Authorized Representatives - NA
 
(01/01/21 - 12/31/21)
 
This policy is effective for all applications received on or after 12/01/2021. For applications received before 12/01/2021 use the prior policy.
 
The Primary Informant(g) can appoint an authorized representative. This must be done in writing on the the FAA-1493A form or the C034 notice.
 
An NA authorized representative cannot be any of the following:
 
A retailer involved in the acceptance of NA
A provider of prepared meals for the homeless, when they are representing a homeless recipient
A state agency employee involved in the issuance of NA, unless authorized in writing by the Region Program Manager (RPM)
An individual disqualified from receiving NA for an intentional program violation (IPV) during their disqualification period
 
NOTE When no one else is available to act as an authorized representative, the individual serving an lPV disqualification may act as the authorized representative. This must be attested to by the Primary Informant (PI) on the Authorized Representative Request (FAA-1493A) form or the Request for Authorized Representative (C034) notice.
 
The individual designated to act as the NA authorized representative must complete the following actions:
 
Complete the authorized representative section on the FAA-1493A form, or the C034 notice.
Check the appropriate box on the FAA-1493A form or C034 notice to indicate whether they are currently serving an NA disqualification due to an IPV.
Sign the form in the designated area.
 
NOTE When the PI has attested that the individual is the only one available to serve as the NA authorized representative on the FAA-1493A form or the C034 notice, the individual is not required to provide their date of birth.
 
FAA Staff must review the information to determine whether the individual selected as an authorized representative is serving a current NA disqualification due to an IPV. Determine whether the individual is eligible to act as an authorized representative as follows:
 
When the selected authorized representative is currently serving an NA disqualification for an IPV, they are not eligible to act as the authorized representative unless the PI attested to the fact that no one else is available on the FAA-1493A form or C034 notice.
When the authorized representative states they are not currently serving a disqualification for an IPV, review information in AZTECS as follows:
Search on the Client Inquiry (CLIN) Screen using the individual’s name and Date of Birth.
When the individual is keyed as DF in an active NA case, review AZTECS to determine whether they are disqualified for an IPV.
An IPV is indicated by an IP code displayed on the Program and Person Alerts (PRAP) screen.
When the individual is serving a current disqualification period, inform the PI that the individual is ineligible to act as the authorized representative unless there is no one else who can serve as the authorized representative.
When it is determined that the individual is not eligible to serve as an NA Authorized Representative, this must be documented in the case file(g).
When the individual answers that they are not currently disqualified for an NA IPV they are eligible to serve as the authorized representative when one of the following occurs:
AZTECS data and case file documentation does not indicate the individual has been disqualified for an IPV.
The individual cannot be located in AZTECS.
Document the case file to indicate the individual is eligible to act as the NA authorized representative.
 
NOTE When the selected individual is currently serving a disqualification for an IPV and the PI names a different individual, the steps above must be repeated for the new individual.
 
Participants who live in a Group Living Arrangement (GLA) and decide to have an authorized representative, may choose either of the following based on their abilities:
 
The authorized representative of the GLA
Their own authorized representative
 
Participants who live in an eligible drug or alcohol treatment center must have an authorized representative. The authorized representative must be an employee of the center.
 
Policy and procedures regarding NA authorized representatives are outlined as follows: