1. Homecare Worker Orientation
Welcome!
Go over Classroom Guidelines
Schedule
Orientation is scheduled until 1:30 PM. You must attend the entire orientation to receive credit.
You will have one 20-minute break at approximately 10:30 AM.
If you must leave early due to an emergency, please let us know and we will contact you with your options to complete orientation.
Cellphones
Please silence your cellphones
If you must take an urgent call, quietly exit the room through the doors to your right
Pay Attention - No Sleeping
You are responsible for understanding the materials covered in class today.
If you are sleeping or not paying attention, we may ask you to leave and you will not get credit for attending the class.
Feel free to stand, stretch, get water, and eat anytime during class to help you focus.
Write your questions down
Most questions are answered throughout the presentation. Please wait for the designated time to ask questions.
Restrooms
Restrooms are located directly outside the main classroom doors to your left.
Please, do not take phone calls in the hallway or inside the restroom at any time
Do not linger in the hallway for any reason- return directly to class when you are done
Exiting the Classroom
If you need to leave for any reason, go out the doors to your right
If you are returning to class, come to the back door and we will let you in.
Germs - Its Cold & Flu Season!
Tissue and hand sanitizer are provided at the back of the classroom for your use
Please sanitize or wash your hands after using a tissue, sneezing, coughing, touching your face, and each time you use the bathroom.
Homecare Worker Orientation

2. What You’ll Learn Today
What HCWs are and what they do
How to become a HCW
The employment relationship
Professionalism: Roles and Expectations
What a Task List is
How HCWs get paid
The travel time policy

3. What You’ll Learn Today
Oregon Home Care Commission (OHCC)
OHCC Registry and Trainings
Confidentiality
Mandatory Reporting & Types of abuse
Safety and Universal Precautions

4. Why Being a HCW is Important
Aging and People with Disabilities’ In-Home services are designed to protect a person’s independence, dignity and choice and enables people to stay at home.
YOU are an important part of making that happen!
Portland Business Journal April
Over 60,000 Oregonians receive care in their homes and in long-term care communities
In ,031 Oregonians were 65 or older. Of that 84,668 were over the age of 85
Estimated by 2035 There will be 173,634 Oregonians over the age of 85
Keep in mind, this is only our Aging population.
Oregon ranked 4th out of the 50 United States on AARP’s Long-Term Services and Supports State Scorecard
The first Assisted Living Facility (in the US) was opened in Oregon in 1985
In 1981 Oregon was the first state to apply for a waiver to offer Medicaid funded services outside of nursing facilities
This program allows aging and people with disabilities access to care while maintaining dignity, choice, and independence.
Thank you for being here today. You are who make this program successful.

5. What Does a Homecare Worker Do?
HCWs help seniors and people with disabilities live at home as safely and independently as possible.
Personal care/ ADL/ Activities of Daily Living:
bathing, dressing, grooming, hygiene, toileting, moving around,
bowel and bladder care, and eating.
Cognition – Decision Making, Ability to Understand & Communicate Needs, Challenging Behaviors
Household tasks/IADL/ Instrumental Activities of Daily Living:
housekeeping, laundry, meal preparation, and shopping.
medication and oxygen management, wound care, and transportation
What Does a Homecare Worker Do?
HCW Guide Chapter 1 (pgs. 3-7)

6. All HCWs are professionals
Types of Homecare Workers
Career HCWs
Can work for anyone on an hourly basis who qualifies for Medicaid in-home services.
Restricted HCWs
Can work on an hourly basis for only one specific consumer.
Career HCWs
Can work for any Consumer-Employer who has been approved for Medicaid in-home services.
Restricted HCWs
Can only work for a specific Consumer-Employer (family member/friend)
Restriction may be removed later on as determined by the background check unit
All HCWs are professionals
All HCWs are professionals

7. What do I need to know to get started?

8. To enroll, you must: Attend this Orientation and
Be at least 18 years old
Fill out an application
Prove you can legally work in the U.S. (I-9)
Have a legal name that matches your SSN
Have an approved background check
Sign a Provider Enrollment Agreement
Have the skills, knowledge and ability to work
Fill out a W-4 for tax withholding
Trainer Notes:
Be at least 18 years old
Born on or before today’s date in 2001
Fill out an application
Prove you can legally work in the U.S. (I-9) - (e.g., birth certificate, passport or driver’s license), which must be viewed by the local APD/AAA office in order to complete the I-9 form. You must present original, unexpired documents for your I-9 (no photo copies; no expired ODL)
Have a name that matches your SSN – This will be verified before you are given a provider number
Have an approved background check –
Sometimes, fingerprints are required.
This is rechecked every 2 years.
Failure to list every conviction could result in being denied.
Processing 2 to 8 weeks
Sign a Provider Enrollment Agreement
Sign a confidentiality agreement
We will sign as witness
Have the skills, knowledge and ability to work
Example: sleeping in class
Fill out a W-4 for tax withholding
After your application has been approved and have passed your background check, you will be issued a provider number from the APD central office in Salem. This provider number shows you are enrolled in the Consumer-Employed Provider Program. It is used for issuing provider payments to you. 8

