DPSS ePolicy

There has been a revision to existing policy and/or form(s)

 What changed?

1. Clarifies legal representative; and
   
   
2. Provides new and updated forms for the filing of Authorized Representative (AR) information and/or designation of a Timesheets and Other Provider-Related Documents (TPRD) signatory.

Note: Changes are shown highlighted in grey throughout the document.

Pursuant to Welfare and Institutions Code (WIC) Section 12300.3, an In-Home Supportive Services (IHSS) applicant/recipient may designate an individual to act as an AR for purposes of the IHSS Program. The AR is responsible to act in the applicant’s/recipient’s best interest and not as the applicant/recipient. The county must have access to the applicant/recipient in order to obtain necessary information for IHSS Program eligibility.

Additionally, Manual of Policies and Procedures (MPP) Section 30-769.723 specifies that a recipient must sign and date the IHSS timesheet. However, pursuant to WIC Section 12300.3(g), if the recipient is unable to sign the timesheet or other provider-related documents, their legal representative can authorize a person to sign on their behalf. The recipient’s provider cannot be designated as a TPRD signatory unless the provider is also the recipient’s legal representative (see Definitions).

Note: With the implementation of Electronic Visit Verification in Los Angeles County, recipients (or their legal representative or timesheet signatory) are required to approve/reject timesheets electronically, using the Electronic Services Portal, or telephonically, using Telephone Timesheet System. (See Administrative Release 5775, Electronic Visit Verification Pilot.)

Designating a TPRD Signatory

The SOC 839A, In-Home Supportive Services (IHSS) Designation of Signatory for Timesheets and other Provider-Related Documents (TPRD), (8/25), must be utilized when an IHSS applicant/recipient or their legal representative chooses to designate an individual to sign TPRD on their behalf (e.g., SOC 426A), also known as the TPRD signatory.

Designating an AR

The SOC 839, In-Home Supportive Services (IHSS) Designation of Authorized Representative, (8/25), must be utilized when an IHSS applicant/recipient or their legal representative chooses to designate an individual to function as their AR in any capacity. The applicant/recipient may have multiple AR’s, however, only one AR may serve as timesheet signatory.

The SOC 839 does not authorize an individual to act on an applicant’s/recipient’s behalf at a State administrative hearing. Such authorization may only be granted by having the applicant/recipient complete and submit the form DPA 19, Authorized Representative. The DPA 19 is available through the California State Hearings website: www.cdss.ca.gov/inforesources/State-Hearings.

Criminal Conviction and AR/TPRD Signatory Eligibility

A non-legal representative who would be determined ineligible to be an IHSS provider due to a Tier 1 or Tier 2 criminal conviction cannot serve as an AR or TPRD signatory. Additionally, a spouse or registered domestic partner with a Tier 2 criminal conviction, who is also the provider, cannot perform any AR functions other than signing the SOC 862, In-Home Supportive Services Program Recipient Request for Provider Waiver, (10/18).

Canceling an AR and/or TPRD Signatory

The applicant/recipient can request to cancel the authority of the designated AR and/or TPRD signatory at any time. However, the change in AR status will not be valid until a SOC 839B, In Home Supportive Services (IHSS) Cancellation of Authorized Representative, (6/23), has been completed and received by the county.

Note: Completed SOC 839, SOC 839A, and SOC 839B forms may be submitted by mail, by fax, or in person.

On October 9, 2015, Governor Brown signed Assembly Bill 1436, which added Section 12300.3 to the WIC. Section 12300.3 requires the California Department of Social Services (CDSS) to develop a statewide standardized form and procedures for an IHSS applicant/recipient to designate an AR for IHSS. In accordance with WIC Section 12300.3, CDSS developed three standardized forms: SOC 839 and SOC 839A, for IHSS applicants/recipients to designate an individual to serve as their AR and/or TPRD signatory, and SOC 839B to cancel their AR and/or TPRD signatory.

Authorized Representative (AR)

An individual who is at least 18 years old and has been designated by an applicant/recipient, on the SOC 839 form, to accompany, assist, and represent an applicant/recipient for specified purposes related to the IHSS Program, including, but not limited to:

1. The application process;
   
   
2. Direction of services; and
   
   
3. Redetermination of eligibility.

ARs may not sign their own TPRD form unless they are also a legal representative.

