State Interstate Match Contact

State Interstate Match Contact

The State Interstate Match Contact is for states, Puerto Rico and the District of Columbia, to post contact information for interstate communication to assist in resolving matches. This is to augment the contact information already provided with each interstate match. In addition to being a resource to the PARIS community, the new State Interstate Match Contact page will lessen the calls made to the State Administrative Representatives currently listed on the PARIS website (www.acf.hhs.gov/programs/paris). Please complete and submit the following for updating the web page: State Interstate Match Contact - Form (doc 43.5KB)

NOTE: To access Puerto Rico or other territories, go to the bottom of the dropdown list.

Last Reviewed: June 11, 2018

Alabama

Primary Contact Resource
Secondary Contact Resource
Note: The State Interstate Match Contact web page can list up to two separate contact groups per state, e.g., one for TANF/FS and secondary for MA. Submit a separate page for each contact.

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
X ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

[ X ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
# 2 Email, # 1 Phone, # 3 FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: PIDPARIS@medicaid.alabama.gov
ii. Phone: ______
iii. FAX: ______

B. Multiple contact points:
X ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

Program Support via Contact Point (check all that apply):
[ X ]  TANF (Temporary Assistance to Needy Families)

[ X ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

[  ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
# 2 Email, # 1 Phone, # 3 FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: ______
ii. Phone: ______
iii. FAX: ______

B. Multiple contact points:
X ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

 

Alaska

Primary Contact Resource
Secondary Contact Resource
Note: The State Interstate Match Contact web page can list up to two separate contact groups per state, e.g., one for TANF/FS and secondary for MA. Submit a separate page for each contact.

Program Support via Contact Point (check all that apply):
[ X ]  TANF (Temporary Assistance to Needy Families)

X ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[ X ]  GA (General Assistance)
X ]  SSI (Supplemental  Security Income)

[ X ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

[ X ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
# 2 Email, # 1 Phone, #3 FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: sally.dial@alaska.gov
ii. Phone: 907-269-7664
iii. FAX: 907-269-0987

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

Program Support via Contact Point (check all that apply):
[ X ]  TANF (Temporary Assistance to Needy Families)

[ X ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[ X ]  GA (General Assistance)
X ]  SSI (Supplemental  Security Income)

X ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

X ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
# 2 Email, # 1 Phone, #3 FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: sally.dial@alaska.gov
ii. Phone: 907-269-7664
iii. FAX: 907-269-0987

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

 

American Samoa

Primary Contact Resource
Secondary Contact Resource
Note: The State Interstate Match Contact web page can list up to two separate contact groups per state, e.g., one for TANF/FS and secondary for MA. Submit a separate page for each contact.

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

[  ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
#   Email, #   Phone, #   FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: ______
ii. Phone: ______
iii. FAX: ______

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

[  ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
#   Email, #   Phone, #   FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: ______
ii. Phone: ______
iii. FAX: ______

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

 

Arizona

Primary Contact Resource
Secondary Contact Resource
Note: The State Interstate Match Contact web page can list up to two separate contact groups per state, e.g., one for TANF/FS and secondary for MA. Submit a separate page for each contact.

Program Support via Contact Point (check all that apply):
X ]  TANF (Temporary Assistance to Needy Families)

X ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

X ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
# 1 Email, # 2 Phone, #3 FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: FAAPARISRequest@azdes.gov
ii. Phone: 602-542-8201
iii. FAX: 602-542-3585

B. Multiple contact points:
X ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

[  ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
#   Email, #   Phone, #  FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: ______
ii. Phone: ______
iii. FAX: ______

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

 

Arkansas

Primary Contact Resource
Secondary Contact Resource
Note: The State Interstate Match Contact web page can list up to two separate contact groups per state, e.g., one for TANF/FS and secondary for MA. Submit a separate page for each contact.

Program Support via Contact Point (check all that apply):
[ X ]  TANF (Temporary Assistance to Needy Families)

X ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

X ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
# 1 Email, # 3 Phone, # 2 FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: ______
ii. Phone: ______
iii. FAX: ______

B. Multiple contact points:
X ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:  First attempt contact to phone number or fax number in file

Last Updated: March 14, 2018

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

[  ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
#   Email, #   Phone, #  FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: ______
ii. Phone: ______
iii. FAX: ______

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

 

California

Primary Contact Resource
Secondary Contact Resource
Note: The State Interstate Match Contact web page can list up to two separate contact groups per state, e.g., one for TANF/FS and secondary for MA. Submit a separate page for each contact.

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

X ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
# 1 Email, #   Phone, # 2 FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: PARIS@DHCS.CA.GOV

ii. Phone: ______
iii. FAX:  (916) 440-5233

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

[  ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
#   Email, #   Phone, #  FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: ______
ii. Phone: ______
iii. FAX: ______

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

 

Colorado

Primary Contact Resource
Secondary Contact Resource
Note: The State Interstate Match Contact web page can list up to two separate contact groups per state, e.g., one for TANF/FS and secondary for MA. Submit a separate page for each contact.

Program Support via Contact Point (check all that apply):
X ]  TANF (Temporary Assistance to Needy Families)

X ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

X ]  GA (General Assistance)
X ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

X ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
# 2 Email, # 1 Phone, # 3 FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: ______
ii. Phone: ______
iii. FAX: ______

B. Multiple contact points:
[ X ]  Use contact data in match
[ ] Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

[  ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
#   Email, #   Phone, #  FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: ______
ii. Phone: ______
iii. FAX: ______

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

 

Commonwealth of the Northern Mariana Islands

Primary Contact Resource
Secondary Contact Resource
Note: The State Interstate Match Contact web page can list up to two separate contact groups per state, e.g., one for TANF/FS and secondary for MA. Submit a separate page for each contact.