9. HCW Provider Number A 6 digit number assigned just to you.
You cannot be paid as a HCW without having a current, valid provider number.
It is YOUR responsibility as a HCW to know when your provider number expires and to renew it on time (look on the Registry).
You must begin the renewal process a minimum of 70 days before your credential expires by contacting the local office.
If not, there is no guarantee your paperwork will be completed in time and you cannot work and can’t be paid.
Trainer Notes: - Each click reveals line.
Once you complete the enrollment process, you will be assigned a provider number by DHS. This is a six digit number and it is used to identify you as a HCW and you must have one in order to get paid. You will see your provider number on your payment voucher, Task List, and remittance advice. You will use this number on the Registry and on the paperwork you will fill out during trainings.
When you call the local APD office or the OHCC, they may ask for your provider number. It’s a good idea to memorize your provider number or keep it where you can easily find it.
Your provider number must be “active” to get paid. In order to keep your number active, you must renew your credential by making sure to renew your background check on time. If you don’t do your background check on time, your provider number will expire and you won’t be able to work or get paid.
Your provider number may also expire if you don’t work and receive payment within a 12-month period. If that happens, you will have to go through the entire enrollment process again. If you do not have an active provider number, you will not be referred out on the Registry.
There are several reasons why your provider number could be terminated, which means you will be disenrolled from the program and will no longer be able to work as a HCW (see next slide).
If you do not have an active provider number you will not get paid. Even if you have been verbally authorized to work., you will not get paid. If it your responsibility to make sure you have an active provider number.

10. Medicaid Provider
As a HCW, you are a Medicaid Provider and must follow Medicaid rules.
If you do not, you could:
Not get paid
Lose your provider number
And for fraud and abuse, go to jail
KNOW THE RULES

11. Common Rule Violations You can lose your provider number for:
Committing abuse;
Taking or borrowing money or items belonging to your employer.
Neglecting your employer’s service needs.
Verbally abusing your employer
Committing fraud
Claiming hours not worked.
Forging a signature or falsifying payment records.
Working unauthorized overtime.
Training Notes:
Each click reveals line.
Your provider number is more than a number to use for payment. It signals that you have the privilege of being approved to provide support services to seniors or people with disabilities. These are just some of the reasons you can lose your provider number.
Committing abuse;
Neglecting your employer’s service needs. – Remember if you have concerns about the consumer’s health or safety, you should notify the CM.
Verbally abusing your employer – this can mean yelling at them, cursing in their presence or at them.
Committing fraud
Claiming hours not worked. This includes going to your consumer-employer’s home and not performing tasks on the task list. You are being paid to perform those tasks. If you are doing other things, chatting, watching TV etc….it may be fraud.
Forging a signature or falsifying payment records.
Working unauthorized overtime.
It also means that you are held to particular standards which include:
Confidentiality.
Respecting appropriate boundaries.
Honoring boundaries around finances/money/services.
Treating each person with respect.
Helping the person you support avoid being abused.
Reporting any suspected abuse.
Telling the truth – especially about the hours you work.
Being a responsible employee (not drinking or using drugs while at work).
Do not bring people or pets to the consumers’ home without your consumers’ permission.
Always show up to work on time
If you have questions about what you are asked to do for your consumer, contact the consumer’s Case Manager

12. You can lose your provider number for:
Sharing something that is confidential, even with someone you think you can trust.
Don’t give someone else your voucher to turn in
Do not use your voucher for employment verification
Being intoxicated in the workplace or while working.
Repeatedly being late or absent from work.
Training Notes: Each click reveals line.
The individuals you serve are depending on you. This means that you are meeting their needs and that you are protecting their confidentiality.
Sharing something that is confidential, even with someone you think you can trust like your spouse or children.
Don’t give someone else your voucher to turn in
Do not use your voucher for employment verification
Do not talk about your consumers with anyone but the consumer, their representative (if they have one), the community LTC Nurse or the CM. Your consumer may ask you to speak to someone else like their doctor or pharmacy. That is allowed.
If you are at the local office, please speak quietly when speaking about your consumer.
Being intoxicated while working.
Repeatedly being late or absent from work
Remember, it is a privilege to be a HCW. If you cannot meet expectations, you may lose your provider number and be unable to be a provider.

