SSP 14

Eligibility Workers must follow the process and the time frame below to ensure the validity of the SSP 14:

• A new SSP 14 must be signed every 12 months. The SSP 14 is only binding for 12 months, therefore; the SSP 14 MUST be completed at each RRR. Copies are retained in Imaging.
• The SSP 14 must be completed entirely and correctly. To be valid, the SSP 14 must include:
  • Client's Name
  • Client's Social Security Number
  • Client's Address (If client is homeless, it must be noted in the address field)
  • County IA Agency (Santa Clara County Social Services Agency)
  • GR Code (05530) 
  • Correct Identification of action being authorized: Initial or Post eligibility claim (only one box must be checked)
  • Signature of the Individual receiving Interim Assistance and signature of the Eligibility Worker and,
  • Date
• If both “Initial” and Posteligibility boxes are checked the SSP 14 is NOT binding. Mark the box “Initial” for Initial payments. Mark the box for Posteligibility ONLY if the individual has been suspended or discontinued by SSA for whatever reason, and have appealed that decision to reinstate SSI and receive benefits.
• The SSP 14 must be explained to the client and must be signed and dated by both applicant/recipient and County Staff (County staff signs as “State Representative”) for the “Authorization” to be valid. 
• The completed SSP 14 must be received by Social Security Administration within 30 calendar days of the date it was signed. Santa Clara County is an Automated County since 1993, therefore, uses the electronic system to send authorization information to SSA. For Counties using the electronic systems, SSA must receive the authorization information within 30 calendar days of the state matching the client’s SSI record with the client’s state record. 
• A new SSP 14 must be completed when a GA client files for a new SSI/SSP application.
• SSA sends an eIAR communication when the “Authorization For Reimbursement” (SSP 14) is not received within the 30 calendar-day time line. Because our Agency missed the deadline, we are not eligible to receive the Interim Assistance reimbursement.
• The SSP 14 is NOT given to the client to take to SSA to apply for SSI. The only exception is when the County Code 43 is missing from the MEDS INQX screen.
• A copy of the signed SSP 14 MUST be in Imaging. Without a copy of the SSP 14 the County cannot recoup the IAR.