Authorized Representative

Authorized Representative During Incarceration

While an individual is incarcerated, the EW may only communicate with the AR listed on the SSApp and the cover letter. If, for any reason, the individual listed as AR on the SSApp and cover letter must be changed (i.e. turn over), a new AR form from page 15 in the SSApp is required. While in custody, the inmate authorizes the California Department of Corrections and Rehabilitation (CDCR) Transitional Case Management Program (TCMP) benefit workers to be their AR for purposes of assisting them in filling out the MC application and submitting the application. 

The AR is valid until the client cancels or requests a change in AR designation.

Responsibility WHILE Inmate is INCARCERATED

WHO

ACTION

TCMP (listed on the

pre-release cover letter and the SSApp)
  • Submit a new AR form from page 15 on the SSApp.
  • Contact worker via phone to confirm that the updated AR form was received.
  • Follow up with an email.
  • Provide the inmate with the contact information for the EW/District Office.

Eligibility Worker
  • Keep AR information up to date in CalSAWS.
  • Communicate and share information only with designated individuals/organizations.
  • Complete the pre-release application timely.

Authorized Representative After Release

The Authorization of Release of Information CDCR 7385-A form is submitted with the pre-release MC application to identify the individuals and entities who may request information both pre- and
post-release. These forms also identify the type of information that may be released, why the information is being requested and when the authorization expires.

Responsibility AFTER the Inmate is RELEASED

Who

Action

TCMP (listed on the pre-release cover letter and the SSApp)
  • No responsibility after the inmate is released

CDCR Parole Staff (listed on the CDCR 7385-A):

  • Parole Agents
  • Psychiatrists,
  • Licensed Clinical Social Workers,
  • Parole Services Associates,
  • Parole Administrators
  • Request and receive eligibility information after release for up to one year.

Eligibility Worker
  • Send all Notices of Action to the address listed in MEDS.
  • Communicate with designated individuals/organizations listed on the CDCR 7385-A and share only the specific information listed on the CDCR 7385-A until the date of expiration.
  • Contact the regional contacts to confirm that the requests for information are valid, if questions or issues arise.

Cancellation of the Authorized Representative

Submission of a new AR form implies that the previous AR is canceled. The EW must take appropriate action in CalSAWS to end the previous AR. Page two of the CDCR 7385-A identifies the specific date the client is canceling the AR. The agreement generally allows up to one year, for CDCR to provide continued assistance with MC coverage.

Related Topics

Juveniles in Public Institutions

Medi-Cal Inmate Eligibility Program (MCIEP)

Medical Parole and Compassionate Release