111.01 Authorized Representative (AR) Acting in Place of the Individual (MAM)

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To act in place of the individual in the eligibility process, the authorized representative (AR) must be all of the following:

. an adult or agency.

. designated in writing using DFA Form 778, Authorized Representative Declaration, or using Appendix C if applying on DFA Form 800MA, Application for Health Coverage & Help Paying Costs. The individual who chooses an AR must complete all sections of DFA Form 778 or Appendix C.

. must be a person or agency who has:

- expressed concern for the individual's well being;

- sufficient knowledge about the individual's circumstances to assist in the application for and/or the continuation of assistance; and

- the capability of obtaining information about the individual's circumstances.

If the District Office establishes that an AR is not acting in the best interests of the client, notify the client of the circumstances so that the client may make an informed decision regarding the continuation of the individual as an AR.

References: He-W 601.01(w); He-W 603.01; 42 CFR 435.908(b); 42 CFR 435.923