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

[  ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
#   Email, #   Phone, #   FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: ______
ii. Phone: ______
iii. FAX: ______

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

[  ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
#   Email, #   Phone, #   FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: ______
ii. Phone: ______
iii. FAX: ______

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

 

Connecticut

Primary Contact Resource
Secondary Contact Resource
Note: The State Interstate Match Contact web page can list up to two separate contact groups per state, e.g., one for TANF/FS and secondary for MA. Submit a separate page for each contact.

Program Support via Contact Point (check all that apply):
X ]  TANF (Temporary Assistance to Needy Families)

X ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

X ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
#   Email, #   Phone, # 1  FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: 
ii. Phone: 

iii. FAX: 860-424-5333

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions: FAX only requests.

Last Updated: March 14, 2018

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

[  ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
#   Email, #   Phone, #   FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: ______
ii. Phone: ______
iii. FAX: ______

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

 

Delaware

Primary Contact Resource
Secondary Contact Resource
Note: The State Interstate Match Contact web page can list up to two separate contact groups per state, e.g., one for TANF/FS and secondary for MA. Submit a separate page for each contact.

Program Support via Contact Point (check all that apply):
X ]  TANF (Temporary Assistance to Needy Families)

X ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

X ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

X ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

X ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
# 1 Email, #   Phone, #   FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: DE_PARIS-ARMS@state.de.us

ii. Phone: ______
iii. FAX: ______

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:    "Out-of-State Inquiry" in subject line, include your contact information. Include the names and date of birth for household members and their last 4 digits of SSN. List current address for household and date it was reported to your state. Expect an email  response within 5 business days.

Last Updated: March 14, 2018

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

[  ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
#   Email, #   Phone, #   FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: ______
ii. Phone: ______
iii. FAX: ______

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

 

 

 

Last Updated: March 14, 2018

 

 

District Of Columbia

Primary Contact Resource
Secondary Contact Resource
Note: The State Interstate Match Contact web page can list up to two separate contact groups per state, e.g., one for TANF/FS and secondary for MA. Submit a separate page for each contact.

Program Support via Contact Point (check all that apply):
X ]  TANF (Temporary Assistance to Needy Families)

X ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

X ]  GA (General Assistance)
X ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

X ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
# 1 Email, # 3 Phone, # 2 FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: hermena.kinard@dc.gov
ii. Phone: 202-535-1462
iii. FAX: 202-535-1455

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

[  ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
#   Email, #   Phone, #  FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: ______
ii. Phone: ______
iii. FAX: ______

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

 

Florida

Primary Contact Resource
Secondary Contact Resource
Note: The State Interstate Match Contact web page can list up to two separate contact groups per state, e.g., one for TANF/FS and secondary for MA. Submit a separate page for each contact.

Program Support via Contact Point (check all that apply):
X ]  TANF (Temporary Assistance to Needy Families)

X ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

X ]  GA (General Assistance)
X ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

X ]  WC (Workers’ Compensation)

X ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
# 1 Email, # 2 Phone, # 3 FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: SNR.D11.SFL.CallCenter@myflfamilies.com
ii. Phone: 866-762-2237
iii. FAX: 866-735-2469

B. Multiple contact points:
X ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

[  ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
#   Email, #   Phone, #   FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: ______
ii. Phone: ______
iii. FAX: ______

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

 

Georgia

Primary Contact Resource
Secondary Contact Resource
Note: The State Interstate Match Contact web page can list up to two separate contact groups per state, e.g., one for TANF/FS and secondary for MA. Submit a separate page for each contact.

Program Support via Contact Point (check all that apply):
X ]  TANF (Temporary Assistance to Needy Families)

X ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

X ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
# 3 Email, # 2 Phone, # 1 FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: ga.paris@dhs.ga.gov
ii. Phone: 888-295-1769
iii. FAX: 404-463-0093

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

[  ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
#   Email, #   Phone, #   FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: ______
ii. Phone: ______
iii. FAX: ______

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

 

Guam

Primary Contact Resource
Secondary Contact Resource
Note: The State Interstate Match Contact web page can list up to two separate contact groups per state, e.g., one for TANF/FS and secondary for MA. Submit a separate page for each contact.

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

[  ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
#   Email, #   Phone, #   FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: ______
ii. Phone: ______
iii. FAX: ______

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

[  ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
#   Email, #   Phone, #   FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: ______
ii. Phone: ______
iii. FAX: ______

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

 

Hawaii

Primary Contact Resource
Secondary Contact Resource
Note: The State Interstate Match Contact web page can list up to two separate contact groups per state, e.g., one for TANF/FS and secondary for MA. Submit a separate page for each contact.

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

X ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
# 1 Email, # 3 Phone, # 2 FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: ehirabara@dhs.hawaii.gov
ii. Phone: (808) 692-8076
iii. FAX: (808) 692-8173

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

[  ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
#   Email, #   Phone, #   FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: ______
ii. Phone: ______
iii. FAX: ______

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

 

Idaho

Primary Contact Resource
Secondary Contact Resource
Note: The State Interstate Match Contact web page can list up to two separate contact groups per state, e.g., one for TANF/FS and secondary for MA. Submit a separate page for each contact.

