MEAL BENEFIT INCOME ELIGIBILITY FORM
Dear Parent or Guardian:
This center/home participates in the United States Department of Agriculture's
(USDA) Child and Adult Care Food Program (CACFP) and receives Federal funds to
provide healthy meals and snacks to enrolled children. The amount of
reimbursement the center receives is based on the information provided on the
attached CACFP Meal Benefit Income Eligibility Form (IEF). Part of the USDA
requirement is to complete the IEF. If household income is equal to or less than
the income listed in the chart below for household size, the center will receive
a higher level of reimbursement. Please return the completed IEF back to the
center as soon as possible.
If a member of the family (child or adult) receives Supplemental Nutrition
Assistance Program (SNAP), Temporary Assistance for Needy Families (TANF) or
Food Distribution Program on Indian Reservations (FDPIR) benefits or cares for a
foster child(ren) that is the legal responsibility of the Virginia Department of
Social Services or the court, children are categorically eligible for meal
benefits regardless of household income.
If the household income is over the income guidelines listed below, the family
is not required to complete this application. Instead, please write the child’s
name on the IEF and return it to the center. Please notify the center staff if
someone in the household becomes unemployed and the loss of income causes the
household income to be within the income eligibility standards.
The information provided on the IEF will be used to determine the child’s
eligibility for meal benefits. The information will be kept confidential and
only available to staff directly connected with administering the CACFP.
Family Access to Medical Insurance Security Plan (FAMIS)
FAMIS is Virginia’s health insurance program for children. It provides
access to quality health services for children who do not have health
insurance. FAMIS Plus is Virginia’s name for children’s Medicaid. FAMIS Plus
also provides great benefits and covers children in families with low or no
income, even if the children are covered by health insurance.
By signing the section on the application for FAMIS or FAMIS Plus, the family is stating they do not want information shared with the local Department of Social Services. If IEF information is disclosed, it may be used to identify the child(ren) for the health insurance program. More information on FAMIS is available at 1-866-873-2647 – Interpreters are available. Log onto www.famis.org to apply online.
