DPSS ePolicy

Code of Federal Regulations, Title 20, §416.1901 et seq. authorizes the SSA to reimburse the state or county agencies for IA payments made to SSI/SSP participants whose applications are approved or whose eligibility is reinstated.

As a condition for participation in the IAR program, SSA regularly conducts audits with the assistance of the California Department of Social Services to reveal the pattern of procedural errors and minor infractions involving record retention and use of the forms.

GR Program will follow guidance released by ACL 24-41, dated June 14, 2024, for CAPI which states that a TS with an audio recording is acceptable on the SSP 14 (09/10) in lieu of a wet signature. Staff is not required to obtain a wet signature in addition to a TS.

IAR

A payment SSA makes to reimburse a state that has provided IA in cash or through vendor payments to an individual for meeting basic needs.

SSI/SSP

The SSI Program is a federally funded program which provides income support to eligible individuals who are aged 65 or older, blind, or disabled. SSI benefits are also available to qualified blind or disabled children. The SSP Program is the state program which augments SSI.

SSI/SSP benefits are administered by SSA. Eligibility to both programs is determined by SSA using federal criteria. If an eligible individual qualifies for SSI, they qualify for SSP.

TS

A type of electronic signature that uses an individual’s recorded spoken signature or verbal assent in place of an actual written signature. The person being recorded must provide a verbal affirmation as to their understanding that the provided information is true and accurate.

A TS is considered a signature if the signatory understands that a TS is being used, consents to the use of a TS, and intends for the signature to have the same force and effect as a written signature.

IAR Agreement

The IAR agreement form jointly approved by SSA and the State of California is the SSP 14 Authorization For Reimbursement of Interim Assistance Initial Claim or Posteligibility Case (09/10).

To ensure the maximum amount of IAR is collected, each GR applicant/participant must complete and sign the SSP 14 (09/10) in their threshold language. Each completed agreement must indicate that the applicant/participant is making an Initial Claim (IC) or a Posteligibility (PE) case.

1. IC refers to the applicant’s/participant’s initial SSI/SSP application. The IAR is collected from the period that covers the month of initial application to the month the actual SSI/SSP payment begins.
2. PE case refers to the applicant’s/participant’s SSI/SSP re-application. The IAR is collected from the period that covers the month payments are resumed after a period of suspension or termination and ends with the month the actual SSI/SSP payment begins.
   
   Note: When in doubt as to whether the applicant/participant is making an IC or PE claim, the IC authorization box must be marked, as it will establish the protective filing date for SSI/SSP eligibility (one box per claim must be marked). If both boxes are marked or neither box is marked, the form is not valid and the IAR authorization may not be binding.

An IAR authorization is valid if the SSP 14 (09/10) is signed and dated by both the applicant/participant and the county representative. The SSP 14 (09/10) expires every 12 months.

A signed agreement remains in effect until:

1. One year from the date it is signed, if the applicant/ participant does not file an SSI/SSP application;
2. Less than one year, if the applicant/participant is denied SSI/SSP and fails to file for the next stage;
3. SSA makes a final determination (including a determination on appeal);
4. SSA releases the retroactive payment on a claim; or
5. LA County and the applicant/participant agree to terminate the authorization.

When one of the above occurs, the applicant/participant must sign a new IAR agreement if they are still receiving GR benefits.

If the SSP 14 (09/10) is expired, IAR may not be collected by the county from the applicant’s/participant’s first SSI/SSP check unless a new authorization has been signed by the applicant/participant and the county representative. If the county has collected IAR from an applicant’s/participant’s first SSI/SSP check when no valid authorization was in effect, the county is required to refund that money to the applicant/participant, regardless of the amount of GR or other benefits previously paid to the applicant/participant by the county.

Signature Types for the SSP 14

The SSP 14 (09/10) is valid if it has been signed using one of the following methods:

1. With a wet signature (pen and ink) by the GR/CAPI applicant/participant and a county representative; or
2. Via TS by the GR/CAPI applicant/participant and a county representative.

Note: The SSP 14 (09/10) signed telephonically must include the TS recording captured separately from any other form.

GR applicants/participants have the following options to return the completed and signed SSP 14 (09/10):

1. By mail or eFax;
2. Drop-off to the district office; or
3. Upload to BenefisCal.

Note: A photo upload of a completed and signed SSP 14 (09/10) is acceptable. The signature of the applicant/participant and date must be clearly visible.

GR applicants/participants can also complete the SSP 14 (09/10) over the phone by calling the Customer Service Center (CSC) at (866) 613-3777.