Program Support via Contact Point (check all that apply):
X ]  TANF (Temporary Assistance to Needy Families)

X ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
X ]  SSI (Supplemental  Security Income)

X ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

X ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
# 1 Email, #   Phone, #   FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: welfraud@dhw.idaho.gov
ii. Phone: ______
iii. FAX: ______

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

[  ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
#   Email, #   Phone, #   FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: ______
ii. Phone: ______
iii. FAX: ______

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

 

Illinois

Primary Contact Resource
Secondary Contact Resource
Note: The State Interstate Match Contact web page can list up to two separate contact groups per state, e.g., one for TANF/FS and secondary for MA. Submit a separate page for each contact.

Program Support via Contact Point (check all that apply):
X ]  TANF (Temporary Assistance to Needy Families)

X ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

X ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
# 1 Email, # 2 Phone, # 3 FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: galen.wickline@illinois.gov
ii. Phone: 217-524-9665
iii. FAX: 217-524-9687

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

[  ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
#   Email, #   Phone, #   FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: ______
ii. Phone: ______
iii. FAX: ______

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

 

Indiana

Primary Contact Resource
Secondary Contact Resource
Note: The State Interstate Match Contact web page can list up to two separate contact groups per state, e.g., one for TANF/FS and secondary for MA. Submit a separate page for each contact.

Program Support via Contact Point (check all that apply):
X ]  TANF (Temporary Assistance to Needy Families)

X ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

X ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
# 1 Email, #   Phone, #   FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: PARISinquiries@fssa.IN.gov
ii. Phone:
iii. FAX:

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

[  ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
#   Email, #   Phone, #   FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: ______
ii. Phone: ______
iii. FAX: ______

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

 

Iowa

Primary Contact Resource
Secondary Contact Resource
Note: The State Interstate Match Contact web page can list up to two separate contact groups per state, e.g., one for TANF/FS and secondary for MA. Submit a separate page for each contact.

Program Support via Contact Point (check all that apply):
X ]  TANF (Temporary Assistance to Needy Families)

X ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

X ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
#   Email, # 1 Phone, #   FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: ______
ii. Phone: 1-877-855-0021
iii. FAX: ______

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: 1-877-855-0021
iii.FAX: ______

Special Instructions:  Need client zipcode to be routed

Last Updated: March 14, 2018

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

[  ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
#   Email, #   Phone, #   FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: ______
ii. Phone: ______
iii. FAX: ______

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

 

Kansas

Primary Contact Resource
Secondary Contact Resource
Note: The State Interstate Match Contact web page can list up to two separate contact groups per state, e.g., one for TANF/FS and secondary for MA. Submit a separate page for each contact.

Program Support via Contact Point (check all that apply):
X ]  TANF (Temporary Assistance to Needy Families)

X ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

X ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

[  ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
# 1 Email, # 2  Phone, # 3  FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: DCF.PARIS@ks.gov
ii. Phone: _(785) 296-3874 __
iii. FAX:   _(785) 296-6960___

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:  For PARIS inquiries sent via Fax, please specify "ATTN: PARIS TEAM" on the cover sheet.

Out of State inquiries not related to a PARIS match should be sent to: DCF.EBTMAIL@ks.gov

Last Updated: March 14, 2018

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
X ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

X ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
#   Email, #   Phone, #   FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: CH-PARISREPORT@KDHEKS.GOV
ii. Phone: ______
iii. FAX: _(785) 338-5268___

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

 

 

Last Updated: March 14, 2018

 

Kentucky

Primary Contact Resource
Secondary Contact Resource
Note: The State Interstate Match Contact web page can list up to two separate contact groups per state, e.g., one for TANF/FS and secondary for MA. Submit a separate page for each contact.

Program Support via Contact Point (check all that apply):
X ]  TANF (Temporary Assistance to Needy Families)

X ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

[  ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
# 1 Email, # 3 Phone, # 2 FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: CHFS.DFS.Claims@ky.gov
ii. Phone: (502) 564-3440
iii. FAX: (502) 564- 4021

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

X ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
# 1 Email, # 3 Phone, # 2 FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: outofstateinquiries@ky.gov
ii. Phone: (502) 564-3440
iii. FAX: (502) 564-4021

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: June 11, 2018

 

Louisiana

Primary Contact Resource
Secondary Contact Resource
Note: The State Interstate Match Contact web page can list up to two separate contact groups per state, e.g., one for TANF/FS and secondary for MA. Submit a separate page for each contact.

Program Support via Contact Point (check all that apply):
X ]  TANF (Temporary Assistance to Needy Families)

X ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

[  ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
# 1 Email, # 2 Phone, # 3 FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: Cara.Shields@la.gov
ii. Phone: (225) 342-2342
iii. FAX:  (225) 342-9833

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

X ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
# 1 Email, # 2 Phone, # 3 FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: susan.wright@la.gov 
ii. Phone:(985) 543-4331
 iii. FAX: (225) 376-4753

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

 

Maine

Primary Contact Resource
Secondary Contact Resource
Note: The State Interstate Match Contact web page can list up to two separate contact groups per state, e.g., one for TANF/FS and secondary for MA. Submit a separate page for each contact.

Program Support via Contact Point (check all that apply):
X ]  TANF (Temporary Assistance to Needy Families)

X ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
X ]  SSI (Supplemental  Security Income)

X ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

X ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
# 1 Email, # 3 Phone, # 2 FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: Paris@Maine.gov
ii. Phone: 207-287-2409 
iii. FAX: 207-287-5096

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

[  ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
#   Email, #   Phone, #   FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: ______
ii. Phone: ______
iii. FAX: ______

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

 

Maryland

Primary Contact Resource
Secondary Contact Resource
Note: The State Interstate Match Contact web page can list up to two separate contact groups per state, e.g., one for TANF/FS and secondary for MA. Submit a separate page for each contact.

