As a result of required food stamp and Civil Rights changes, the JFS 07200 (formerly the ODHS 7200) and the JFS 07501 (formerly the ODHS 7501) have been revised, with an effective date of August 1, 2001. Rule 5101:1-2-01 has been revised to reflect the name change and is being issued in MTL 425.

ODJFS 07200

It is now titled "Request for Cash, Medical and Food Stamp Assistance". The CRIS-E generated Printed Copy of Information (PCI) is now considered the application for assistance. This allows the removal of certain items from the JFS 07200 that are federally required to be contained in an application document. These items are being added to the PCI. This change does not affect the current application processing provisions contained in the Public Assistance Manual or Food Stamp Certification Handbook.

All references to ODHS and CDHS have been changed to ODJFS and CDJFS.

The following changes have been made to the JFS 07200:

The Food Stamp Fact Sheet has been removed.

The question regarding whether the assistance group has outstanding medical bills has been removed. This information is captured on the AEFMQ and AEFME screens.

The questions regarding whether the assistance group has group health coverage have been removed. This information is are captured on the AEFMQ and AEFMC screens.

The question regarding pregnancy has been added to the box that captures the individuals at the address.

The question regarding whether a household member is a student has been removed. This information is captured on the AEISA screen.

The Child Support Services request if OWF is denied has been removed. This has been moved to the last page of the PCI (before the rights and responsibilities).

Questions regarding self-declaration have been removed This information is currently captured on the AEISD screen.

The rights and responsibilities pages have been removed, since the CRIS-E generated rights and responsibilities pages are issued at the face-to-face interview or a hardcopy JFS 07501 is provided to individuals who have not completed a face-to-face interview or where CRIS-E is not available.

A Primary Language field for the person completing the form has been added.

A question regarding the need of an interpreter if the assistance group member does not speak English or is hearing-impaired, has been added. If an interpreter is needed at the interview, the CDJFS shall offer an interpreter and if one is provided, it will be done so at no charge to the assistance group.

A question regarding the receipt of benefits in other states in the past has been added. This will allow better tracking for TANF assistance issued in other states that is countable towards Ohio's 36-month time limit, as well as to identify individuals who have participated in the Food Stamp Program in other states as "able-bodied adults without dependents" (ABAWDS).

A box with non-discrimination information, has been added. This information is required by the United States Department of Agriculture.

JFS 07501

The following changes have been made to the JFS 07501 "Rights and Responsibilities":

Information has been added to the "Release of Information on Social Security Number" section of the form as a result of Federal Guidance issued jointly by the Office of Civil Rights, the Department of Health and Human Services and the Department of Agriculture. Specifically, it indicates when a social security number is required.

A new section titled "Information on Citizenship and Immigration Status" has been added as a result of Federal Guidance issued jointly by the Office of Civil Rights, the Department of Health and Human Services and the Department of Agriculture. Specifically, it indicates when verification of citizenship and immigration status is required.

Minor changes have been made to the "Food Stamp Penalty Warning" section, primarily to add the word "benefit" after "Food Stamp", since EBT has replaced the issuance of coupons.

Information has been added regarding voluntarily providing the social security number and other requested information for the Food Stamp Program. Information has been added regarding release of information collected on the applicant, including social security number to Federal, State, and private collection agencies for claims collection action.

A "Civil Rights Information" section has been moved from the JFS 07200 to the JFS 07501.

A new section titled "Prohibition Against Discrimination on the Basis of Disability" has been added as a result of Federal Guidance issued by the Department of Health and Human Services Office for Civil Rights regarding the obligations that Title II and Section 504 of the Rehabilitation Act impose on state and local governments, and on recipients of Federal financial assistance involved in TANF activities. Specifically, this required language will be used by the Office for Civil Rights for compliance reviews and/or investigations of complaints of discrimination on the basis of disability in TANF programs. These requirements are not new and have been part of the Rehabilitation Act of 1973 and Title II of the Americans with Disabilities Act of 1990.

A new section titled "Assisting Persons Who Are Limited English Proficient" has been added to include language that an interpreter will be provided for individuals whose primary language is not English or for hearing-impaired individuals.

A new section titled "Questions or Complaints About Your Civil Rights" has been added along with addresses where individuals can file complaints.

PRINTED COPY OF INFORMATION (PCI)

A Service Request Form (SRF) has been written for the following changes to the Printed Copy of Information:

To add the 2nd phone number that is captured on the AEICI screen.

To move the signature lines from the Rights and Responsibilities page to the last page of the actual PCI (the page before the Rights and Responsibilities).

To add another signature line on the last page of the PCI before the Rights and Responsibilities, indicating whether the assistance group wants child support services if the OWF is denied.

To change the CRIS-E generated "Rights and Responsibilities" pages to match the hard-copy JFS 07501.

These changes are expected to be in production by August 1, 2001. A view flash bulletin will be provided when these changes have been made.

CHANGES TO CRIS-E

Additional Service Request Forms (SRF) have been submitted to MIS that may change the JFS 07200 in the future. One SRF has been submitted to add language to the AEINH screen which would remove question B from page 3 of the revised JFS 07200. A second SRF has been submitted to add the Food Stamp disqualification questions and responses which is Question C on page 3 of the revised JFS 07200. This will affect the AEISD screen. A view flash bulletin will be provided when these changes are in production and the JFS 07200 will be revised to remove these questions. (CCN 4708)

INSTRUCTIONS: