Authorized Representative - Food, Cash and Medical Benefit Issuances

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Revised April 29, 2013

Purpose: This chapter defines an authorized representative (AREP) and provides instruction on: What form to use in order to code someone in ACES or the ECR as an AREP. When to require the DSHS 14-012(x) consent form. When to require the DSHS 17-063 authorization form or HCA 80-020 authorization for the release of information form. When it's permissible to share information without consent. How to identify and code an AREP in our automated systems.

Definition

An AREP can be any adult who is not a member of the AU who is sufficiently aware of the household circumstances and is authorized by the household to act on behalf of the client for eligibility purposes. If an individual AREP is representing an organization, other individuals from that organization within the same department may also act as an AREP. An AREP assists the client with the application, recertification, and general eligibility processes.

NOTE:

In everything we do, we need to maintain confidentiality. For example, King County Public Health is a large organization and while any employee from the Access and Outreach department may be authorized to act as an AREP on behalf of the organization, individuals from other departments within their organization are not authorized to represent the organization as an AREP.

An AREP is not authorized to receive health information about clients unless they have power of attorney or have been named on the completed and signed DSHS 14-012(x) consent form.

An AREP can share any information relevant to eligibility; however, the department can only share information with the AREP that is necessary for the purposes of determining financial eligibility.

An AREP can receive letters, including the income computation sheet, renewal forms, and ProviderOne services cards if the client has authorized the sharing of such correspondence.

What form is used for an AREP?

The client can identify an AREP on the application, eligibility review form, or DSHS 14-532 authorized representative form. The DSHS 14-532 authorized representative form shall be used when a client is authorizing an AREP at a time other than at application or eligibility review. The AREP information shall be reviewed at recertification. See WORKER RESPONSIBILITIES.

AREPs are not automatically eligible to be an EBT Alternate Card Holder for Basic Food or cash benefits. Both the client and Alternate Card Holder must complete and sign the EBT 002 form. Please refer to the EBT Handbook for more information.

Please refer to the Payees on Benefit Issuances - Authorized Representatives chapter, WAC 388-460-0005 through 460-0015 for AREP rules specific to the Basic Food (SNAP) program.

NOTE:

The DSHS 14-532 AREP form is not required when the AREP has Power of Attorney or Legal Guardianship. Power of Attorney and Legal Guardianship must be verified.

Legal Guardianship is designated by coding the AREP screen Rep Type field in ACES with the following:

Cash and Medical : CG or GN
Basic Food: AD or NA

Power of Attorney for cash, medical, and basic food is designated by coding the AREP screen Rep Type field in ACES with AD or NA.

NOTE:

When a child age 18 or younger is institutionalized and the facility is applying on their behalf, the DSHS 14-532 AREP form or the designation of the facility as an AREP on the application or eligibility review is not required when the individual is:

a. In a court ordered, out-of-home placement under chapter 13.34 RCW; or

b. Involuntarily committed to an inpatient treatment program by a court order under chapter 71.34 RCW.

When is a DSHS 14-012(x) Consent form necessary?

The DSHS 14-012(x) consent form is a Health Insurance Portability and Accountability Act (HIPAA) compliant form designed for use by the client to authorize an exchange of information outside of basic eligibility information shared with an AREP. See AREP definition above. The 14-012(x) is the correct form for authorizing the sharing of specified confidential information between specified parties for a specified period of time.

HIPAA restrictions prevent us from discussing the client's individual health information with an AREP unless a current signed DSHS 14-012(x) consent form is in the record.

NOTE:

Every signed consent form is unique so it is critical that the authorized information, designated parties, and effective dates be carefully reviewed before releasing information.

When is the DSHS 17-063 Authorization or HCA 80-020 Authorization for Release of Information form necessary?

The DSHS 17-063 authorization form and the HCA 80-020 authorization for release of information form are HIPAA compliant forms designed for use by the client to authorize the release of existing documents to a specified individual or agency. These forms allow the disclosure of a designated set of records from the individual's DSHS or HCA file. The Public Disclosure Unit is responsible for approving or denying requests for disclosure of confidential information.

