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 Program (ICP)

x Oregon Administrative Rules

OAR 411-030-0100 In-Home Services

x Tools

ICP Worker Guide

ICP Participant Handbook

Program Descriptions & Brochures


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

ICP Background Check Cover Page (New 07/15/2021)

Workers Compensation Consent and Agreement (English) Form APD 0353

ICP Request for Direct Deposit (DHS 7262I)

Budget and Payroll Forms and Samples

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

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

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

x Transmittals

Transmittal #



APD-IM-21-070 08/02/21 Info: Independent Choices Program (ICP) Training: Module Series Release
APD-AR-21-042 07/29/21 Action: ONE and ICP
APD-AR-21-039 07/16/21 Action: EDMS Update: Scanning HCW and ICP-PSW documents to EDMS
SS-PT-21-011 07/07/21 Policy: Oregon Minimum Wage Increase for 2021 Update
APD-IM-21-053 06/17/21 Info: ONE System Modifications (MRP Payments)
APD-IM-21-052 06/16/21 Info: Employee Providers of ICP Participants
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-21-003 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-20-131 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-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
OPAR-IM-18-002 04/24/18 Info: CMU Client Direct Deposit Procedure Changes
Action: Workers' Compensation Consent and Agreement Form (SDS 0353)
Action:Worker's Compensation Insurance for employee providers in the 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)