DHS home page
 <empty> Staff tools Local Offices News Jobs Forms Data About DHS Policies, rules, guidelines Publications Training
DHS home | APD staff tools | Case management tools |Independent Choices

Independent Choices

Updated: 5/10/2012

x Oregon Administrative Rules


OAR 411-030-0100

 

x Tools

ICP Participant Handbook

ICP Worker Guide (updated)

Program Descriptions & Brochures

Forms

  1. Forms Processing Chart
  2. Participant Agreement (updated)
  3. Representative Agreement (updated)
  4. Statement of Understanding
  5. Payment Coupon for Workers' Benefit Fund Assessment
  6. Notice of Eligibility and Responsibility (SDS 0541)
  7. ICP Benefit Calculation (SDS 0546IC) (updated)
  8. ICP Employee Provider(s) Information (SDS 0548)
  9. Workers Compensation Consent and Agreement (SDS 0353)
  10. ICP Request for Direct Deposit (DHS 7262I)
  11. Client Choice of Service Options (SDS 0914)

Budget and Payroll Forms and Samples

Coding for ICP (updated)

Resources & Checklists

Web Links

 

For ICP information, please contact Kelsey Weigel, ICP Program Coordinator at (503) 945-6413, email at: Kelsey.C.Weigel@state.or.us or icpspd@state.or.us

x Transmittals

Transmittal #

Date

Title
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-10-076 09/22/10

Info: Independent Choices Program - Second Notice Sent to Participants Regarding Workers' Compensation Coverage for Employee Providers
SPD-AR-10-085 09/28/10 Action: Independent Choices Program (ICP) - Workers' Compensation Coverage for Employee Providers
SPD-AR-09-056 12/23/09 Action: Independent Choices Benefit Calcuation form update
SPD-AR-09-047 10/28/09 Action: Independent Choices Program updates
SPD-PT-08-024 12/09/08 Policy: Independent Choices Program
SPD-IM-08-073 09/26/08 Info: Fall 2008-Training Schedule: HCW Terminations, Independent Choices, CAPS 2 and Case Management
SPD-AR-08-054 08/26/08 Action: Independent Choices Program Training and Statewide Rollout
SPD-PT-08-008 04/16/08 Policy: Independent Choices Program

 

If you have a disability and need a document on this Web site to be provided to you in another format, please contact the Office of Document Mangement (ODM) at 503-378-3486 or by e-mail at dhs.forms@state.or.us.
If you have questions about DHS or problems getting DHS services, send e-mail to dhs.info@state.or.us. If you have comments about this site, send e-mail to spd.web@state.or.us.
Oregon Department of Human Services
500 Summer St. NE E02, Salem, OR 97301-1073
Phone: (503) 945-5811
Toll-free: (800) 282-8096 (V/TTY)