DPSS ePolicy

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The California Manual of Policies and Procedures Sections 19-005.1 and 19-005.4, and the Welfare and Institutions Code Section 11206 indicate that information related to eligibility that was provided solely by the IHSS applicant/recipient contained in applications and other records made or kept by the County relating to the administration of IHSS, shall be open to inspection by the applicant/recipient or their AR.

Authorized Representative (AR)

An AR is a person who is at least 18 years old and has written authorization from the applicant/recipient to act on their behalf. A request from an AR may be received at any time; however, authorization must be granted by the applicant/recipient prior to the AR gaining access to the case records information.

Once authorization has been granted, ARs may receive information about the client, inspect and receive hard copies of non-privileged and non-confidential information contained in the case records regardless of whether the applicant/recipient is present.

Legal Representative

An individual with the legal authority to act on behalf of the applicant/recipient. This includes decision-making authority on the applicant/recipient's issues, including those related to the IHSS Program. A legal representative can be:

• A court-appointed guardian or conservator; or
• 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.

The legal representative is not required to complete an AR form to represent the applicant/recipient, including the review of the case records on behalf of the applicant/recipient.

Confidential Information

Information and documents that the applicant/recipient may not be authorized to inspect. Confidential information may include but is not limited to:

• Adult or Child Protective Services referrals;
• Domestic abuse;
• Information received from a third party that was not obtained pursuant to an authorization from the applicant/recipient;
• When a health care professional determines that inspection of a document would have a harmful effect on the individual's physical safety or psychological well-being if seen by the individual; and
• Welfare Fraud Prevention and Investigations (WFP&I) files.

Note: The applicant/recipient may have the right to inspect the WFP &I files only when the County has taken an administrative action and the applicant/recipient has requested a State Hearing contesting the basis for the administrative action. Prior to inspection, the County must redact or remove any confidential or privileged information from the WFP&I file. The applicant/recipient will have access to non-privileged, non-confidential information that the County has used in taking the administrative action.

Privileged Information

Information that is produced between two parties that the law recognizes as a private, protected relationship. Privileged information includes but is not limited to:

• Communication between attorney and client;
• Communications between physician/psychotherapist and patient; and
• Identity of informant reporting fraud or adult/child abuse.

If the applicant/recipient is the holder of the privilege, then they may have access to the privileged information.

Third Party Documentation

Information received by the County about the applicant/recipient that comes from a third party without permission from the applicant/recipient.

The State requires IHSS staff to comply with the following requirements regarding the release of case records:

Requirement and Limit/Condition

Release of Case Information to Applicants/Recipients

IHSS applicants/recipients are entitled to inspect non-privileged and non-confidential information/documents contained in their case records.  Therefore, IHSS staff must:

1. Comply with the request as expeditiously as possible;
   
   
2. Ask pertinent questions to assist in identifying the case records information they want to inspect.  Do not ask about the reason for the request;
   
   
3. Inform them of the types of information/documents contained in the Case Management, Information and Payrolling System (CMIPS) and in the Document Viewing Retrieval (DVR) System, that they are authorized to inspect;
   
   
4. Set up a reasonable timeframe for the inspection;
   
   
5. Review all information to redact and/or remove documents considered confidential/privileged.  Consult with County Counsel as appropriate to determine whether information or documents must be withheld or redacted based on privilege and/or confidentiality;
   
   
6. Secure a private setting for the inspection and assist during the review;
   
   
7. Provide reasonable accommodations as needed, due to a disability or lack of English language proficiency; and
   
   
8. Inform applicant/recipient of the dispute resolution process if they are dissatisfied or have issues regarding the case review process.

Release of Case Information to Public Officials

Except as provided in Section E. above, the case records review must be directly connected with the administration of the IHSS Program, including but not limited to, request for repayment, fraud investigations, civil or criminal prosecutions, audits, etc.

The following verifications are required when an applicant/recipient designates an AR to inspect their case records:

Category and Acceptable Documents

Written Authorization

SOC 839 (6/18), IHSS Designation of Authorized Representative.  A written authorization must include the name, address and telephone number of the AR, and must be signed and dated by the AR and the applicant/recipient. 

Note: If the applicant/recipient requests a State Hearing and wishes to name an AR to represent them during the hearing process, then they must complete the DPA 19, State Hearing Authorized Representative form instead of the SOC 839.  The forms must be provided in the applicant/recipient’s preferred written Department of Public Social Services (DPSS) threshold language.  If the form is not available in the preferred written language, staff must provide the English version of the form along with the GEN 1365, Notice of Language Services

Telephone Authorization

This authorization may be accepted in lieu of written authorization if the applicant/recipient has properly identified themself over the phone.  If staff is uncertain about the caller’s identity, they should ask for additional information to confirm the caller’s identity, i.e., case number, SSN, birth date, etc.

All telephone authorizations are temporary and must be followed up by written authorization, which may be faxed.

In-Person Authorization

An applicant/recipient is not required to provide a written authorization when the applicant/recipient is physically present, accompanied by another person, and verbally authorizes the person to act as his/her AR to inspect the case records.

Staff must ensure that the adequate forms of identification are provided by the applicant/recipient or AR prior to allowing the case inspection.