13. Employment Relationship
HCW Guide Chapter 2 (pgs. 8-13)

14. HCWs have a unique employment relationship
Your application and payment records are processed and approved by the local APD/AAA office.
You are employed by the person receiving services (consumer). You are not a state employee.
Your payment is processed and mailed by the State of Oregon.
To get paid, you must keep your address up-to-date with the local office.
Trainer Notes
Provide information about your local office – whether APD, AAA, Local government
The employer may also have his or her own application for the worker to fill out. This is not the same as the provider application required by the state.
In the Independent Choices Program, you are paid directly by the consumer. 14

15. Who is your employer?
Your EMPLOYER is the consumer who hires you to work. You may have several employers at one time.
Your employer is NOT your “client.”
Having a client implies you provide direction.
Having an employer means the individual directs you.
The people receiving services in the in-home program have free choice in managing their lives and making decisions about the services that they receive and who provides them.
Your employer makes decisions on hiring and firing homecare workers.
Medicaid Consumer/Client
Your Employer not your client
Employer implies giving direction
Employer can always their own decisions, even bad ones
If you believe there is a risk to their safety, please contact the case manager
Hiring/firing- For any reason
*** You do not and should not allow harm or risk to yourself as a result of the Employer’s poor choices***
Oxygen and smoking example.
“Do not have light yourself on fire to keep other people warm”
Get to safety and immediately call EMS, CM, Employer’s Emergency Contact/Rep
The Home Care Commission offers a voluntary training program for consumers to learn about their responsibilities and tips for hiring and managing workers 15

16. Your Relationship with Your Employer
Your employer defines their expectations including;
Your work schedule, time off, and if you’ll be late for work;
Your Task List;
How and when he or she would like a task done;
House rules;
Whether you need training on how to do a specific task;
Any work-related concerns or questions you have;
Signing your voucher AFTER you have worked all your hours;
What do to in an emergency;
Whom you can talk to (i.e. employer’s family; physician; pharmacy, etc.).

17. When to Contact the Case Manager
Changes in your employer’s condition;
Questions about the Task List;
Concerns about your employer’s well-being;
Work concerns you can’t resolve with your employer;
Safety issues;
Working more hours than authorized due to an emergency;
Issues related to travel time or mileage;
Using paid time off;
When you are no longer working for your employer.
Trainer Notes:
Case Manager Presents slides
Each click reveals line.
The Homecare worker is usually the person who has the most frequent contact with the consumer/employer.
1st Bullet: Workers should discuss any changes in conditions, abilities, etc. with the employer and suggest he or she talk to the case manager and/or primary care provider. Case managers need to be notified of any hospitalizations.
Hand out the Home Care Commission Communication Guidelines and discuss how and when the HCW should call the case manager.
4th Bullet: You should always try to resolve work related problems with your employer first. However, there may be times you and your employer need more help in resolving an issue. Some examples of work related issues are:
Frequent schedule changes
Repeatedly being asked to do things not on the task list
Problems setting and maintaining professional boundaries
Challenges with completing tasks on the task list
Behavioral challenges that impact your ability to do your job
Consumers choosing not to take medications or receive services on the task list
5th Bullet: Please let your case manager know if there are safety issues in your consumer’s home either because of the environment, something happening in the home, or being asked to provide services that are unsafe. Examples include:
Being asked by your consumer to manually transfer her even though she requires a hoyer lift
Vicious animals that are not locked up
Loaded firearms being left out
Physical aggression towards you either by the consumer or someone else in the home
Domestic violence
Drug manufacturing in the home
Rotting floor boards

18. Reasons to contact the local office
Changes in your address or telephone number;
To provide an updated copy of your CPR/First Aid card;
Questions about your provider number, credential, or background check status;
Questions about your voucher or payments;
Trainer Notes:
Each click reveals line.

19. Professionalism
HCW Guide Chapter 3 (pgs )

20. Be a professional by:
Respecting your employer’s wishes, preferences, beliefs, customs, and routines.
Not assuming you know what’s best for your employer.
Setting and maintaining professional boundaries.
Not oversharing about your personal life.
It is NOT professional if you are:
Taking over or being overly involved in your employer’s life.
Making decision for your employer.
Trainer Notes:
Each click reveals line.
1st Bullet: Remind HCW’s that it is important to respect the employer’s wishes.
HCW’s should NEVER impose their beliefs or lifestyles on the people they work for. Discuss ways that people might have different customs, routines, etc.
Such as:
Types of food
Religious holidays
Cleanliness of the household
Beliefs in God or higher power – and sometimes NO belief in a higher power
Attitudes about political issues
2nd Bullet: Homecare Workers should never assume to know what is best for the employer. Employers have the right to make their own decisions, even if they are ones you don’t agree with.
3rd Bullet: Being aware of your professional and personal boundaries is important for you and your employer. It’s best to establish them at the beginning of your working relationship. Boundaries are limits about what you will or won’t allow or do. They are meant for your well-being and protection and they help you decide what types of communication, behavior, and interactions are appropriate. A lack of boundaries is like leaving the door to your home wide open, anyone, including welcome and un-welcomed guests can walk in without hesitation.
4th Bullet: It’s fine to share information about yourself as a way of building rapport and a good working relationship. You may find you and your employer have several things in common. Make sure, however, you aren’t sharing too much or too often. Ask yourself whether it’s appropriate to share the information. You and your employer are not each other’s friend, counselor, or confidant. Don’t share information because you need to talk or to help you feel better. If there is information you prefer to keep private, it is ok to say that. It’s natural to care for the people you help. Realize, they care about you, too. Sharing too much can be burdensome, especially if you are talking about problems you may be having. Your employer will worry when you share your troubles.
5th Bullet: This is especially important in setting and maintaining professional boundaries. You are paid to provide authorized services as a homecare worker, not to become a friend or confidant. Remember your role is providing help with what’s on your task list or job description. That’s it.
6th Bullet: Your role is not to make decisions on behalf of your employer, especially related to services, health, finances, or medical care. You take direction from your employer, not the other way around. Although your employer may want you to be present during his or her reassessments, your role is not to make decisions about what is on the service plan or what information your employer should or should not share with the case manager or personal agent. Never talk for your employer. You should not present yourself as a decision-maker when your employer is in the hospital or direct hospital staff to contact you to discuss medically related issues.

