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Independent Choices Program (ICP)

Oregon Administrative Rules

OAR 411-030-0100

Tools

ICP Worker Guide

ICP Participant Handbook

ICP Letter to Participants Explaining Discontinuing Requirement to Return Cash Benefit

Program Descriptions & Brochures

Forms

ICP Forms Processing Chart

ICP Participation Agreement (English) Form DHS 2876

Representative Agreement

Payment Coupon for Workers' Benefit Fund Assessment

Notice of Eligibility and Responsibility (English) Form APD 0541

Notice of ICP Payment Ending (English) Form SDS 0540ICP

ICP Benefit Calculation 2 Week Authorization (English) Form SDS 0546IC2Wk

ICP Employee Provider(s) Information (English) Form APD 0548

Workers Compensation Consent and Agreement (English) Form APD 0353

ICP Request for Direct Deposit (DHS 7262I)

Budget and Payroll Forms and Samples

Budget Worksheet Print Version (Updated 03/24/2021)
Budget Worksheet Digital Version (Updated 03/24/2021)
Budget Worksheet Instructions
Completed Budget Worksheet - Sample
Six Month Budget Review Checklist
Six Month Budget Review Process (New 03/04/2021)
Budget Monitoring Review Letter (to be printed on local office letterhead) (New 03/04/2021)
Six Month Budget Review Coming Due Letter (to be printed on local office letterhead) (New 03/04/2021)

Coding for ICP

Acumen - Customer Service Phone Number (866) 235-4745

Acumen Referral Form
ICP Participant Letter with EVV Information
Acumen Referral Fact Sheet
Acumen EVV FAQs Brochure
Acumen FAQs
Acumen Introduction Power Point Material
Acumen Introduction Webinar Recording with Audio
Acumen Trifold Brochure
Acumen Request for Vendor Payment/Reimbursement Form
Acumen ICP Employer Enrollment Forms
- ICP Employer EVV Only 'Good to Go Notification' (FYI only-Acumen sends out when enrollment is completed) (New 12/22/2020)
- ICP Employer EVV Only 'Welcome Letter' (FYI only-Acumen sends out when enrollment is completed) (New 12/22/2020)
- ICP Employer 'How to Approve/Review Time in the Web Portal' (FYI only-Acumen sends out when enrollment is completed) (New 12/22/2020)
- ICP Employer EVV Email Template (FYI only-Acumen sends out when enrollment is completed) (New 12/22/2020)
Acumen ICP Provider Enrollment Forms (FYI only-Acumen will work with ICP providers to complete forms.)
- ICP Employee Provider EVV Only 'Good to Go Notification' (FYI only-Acumen sends out when enrollment is completed) (New 12/22/2020)
- ICP Employee Provider 'Time Entry Instructions' (FYI only-Acumen sends out when enrollment is completed) (New 12/22/2020)
- ICP Employee Provider EVV Only 'Time Entry Report Schedule for 07/2020 - 06/2020' (FYI only-Acumen sends out when enrollment is completed) (New 12/22/2020)

ICP FAQ Podcasts (Note: Please listen to the Podcast in Firefox or Microsoft Edge)

ICP FAQ Podcast 1.0 Recording (New 01/06/2021)
ICP FAQ Podcast 1.0 Script (New 01/06/2021)

Resources & Checklists

Web Links

For ICP information, please contact Christine Maciel, ICP Policy Analyst at: Christine.C.Maciel@dhsoha.state.or.us or icp.spd@dhsoha.state.or.us