Electronic Services Portal (ESP)

An online service system where registered providers can view timesheet and payment status, request additional timesheets, enroll in direct deposit, claim sick leave, and submit timesheets electronically. Recipients can use this online service to approve or reject timesheets.

Legal Representative

An individual with the legal authority to act on behalf of the applicant/recipient that includes decision-making authority for purposes related to the IHSS Program. A legal representative is limited to the following:

1. A court-appointed guardian or conservator; or
   
   
2. If the applicant/recipient is a minor, a parent or other individual determined by the county to be the legally authorized decision-maker for the applicant/recipient.
   
   Note: An individual who has power of attorney over an applicant/recipient is not considered a legal representative for purposes of the IHSS Program.

Legal representatives may sign their own TPRD if they or the applicant/recipient complete and submit the SOC 839A form.

Power of Attorney

A written legal document that authorizes an individual to act on another’s behalf. Power of attorney is not court-appointed.

Tier 1 Crime

Disqualifying crime includes:

1. Specified abuse of a child, pursuant to Penal Code (PC) Section 273a(a);
   
   
2. Abuse of an elder or dependent adult, as specified in PC Section 368; and
   
   
3. Fraud against a government health care or supportive services program.

Tier 2 Crime

Disqualifying crime includes:

1. A violent or serious felony, as specified in PC Sections 667.5(c) and 1192.7(c);
   
   
2. A felony offense for which a person is required to register as a sex offender, pursuant to PC Section 290(c); and
   
   
3. A felony offense for fraud against a public social services program, as defined in WIC Sections 10980(c)(2) and (g)(2).

Telephone Timesheet System (TTS)

Self-service and interactive voice response telephone system that allows providers and recipients to submit, review, approve, and reject timesheets telephonically.

Timesheets and Other Provider-Related Documents (TPRD) signatory

An authorized individual chosen by the IHSS applicant/recipient or their legal representative, who can sign the timesheets or other provider-related documents, on the behalf of an IHSS recipient.

N/A

Minor Recipients

A parent or other individual determined to be a legally authorized decision-maker may act as the legal representative for a minor. They need to indicate the basis for their status on the SOC 839/SOC 839A and acknowledge that the information they are providing is true and correct.

An individual seeking to serve as the legally authorized decision-maker for a minor recipient (e.g., grandparent) must be authorized by the county and/or verified as such by the Social Worker (SW). Acceptable verification must be provided for the SW to make a determination.

Acceptable verification includes, but is not limited to the following:

• A custody order;
  
  
• Guardianship documentation;
  
  
• A Caregiver Authorization Affidavit with items 1-8 completed (see Family Code Section 6550 and 6552); or
  
  
• A statement signed by a parent granting another person power of attorney of the child. This statement must be either notarized or witnessed by two individuals who are not a party to the power of attorney agreement (see Probate Code Section 4121).

Adult Recipients

Court-appointed conservators may serve as legal representatives. These individuals may include spouses/registered domestic partners or other individuals serving as conservators. Legal representatives are not required to verify their status. They only need to indicate the basis for their status on the SOC 839/SOC 839A and acknowledge that the information they are providing is true and correct. However, should the county determine that an individual who signed the SOC 839/SOC 839A is not a legal representative, the information provided will be deemed null and void. Additionally, staff should initiate a fraud complaint if fraudulent activity is suspected and complete an Adult Protective Services report if financial or other abuse is suspected. (See Administrative Release 5372, Fraud Complaints, and Form Release 5435, SOC 341, Report of Suspected Dependent Adult/Elder Abuse.)

Individuals being designated as ARs and/or TPRD signatory are not required to be fingerprinted for a criminal background check, but they must acknowledge on the SOC 839/SOC 839A that they have never been convicted of a Tier 1 or 2 crime.

The county must not require or insist that the family seek a conservatorship over the applicant/recipient in order to process the applicant’s/recipient’s application for IHSS.

N/A