21. Be a professional by: Refusing to break the law or bend the rules.
Not doing special favors, giving gifts, or accepting gifts or money from your employer.
Not borrowing anything from your employer or accepting loans.
Doing what’s right even when no one is looking.
Communicating in a respectful and appropriate manner.
Treating others the way they want to be treated (Platinum Rule).
Trainer Notes:
Each click reveals line.
1st Bullet: As a homecare worker, it is your responsibility to know what the State rules and policies are. You can lose your ability to work as a homecare if the rules are broken. You may be asked to do things for other people in your employer’s home since “ you are doing the laundry anyway.” Providing services to others in the home you are not authorized to work for is against the rules. It is also against the rules to accept more money from employers or their family members on top of what you are paid as a Medicaid provider. As an example, a daughter may want to give you a couple of more dollars per hour than what you get as a Medicaid provider. A daughter may ask you to work extra hours for mom and will pay you under the table. This is definitely against the rules. If in doubt, ask your employer’s case manager.
2nd Bullet: Are you treating this employer differently than your other employers? Part of being ethical is showing equal courtesy and respect to all your employer, not just “favorites.” Do not accept money or gifts from employers. Perishable items, such as food or flowers, are generally not a problem as long as they are of a minimal value and are not considered payment for work. But any item could be considered a gift and could result in an investigation.
3rd Bullet: Borrowing from your employers or accepting loans from them, is against the rules, is considered a fiscal impropriety, and you could be terminated as a worker. Even if you are your employer’s family member or close friend, this can cause problems. Do not take over financial issues for your consumer. You may assist at their request but cannot move money or make financial decisions for them.
4th Bullet: Be ethical and have integrity. This means choosing to do the right thing.
5th Bullet: Not only does this include with your employer, but with the local office, as well. You must be professional at the local office and on the phone.
6th Bullet: The Platinum Rule recognizes that everyone is different and how you want to be treated may not be the same as what someone else wants. This mean you need to get to know the person and what matters to them. People have different religions, cultures, values, preferences, personalities, and communication styles.

22. Be a professional by: Being positive. Being an adult.
Demonstrating “grace under pressure.”
Showing up.
Looking like a professional
Wear clean, work appropriate clothing
Have good personal hygiene and grooming habits
Trainer Notes:
Each click reveals line.
1st Bullet: : Focus on what is positive. Focus on your employer’s strengths and what he or she can do. Being around someone who is negative is draining.
2nd Bullet: This means taking responsibility for your actions, words, and attitude. It is also about being accountable ,dependable, and consistent. Others count on you. Being an adult is accepting feedback and recognizing it’s just part of the job, it isn’t personal. It’s great to be young at heart, but don’t act childish.
3rd Bullet: This means staying cool and calm when you are under stress and not melting down in front of your employer. Keep things in perspective, breathe, and take a quick break if you need one.
4th Bullet: Not only do you physically report to work on time and are ready to work, you show up mentally. Be present in the moment and give your employer and the work you do your full attention. There is such as thing as “presenteeism.” This is when you physically show up, but your heart and mind aren’t into the work you are doing. You are there without really being there, which is not safe for you or your employer, especially if you help with transferring, medications, driving, or supervision.
If you accept a job interview, show up. If you are unable to make it for some reason, call the consumer and let him know right away. Being a no show is a prime example of unprofessionalism. You do not want to have a reputation as being unreliable.
Return phone messages of consumers who are interested in interviewing you, even if you are declining.
Have good phone etiquette, with consumers and DHS staff. If you are calling a local office, be polite and clearly state who you are, your provider number, and why you are calling.
Your address and voice mail message can make the difference between getting a job or no. If you are going to use them as part of your career, make sure they are appropriate and professional.
5th Bullet: Remember, even though you are working in an informal setting like someone’s home, it’s important to look like a professional. This shows you take your work seriously and take pride in what you do. Just as important, is having good personal hygiene and grooming habits, especially since you will physically work closely with your employer.