Transmittals

Transmittal #	Date	Title
APD-PT-21-002	03/16/21	Policy: VDQ Certification Requirement
APD-IM-21-025	03/15/21	Info: OHCC Conditional Certifications
APD-IM-21-024	03/15/21	Info: OregonSaves Benefit for Homecare Workers and Personal Care Attendants
APD-IM-21-007	01/25/21	Info: Weekly Update for CM Tools Website (ICP SUTA Rate Change) (01/11/21-01/22/21)
APD-IM-21-004	01/19/21	Info: Carewell SEIU 503 Refresher Training Pilot
APD-IM-21-003	01/14/21	Info:COVID-19 Vaccine Informational Flyer Sent to Homecare Workers, Personal Care Attendants, and Individuals Who Receive Medicaid/Oregon Project Independence In-Home Services
APD-IM-20-136	12/11/20	Info: ICP Participants and Providers Online EVV Trainings Offered by Acumen
APD-IM-20-132	12/10/20	Info: Checks not mailed for Medical Related Payments and Daycare
APD-IM-20-131	12/09/20	Info:New Worker Training Series for Homecare and Personal Support Workers Now Available Statewide
APD-IM-20-124	11/19/20	Info: URGENT - Changes to Independent Choices and Special Needs Payments when Cases Converted to ONE at Wave 1
APD-IM-20-094	08/18/20	Info: Mandatory Training for Homecare and Personal Support Workers – Carewell SEIU 503 Training Begins Voluntary Pilot
APD-AR-20-068	07/06/20	Action: Independent Choices Program (ICP) Work to Prepare for Electronic Visit Verification (EVV)
APD-IM-20-071	07/02/20	Info: Carewell SEIU 503 CARES PTO benefit - Expanded Leave Benefit
APD-AR-20-066	07/01/20	Action: Independent Choices Program (ICP) Benefit Calculation Form Updated Due to Wage Increase Effective 07/01/2020
APD-IM-20-066	06/29/20	Info: Virtual Independent Choices Program training sessions now scheduled
APD-AR-19-056	12/20/19	Action: Independent Choices Program (ICP) Benefit Calculation Form Updated Due to Wage Increase and Wage Increase and WBF Rate Change for 2020
APD-IM-19-017	03/29/19	Info: New Fiscal Intermediary 'Acumen' for Independent Choices Program (ICP) Participants (Voluntary Program)
APD-PT-19-013	03/29/19	Policy: Independent Choices Program Cash Benefit Requirement Change
APD-IM-19-016	03/28/19	Info: Changes to the APD Receipting Solutions (APDRS)
APD-IM-19-006	01/23/19	Info: Independent Choices Program 2019 Taxes
OPAR-IM-18-002	04/24/18	Info: CMU Client Direct Deposit Procedure Changes
APD-IM-18-028	03/26/18	Info: Independent Choices Benefit Calculation form updated due to wage increase for 2018
APD-IM-17-095	12/29/17	Info: No new Independent Choices Program Benefit Calculation form needed
APD-AR-17-060	09/22/17	Action: Updated Independent Choices Benefit Calculation form due to Live-in Services closing and two week authorizations
APD-IM-17-053	07/14/17	Info: Letter for Individuals Currently Receiving Live-in Services
APD-AR-17-037	06/26/17	Action: Independent Choices Benefit Calculation form updated due to wage increase for 2017
APD-PT-17-019	06/15/17	Policy: In-Home Services Live-in Option Closure
APD-AR-17-002	01/19/17	Info: Independent Choices Benefit Calculation form updated due to wage increase for 2017satt
APD-IM-16-105	11/17/16	Info: UPDATED Direct Deposit form (DHS 7262i)
APD-AR-16-064	08/31/16	Action: In-home Service Options brochure
APD-AR-16-047	07/01/16	Action: Independent Choices Benefit Calculation form updated due to minimum wage increase
APD-PT-16-020	05/26/16	Policy: Homecare workers acting as consumer representatives *(Corrected)*
APD-IM-15-115	12/28/15	Info: UPDATED Independent Choices Benefit Calculation form (546ic)
APD-AR-15-076	12/23/15	Action: Indepenedent Choices Benefit Calculation form updated due to wage increase and tax rate changes for 2016
APD-PT-15-025	07/28/15	Policy: New Authorization Criteria for Live-in/Shift Services under the In-Home Services Program, Including the Independent Choices Program and Spousal Pay Program
APD-AR-14-076	12/24/14	Action: Independent Choices Benefit Calculation form updated due to wage increase and tax rate changes
SPD-AR-10-118	12/20/10	Action: Independent Choices Benefit Calculation Form Update and Workers' Compensation Forms
SPD-AR-10-117	12/20/10	Action: Workers' Compensation Consent and Agreement Form (SDS 0353)
SPD-IM-10-069	09/07/10	Action:Worker's Compensation Insurance for employee providers in the Independent Choices Program

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