Web Tutorial for PSWs How to Complete Enrollment with PCG Public Partnerships

What is PCG Public Partnerships? PCG Public Partnerships is Oregon’s Financial Management Agent Service (FMAS). Our job is to help people who employ Personal Support Workers (PSWs) manage the paperwork and responsibilities that come along with being an Employer. PCG Public Partnerships is responsible for issuing payment for the hours that you work. CME Webinar for enrolling new Employers and PSWs

Why did I get this packet? You have identified that you want to begin providing services to someone who receives developmental disability services. This person has also indicated that they would like to hire you to provide this service. In order for you to be paid for the hours that you work it is necessary for you to provide some information to PCG Public Partnerships. CME Webinar for enrolling new Employers and PSWs

Confirm information in Enrollment Packets If any of the information on this sheet is incorrect, please contact PPL’s customer service so information can be corrected and new forms can be mailed to you. Toll-free number – English 1-888-419-7705 Toll-free number – Spanish 1-888-419-7720 Toll-free number – Russian 1-888-419-7734 TTY 1-800-360-5899 Fax number (e-fax) 1-844-399-6593 E-mail address for Customer Service PPLORFMAS-CS@pcgus.com Customer Service Hours Monday – Friday, 8am-5pm PT (excluding State/Federal holidays) Information Session for PSWs and Employers

Before we get started… Forms to Complete Many of the documents in your packet are informational only. Please pull out the documents listed below before we get started. Forms to Complete Employees (PSWs) Signatures 1. Provider Information and Attestation Form (7 pages) PSW and Employer 2. I-9 Employment Eligibility Verification (3 pages) 3. W-4 PSW Only CME Webinar for enrolling new Employers and PSWs

Provider Information and Attestation Form # of pages: 7 Who needs to sign?: PSW and Employer What am I signing?: PPL uses this form to enroll someone in their system. It also tells PPL: How to manage withholding for Difficulty of Care payments How the PSW wants to be paid The relationship between the Employer and PSW for tax purposes Communicates responsibilities of a PSW in this program. Where do I sign? Both the PSW and Employer must sign this form on page 7 Note: PSWs must complete this form for every Employer they work for CME Webinar for enrolling new Employers and PSWs

Provider Information and Attestation Form Page 2: Preferred Method of Contact Service Recipient First and Last Name Your First and Last Name CME Webinar for enrolling new Employers and PSWs

Provider Information and Attestation Form Page 3: Difficulty of Care CME Webinar for enrolling new Employers and PSWs

Provider Information and Attestation Form Page 4: Payment Information Complete this page to inform PPL whether you would like payment via Direct Deposit (DD), ADP Aline Payroll (debit) card, or paper checks. Bank information is required for DD. Service Recipient First and Last Name Your First and Last Name CME Webinar for enrolling new Employers and PSWs

Provider Information and Attestation Form Page 5: Relationship Questionnaire Check off the Yes/No boxes to indicate your relationship to the employer; we use this to properly withhold your taxes and determine if eligible for exemption of FICA/FUTA withholdings. Information Session for PSWs and Employers

Provider Information and Attestation Form Page 6: Mutual Responsibilities Information Session for PSWs and Employers

Provider Information and Attestation Form Page 7: Signature Page Information Session for PSWs and Employers

I-9 Employment Eligibility Verification # of pages: 3 Who needs to sign?: PSW and Employer What am I signing?: The Employment Eligibility Verification Form I-9 is a U.S. Citizenship and Immigration Services form. It is used by an employer to verify an employee's identity and to establish that the worker is eligible to accept employment in the United States Where do I sign? PSW must sign and date page 1 where highlighted to the right. Employer must sign and date the bottom of page 2. Note: PPL cannot pre-populate this form due to DHS guidelines surrounding employer liability. Information Session for PSWs and Employers

I-9 Employment Eligibility Verification Section 1: 1 PSW to complete the following information: PSW (Employee) Demographic Information (including SSN) Checkbox verifying citizenship status Employee signature 2 3 Information Session for PSWs and Employers

I-9 Employment Eligibility Verification Section 2: Your Employer is to complete the following information: PSW name You will be required to provide documentation which verifies your identity. Depending on what type of documentation you provide your Employer will complete the information in List A or List B and C. PSW’s first date of employment Employer signature and demographic information Please reference page 3 of the I-9 form for more information on authorized forms of ID 1 2 3 4 Information Session for PSWs and Employers

I-9 Employment Eligibility Verification Do not fill out anything in section 3 Information Session for PSWs and Employers

Federal Form W-4 # of pages: 2. Page 1 is all that is required to be completed and returned. Who needs to sign?: PSW only What am I signing?: Complete this form so that PPL can withhold the correct federal income tax from your pay on behalf of your employer. Where do I sign? PSW must sign and date page 1 where highlighted to the right. Information Session for PSWs and Employers

Submitting Your Enrollment Paperwork: PSWs can send their completed packet in one of three ways: Fax: 1-844-399-6593 Paperwork E-mail: PPLORFMAS@pcgus.com Mail: Public Partnerships – OR FMAS PO Box 50040 Phoenix, AZ 85076 PPL will process all enrollment paperwork within 4 days of receipt. You will then receive an automated call from PPL either confirming your enrollment with PPL is complete or asking you to contact customer service to address any errors or missing forms. Information Session for PSWs and Employers

When can you begin work? The Answer: IT DEPENDS The ability to begin providing services as a Personal Support Worker rely on a variety of factors. Completing the enrollment paperwork with PCG Public Partnerships is just one piece. PSWs must also have: 1. A Completed Provider Enrollment Application and Agreement 2. A Criminal Background Check 3. A Signed and Active Job Description for the Person Being Served For more information about the status of these other requirements contact the Brokerage or CDDP you are working with. Information on how to register for eXPRS (the system for entering your timesheets) please visit: Information Session for PSWs and Employers

PPL contact information Customer Service hours Monday – Fridays, 8am-5pm PST (excluding State/Federal holidays) Toll-free number – English 1-888-419-7705 Toll-free number – Spanish 1-888-419-7720 Toll-free number – Russian 1-888-419-7734 TTY 1-800-360-5899 Fax number (e-fax) 1-844-399-6593 E-mail address for Customer Service PPLORFMAS-CS@pcgus.com Paperwork Submission e-mail address PPLORFMAS@pcgus.com OR FMAS Website for useful information http://publicpartnerships.com/programs/oregon/fmas This presentation along with other webinars, FAQs, and a Better Online user manual are posted on the PPL’s dedicated OR FMAS website: http://www.publicpartnerships.com/programs/oregon/fmas Information Session for PSWs and Employers