For more information see Confidentiality and Public Disclosure.

When is it permissible to share information without consent?

There are times when we can share confidential client data without the client's permission:

When release is required by law (commonly by court order or subpoena); or
When the information is needed from DSHS to administer a DSHS program and get needed services to a client (example; verification for a child care provider; however, only share information that would be necessary for the provider to provide child care).

To learn more about when it is permissible to share client information please refer to DSHS Administrative Policy 5.02, Section D;4.

EXAMPLE

The designation of an individual as AREP on the application: A mom with one child applies for family medical. She names her adult daughter as AREP on the application form. The adult daughter named as the AREP may only receive information necessary to determine financial eligibility and other information related to the benefits such as certification periods, benefit issuances, etc.

NOTE:

In this example the AREP section of the application does not specify which letters the AREP is designated to receive. Further communication or clarification with the client may be necessary and should be documented in remarks behind the AREP screen in ACES.

EXAMPLE

The designation of an AREP verses the authorization of sharing specified medical information: A client is receiving ABD cash benefits. The client's mom has been designated as the AREP on the most current application. There is also a signed DSHS 14-012 consent form on file authorizing the exchange of medical information between DSHS and the medical provider. The AREP (mom) is not included on the DSHS 14-012 consent form. The AREP calls DSHS requesting information on her daughter's medical treatment plan. The department cannot share that information with the AREP because DSHS is only authorized to share medical information with the medical provider. As the AREP, the mom is not entitled to this information because it is not related to the purpose of determining financial eligibility.

NOTE:

Naming the medical provider on the signed DSHS 14-012 consent form does not make them an AREP. Only the client's mom should be coded as an AREP.

EXAMPLE

The designation of an agency as AREP on the application: A hospitalized patient applies for medical benefits designating the hospital as an AREP on the application. Because there is no DSHS 14-012 consent form authorizing the exchange of medical information, the department can only share information necessary to determine financial eligibility.

EXAMPLE

The designation of an AREP and the authorization of sharing specified medical information: A hospitalized patient applies for the ABD program. The hospital is named as an AREP on the application. The client has also signed a DSHS 14-012 consent form authorizing the sharing of medical information between the two agencies. The hospital and the department can exchange information necessary to determine financial eligibility and they can also exchange medical information specified on the DSHS 14-012 consent form.

NOTE:

Naming the hospital on the signed DSHS 14-012 consent form does not make them an AREP; however, since the hospital is also name as an AREP on the application, they should be coded as an AREP in ACES.

WORKER RESPONSIBILITIES

For information regarding AREP for Long-Term Care cases see: Long-Term Care AREP or Long-Term Care for Families and Children.

An AREP may receive letters/notices/forms/warrants/EFT/ProviderOne service cards or they may have permission to only discuss the case and not receive any written correspondence. Record the representative's name and address on the AREP screen in ACES. The REP Type code on the AREP screen determines what forms, letters, etc. they receive. See the Authorized Representative Payee Chart.

NOTE:

There is no ACES code for being an AREP who doesn't receive written correspondence. The workaround for this situation is to record the AREP information in the Electronic Case Record (ECR). As soon as this functionality is programmed into ACES, the AREP form and this chapter will be updated.

2. At each review, check that the AREP information coded in ACES is consistent with what the client indicated on the review form. AREP designation is not valid after the certification period and should not be extended without confirming with the client that the AREP information is still valid. Document extensions or changes to the designated AREP in remarks behind the AREP screen in ACES.

3. If the client is completing their review over the phone without an eligibility review form and they are designating a new AREP, the client should complete a DSHS 14-532 AREP form. The worker should not add the new AREP until they receive the completed DSHS 14-532 AREP form or written confirmation from the client. Completing the DSHS 14-532 AREP form is not required if they are confirming or making changes to their current AREP.

4. Initial designation of an AREP by a client should be made on the application, review or DSHS 14-532 AREP form. Changes to an AREP can be made verbally but must be well documented in the remarks behind the AREP screen in ACES.

ACES PROCEDURES

Authorized Representative/Protective Payee