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Page | 24 (3) Office of Civil Rights, US Department of Health and Human Services, 200 Independence Ave, S.W. Room 509F HHH Bldg., Washington DC 20201

1320 COMPLAINT REQUIREMENTS

To facilitate investigations, complaints should contain the following information: A. Name, address and telephone number or other means of contacting the individual alleging discrimination; B. The location and name of the organization or office which is accused of discrimination practices; C. The nature of the incident or the aspect of the program leading the person to allege discrimination; D. The reason for the alleged discrimination (age, race, color, sex, handicap, religious belief, national origin or political belief); E. The name(s), title(s) (if appropriate), and address(es) of the individual or individuals who may have knowledge of the alleged discriminatory act; and F. The date(s) on which the alleged discriminatory act occurred.

The brochure, Information on filing a Discrimination Complaint, includes a Discrimination Complaint Form that may be used by the individual to report the above information.

1330 PUBLIC NOTIFICATION OF NONDISCRIMINATION

DSS will: A. Publicize the procedure for handling civil rights complaints. B. Display the “And Justice for All” poster in DSS offices.

C. Provide the brochure, Information on filing a Discrimination Complaint, to the individual when an individual alleges discrimination or requests additional information. The brochure must be provided to them within 10 days of the request date.

1340 OTHER CONCERNS

Other concerns such as processing standards, service, program complaints, etc. must be directed to the Supervisor. Concerns may be expressed verbally or submitted in writing. Supervisors follow up, resolve, and take corrective action, if warranted. After the concern has been resolved, the customer concern data base must be completed. The data base is located on the M drive/DSS/EAMgmt/Customer Concern Log. The supervisor also reports any corrective action completed to the Regional Manager. Either the Supervisor, Regional Manager, or State Office staff will respond to the complainant on the disposition of the complaint.

The Regional Manager periodically reviews and monitors concerns via the database, and completes any corrective action needed. At least annually, SNAP program staff review the customer concern log to assess whether patterns or problems may be present and take corrective action, if warranted.

1350 RACIAL/ETHNIC DATA COLLECTION

Requests to provide race or ethnicity information on the application form is voluntary and does not affect the applicant’s eligibility or benefit levels. The information is requested to assure that program benefits are distributed without regard to race, color, national origin, sex (including gender identity and sexual orientations), religious creed, disability, age, political beliefs, or reprisal or retaliation for