliable
third-party source to confirm the identity of the caller. The inability to confirm the identity of the
caller would not necessarily lead to termination of the interview, but the
county agency would be unable to provide (but could receive and document)
confidential information during the call and would need to verify information
independent of the phone call.
Summary of Application and Procedures for
Correcting Application Information
Federal rules require that individuals who provide a telephonic
signature, for initial application or recertification, shall be provided a
written copy of their completed application with instructions for correcting
any errors or omissions. Approval notices
list income, deductions and other factors used to determine eligibility;
therefore, this is considered a copy of the completed application. Approval
notices also include instructions on how to correct any errors.
For pending cases, the county agency is to issue the JFS 07105
“Application/Reapplication Verification Request Checklist” requesting needed
documentation to determine eligibility (if any) and to summarize the
application and interview information. An individual who can be denied at the
time of the application will still need to receive a JFS 07105, which will
summarize the application and interview information. The application summary
language is provided in separate guidance from ODJFS.
This language will give all applicants - regardless of whether
they apply in writing, online or by telephone - ten days to contact the county
agency to correct any information. If an individual contacts the county agency
to correct an error or omission, the county agency must act upon the
information in accordance with the rules of the Ohio Administrative Code.
Implementation: At this time, only
those county agencies working with Shared Services may implement the procedure
for accepting applications over the phone.
County agencies not currently working with Shared Services should email DASOhioIE.Maintenance@das.ohio.gov for
more information about adopting this procedure.
Intake - Telephonic Signature Script
If English is not your primary language, we can provide someone
who can help you understand the questions during this application and in the
interview. Do you need an interpreter? [If YES, get the interpreter
before proceeding]
Once I obtain your name, address and signature over the phone,
this application for assistance will be dated XX/XX/XXXX. You have the right to
authorize another person to act on your behalf and will have a chance to add an
authorized representative during this call. Are you
calling to apply for yourself?
[If YES, proceed]
[If NO, ask individual to
identify himself or herself] If you are the authorized
representative but have not yet been designated in writing by the applicant,
you will need to apply online or submit a paper application at your local JFS
office unless the applicant is with you on this call. If you are calling today
on behalf of an individual and they are with you, the individual can designate
you as the authorized representative on this call and written authorization is
not required. Are you calling as an authorized representative?
[If NO, advise the caller that
we will not be able to continue because an application is required to be
submitted by the applicant or authorized representative.]
[If YES, determine if there is
already written authorization to represent in the case record or if the
applicant is on the call.]
[If YES to authorization in
writing, proceed.]
[If YES to applicant also on
call] Ask applicant to identify himself or herself and to confirm the caller
can speak on their behalf during the call and that they intend to designate the
caller as their authorized representative during the application process. Then
state the following to the applicant: You will need to provide your telephonic
signature at the end of this call to officially designate the caller as your
authorized representative and to submit your application.
[If NO, advise caller that he or
she must apply online at ohiobenefits.ohio.gov or submit a paper application at
the local JFS office.]
Please
listen to the brief description of our programs. After each description of the
program you will be asked if you would like to apply for this program. Only programs that you say “yes” to will be
reviewed for eligibility:
- Cash assistance programs include the Ohio
Works First and Refugee Cash Assistance programs. To qualify you must either
have a minor child(ren), be at least 6 months pregnant or be a refugee who is
within 8 months of arrival. You will get an answer about your application
within 30 days. Would you like to apply
for Cash assistance? [YES/NO]. [AFTER ANSWERING PROCEED TO NEXT PARAGRAPH].
- The Supplemental Nutrition Assistance Program,
also known as SNAP and formerly known as Food Assistance, helps people afford
healthy food. To qualify, you must meet certain financial and non-financial
requirements. You will get an answer about your application within 30
days. During the interview you will be
asked a series of questions to help determine your eligibility for assistance
as well as questions to see if you are eligible to receive SNAP benefits within
7 days. Would you like to apply for SNAP? [YES/NO]. [AFTER ANSWERING
PROCEED TO NEXT PARAGRAPH].
- Medical assistance includes Medicaid, the
Children’s Health Insurance Program (CHIP), Medicare Premium Assistance
Programs (MPAP), and payment for Long-Term Services and Supports (LTSS). To qualify, you must meet certain financial
and non-financial requirements. You will
get an answer about your application within 90 days if you’re applying because
you have a disability, and 45 days if you don’t have a disability. Would you like to apply for medical
assistance? [YES/NO].