23. Service Plan & Task List
HCW Guide Chapter 4 (pgs )

24. The Service Plan and Task List
When you are hired by a consumer, you will receive a Task List from the case manager. It shows:
How many hours you are hired to work each month.
What types of support you will provide.
Any other specific information needed to do the job.
Trainer Notes:
You should receive a Task List from the case manager before starting work. It is like a job description. If you do not receive one, contact the case manager right away.
What’s on the Task List is based on an assessment and is determined by the case manager and consumer.
If you do not understand something on the Task List, make sure you ask. It’s important to know what you are being paid do to and what the expectations are.
How and when tasks are done is determined by your employer.
You can only be paid for authorized tasks.
You can only provider service to the eligible consumer identified on the Service Plan and Task List.
If you have questions about whether you should be providing services, contact the case manager.
Ask questions of the employer about the tasks to be done and clarify expectations.
HCW’s must not perform work that is not on the Task List because:
The state cannot pay for work not on the list
The HCW is not covered under Worker’s Compensation insurance if injured doing tasks not on this list.
Funds for homecare cannot be used to provide services for anyone other than the intended recipient or for services not covered under the state in-home programs
Your employer determines how and when tasks are done.
The Task List does NOT authorize you to provide help in the hospital.

25. Unauthorized Services
You cannot help with some things because Medicaid
will not pay you to do it. This includes, but is not
limited to:
Yard work
Pet care
Moving or relocating the consumer/employer
Caring for the employer’s children or grandchildren
Services that benefit the entire household (e.g. making family meals, everyone’s laundry, etc.)
Trainer Notes:
More examples of non-authorized services:
Home repair or maintenance, such as roofing, carpeting, painting
Gardening, carrying and using yard equipment
Caring for farm-type animals
Sewing or tailoring clothing
Vehicle maintenance and cleaning
Purchasing illegal or recreational drugs for the employer
Helping with finances
Running personal errands other than shopping or picking up medications.
Refer to next slide: Discuss what the workers should do when asked to do a non-authorized task. (It’s OK to say no). Remind them that if they wish to do unauthorized tasks it is strictly as a volunteer and they are not covered by worker’s compensation 25

26. What You Can Say…..
If asked by your employer to help with something not on your Task List: “I am paid by the state to do certain tasks and I could lose my provider number if I don’t do them or do something that’s not on my Task List. Maybe we should talk to your case manager about this.” “I’m concerned that I could be injured doing this activity and I’m not covered under my Workers’ Compensation plan if it’s not on my Task List.” “I’m not sure that is something I can do under the state rules. Let me talk to your CM before I say yes.”
Trainer Notes:
Read the examples and then ask if anyone has any other examples. 26

27. Hand out a sample task list and review each section
CONSUMER-EMPLOYER NAME
Consumer-Employer Address
City, State
Zip Code
CM Name
HCW Name
123456
Consumer-Employer Name
Medicaid ID
Trainer Notes:
Hand out a sample task list and review each section 27

28. Consumer-Employer Name
Consumer-Employer Address
City, State
Zip Code
Medicaid ID
CM Name
Consumer-Employer Name

29. Payment for Services
HCW Guide Chapter 5 (pgs )

30. Important Note: Before you start working with a consumer
Confirm that your credential (e.g. background check) and provider # are active and valid AND You are authorized to work OR You may not get paid! DO NOT WORK UNTIL YOU HAVE THE PROVIDER NUMBER AND THE VOUCHER.
Authorization to work is the voucher, Do not work without the voucher. If you start work before you receive the voucher, you will NOT be paid.
If you expected to receive a voucher and did not receive one, contact the local office before you start working.

31. Registry – Credential Information
Trainer Notes
Let workers know that at the bottom of the Personal Info Page on the Registry they can see their credential date. This is the date their background recheck is due. If they do not do this, they will stop being paid. It’s the worker’s responsibility to know their date and make sure to take care of background rechecks to avoid any loss in pay.

