Application Assistance and Training

Download CalFresh application forms and print for use with clients in Humboldt County. A complete application consists of both the SAWS1 and the PIE (Pre-Interview Evaluation) forms. Click any of the titles below to download and/or print. Also, please view the document that points out what's new about these forms, what to look out for and who to contact or send completed forms to.

• PIE (English)
• PIE (Spanish)
• SAWS1 (English)
• SAWS1 (Spanish)

Help CalFresh recipients fill out the SAR 7 form in order to submit a 6-month report form, which is required in order to keep receiving CalFresh benfits. Download this SAR 7 training document, with detailed instructional notes on how to fill out the SAR 7. All customers will have to complete a SAR 7.

• Most households have a one year certification period and will need to submit a SAR 7 in the 6th month.
• Households that reside on a Native American reservation have a longer certification period.
• Households in which all members are seniors age 60+ and/or disabled, and do not have earned income, have a longer certification period before needing to renew their CalFresh case. As of 1/24/22, these households have a 3-year certification period. These households will receive a SAR2 form reminding them of their mid-period reporting requirements at the 12th and 24th months of receiving benefits. 

If you've had a change in income or household status before your Semi-Annual Report form or recertification is due, you can also fill out a SAR3 Mid-Period Status Report and submit it to Humboldt County DHHS Social Services Branch to have your CalFresh benefits level adjusted. This report is used for any status change that occurs mid-period. Please click here for the Spanish version of the form.

The SAR3 Mid-Period Status Report form can also be initiated by calling the DHHS Telephone Service Center at 1-877-410-8809 or online at https://www.benefitscal.org/

Download and fill out the Recertification Form, which is required in order to renew benefits at the end of a certification period (1 year for most households; 3 years for some seniors and people with disabilities).

When assisting clients with a CalFresh application, it is helpful to provide additional information that ensures a successful eligibility determination process once it leaves your hands. This includes reviewing the types of documentation the County will require in order to complete the eligibility process and grant the maximum amount of benefits it possibly can.  Please use this handy checklist available for download by clicking here. Check off items that apply to each unique household you work with, and encourage them to start gathering the documentation and making copies to provide to the County when requested. Better yet--as an Application Assistor, encourage clients to bring copies directly to you (or make the copies for them), and send those copies along to the county with the application. This pays off later so the eligibility determination process can go as fast and smooth as possible. (Updated June 2015)

Release of Information (ROI) 

When assisting with CalFresh applications, it is a good practice to work with clients to fill out the Release of Information (ROI) form, so that you can advocate on their behalf (as an application assister) in communications with the County. This might include checking in with the County on something a client is confused about, advocating on a client's behelf regarding a potential error in the eligibility process, or helping to faciliate better understanding between client and County, as needed.

Please click here to downlad the new (as of September 2021) ROI form in English. Click here to download the new ROI in Spanish. Previous versions of the form will be valid until they expire, but you will need to use this version moving forward. This is to make sure DHHS is meeting confidentiality requirements in their programs. The form now lists more benefit programs for customers to select, including CalWORKS and Welfare to Work, guaranteeing that this one ROI is good for the entire DHHS office.

DHHS has created a series of dowloadable information sheets for partners, explaining the application and eligibility processes for many different Social Services programs, including CalFresh, Medi-Cal, and information on special circumstances for specific populations. Click here to view and download info sheets. Topics include:

• What happens and what to expect after submitting a CalFresh and/or Medi-Cal application in Humboldt County
• CalFresh and MediCal for specific populations such as students, Native Americans, seniors age 60+, persons with disabilities
• Adding health care coverage to a CalFresh case
• Inter-County transfers (moving from county to county and transfering a CalFresh case to the new county)
• E-tools available for program participants (e-notifications, texting, and using c4yourself.com
• ...and much much more!

Click here to view an assortment of past CalFresh Outreach webinars hosted by the California Association of Food Banks (CAFB). They include recorded webinars on the ABAWD rule (Able-Bodied Adults Without Dependents), students, recertification, sponsorship/non-citizen situations, prior drug convictions, client rights and fair hearings, seniors, and much more. Click here to watch webinars hosted by Alliance to Transform CalFresh. They include recorded webinars on new CalFresh policies for seniors and persons with disabilities, electronic signatures, streamlining enrollment, CalFresh/Medi-Cal combined outreach, verifications, student hunger & eligibility, ABAWD, school meals & CalFresh, recertification, same day service, churn, and more.

Food for People created a tool for helping partners to reframe CalFresh when working directly with clients. These tools help with overcoming some of the stigma, myths, fears and misinformation about the program, and provide ideas for talking about CalFresh comfortably and knowledgeably with clients. Click here to view and/or download this CalFresh reframing handout.

Legal Services of Northern California (LSNC) regularly updates its Guide to CalFresh Benefits, with detailed information on CalFresh, eligibility, applying, explanations of what is considered income or resources, how to keep benefits, overpayment or underpayment of benefits, notices, and fair hearings. Click here to visit LSNC's Guide to CalFresh Benefits.

The State of California put together this online toolkit for CalFresh Outreach workers, which includes information on doing CalFresh Outreach and provides a bounty of downloadable flyers for clients. Flyer topics include: Using CalFresh Benefits, People with Disabilities, People without a home, Immigration & Public Charge, Students, People with Refugee and Asylee status, and Older Adults. The site also provides samples of Outreach tracking forms Outreach workers can use to track their work and follow-up with clients.

Churn is the term for when households lose their CalFresh benefits while still eligible and then quickly reapply. Often this occurs when recertfication or reporting of some kind is due, though there are other reasons too.

• The Alliance to Transform CalFresh put together this explanation of and research on churn, which is also downloadable as a fact sheet at this link.
• The Center on Budget & Policy Priorities published their research on churn "Lessons Churned," which measures the impact on participants and state and local agencies.

If a CalFresh participant owes CalFresh benefits back to the county, for whatever the reason, there is a regulation in place that the county will not collect over-issuances below a certain amount. For instance, active (current) CalFresh participants do not need to pay back over-issuances under $35. Inactive (former) CalFresh participants do not have to pay back over-issuances below $125. Over-issuances between $35 and $125 for active (current) CalFresh households determined to be ineligible for CalFresh prior to establishment of the over-issuance will not have to pay back the over-issuance. More details here.

For households that have recently moved to Humboldt County from another California County (out of state must re-apply for CalFresh) in which the household is already receiving CalFresh benefits, the household will need to contact their former county agency to initiate an Inter-County Transfer of Benefits. Application assistors can provide the contact information for the household’s previous county agency here. Application assistors can assist with the Inter-County Transfer with Release of Information from the California Department of Social Services that is signed by the client. Click here to link to the Inter-County Transfer info sheet.

This video about CalFresh Outreach, (can also be viewed below) featuring CalFresh application assistors from around the state of California, is a fabulous introduction to CalFresh application assistance. It demonstrates what our colleagues from other counties are doing to help their communities by working one-on-one with clients.

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