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120 (07/2026) Chapter 2:Eligibility • Section 1: Application benefits, the ARs are disqualified. ODHS|OHA can disqualify them for one year after sending written notification of the disqualification to the individual and the AR 45 days prior to the disqualification. The notice must specify the reason for the disqualification, the disqualification period and the individual’s right to request a hearing. Note: Only one authorized representative is allowed per case. If a member would like the Department to share case information with an additional individual, the member may complete an MSC 3010 form. This form allows the Department to exchange case information with a second individual for a specified period of time. Please note that a request to share information with a non-case member does not mean the person is being designated as an authorized representative. An individual listed on the MSC 3010 is not considered an authorized representative and cannot complete renewals or take actions on behalf of the member. The form only authorizes the Department to share information with that individual. Click here for examples: Authorized representative. Oregon Administrative Rule(s) 461-115-0090 — Authorized Representatives; General 410-200-0111 — Authorized Representatives 414-175-0006 — Authorized Representatives Other resources Call Center Software Recordings and Verbal Signature: Responsibilities and AVS recordings and capturing a verbal signature in Agent Portal Web for filing dates, Applications, AVS consent, the Authorized Representative Verbal Signature, and individual waiving timely notice rights for medical. Alternate payee An alternate payee (AP) is an individual or organization authorized by another individual to obtain and use benefits for and in the best interest of the benefit group. When an AP is designated, ODHS|OHA may issue an electronic benefit transfer (EBT) card or other program benefits to the alternate payee. The following individuals may appoint an AP in writing on an Authorized Representative and Alternate Payee (MSC 0231) form: • The head of household, primary person, primary contact or authorized representative of any age, or • An individual given legal guardianship or power of attorney for an individual age 18 and older. An AP cannot be any of the following. Exceptions can be made at ODHS|OHA’s discretion when there are no other available AP options: • An individual serving a disqualification for an intentional program violation (IPV) • A person who may cause harm • A person who may have a conflict of interest including:
Landlords and other vendors of goods or items who deal directly with the individual, including retailers