32. Payment Information
Work week = 12:00 AM Sunday through 11:59 PM Saturday
CONSUMER-EMPLOYER NAME
PRIME ID
HCW NAME
HCW #
Trainer notes:
Go over voucher with attendees.
The second page of the voucher has the service plan authorization information at the top. If any of this information is incorrect contact a worker right away!
Each time you receive a voucher you should confirm the following information in this area is correct:
Recipient name and number
Your name and your provider #
Case worker information
Service period auth.
Hours authorized
Any mileage that was authorized
DO NOT CHANGE ANYTHING IN THE AUTHORIZATION PART OF THE VOUCHER. DO NOT PHOTOCOPY THE VOUCHER AND MAKE CHANGES FOR ANY REASON.
THIS INCLUDES WORKING OUTSIDE THE SERVICE PERIOD AUTH ON THE VOUCHER.
REFERENCE:
HCW Time Tracking Sheet
Tool to track hours as a backup. Not a voucher.
REVIEW:
HCW must have a voucher before starting to work for a consumer
All shifts must be written on the voucher, including the date, start and end time
Check the authorization section on each voucher to make sure it is for the correct period, correct consumer, and correct number of hours. Call the consumer’s Case Manager if you have any questions
In order to be paid, your voucher must be legible and must be signed by the HCW and the consumer or consumer's authorized representative
HCW may not be paid for hours that are not prior authorized
If an emergency situation happens after hours, and you must work more hours than authorized for your consumer, HCW may be paid if they contact the consumer’s Case Manager within two business days and explain why they had to work more than the authorized hours
HCW can be paid for prior authorized mileage when they must drive to perform duties from a consumer’s task list
A HCW may never sign a voucher in the “employer/Rep Signature” field
A HCW may never ask a consumer to sign an incomplete voucher
HCW should keep a backup record of their dates, start times and ends times
CASE MANAGER NAME 32

33. Payment Information You may NEVER sign as the Employer Training Notes:
By signing this form, you are saying you worked all of the days and times you recorded. If you did not really work all the days and times you turned it, this is considered Medicaid fraud and it is a crime.
The lower portion of the voucher has the signature fields for you and your consumer/employer.
This area must be signed by both you and your employer AFTER all services have provided for the authorized period
The fourth page (back page) has a new section for Notes to Case Worker.
This is an opportunity to provide some care notes to the case worker on a regular basis
This section is not to be used for reporting or requesting extra hours or vacation.
PLEASE DO NOT USE THIS TO TELL THE CM ABOUT CONCERNS ABOUT THE CONSUMER’S HEALTH OR SAFETY. Please call the CM about these issues.
Signing you worked hours/days you didn’t is Medicaid Fraud and is a crime.
You may NEVER sign as the Employer 33

34. Payment Information
Use the following steps to make sure that you receive your correct paycheck in a timely manner:
Once your employer has hired you and notified the case manager, you will receive a payment voucher.
Know how many hours you have for the pay period and schedule your work to stay within the authorized hours.
Make sure all the fields are completed (date; a.m.; p.m.; time in/out.
Write legibly (if it can’t be read, it will be returned to you to fix which will delay your pay).
DO NOT MAKE ANY CHANGES TO THE PRE-PRINTED FIELDS
Trainer Notes:
Each click reveals line.
If you have more than one employer, you will receive a payment voucher for each employer. *When you receive your voucher review the information and make sure all is correct. Make a copy of your completed voucher to keep for your files.
Do not turn in the voucher before the end of the payment period. If you haven’t received a check within 10 days of submitting a completed voucher to the local office, please call the local office. 34

35. Payment Information Verify that the days and time worked are accurate.
After you have completed all service hours for the pay period, have your employer sign it. Do not ask the employer to sign a blank or incomplete voucher.
Then you sign it and mail it or drop it off at the local APD/AAA office.
Make sure you have provided the most current mailing address.
Any errors on the voucher may result in delays in being paid.
Trainer Notes:
Each click reveals line. 35

36. Payment Information
10. HCWs are not allowed to provide group services (claiming hours for doing the same task for multiple consumers at the same time). Examples: taking all your consumers’ laundry home to launder at the same time; shopping for all your consumers’ groceries during the same shopping trip. All tasks for different consumer-employers should be completed separately. 11. If you are an HCW and PSW – you can’t claim hours on your voucher you worked as a PSW and vice versa. Example: As a HCW, you wrote on your voucher you worked Monday from 8:30 a.m.-10:30 a.m. and then entered the same date and time in eXPRS as a PSW. This is Medicaid fraud.

37. Payment Information
If an emergency comes up or you end up substituting for another worker, you must let the CM know within two business days or you will not get paid.
You can only be paid for prior authorized hours
Trainer Notes:
Each click reveals line. 37

38. Common Voucher Errors
Claiming more hours than you are authorized for payment;
Incomplete information;
Not having the payment voucher signed by you and your employer;
Using a pencil to fill out or sign the payment voucher (ink is required);
Trainer Notes: 3 slides of errors: 1 of 3
1st Bullet: Most common reason 38

39. Common Voucher Errors
Covering mistakes with correction fluid — instead, cross out any mistakes with one line and have your employer initial all corrections;
Entering time incorrectly. Document the actual time you start working and stop working. Do not just write in a standard time;
Mailing or submitting your payment voucher before the last day you worked in the pay period — the payment voucher should be mailed after completion of the service hours for the payment period;
Trainer Notes: 2 of 3 39

40. Common Voucher Errors The numbers or writing cannot be read
be sure to write clearly;
Claiming more mileage than you are authorized;
Mailing the payment voucher late.
Trainer Notes: 3 of 3 40