Program Support via Contact Point (check all that apply):
X ]  TANF (Temporary Assistance to Needy Families)

X ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

X ]  GA (General Assistance)
X ]  SSI (Supplemental  Security Income)

X ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

X ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
# 1 Email, # 3 Phone, # 2 FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: paris.inquiries@maryland.gov
ii. Phone: (410) 238-1249
iii. FAX: (410) 238-1260

B. Multiple contact points:
X ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions: If you do not receive a response from the contact listed in the data match within 5 business days, contact Joyce Westbrook (410) 238-1299 or joyce.westbrook@maryland.gov Please provide how you want information received back, either email or fax. 

Last Updated: March 14, 2018

 

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

[  ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
#   Email, #   Phone, #   FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: ______
ii. Phone: ______
iii. FAX: ______

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

 

 

Last Updated: March 14, 2018

 

Massachusetts

Primary Contact Resource
Secondary Contact Resource
Note: The State Interstate Match Contact web page can list up to two separate contact groups per state, e.g., one for TANF/FS and secondary for MA. Submit a separate page for each contact.

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA& (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

X ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
# 2 Email, # 1 Phone, #3 FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:  Jody Jordan-Kiley
i. Email: Jody.Jordan@state.ma.us
ii. Phone: (617) 847-3124_
iii. FAX: ______

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 21, 2018

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA& (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

X ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
# 2 Email, # 1 Phone, #3 FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:  Jody Jordan-Kiley
i. Email: Jody.Jordan@state.ma.us
ii. Phone: _(617) 847-3124
iii. FAX: ______

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 21, 2018

 

Michigan

Primary Contact Resource
Secondary Contact Resource
Note: The State Interstate Match Contact web page can list up to two separate contact groups per state, e.g., one for TANF/FS and secondary for MA. Submit a separate page for each contact.

Program Support via Contact Point (check all that apply):
X ]  TANF (Temporary Assistance to Needy Families)

X ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

X ]  GA (General Assistance)
X ]  SSI (Supplemental  Security Income)

X ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

X ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
# 1 Email, # 2 Phone, # 3 FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: DHS-ICU-Customer-Service@michigan.gov
ii. Phone: 517-373-3908
iii. FAX: 517-335-6054

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

[  ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
#   Email, #   Phone, #   FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: ______
ii. Phone: ______
iii. FAX: ______

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

 

Minnesota

Primary Contact Resource
Secondary Contact Resource
Note: The State Interstate Match Contact web page can list up to two separate contact groups per state, e.g., one for TANF/FS and secondary for MA. Submit a separate page for each contact.

Program Support via Contact Point (check all that apply):
X ]  TANF (Temporary Assistance to Needy Families)

X ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

X ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

X ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

X ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
#  1 Email, # 3 Phone, # 2 FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: paris.project.dhs@state.mn.us
ii. FAX: 651-431-7529
iii. Phone:  651-431-3010

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:  When contacting Minnesota, please put "PARIS Inquiry" in the subjsect line and provide the clients name, DOB and SSN.

Last Updated: March 14, 2018

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

[  ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
#   Email, #   Phone, #   FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: ______
ii. Phone: ______
iii. FAX: ______

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

 

Mississippi

Primary Contact Resource
Secondary Contact Resource
Note: The State Interstate Match Contact web page can list up to two separate contact groups per state, e.g., one for TANF/FS and secondary for MA. Submit a separate page for each contact.

Program Support via Contact Point (check all that apply):
X ]  TANF (Temporary Assistance to Needy Families)

X ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

[  ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
# 1 Email, # 3 Phone, # 2 FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: EA.CustomerService@mdhs.ms.gov 
ii. Phone: 1-800-948-3050
iii. FAX: 601-359-4435

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:  First attempt contact to phone number or fax number in file

Last Updated: March 14, 2018

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

[  ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
#   Email, #   Phone, #   FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: ______
ii. Phone: ______
iii. FAX: ______

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

 

Missouri

Primary Contact Resource
Secondary Contact Resource
Note: The State Interstate Match Contact web page can list up to two separate contact groups per state, e.g., one for TANF/FS and secondary for MA. Submit a separate page for each contact.

Program Support via Contact Point (check all that apply):
X ]  TANF (Temporary Assistance to Needy Families)

X ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

X ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

X ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

X ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
# 1 Email, # 2 Phone, # 3 FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: Cole_Howerton.FSD_C&I@dss.mo.gov 
ii. Phone: 855-373-4636
iii. FAX: 573-522-6220

B. Multiple contact points:
X ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: Ask.MHD@dss.mo.gov 
ii. Phone: 573-751-3425
iii.FAX: 573-751-6564

Special Instructions:

Last Updated: March 14, 2018

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

[  ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
#   Email, #   Phone, #   FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: ______
ii. Phone: ______
iii. FAX: ______

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

 

Montana

Primary Contact Resource
Secondary Contact Resource
Note: The State Interstate Match Contact web page can list up to two separate contact groups per state, e.g., one for TANF/FS and secondary for MA. Submit a separate page for each contact.