Let's
continue with the questions needed to complete the interview and determine
eligibility. A summary will be repeated back to you at the end of the call. You
must confirm the information is correct in order for this to be considered your
application.
Worker
conducts interview.
The following will be
recorded and serve as your application for benefits. You always have the right
to submit an application in writing; however, once your telephone application
is submitted over the phone, it will be treated exactly the same as a written
application. We will now begin
recording…
Start Recording
If you are not registered to vote where you live now, would you
like to apply to register to vote? [YES/NO]. If you said “YES”, a voter registration form will be sent
to you following this interview. Follow the instructions on the form once
received. If you said “NO”, you will be considered to have decided not to
register to vote at this time.
By signing this application over the phone, you are certifying
under penalty of perjury that the information or answers you provide for
yourself and for everyone in your household in this application, during the
interview, or in any reported change are complete and accurate to the best of
your knowledge, including information provided about the citizenship status for
each household member applying for benefits.
By completing this application over the phone, you are
confirming that you understand the following:
Your right to:
- Receive fair treatment without regard to race,
color, national origin, sex, age, sexual
orientation, gender identity (including gender expression), disability, marital
status, family/parental status, income derived from a public assistance
program, reprisal or retaliation for prior civil rights activity, and in some
cases, religion or political beliefs because this institution is an equal
opportunity provider; and,
- Request a fair hearing if you disagree with any
action on your application by calling or writing your local county agency. Your
fair hearing will be heard before the Ohio Department of Job and Family Services.
Your responsibility:
- Provide proof that you are eligible.
- Report a change within 10 days if anything
changes (or is different than) what you said in this application. A change in
your information may affect the eligibility for you or members of your
assistance group.
- Understand and agree to provide documents to
prove what you say during this call.
- Understand that the county agency may contact
other persons or organizations to obtain the necessary proof of your
eligibility and level of assistance and/or in some instances, you may be asked
to give consent to the county agency to make those contacts.
- Provide Social Security numbers and identify if
someone is a US citizen for anyone who is applying for cash and food
assistance.
- Understand that Title VI of the Civil Rights Act
of 1964 allows us to ask for racial/ethnic (Hispanic or Latino) information.
Providing this information is voluntary and is used for informational purposes
only. If you do not want to give us the information, it will have no effect on
your case, but we will enter a response for you.
- Understand that a telephonic signature has the
same legal effect and can be enforced in the same way as written signature.
- Not sell, trade, or give away your SNAP benefits.
- Use your SNAP benefits to only buy eligible
items.
- To receive a deduction for the following
expenses in your SNAP budget, you must report and provide verification of: your rent or mortgage payment, utility and/or
shelter costs, medical expenses if you are elderly or disabled, dependent care
expenses, and legally obligated child or medical support paid to a
non-household member. Failure to report or verify any of the above will be seen
as a statement by your household that you do not want a deduction for that
expense.
- Understand that if you are only applying for SNAP,
you do not have to respond to questions about gender.
- Understand that by signing this application and
receiving Ohio Works First cash assistance, you may be required to cooperate
with the child support enforcement agency in establishing paternity or
establishing or enforcing a support order.
If you are required to cooperate with the child support enforcement
agency, a referral will be submitted to the agency on your behalf and any
rights to all support owed to you and the minor children in the assistance
group will be assigned to the State of Ohio.
- Understand that by signing this application and
receiving Medicaid, you are assigning to
the State of Ohio any rights to medical support and any rights to payments by a
liable third party for medical assistance owed to you and/or to any minor child
in your assistance group. You understand
that you must tell the Ohio Department of Medicaid about any health insurance
you have or about any third party responsible for your medical expenses. You
give the Department the right to pursue medical support from an ex-spouse or
parent. If you think that cooperating to
collect medical support will harm your children or yourself, you can tell the
Department and you may not have to cooperate.
- Understand that the Ohio Department of Medicaid
will get information about your financial resources from banks, credit unions,
or other financial institutions to determine your eligibility for medical
assistance. Authorization to get this
information remains in effect until:
your application for medical assistance is denied, your eligibility
ends, or you decide to end your authorization.
If you refuse to authorize the release of this information, or you
decide to end your authorization, you understand that your medical assistance
may be denied or discontinued.
