Families with children eligible for school meals may be eligible for free health care coverage through Medicaid
and/or Ohio’s Healthy Start & Healthy Families programs. These programs include coverage for doctor visits, immunizations,
physicals, prescriptions, dental, vision, mental health, substance abuse and more. Please call 1-800-324-8680 for more information
or to request an application. Information can also be found on the web at http://jfs.ohio.gov/ohp/consumers/familychild.stm.
Anyone who has an Ohio Medicaid card is already receiving these services.
The information provided on the application is confidential and will only be used for the purpose to determine eligibility and may
be verified at any time during the school year by school or other program officials. To discourage the possibility of
misrepresentation, the application forms contain a statement above the space for signature certifying that all information
furnished is true and correct. Applications are being made in connection with the receipt of federal funds. Schools or other
officials may check the information on the application at any time during the school year. Deliberate misrepresentation of
information may subject the applicant to prosecution under applicable state and federal laws.
Households will be notified of the approval or denial of benefits.
Foster children are categorically eligible for free meal benefits regardless of the household’s income. If a family has foster children
living with them and wishes to apply for such meals or milk for them, contact the school for more information.
Under the provision of the policy, Regina Comstock RD LD, cafeteria supervisor, will review applications and determine eligibility.
If a parent or guardian disagrees with the decision on the application or the result of verification, the decision may be discussed
with the determining official on an informal basis. If a formal appeal is desired, the household has the right to a fair hearing. A fair
hearing can be requested either orally or in writing.
Households may apply for benefits any time during the school year. If a household is not currently eligible and if the
household size increases or income decreases because of unemployment or other reasons, the family should contact the school
to file a new application. Such changes may make the children of the family eligible for free or reduced-price benefits if the
family income falls at or below the levels shown above.
Nondiscrimination Statement
In accordance with federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, this
institution is prohibited from discriminating on the basis of race, color, national origin, sex (including gender identity and sexual
orientation), disability, age, or reprisal or retaliation for prior civil rights activity.
Program information may be made available in languages other than English. Persons with disabilities who require alternative
means of communication to obtain program information (e.g., Braille, large print, audiotape, American Sign Language), should
contact the responsible state or local agency that administers the program or USDA’s TARGET Center at (202) 720-2600 (voice and
TTY) or contact USDA through the Federal Relay Service at (800) 877-8339.
To file a program discrimination complaint, a Complainant should complete a Form AD-3027, USDA Program Discrimination
Complaint Form which can be obtained online at:
https://www.usda.gov/sites/default/files/documents/USDA-OASCR%20P-Complaint-Form-0508-0002-508-11-28-17Fax2Mail.pdf,
from any USDA office, by calling (866) 632-9992, or by writing a letter addressed to USDA. The letter must contain the
complainant’s name, address, telephone number, and a written description of the alleged discriminatory action in sufficient detail
to inform the Assistant Secretary for Civil Rights (ASCR) about the nature and date of an alleged civil rights violation. The
completed AD-3027 form or letter must be submitted to USDA by:
- mail:
U.S. Department of Agriculture
Office of the Assistant Secretary for Civil Rights
1400 Independence Avenue, SW
Washington, D.C. 20250-9410; or - fax:
(833) 256-1665 or (202) 690-7442; or - email:
[email protected]
This institution is an equal opportunity provider.