Program Support via Contact Point (check all that apply):
X ]  TANF (Temporary Assistance to Needy Families)

X ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

[  ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
# 1 Email, # 2 Phone, # 3 FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email:  hhsparis@mt.gov
ii. Phone: 406-444-4987
iii. FAX: 406-444-0248

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

X ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
# 1 Email, # 2 Phone, # 3 FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: hhsparis@mt.gov
ii. Phone: 406-444-9401
iii. FAX: 406-444-0248

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

 

Nebraska

Primary Contact Resource
Secondary Contact Resource
Note: The State Interstate Match Contact web page can list up to two separate contact groups per state, e.g., one for TANF/FS and secondary for MA. Submit a separate page for each contact.

Program Support via Contact Point (check all that apply):
X ]  TANF (Temporary Assistance to Needy Families)

X ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

X ]  GA (General Assistance)
X ]  SSI (Supplemental  Security Income)

X ]  CC (Child Care)

X ]  WC (Workers’ Compensation)

X ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
# 1 Email, # 3 Phone, # 2 FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: DHHS.EconomicAssistancePolicyQuestions@nebraska.gov 
ii. Phone:  800-383-4278
iii. FAX:  402-471-9286

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

[  ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
#   Email, #   Phone, #   FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: ______
ii. Phone: ______
iii. FAX: ______

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

 

Nevada

Primary Contact Resource
Secondary Contact Resource
Note: The State Interstate Match Contact web page can list up to two separate contact groups per state, e.g., one for TANF/FS and secondary for MA. Submit a separate page for each contact.

Program Support via Contact Point (check all that apply):
X ]  TANF (Temporary Assistance to Needy Families)

X ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

X ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
#   Email, # 1 Phone, # 2 FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: WelfOOSInquiries@dwss.nv.gov
ii. Phone:702-486-1646
iii. FAX: 775-684-0844

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:  Faxed requests for coverage verification should be submitted on letterhead. 

Last Updated: March 14, 2018

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

[  ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
#   Email, #   Phone, #   FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: ______
ii. Phone: ______
iii. FAX: ______

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

 

New Hampshire

Primary Contact Resource
Secondary Contact Resource
Note: The State Interstate Match Contact web page can list up to two separate contact groups per state, e.g., one for TANF/FS and secondary for MA. Submit a separate page for each contact.

Program Support via Contact Point (check all that apply):
X ]  TANF (Temporary Assistance to Needy Families)

X ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

X ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

X ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
# 1 Email, #   Phone, #  FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email:  outofstateinquiries@dhhs.nh.gov

ii. Phone: ______
iii. FAX: ______

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: May 24, 2018

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

[  ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
#   Email, #   Phone, #   FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: ______
ii. Phone: ______
iii. FAX: ______

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

 

New Jersey

Primary Contact Resource
Secondary Contact Resource
Note: The State Interstate Match Contact web page can list up to two separate contact groups per state, e.g., one for TANF/FS and secondary for MA. Submit a separate page for each contact.

Program Support via Contact Point (check all that apply):
X ]  TANF (Temporary Assistance to Needy Families)

X ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

X ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

[  ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
# 1 Email, # 2 Phone, # 3 FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: DFD.PAIU@dhs.state.nj.us
ii. Phone: ______
iii. FAX: ______

B. Multiple contact points:
X ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:  Request must be from official government email address. No faxed request accepted. Include full name, DOB and the last 4 of SSN in your request.

Last Updated: March 14, 2018

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

X ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
# 1 Email, # 2 Phone, # 3 FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: MAHS.NJPARISMATCH@dhs.state.nj.us
ii. Phone: ______
iii. FAX: ______

B. Multiple contact points:
X ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:  Request must be from official government email address. No faxed request accepted. Include full name, DOB and the last 4 of SSN in your request.

Last Updated: March 14, 2018

 

New Mexico

Primary Contact Resource
Secondary Contact Resource
Note: The State Interstate Match Contact web page can list up to two separate contact groups per state, e.g., one for TANF/FS and secondary for MA. Submit a separate page for each contact.

Program Support via Contact Point (check all that apply):
X ]  TANF (Temporary Assistance to Needy Families)

X ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

X ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

X ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
# 1 Email, # 2 Phone, # 3 FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: HSDOIGFRAUD@state.nm.us
ii. Phone: 800-228-4802
iii. FAX: 505-827-8165

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

[  ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
#   Email, #   Phone, #   FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: ______
ii. Phone: ______
iii. FAX: ______

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

 

New York

Primary Contact Resource
Secondary Contact Resource
Note: The State Interstate Match Contact web page can list up to two separate contact groups per state, e.g., one for TANF/FS and secondary for MA. Submit a separate page for each contact.

Program Support via Contact Point (check all that apply):
X ]  TANF (Temporary Assistance to Needy Families)

X ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

X ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
#   Email, # 1 Phone, #   FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: ______
ii. Phone: ______
iii. FAX: ______

B. Multiple contact points:
[  ]  Use contact data in match
X ]  NYS CONTACT LIST FOR PARIS 201805 Link to spreadsheet as provided by the state; submit revised list to ACF

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

[  ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
#   Email, #   Phone, #   FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: ______
ii. Phone: ______
iii. FAX: ______

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

 

North Carolina

Primary Contact Resource
Secondary Contact Resource
Note: The State Interstate Match Contact web page can list up to two separate contact groups per state, e.g., one for TANF/FS and secondary for MA. Submit a separate page for each contact.

