RCO Customer Employee Forms


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Provider Application	QUALIFIED PROVIDER STATEMENT Oregon Administrative Rules (OAR) state that Seniors and People with Disabilities (SPD) dollars cannot pay for any work done by employees who are not qualified. Under OAR 411-340-0160(1), to be a qualified provider you must: Be at least 18 years of age; Complete and pass the Criminal History Records Check; Prior to working, confirmation must be received by RCO that you are authorized to work. This process may take from 2 to 8 weeks. If you are arrested and/or convicted of a crime, you must notify RCO and new criminal history check will need to be completed. Be legally eligible to work in the United States (See Form I-9); Not be a spouse of the customer; Possess the skills and training necessary to perform the job; Be a mandatory abuse reporter; Present copies of any licenses or certificates that are required for this job (Documents required by the State of Oregon or County Developmental Disabilities Office); Understand requirements of confidentiality and agree to safeguard the customer’s information; Not be on the Centers for Medicare and Medicaid Services list of excluded or debarred providers; and If driving is part of the job, you need to submit copies of your valid Driver’s License and current Certificate of Insurance for your automobile(s). Every time you renew your driver’s license and/or vehicle insurance, a copy must be sent to RCO. RCO may impose the following sanctions under OAR 411-340-0130(9)(b): The provider may no longer be paid with support service funds; The provider may not be allowed to provide services for a specific length of time or until specific conditions for reinstatement are met and approved by the Brokerage or Department, as applicable; or The Brokerage may withhold payments to the provider. Under OAR 411-340-0130(9)(a), RCO has the authority to sanction providers who have: Been convicted of any crime that would have resulted in an unacceptable criminal history check upon hiring or authorization of service; Been convicted of unlawfully manufacturing, distributing, prescribing, or dispensing a controlled substance; Had his/her professional license suspended, revoked, or otherwise limited, or surrendered his/her license; Failed to safely and adequately provide the services authorized; Had an allegation of abuse or neglect substantiated against him/her; Failed to cooperate with a Department or Brokerage investigation, or grant access to or furnish, as requested, records or documentation; Billed excessive or fraudulent charges or been convicted of fraud; Made false statement concerning conviction or crime or substantiation of abuse; Falsified required documentation; Not adhered to the provisions of OAR 411-340-0130(8) or 411-340-0140; or Been suspended or terminated as a provider by another agency within the Department. Back to Top QUALIFIED PROVIDER AGREEMENT By clicking "I Accept" below, you are stating you have read this page and understand your responsibility to maintain your status as a qualified provider. Additionally, you understand that you may not begin working for an RCO customer (or another RCO customer) until you have been told you are a qualified provider and may begin work by the customer and their Personal Agent.

Provider Application

QUALIFIED PROVIDER STATEMENT

Oregon Administrative Rules (OAR) state that Seniors and People with Disabilities (SPD) dollars cannot pay for any work done by employees who are not qualified.

Under OAR 411-340-0160(1), to be a qualified provider you must:

Be at least 18 years of age;

Complete and pass the Criminal History Records Check;

Prior to working, confirmation must be received by RCO that you are authorized to work. This process may take from 2 to 8 weeks.

If you are arrested and/or convicted of a crime, you must notify RCO and new criminal history check will need to be completed.

Be legally eligible to work in the United States (See Form I-9);

Not be a spouse of the customer;

Possess the skills and training necessary to perform the job;

Be a mandatory abuse reporter;

Present copies of any licenses or certificates that are required for this job (Documents required by the State of Oregon or County Developmental Disabilities Office);

Understand requirements of confidentiality and agree to safeguard the customer’s information;

Not be on the Centers for Medicare and Medicaid Services list of excluded or debarred providers; and

If driving is part of the job, you need to submit copies of your valid Driver’s License and current Certificate of Insurance for your automobile(s).

Every time you renew your driver’s license and/or vehicle insurance, a copy must be sent to RCO.

RCO may impose the following sanctions under OAR 411-340-0130(9)(b):

The provider may no longer be paid with support service funds;

The provider may not be allowed to provide services for a specific length of time or until specific conditions for reinstatement are met and approved by the Brokerage or Department, as applicable; or

The Brokerage may withhold payments to the provider.

Under OAR 411-340-0130(9)(a), RCO has the authority to sanction providers who have:

Been convicted of any crime that would have resulted in an unacceptable criminal history check upon hiring or authorization of service;

Been convicted of unlawfully manufacturing, distributing, prescribing, or dispensing a controlled substance;

Had his/her professional license suspended, revoked, or otherwise limited, or surrendered his/her license;

Failed to safely and adequately provide the services authorized;

Had an allegation of abuse or neglect substantiated against him/her;

Failed to cooperate with a Department or Brokerage investigation, or grant access to or furnish, as requested, records or documentation;

Billed excessive or fraudulent charges or been convicted of fraud;

Made false statement concerning conviction or crime or substantiation of abuse;

Falsified required documentation;

Not adhered to the provisions of OAR 411-340-0130(8) or 411-340-0140; or

Been suspended or terminated as a provider by another agency within the Department.

Back to Top

QUALIFIED PROVIDER AGREEMENT

By clicking "I Accept" below, you are stating you have read this page and understand your responsibility to maintain your status as a qualified provider. Additionally, you understand that you may not begin working for an RCO customer (or another RCO customer) until you have been told you are a qualified provider and may begin work by the customer and their Personal Agent.