SOC 839 623 IHSS Designation of Authorized Representative Form

Instructions and help about ca authorized form

hi everyone i'm courtney flickinger i'm the communications specialist at direction home akron canton area agency on aging and disabilities hi my name is melanie spence i am a representative in the aging and disability resource center melanie is here with us today to walk us through the designation of authorized representative form um so what is an authorized representative well when an individual applies for medicaid they have the ability to choose an individual to be their authorized representative and what that person is it's a person that can receive information provide information and speak to the workers that are assisting with the medicaid application through the local county department of job and family service office so this form does need to be completed if you want anyone to assist you with your medicaid application provide information or receive information in the mail regarding your medicaid application your medicaid status this form is good as long as you will honor it wi