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Forms - FSG

Family Support Grant (FSG) Program

  • Must be receiving case management from Scott County
  • Must be deemed disabled by State Medical Review Team or Social Security Administration
  • MA not required
  • Up to $3,000/year, based on need, until recipient reaches age 21
  • Adjusted gross income limit
  • Eligibility and need determined annually
  • State funds
  • Waiting list

For additional information about this program go to the following link on the Minnesota (DHS) Department of Human Service website:
Family Support Grant

The forms in this folder are for clients currently enrolled in this program.
To use these on your computer please highlight the form and use your “save as” option to save the document to your computer for future use. This would allow you to complete and submit the document to your case manager via an e-mail attachment. Or
you may print the form, handwrite the information and submit by mailing or faxing to your case manager at:

        Scott County Health and Human Services
        200 Fourth Ave W
        Shakopee, MN 55379 -1220
        Fax #: 952/496-8551

Contact Information
County Main Number
(952) 445-7750
(952) 496-8170 (TTY)
Health and Human Services
(952) 445-7751
(952) 496-8430 (FAX)
Developmental Disabilities
(952) 445-7751
(952) 496-8551 (FAX)
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