IC 12-20-7
    Chapter 7. Consent to Disclosure of Personal Information

IC 12-20-7-1
Consent; form; filing
    Sec. 1. (a) Each applicant and each adult member of theapplicant's household seeking township assistance must consent toa disclosure and release of information about the applicant and theapplicant's household before township assistance may be provided bythe township trustee. The consent must be made by signing a formprescribed by the state board of accounts. The form must include thefollowing:
        (1) The applicant's name, case number, and address.
        (2) The types of information being solicited, including thefollowing:
            (A) Countable income.
            (B) Countable assets.
            (C) Wasted resources.
            (D) Relatives capable of providing assistance.
            (E) Past or present employment.
            (F) Pending claims or causes of action.
            (G) A medical condition if relevant to work or workfarerequirements.
            (H) Any other information required by law.
        (3) The names of individuals, agencies, and township trusteeoffices that will receive the information.
        (4) The expiration date of the permission to discloseinformation.
    (b) Information that is declared to be confidential by state orfederal statute may not be obtained under the consent formprescribed by this section.
    (c) The township trustee shall keep on file and shall makeavailable to the division of family resources and office of Medicaidpolicy and planning upon request a copy of the signed consent formdescribed in subsection (a).
    (d) The township trustee shall send to the county office a copy ofthe signed consent form described in subsection (a).
    (e) The division of family resources, county offices, and the officeof Medicaid policy and planning shall make available to thetownship trustee upon request a copy of signed consent to disclosureand release of information forms in each entity's files.
    (f) If an individual who is required to sign a form under thissection is unable to sign the form in the township trustee's office dueto a physical or mental disability or illness, the township trustee shallmake alternate arrangements to obtain the individual's signature.
As added by P.L.2-1992, SEC.14. Amended by P.L.4-1993, SEC.193;P.L.5-1993, SEC.206; P.L.46-1995, SEC.57; P.L.51-1996, SEC.31;P.L.259-2001, SEC.5; P.L.73-2005, SEC.39; P.L.145-2006,SEC.115.
IC 12-20-7-2
Information to township trustee
    Sec. 2. (a) The county office shall provide the followinginformation to each township trustee located in the county:
        (1) Information that will identify the types of public assistancethat are being provided to the individual who signed the consentform and the individual's household.
        (2) Information that will identify the amount of publicassistance that is being received by the individual who signedthe consent form and the individual's household.
        (3) Information that will identify the number of individuals inthe household of the individual who signed the consent formwho are receiving public assistance.
        (4) Information regarding the income, resources, or assets ofmembers of the individual's household receiving publicassistance.
    (b) The county office must provide the information required undersubsection (a) not later than fourteen (14) calendar days afterobtaining the information.
As added by P.L.2-1992, SEC.14. Amended by P.L.4-1993, SEC.194;P.L.5-1993, SEC.207; P.L.46-1995, SEC.58; P.L.51-1996, SEC.32.

IC 12-20-7-2.5
Information provided to township trustee by department ofemployment and training
    Sec. 2.5. Upon request of the township trustee, the department ofemployment and training services shall provide without chargeinformation regarding:
        (1) income, resources, and assets of; and
        (2) benefits received by;
members of an applicant's household.
As added by P.L.51-1996, SEC.33.

IC 12-20-7-3
Salary and wage information
    Sec. 3. Upon request of the township trustee, the employer of atownship assistance applicant or a member of the applicant'shousehold shall provide the township trustee with informationconcerning salary or wages earned by the applicant or householdmember for purposes of determining the financial eligibility of thehousehold to receive township assistance.
As added by P.L.2-1992, SEC.14. Amended by P.L.51-1996, SEC.34;P.L.73-2005, SEC.40.

IC 12-20-7-3.5
Provision of information to determine eligibility
    Sec. 3.5. Upon request of the township trustee, a person holdingassets or title to assets of a township assistance applicant or amember of the applicant's household shall provide the townshiptrustee with information concerning the nature and value of those

assets for purposes of determining the household's financialeligibility to receive township assistance.
As added by P.L.51-1996, SEC.35. Amended by P.L.73-2005,SEC.41.

IC 12-20-7-4
Use of consent forms
    Sec. 4. The division of family resources and county offices shalluse the consent forms received under this chapter to do thefollowing:
        (1) Assist in making eligibility determinations for publicassistance programs administered by the division of familyresources and county offices.
        (2) Assist in reducing fraud and abuse in public assistanceprograms administered by the division of family resources andcounty offices.
As added by P.L.2-1992, SEC.14. Amended by P.L.4-1993, SEC.195;P.L.5-1993, SEC.208; P.L.145-2006, SEC.116.

IC 12-20-7-4.5
Authorized use of information
    Sec. 4.5. The township trustee shall use the information receivedunder section 2 of this chapter to assist in reducing fraud and abusein aid programs administered by the township trustee.
As added by P.L.46-1995, SEC.59.

IC 12-20-7-5
Use of information not a public record
    Sec. 5. Information that is received through the use of a consentform described in section 1 of this chapter and that is not a publicrecord open to inspection and copying under any statute may be usedonly in connection with the following:
        (1) The administration of the township trustee's townshipassistance program.
        (2) The administration of public assistance programs that areadministered by the division of family resources and countyoffices.
As added by P.L.2-1992, SEC.14. Amended by P.L.4-1993, SEC.196;P.L.5-1993, SEC.209; P.L.73-2005, SEC.42; P.L.145-2006,SEC.117.

IC 12-20-7-6
Unauthorized use or disclosure of information
    Sec. 6. A township trustee, an assistant of a township trustee, oran employee or a director of the division of family resources, theoffice of Medicaid policy and planning, and county offices whoknowingly discloses or uses information that is obtained through theuse of a consent form described in section 1 of this chapter, exceptas authorized by this chapter, commits a Class A misdemeanor.
As added by P.L.2-1992, SEC.14. Amended by P.L.4-1993, SEC.197;

P.L.5-1993, SEC.210; P.L.145-2006, SEC.118.