- Understand that the Ohio Department of Medicaid
will check your answers using Social Security numbers and information from
computer data sources, including the Internal Revenue Service (IRS), the Social
Security Administration (SSA), the Department of Homeland Security, and
others. If the information does not
match, you understand the Ohio Department of Medicaid may ask you to send more
information.
- Understand that if you are permanently
institutionalized or age 55 or older when you receive Medicaid benefits, the
Estate Recovery Program may recover payments for the cost of your care paid by
Medicaid from your estate. The cost of
your care may include the capitation payment that Medicaid pays to your managed
care plan, even if the capitation payment is greater than the cost of the
services you actually received.
- Understand that you authorize any person who
furnishes health care, medical supplies, or services to give the Ohio
Department of Medicaid, the Ohio Department of Job and Family Services, or the
Ohio Department of Health any information related to the extent, duration, and
scope of services provided under the Medicaid program, WIC, and other medical
assistance programs. You also understand that you authorize the previously
mentioned departments to exchange any information you have provided to enable
the departments to determine your eligibility for medical assistance benefits.
Read one of the following:
If
ONLY the Applicant is completing the application
|
If
Authorized Representative (already designated in writing) is completing the
application
|
What
is your first and last name? What
is your address? Would
you like to add an authorized representative? [YES/NO] [If
YES] What is the Authorized
Representative’s name? What is the Authorized Representative’s
address? [If NO, proceed] | What
is your first and last name? What
is the first and last name of the person you are applying for? What
is your address? What
is the address of the person you are applying for? |
I will now read a
summary of the information you have provided and record your verbal signature.
You will be read a list of statements and after these statements have been
read, you will be asked to confirm that you agree with and understand the
statements. This is done to confirm what you said
and make sure you understand everything we have discussed. Please listen
carefully and let me know if the information needs to be changed. [When
an applicant is designating an authorized representative during the call and
that person is also on the phone with the applicant, the applicant must answer
the following questions to officially designate the person as an authorized
representative and to complete the application.]
[If the household does not claim
to be homeless] Your home address is [Insert home address]
and your mailing address is [The same as your home address OR Insert other mailing
address] in [Insert county] County, Ohio.
[Only read if the household
claims to be homeless] You have reported that you do not have a
home address and wish to receive mail at [Insert mailing address].
You reported that your
household has [Earned/Unearned
income] in the monthly amount of [Insert monthly amount] from [Source
of income].
You reported your
household currently pays the following: [Insert applicable deduction
amounts for Rent/Mortgage, Utilities, Medical Expenses, Child or Dependent Care
Costs or Child Support Payments].
You have reported [NO] resources
OR Resources in the amount of [Insert resources amount] from [Source
of resources].
[Only read if an authorized
representative is designated during the call] You have named [Insert
name] as your authorized representative on this call.
Do you agree that the
information I just went over is correct? If yes, please state “I agree”.
Would you like to make
any updates?
[If NO, proceed to the next question]
Do you want to submit this application for assistance over the
phone?
[YES/NO]
[If
YES] Let me confirm your name and address [REPEAT
NAME AND ADDRESS]. You have now completed an application for [REPEAT
PROGRAM(S) CLIENT REQUESTED] that will be dated for today [TODAY’S
DATE].
[If NO] Your request
to apply for assistance is incomplete, we will not be able to continue without
your understanding and agreement. [END]
Now we will stop recording. Please stay
on the line to finish the last step of the application process by listening to
the following Rights and Responsibilities:
Stop Recording
Recertification - Telephonic Signature Script
If English is not your primary language, we can provide someone
who can help you understand the questions during this application and in the interview.
Do you need an interpreter? [If YES, get the interpreter before proceeding]
[Confirm identity of person on the phone]
Once I obtain your name, address and signature over the phone,
this application for assistance will be dated XX/XX/XXXX. You will get an
answer about your application by the end of your current certification period.
You have the right to authorize another person to act on your
behalf and will have a chance to add an authorized representative during this
call. Are you calling to apply for yourself?
[If YES, proceed]
[If NO, ask individual to
identify himself or herself] If you are the authorized
representative but have not yet been designated in writing by the applicant,
you will need to apply online or submit a paper application at your local JFS
office unless the applicant is with you on this call. If you are calling today
on behalf of an individual and they are with you, the individual can designate
you as the authorized representative on this call and written authorization is
not required. Are you calling as an authorized representative?