41. Important Notes
Overtime: IF you repeatedly work more than 40 hours per week and have not been approved to do so, you provider enrollment can be terminated. Working Extra Hours: IF you work more hours than authorized due to an emergency, you MUST contact the consumer’s case manager within 2 business days. IF you repeatedly turn in vouchers with more hours than authorized, your provider enrollment can be terminated.
Trainer Notes:
An emergency may be you consumer becomes ill or an HCW who is scheduled to relieve you calls in or doesn’t show up. If this happens when the local office is closed, leave a message. You must get authorization from the case manager within 2 business days in order to claim more hours on your voucher. 41

42. Follow the Payroll Calendar for:
Vouchers
As of 10/1/17, vouchers are issued for a fourteen (14) day pay period. It starts on a Sunday and ends 14 days later on a Saturday.
Follow the Payroll Calendar for:
Voucher submission deadlines - if you miss it, your voucher won’t be paid until the next Pay Day
Pay processing dates
Trainer Notes
Emphasize that if they miss the voucher submission deadline, their voucher won’t be paid until the next Pay Day.
Pay Processing Date – Checks may be received 1-3 business days after the check date, depending on mail service.
If you have direct deposit: Direct deposit will be available 3 business days after the pay process date. check with your financial institution to found out when your direct deposit will be available. 42

43. Payment Timelines
You must turn in your voucher to the local office no later than close of business on the Wednesday following the end of the two week pay cycle (remember, it ends on a Sunday). This is called the HCW voucher submission deadline.
The pay processing date is eight (8) business days after the HCW voucher submission deadline. If this falls on a holiday or agreed upon office closure, this date will be moved to the next business day.
Trainer Notes:
Remind HCWs to refer to their payroll calendar. It shows the date vouchers are due and when the pay processing dates are.
HCWs can submit a timesheet prior to the end of the pay period as long as you have completed all work shifts for the consumer.
1st Bullet: If the local APD/AAA office is closed expectantly, you will be given more time to turn in your voucher. For instance, if the office was closed one business day, you would be given another business day after the original deadline. 43

44. Payment Timelines
Paper paychecks will be issued and mailed no later than eight (8) business days after the HCW submission deadline. Direct deposits will be sent to the HCW’s financial institution on the pay processing date.
If pay processing dates have to be extended because of an unexpected office closure, we will let you know by posting the information on OHCC’s Facebook page.
Trainer Notes:
Remind HCWs to refer to their payroll calendar. It shows the date vouchers are due and when the pay processing dates are.
Remind HCWs to notify the local APD/AAA office right away if his or her address changes. They need to also make sure that the banking account they are using for direct deposit is not closed. They will need to fill out a new direct deposit form to change account information. 44

45. If there is a problem with how you reported your hours on your voucher:
The local office will let you know within 24 hours that you need to fix it – Make sure your contact information is up-to-date.
You will be given the opportunity to correct the voucher before it is processed for payment. Take action as soon as you hear from the local office. Otherwise, your payment may be late.
Trainer Notes 45

46. When you get paid:
You will receive a Remittance Advice. Put it somewhere you can easily find it.
Check the remittance advice carefully to make sure it is accurate.
Always read any messages at the bottom of the remittance. They contain important information.
Trainer Notes
You may need your remittance advice if you apply for a loan or for some other reason. Keep your RA’s where you can easily find them. It will take more time if you have to contact the local office for a copy. When you use the RA, make sure to black out the name of your employers because this is confidential information. 46

47. More payment issues Mileage Tax withholding Direct deposit
Unemployment
For purposes of unemployment, the State of Oregon represents the employer.
Trainer Notes:
Hand out (if not done previously) the Direct Deposit Authorization (DHS 189) and explain
If you change your address, it is important to notify our office. If you have direct deposit set up and change banks, you need to cancel the Direct Deposit
If the HCW is “laid off” due to change in services, consumer relocating, or being let go without cause, they may qualify for unemployment.
If applying for unemployment, the employer of records is the Homecare Worker program, 500 Summer St NE, E-10 Salem, OR Do NOT give the consumer/employer’s name. 47

48. If you no longer want to be a HCW:
Notify the local APD/AAA office in writing:
The last day you will be providing or had provided services for all consumers.
That you intend to not work with additional consumers in the future.
You will be paid on the next regularly scheduled pay date if you turn in a valid voucher.
Trainer Notes 48

49. Travel Time HCW Guide Chapter 6 (pgs. 34-35)
REFERENCE:
Travel Time Tracking Sheet
SAY:
Homecare Workers are now paid for travel time between employers. There are some rules to this:
You must be going directly from one job to the next.
You will be paid for the shortest/fastest distance.
You may stop to fill up your gas tank or use the restroom.
Travel must take less than one hour
Travel hours can take up no more than 10% of a HCW’s total paid hours
Travel time must not overlap with hours of care provided to the consumer
Use the travel time tracking sheet to claim travel hours
Information if asked:
What if I am traveling between someone receiving services from ODDS and someone who is receiving services through APD? Can I be paid for that time?
Yes. This is also handled through a paper process – only for the travel between a person receiving services in one program to someone receiving services in another program. Any time between employers within the ODDS system, must be billed through eXPRS.
Additional information: APD-AR (
HCW Guide Chapter 6 (pgs )

