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______________________________________________________________________________ DIVISION OF WELFARE AND SUPPORTIVE SERVICES Child Care Policy Manual • A primary AR receives all requests for information along with any attachments plus all notices. They hold the same responsibility as the client in securing information for determining eligibility, reporting responsibilities and they are the only one authorized to sign on behalf of the client. Primary representatives have the same access to case information as the client. There can only be one active primary AR on the case at any given time. • A secondary AR is a before/after school provider who has limited responsibilities which are designated by the client. The secondary AR is not responsible for securing or reporting information, however, if they choose, they may secure and report information to the Child Care office. The secondary AR does not have the same access to case information as the client. A before/after school provider can be designated as a secondary AR to sign and date an attendance record. To designate an AR, the client and AR must complete the Designation of Authorized Representative, Form 2163-WC. The form must include the name, address and phone number of the person chosen as the AR and both the client and the AR must sign and date the form before the request can be processed. With each subsequent application, the designation of the AR is required. The original signed document must be kept in the eligibility case file and a copy provided to the client and AR. If the household member is physically or mentally incapable of signing their name, someone other than the AR must witness their mark. To qualify as an AR, the individual must be: • 18 years of age or older, • Designated by the client; and • Not providing child care services to the household except for a before/after school provider. Refer to secondary AR section above. Note: If the individual is a DWSS or Child Care employee, they must be related by blood or marriage to the client/participant to be the AR. In addition, if the AR is a Child Care employee, the AR must declare the relationship to management staff immediately and the individual must not be allowed access to the client/participant’s files (e.g. case file locked up, etc.). 122.1 Abuse by an Authorized Representative Authorized representatives may be disqualified from representing a household in the program if evidence is obtained that the AR has misrepresented a household’s circumstances and/or has knowingly provided false information pertaining to the household. In addition, the client and/or AR may be liable for any overpayment resulting from inaccurate information provided by the AR. 123 Required Forms at Application The following forms are required to be completed at each application unless the household has received a NEON funded subsidy. The original forms, signed and dated by the client, must be received prior to the authorization of subsidy benefits. Electronically transmitted (fax or email) signed forms are acceptable. Refer to MS 541 for additional information regarding NEON funded subsidy renewals. 123.1 Client Agreement 100-Program Overview [10] MTL 01/24 July 1, 2024