Program Support via Contact Point (check all that apply):
X ]  TANF (Temporary Assistance to Needy Families)

X ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

X ]  GA (General Assistance)
X ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

X ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
# 2 Email, # 1 Phone, #3  FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: ______
ii. Phone: ______
iii. FAX: ______

B. Multiple contact points:
X ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:  Contact is county switchboard – ask to speak to interstate match worker.

Last Updated: March 14, 2018

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

[  ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
#   Email, #   Phone, #   FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: ______
ii. Phone: ______
iii. FAX: ______

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

 

North Dakota

Primary Contact Resource
Secondary Contact Resource
Note: The State Interstate Match Contact web page can list up to two separate contact groups per state, e.g., one for TANF/FS and secondary for MA. Submit a separate page for each contact.

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

X ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
# 1 Email, # 3 Phone, # 2 FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: joyjohnson@nd.gov and adura@nd.gov

ii. Phone:701-328-2064 Arlene or Joyce 701-328-8990
 iii. FAX: 701-328-1060
 

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: April 4, 2018

Program Support via Contact Point (check all that apply):
X ]  TANF (Temporary Assistance to Needy Families)

X ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

X ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

X ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
# 3 Email, # 2 Phone, # 1 FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: dhs.eap@nd.gov
ii. Phone: 701-328-2332
iii. FAX: 701-328-1060

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

 

Ohio

Primary Contact Resource
Secondary Contact Resource
Note: The State Interstate Match Contact web page can list up to two separate contact groups per state, e.g., one for TANF/FS and secondary for MA. Submit a separate page for each contact.

Program Support via Contact Point (check all that apply):
X ]  TANF (Temporary Assistance to Needy Families)

X ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

X ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

X ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

X ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
# 1 Email, # 3 Phone, # 2 FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: ______
ii. Phone: ______
iii. FAX: ______

B. Multiple contact points:
X ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

[  ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
#   Email, #   Phone, #   FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: ______
ii. Phone: ______
iii. FAX: ______

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

 

Oklahoma

Primary Contact Resource
Secondary Contact Resource
Note: The State Interstate Match Contact web page can list up to two separate contact groups per state, e.g., one for TANF/FS and secondary for MA. Submit a separate page for each contact.

Program Support via Contact Point (check all that apply):
X ]  TANF (Temporary Assistance to Needy Families)

X ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

X ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

X ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
# 1 Email, # 3 Phone, # 2 FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: OIG.PARIS@OKDHS.ORG
ii. Phone: 800-784-5887
iii. FAX: 405-522-4642

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:  Oklahoma Health Care Authority is secondary contact for on-line enrollment medical

Last Updated: March 14, 2018

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

X ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
# 1 Email, # 2 Phone, #   FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: eligibility@okhca.org
ii. Phone: 1-800-987-7767
iii. FAX: ______

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:  Cover PARIS matches for Oklahoma Medicaid Online enrollment only

Last Updated: March 14, 2018

 

Oregon

Primary Contact Resource
Secondary Contact Resource
Note: The State Interstate Match Contact web page can list up to two separate contact groups per state, e.g., one for TANF/FS and secondary for MA. Submit a separate page for each contact.

Program Support via Contact Point (check all that apply):
X ]  TANF (Temporary Assistance to Needy Families)

X ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
X ]  SSI (Supplemental  Security Income)

X ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

X ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
# 1 Email, #   Phone, # 2 FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: ______
ii. Phone: ______
iii. FAX: ______

B. Multiple contact points:
X ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: OR.Paris@state.or.us
ii. Phone: ______
iii.FAX:  503-378-3207

Special Instructions:

Last Updated: March 14, 2018

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

[  ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
#   Email, #   Phone, #   FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: ______
ii. Phone: ______
iii. FAX: ______

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

 

Pennsylvania

Primary Contact Resource
Secondary Contact Resource
Note: The State Interstate Match Contact web page can list up to two separate contact groups per state, e.g., one for TANF/FS and secondary for MA. Submit a separate page for each contact.

Program Support via Contact Point (check all that apply):
X ]  TANF (Temporary Assistance to Needy Families)

X ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

X ]  GA (General Assistance)
X ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

X ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
# 2 Email, # 1 Phone, #3 FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: ______
ii. Phone: ______
iii. FAX: ______

B. Multiple contact points:
[  ]  Use contact data in match
X ] PA County - PARIS Match contacts - 04052018 Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:  Match first two digits of record # with county on list.

Last Updated: April 13, 2018

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

[  ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
#   Email, #   Phone, #   FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: ______
ii. Phone: ______
iii. FAX: ______

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

 

Puerto Rico

Primary Contact Resource
Secondary Contact Resource
Note: The State Interstate Match Contact web page can list up to two separate contact groups per state, e.g., one for TANF/FS and secondary for MA. Submit a separate page for each contact.

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  NAP (Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

X ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
# 1 Email, #   Phone, #   FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: sesantos@salud.pr.gov
ii. Phone: 787-765-2929 Ext. 6758
 iii. FAX: 787-250-0990

 B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

Program Support via Contact Point (check all that apply):
[ X ]  TANF (Temporary Assistance to Needy Families)

X ]  NAP (Nutrition Assistance Program, formerly Food Stamps)

X ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

X ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

[  ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
# 1 Email, # 2 Phone, # 3 FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: intorres@adsef.pr.gov
ii. Phone: 787-289-7600 EXT 2424 or 2423
iii. FAX: 787-289-7606

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

 

Rhode Island

Primary Contact Resource
Secondary Contact Resource
Note: The State Interstate Match Contact web page can list up to two separate contact groups per state, e.g., one for TANF/FS and secondary for MA. Submit a separate page for each contact.