[If NO, advise the caller that
we will not be able to continue because an application is required to be
submitted by the applicant or authorized representative.]
[If YES, determine if there is
already written authorization to represent in the case record or if the
applicant is on the call.]
[If YES to authorization in
writing, proceed.]
[If YES to applicant also on
call] Ask applicant to identify himself or herself and to confirm the caller
can speak on their behalf during the call and that they intend to designate the
caller as their authorized representative during the application process. Then
state the following to the applicant: You will need to provide your telephonic
signature at the end of this call to officially designate the caller as your
authorized representative and submit the application.
[If NO, advise caller that he or
she must apply online at ohiobenefits.ohio.gov or submit a paper application at
the local JFS office.]
Let's continue with the
questions needed to complete the interview and determine eligibility. If you
are applying for SNAP, a summary will be repeated back to you at the end of the
call. You must confirm the information is correct in order for this to be
considered your application.
Worker
conducts interview.
The following will be recorded and serve as your application for
benefits. You always have the right to submit an application in writing;
however, once your telephone application is submitted over the phone, it will
be treated exactly the same as a written application.
Let's continue with the questions needed
to complete the interview and determine eligibility. A summary will be repeated
back to you at the end of the call. You must confirm the information is correct
in order for this to be considered your application.
We will now begin recording…
Start Recording
If you are not registered to vote where you live now, would you
like to apply to register to vote? [YES/NO]. If you said “YES”, a voter
registration form will be sent to you following this interview. Follow the
instructions on the form once received. If you said “NO”, you will be
considered to have decided not to register to vote at this time.
By signing this application over the phone, you are certifying
under penalty of perjury that the information or answers you provide for
yourself and for everyone in your household in this application, during the
interview, or in any reported change are complete and accurate to the best of
your knowledge, including information provided about the citizenship for each
household member applying for benefits.
By completing this application over the phone, you are
confirming that you understand the following:
Your right to:
- Receive fair treatment without regard to race,
color, national origin, sex, age, sexual orientation, gender identity
(including gender expression), disability, marital status, family/parental
status, income derived from a public assistance program, reprisal or
retaliation for prior civil rights activity, and in some cases religion or
political beliefs because this institution is an equal opportunity provider;
and,
- Request a fair hearing if you disagree with any
action on your application by calling or writing your local county agency. Your
fair hearing will be heard before the Ohio Department of Job and Family
Services.
Your responsibility:
- Provide proof that you are eligible.
- Report a change within 10 days if anything
changes (or is different than) what you said in this application. A change in
your information may affect the eligibility for you or members of your
assistance group.
- Understand and agree to provide documents to
prove what you say during this call.
- Understand that the county agency may contact
other persons or organizations to obtain the necessary proof of your
eligibility and level of assistance and/or in some instances, you may be asked
to give consent to the county agency to make those contracts.
- Provide Social Security numbers and identify if
someone is a US citizen for anyone who is applying for cash and food
assistance.
- Understand that Title VI of the Civil Rights Act
of 1964 allows us to ask for racial/ethnic (Hispanic or Latino) information.
Providing this information is voluntary and is used for informational purposes
only. If you do not want to give us the information, it will have no effect on
your case, but we will enter a response for you.
- Understand that telephonic signature has the
same legal effect and can enforced in the same way as a written signature.
- Not sell, trade, or give away your SNAP benefits.
- Use your SNAP benefits to only buy eligible
items.
- To receive a deduction for the following
expenses in your SNAP budget, you must report and provide verification of: your
rent or mortgage payment, utility and/or shelter costs, medical expenses if you
are elderly or disabled, dependent care expenses, and legally obligated child
or medical support paid to a non-household member. Failure to report or verify
any of the above will be seen as a statement by your household that you do not
want a deduction for that expense.
- Understand that if you are only applying for SNAP,
you do not have to respond to questions about gender.
- Understand that by signing this application and
receiving Ohio Works First cash assistance, you may be required to cooperate
with the child support enforcement agency in establishing paternity or
establishing or enforcing a support order.
If you are required to cooperate with the child support enforcement
agency, a referral will be submitted to the agency on your behalf and any
rights to all support owed to you and the minor children in the assistance
group will be assigned to the State of Ohio.
