Manual Food Instruments


DOES NOT APPLY (PROCEED TO NEXT SECTION) - Checked

1. Manual Food Instrument Policy

  1. Manual food instruments are utilized for the following reasons:
    • New participants
    • Automated food instruments not available
    • Mutilated automated food instruments
    • Wrong food package on automated food instrument
    • Provide for the special needs of the homeless
    • Food package tailoring
    • Routine monitoring visits (i.e., educational buys) of vendors
    • Compliance buys of vendors
    • Special conditions, e.g., disasters
    • Other (specify):
  2. The State agency requires the following for completing the manual food instrument register:
    • Participant/proxy signature
    • Local agency staff initials
    • Date of food instrument pick-up
    • other (specify):
  3. Manual food instruments have a "Not to Exceed Value" of:
    • Same dollar amount for all manual food instruments $
    • Variable dollar amount depending on type of prescription on manual FI
    • No limit
    • Other (specify):

ADDITIONAL DETAIL: Food Delivery Appendix and/or Procedure Manual (citation):

2. Manual Food Instrument Documentation and Disposition

  1. A report containing the serial numbers of manual food instruments issued by local agencies is sent to the State agency:
    • Not applicable
    • Weekly
    • Monthly
    • Other (specify):
  2. Local agencies are required to provide documentation to substantiate a valid or invalid certification record for manual food instruments issued and redeemed but for which no participant record currently exists by utilizing:
    • Turnaround documents to establish valid certification records
    • Telephone calls to the State/local agency on irregularities
    • Other (specify):
  3. If the manual food instrument inventories do not achieve 100% reconciliation of all issued and unissued food instruments, the local agency (check all that apply):
    • Reports the food instrument serial numbers to the State agency
    • Provides the food instrument serial numbers to local vendors
    • Other (specify):
  4. (Provide a copy/citation of the State agency's prescribed procedures if the manual food instrument inventory cannot be reconciled).

ADDITIONAL DETAIL: Food Delivery Appendix and/or Procedure Manual (citation):