Program Support via Contact Point (check all that apply):
X ]  TANF (Temporary Assistance to Needy Families)

X ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

X ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

X ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
# 1 Email, # 2 Phone, # 3 FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: acalitri@dhs.ri.gov
ii. Phone:  401-462-6870
iii. FAX:  401-462-2975

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

[  ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
#   Email, #   Phone, #   FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: ______
ii. Phone: ______
iii. FAX: ______

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

 

South Carolina

Primary Contact Resource
Secondary Contact Resource
Note: The State Interstate Match Contact web page can list up to two separate contact groups per state, e.g., one for TANF/FS and secondary for MA. Submit a separate page for each contact.

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
X ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

X ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
# 2 Email, # 3 Phone, # 1 FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: INTERFACES@SCDHHS.GOV
ii. Phone:  803-898-3020
iii. FAX:  803-255-8203

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

Program Support via Contact Point (check all that apply):
X ]  TANF (Temporary Assistance to Needy Families)

X ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

[  ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
# 1  Email, # 2  Phone, # 3  FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: scdssverfiy@dss.sc.gov
ii. Phone: 803-898-1764 option 6
iii. FAX:  803-898-1214 attention Nadine Livingston

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:  Fraud and PARIS matches handled by Angela Clark at angela.clark@dss.sc.gov

Last Updated: June 11, 2018

 

South Dakota

Primary Contact Resource
Secondary Contact Resource
Note: The State Interstate Match Contact web page can list up to two separate contact groups per state, e.g., one for TANF/FS and secondary for MA. Submit a separate page for each contact.

Program Support via Contact Point (check all that apply):
X ]  TANF (Temporary Assistance to Needy Families)

X ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

X ]  GA (General Assistance)
X ]  SSI (Supplemental  Security Income)

X ]  CC (Child Care)

X ]  WC (Workers’ Compensation)

X ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
# 1 Email, # 2 Phone, # 3 FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: vicki.vandenbos@state.sd.us
ii. Phone: 605-773-4678
iii. FAX: 605-773-7183

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

[  ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
#   Email, #   Phone, #   FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: ______
ii. Phone: ______
iii. FAX: ______

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

 

Tennessee

Primary Contact Resource
Secondary Contact Resource
Note: The State Interstate Match Contact web page can list up to two separate contact groups per state, e.g., one for TANF/FS and secondary for MA. Submit a separate page for each contact.

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[ X ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

X ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
# 1  Email, # 2 FAX, # 2 Phone

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: frances.neal@tn.gov;paris.inquiries@tn.gov
ii. Phone: 615-507-6467
iii. FAX: 615-532-5236

B. Multiple contact points:
[ X ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email:  ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:  Place Paris Match in subject line. Include the begin date of eligibility and current mailing address.

Last Updated: April 13, 2018

Program Support via Contact Point (check all that apply):
[ X ]  TANF (Temporary Assistance to Needy Families)

[ X ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

[  ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
 # 1   FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: ______
ii. Phone: ______
iii. FAX: 615-687-5535

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions: This contact is for verification ONLY if a termination is needed fax that request to 615-532-5236.

Last Updated: March 14, 2018

 

Texas

Primary Contact Resource
Secondary Contact Resource
Note: The State Interstate Match Contact web page can list up to two separate contact groups per state, e.g., one for TANF/FS and secondary for MA. Submit a separate page for each contact.

Program Support via Contact Point (check all that apply):
X ]  TANF (Temporary Assistance to Needy Families)

X ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
X ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

X ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
#   Email, #   Phone, # 1 FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: ______
ii. Phone: ______
iii. FAX: 1-877-447-2839

B. Multiple contact points:
X ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: 1-877-447-2839

Special Instructions:  Fax must be on your agency letterhead. Please submit one inquiry per page.

Last Updated: March 14, 2018

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

[  ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
#   Email, #   Phone, #   FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: ______
ii. Phone: ______
iii. FAX: ______

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

 

Utah

Primary Contact Resource
Secondary Contact Resource
Note: The State Interstate Match Contact web page can list up to two separate contact groups per state, e.g., one for TANF/FS and secondary for MA. Submit a separate page for each contact.

Program Support via Contact Point (check all that apply):
X ]  TANF (Temporary Assistance to Needy Families)

X ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

X ]  GA (General Assistance)
X ]  SSI (Supplemental  Security Income)

X ]  CC (Child Care)

X ]  WC (Workers’ Compensation)

X ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
#   Email, # 1 Phone, #   FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: ______
ii. Phone: 1-866-435-7414
iii. FAX: ______

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

[  ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
#   Email, #   Phone, #   FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: ______
ii. Phone: ______
iii. FAX: ______

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

 

Vermont

Primary Contact Resource
Secondary Contact Resource
Note: The State Interstate Match Contact web page can list up to two separate contact groups per state, e.g., one for TANF/FS and secondary for MA. Submit a separate page for each contact.

Program Support via Contact Point (check all that apply):
X ]  TANF (Temporary Assistance to Needy Families)

X ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)


[   ]  MA (Medical Assistance)

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
TANF and SNAP: # 2 Email, # 1 FAX

Medical Assistance: #1 Email, #2 FAX, #3 Phone

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:

TANF and SNAP
i. Email:  ahs.dcfesdparis@vermont.gov
ii. Phone:
iii. FAX: 802-241-0960

B. Multiple contact points:
X ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

[X ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
# 1  Email, # 3  Phone, # 2  FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: AHS.DVHABenficiaryFraud@vermont.gov
ii. Phone:(802) 879-5900
iii. FAX: (802) 674-4194

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

 

Virgin Islands

Primary Contact Resource
Secondary Contact Resource
Note: The State Interstate Match Contact web page can list up to two separate contact groups per state, e.g., one for TANF/FS and secondary for MA. Submit a separate page for each contact.