- Understand that by signing this application and
receiving Medicaid, you are assigning to
the State of Ohio any rights to medical support and any rights to payments by a
liable third party for medical assistance owed to you and/or to any minor child
in your assistance group. You understand
that you must tell the Ohio Department of Medicaid about any health insurance
you have or about any third party responsible for your medical expenses. You
give the Department the right to pursue medical support from an ex-spouse or
parent. If you think that cooperating to
collect medical support will harm your children or yourself, you can tell the
Department and you may not have to cooperate.
- Understand that the Ohio Department of Medicaid
will get information about your financial resources from banks, credit unions,
or other financial institutions to determine your eligibility for medical
assistance. Authorization to get this
information remains in effect until: your application for medical assistance is
denied, your eligibility ends, or you decide to end your authorization. If you refuse to authorize the release of
this information, or you decide to end your authorization, you understand that
your medical assistance may be denied or discontinued.
- Understand that the Ohio Department of Medicaid
will check your answers using Social Security numbers and information from
computer data sources, including the Internal Revenue Service (IRS), the Social
Security Administration (SSA), the Department of Homeland Security, and
others. If the information does not
match, you understand the Ohio Department of Medicaid may ask you to send more
information.
- Understand that if you are permanently
institutionalized or age 55 or older when you receive Medicaid benefits, the
Estate Recovery Program may recover payments for the cost of your care paid by
Medicaid from your estate. The cost of
your care may include the capitation payment that Medicaid pays to your managed
care plan, even if the capitation payment is greater than the cost of the
services you actually received.
- Understand that you authorize any person who
furnishes health care, medical supplies, or services to give the Ohio
Department of Medicaid, the Ohio Department of Job and Family Services, or the
Ohio Department of Health any information related to the extent, duration, and
scope of services provided under the Medicaid program, WIC, and other medical
assistance programs. You also understand that you authorize the previously
mentioned departments to exchange any information you have provided to enable
the departments to determine your eligibility for medical assistance benefits.
Read
one of the following:
If ONLY the Applicant is completing the application
|
If Authorized Representative (already
designated in writing) is completing the application
|
What is your first and last name? What is your address? Would you like to add an authorized
representative? [YES/NO] [If YES] What is the Authorized Representative’s name? What is the
Authorized Representative’s address? [If
NO, proceed] | What is your first and last name? What is the first and last name of the person
you are applying for? What is your address? What is the address of the person you are
applying for? |
I will now read a summary of the information you have provided
and record your verbal signature. You will be read a list of statements and
after these statements have been read, you will be asked to confirm that you
agree with and understand the statements. This is done to confirm what you
said, and make sure you understand everything we have discussed. Please listen
carefully and let me know if the information needs to be changed. [When an
applicant is designating an authorized representative during the call and that
person is also on the phone with the applicant, the applicant must answer the
following questions to officially designate the person as an authorized
representative and to complete the application.]
Your application is based on a reported household size of [#]
people, which includes [Name(s) of individuals]. [Only
read if requesting SNAP] You reported [Name of individuals] purchase
and prepare food together.
You reported that your household has [Earned/Unearned income]
in the monthly amount of [Insert monthly amount] from [Source
of income].
You reported your household currently pays the following: [Insert
applicable deduction amounts for Rent/Mortgage, Utilities, Medical Expenses,
Child or Dependent Care Costs or Child Support Payments].
Other reported changes include [Insert other reported changes].
[Only
read if an authorized representative is designated during the call] You
have named [Insert
name] as your authorized representative on this call.
Do you agree that the information I just went over is correct?
If yes, please state “I agree”.
Would you like to make any updates? [If NO, proceed to the next
question.]
Do you want to submit this application for assistance over the
phone? [YES/NO]
[If
YES] Let me confirm your name and address [REPEAT
NAME AND ADDRESS]. You have now completed a reapplication for [REPEAT
PROGRAM(S) CLIENT REQUESTED] assistance that will be dated for
today
[TODAY’S DATE]. Now we will stop recording and begin the
interview.
[If
NO] Your request to apply for assistance is incomplete, we will
not be able to continue without your understanding and agreement. [END]
[If
NO] Your request to apply for assistance is incomplete, we will
not be able to continue without your understanding and agreement. [END]
Now we will stop recording. Please stay on the line to finish
the last step of the reapplication process by listening to the following Rights
and Responsibilities:
Stop Recording