DD Brokerage Personal Agent Tools

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Welcome to the Brokerage Personal Agent Tools web page. Support Service Brokerages employ Personal Agents who help enrolled individuals develop an individual support plan, obtain available resources necessary to implement the plan, select people or organizations to provide specific support services, and monitor and evaluate the outcomes of delivered services.

On this page Personal Agents can find much of the information needed to help fulfill their role in the key functions of a Support Services Brokerage.

After consulting the resources below, as well as the brokerage's own internal resources, brokerage staff are encouraged to send unanswered, non-urgent, general policy and procedure questions to brokerage.questions@state.or.us to get further clarification.

Basic Brokerage References

• Rate Guidelines (effective 4/1/13)
• Rate Guidelines (effective 7-1-09)
• Benefit matrix for 4-1-13 Increase
• Support Service Administrative Rules
• Rate guideline information
• Expenditure guidelines
• eXPRS Login
• Relevant SPD transmittals
• County to County Transfer Guidelines
• DD Procedural Codes for Admin Exams v. 3

Forms

• DHS 60-01, Variance Request: (Word PDF)
• DHS 0203, Base Plus Tool
• Base Plus Tool Instructions
• DHS 0520, Title XIX Waiver
• Support Services Plan
• ISP Authorization Checklist
• Customer Goal Survey
• DHS 4111 Customer Information Update
• Crisis Addendum
• Environmental Adaptation over $5000
• Promissory Note (Individual)
• Promissory Note (Family)
• Geographic Service Area Exception
• Environmental Adaptation Final Inspection
• SDS 0705 Death Reporting Form
• SDS 0949 Notification of Rights (Word)
• SDS 0946 Developmental Disabilities Complaint Form (Word)
• SDS 0947 Notification of Planned Action (Word)
• SDS 0948 FACT SHEET for: Complaints, Grievances, Administrative Review and Medicaid Fair Hearings (PDF)
• SDS 0353 Workers' Compensation Consent and Agreement (Word PDF)
• SDS 0550 Developmental Disabilities Employer/Personal Support Worker/Domestic Employee Information (Word)
• What to do if you are injured on the job handout (PSW)

Other Brokerage References

• Policy and Practice Interpretations
• The Goal Loop (PowerPoint)
• TCM and Progress Notes
• Support Services Waiver
• A Road Map to Services - English
• Support Services FAQs
• Una Guia de Servicios de Apoyo. Edicion En Espanol
• Providers
  • Is a provider an independent contractor or domestic employee? Have providers contact the Employment Department Tax Staff for assistance.
  • Disability Compass
  • Rate setting manual
• ORS Chapter 427 (Chapter 427 covers persons with mental retardation and persons with developmental disabilities.)
• Brokerage contact information
• Supported Employment (Information about employment including links to VR and high school transition materials.)
• Crisis Matrix for Support Services

Other useful information

• CDDP Rule
• Housing assistance
• Disability Rights Oregon
• High school transition information
• BOLI (FAQ's contain useful information)
• Social Security Administration (SSA)
• SSA Representative Payee Program (When people need help managing their SS or SSI payments.)
• Supports for Adults with Developmental Disabilities

Other useful links

• Nursing Tools (including care giver self-study tools)
• Person centered planning
• Oregon Helps (benefits screening tool)
• The ARC of Oregon
• Oregon Developmental Disabilities Coalition