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

[  ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
#   Email, #   Phone, #   FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: ______
ii. Phone: ______
iii. FAX: ______

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

[  ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
#   Email, #   Phone, #   FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: ______
ii. Phone: ______
iii. FAX: ______

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

 

Virginia

Primary Contact Resource
Secondary Contact Resource
Note: The State Interstate Match Contact web page can list up to two separate contact groups per state, e.g., one for TANF/FS and secondary for MA. Submit a separate page for each contact.

Program Support via Contact Point (check all that apply):
X ]  TANF (Temporary Assistance to Needy Families)

X ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

X ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
# 3 Email, # 1 Phone, # 2 FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: ______
ii. Phone: ______
iii. FAX: ______

B. Multiple contact points:
X ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

[  ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
#   Email, #   Phone, #   FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: ______
ii. Phone: ______
iii. FAX: ______

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

 

Washington

Primary Contact Resource
Secondary Contact Resource
Note: The State Interstate Match Contact web page can list up to two separate contact groups per state, e.g., one for TANF/FS and secondary for MA. Submit a separate page for each contact.

Program Support via Contact Point (check all that apply):
X ]  TANF (Temporary Assistance to Needy Families)

X ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

X ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

X ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

X ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
#   Email, # 2 Phone, # 1 FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: 
ii. Phone: 1-855-927-2747 or 1-855-WAPARIS 
iii. FAX: 888-212-2319

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

[  ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
#   Email, #   Phone, #   FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: ______
ii. Phone: ______
iii. FAX: ______

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

 

West Virginia

Primary Contact Resource
Secondary Contact Resource
Note: The State Interstate Match Contact web page can list up to two separate contact groups per state, e.g., one for TANF/FS and secondary for MA. Submit a separate page for each contact.

Program Support via Contact Point (check all that apply):
X ]  TANF (Temporary Assistance to Needy Families)

X ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

X ]  GA (General Assistance)
X ]  SSI (Supplemental  Security Income)

X ]  CC (Child Care)

X ]  WC (Workers’ Compensation)

X ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
# 1 Email, # 2 Phone, # 3 FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:  (A-L Surnames)
i. Email:  tammy.w.hollandsworth@wv.gov
ii. Phone: 304-847-2861
iii. FAX: 304-847-7244
A. Single Point of Contact(M-Z Surnames)
i. Email:  rusty.b.udy@wv.gov
ii. Phone: 304-465-9613
iii. FAX:304-465-7288

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

[  ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
#   Email, #   Phone, #   FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: ______
ii. Phone: ______
iii. FAX: ______

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

 

Wisconsin

Primary Contact Resource
Secondary Contact Resource
Note: The State Interstate Match Contact web page can list up to two separate contact groups per state, e.g., one for TANF/FS and secondary for MA. Submit a separate page for each contact.

Program Support via Contact Point (check all that apply):
 ]  TANF (Temporary Assistance to Needy Families)

X ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

X ]  GA (General Assistance)
X ]  SSI (Supplemental  Security Income)

 ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

X ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
# 1 Email, # 2 Phone, #  FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: DHSOIGPARIS@dhs.wisconsin.gov
ii. Phone: 608-267-0470
iii. FAX:

B. Multiple contact points:
[  ]  Use contact data in match

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

Program Support via Contact Point (check all that apply):
[ X ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[ X ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

[  ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
# 1 Email, # 3 Phone, # 2 FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: DCFOIG@wisconsin.gov
ii. Phone:
iii. FAX:

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

 

Wyoming

Primary Contact Resource
Secondary Contact Resource
Note: The State Interstate Match Contact web page can list up to two separate contact groups per state, e.g., one for TANF/FS and secondary for MA. Submit a separate page for each contact.

Program Support via Contact Point (check all that apply):
[  ]  TANF (Temporary Assistance to Needy Families)

[  ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

X ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
# 1 Email, #  Phone, #  FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email:  penny.davis@wyo.gov
ii. Phone: 307-777-3772
iii. FAX: 307-777-6964

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

Program Support via Contact Point (check all that apply):
X ]  TANF (Temporary Assistance to Needy Families)

X ]  SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps)

[  ]  GA (General Assistance)
[  ]  SSI (Supplemental  Security Income)

[  ]  CC (Child Care)

[  ]  WC (Workers’ Compensation)

[  ]  MA (Medical Assistance), Medicaid/Medical in most states

Preferred Contact Method: (Rank contact methods from #1 to #3; #1 being preferred.)
# 1 Email, #   Phone, #   FAX

Contact Format used by State: (Answer for either A or B, but not both.)
A. Single Point of Contact:
i. Email: annette.jones@wyo.gov
ii. Phone: 307-777-5846
iii. FAX: 307-777-6276

B. Multiple contact points:
[  ]  Use contact data in match
[  ]  Link to PDF as provided by the state; submit revised list to ACF 

C. Contact for benefit redemption history/medical claims history if different from above:
i. Email: ______
ii. Phone: ______
iii.FAX: ______

Special Instructions:

Last Updated: March 14, 2018

 

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