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

2. 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

3. 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

4. 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
Toll-free number – Spanish
Toll-free number – Russian
TTY
Fax number (e-fax)
address for Customer Service
Customer Service Hours
Monday – Friday, 8am-5pm PT
(excluding State/Federal holidays)
Information Session for PSWs and Employers

5. 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

6. 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

7. 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

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

9. 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

10. 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

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

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

13. 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

14. 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

15. 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

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

17. 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

18. Submitting Your Enrollment Paperwork:
PSWs can send their completed packet in one of three ways: Fax: Paperwork Mail: Public Partnerships – OR FMAS PO Box 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

19. 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

20. PPL contact information
Customer Service hours
Monday – Fridays, 8am-5pm PST (excluding State/Federal holidays)
Toll-free number – English
Toll-free number – Spanish
Toll-free number – Russian
TTY
Fax number (e-fax)
address for Customer Service
Paperwork Submission address
OR FMAS Website for useful information
This presentation along with other webinars, FAQs, and a Better Online user manual are posted on the PPL’s dedicated OR FMAS website:
Information Session for PSWs and Employers