50. Travel Time Policy
You can only be paid for travel time if you provide authorized services for more than one employer on the same day.
You must be going directly from one job to the next. You do not get paid for traveling to/from your home (even if you and an employer live together).
You will be paid for the most direct and reasonable route.
If the time took longer than expected, document why it took so long.
Trainer Notes:
Each click reveals line.
Travel time is paid at the base rate, even if you receive a differential based on professional development certification, helping someone who qualifies for the QVD rate, or because you are an enhanced HCW.
Travel time must be authorized and must occur on the same day you work for more than one employer during that day.
If there is a significant break in time while going to one home to another, you may not be paid. A significant break is defined as 60 minutes. An example is stopping for lunch or doing personal errands. You do not get paid from traveling from your home to your employer’s home, even if you and an employer live together.
A publicly-available web-based mapping program such as MapQuest or Google Maps will be used to determine the most direct route and the amount of time to allow for travel. If it takes longer to get from one employer’s home to another due to unforeseen construction, traffic, or weather incident, provide documentation whenever possible. You can do this by writing it on the travel form or another piece of paper. 50

51. Travel Time Policy
If your mode of transportation is not a personal vehicle, write in the mode of transportation next to “from address.”
Travel must take less than one hour.
Travel time can take up to no more than 10% of the total authorized hours you worked during each pay period.
Trainer Notes:
Each click reveals line.
Other modes of transportation can include walking, bicycle, scooter or wheelchair, bus, other forms of public transportation.
6. Refer to travel time worksheet: As an example, if you are worked a total of 40 hours for the pay period, your travel time can’t be more than 4 hours for that time period. 51

52. Travel Time Policy
Travel time must not overlap with hours of care provided to the consumer.
You do not receive mileage reimbursement for travel time.
Use the travel time tracking sheet to claim travel hours. They can be audited.
Time spent on personal business will not be paid.
Trainer Notes:
Each click reveals line.
7. It can be considered fraud if you claim travel time and hours working for someone at the same time. For instance, you can’t document you drove from 9:00-9:30 am, but on your timesheet, you wrote that you were working for consumer A from 9:00 -9:30.
Although you get paid for the time it takes to travel, you will not be reimbursed for mileage during that time. You only get mileage reimbursement for service related transportation if you have been authorized.
Make sure to keep a copy of the form.
10. Personal business includes, but is in no way limited to: grocery shopping, stopping at your home, stopping at a family member of friend’s home, or stopping for lunch. 52

53. Travel Time Policy
You may stop to fill up your gas tank and use the restroom in between consumers’ homes but these are short stops.
The Department is not responsible for vehicle damage or personal injury sustained when you use your own person vehicle or community transportation, except as may be covered under workers’ compensation.
Trainer Notes:
Each click reveals line. 53

54. Travel Time Policy
You must provide verification to the local APD/AAA office that your driver’s license and automobile insurance are up-to-date if you will be using your own personal vehicle for authorized transportation. Proof of insurance can be your auto liability insurance identification card, or other document you receive from your insurance company proving you have current insurance coverage.
You must provide insurance verification a minimum of every six (6) months, or as frequently as you renew your policy.
Trainer Notes: 54

55. Travel Time Tracking Sheet
Make sure you read this statement carefully before you sign it.
If you sign it, but you did not really report actual dates and times, it is considered Medicaid fraud.
Trainer Notes:
Click reveals 2nd part of line.
Pass out travel time tracking sheets and go over it. Next slides include example of sheet filled out and the maximum payable travel time calculation. 55

56. Travel Time Tracking Sheet
HCW Name
HCW #
11/24/19 to 12/07/19
11/24/19
Address of Consumer-Employer 1
9:00
9:30
11/24/19
Address of Consumer-Employer 2
Use this space to explain longer than normal travel time
Prime # can be found on the voucher 56

57. Maximum Payable Travel Time Calculation
Program
Hours Worked
Base Rate
Gross Wages
Maximum Allowable Travel Time Wages
Maximum hours of compensable travel time
APD 40
$14.65
$586.00
ODDS
AMH
Total Gross Wages
.10
$58.60 4
HCW Travel Time Compensation may not exceed 10% of gross wages for the pay period
Use the table above to calculate your Maximum Allowable Travel Time Wages
Enter the total hours worked for each program during the pay period (14 days)
Multiply the total hours for each pay period by the rate of pay
Add up the gross wages under “Total Gross Wages”
Multiply the Total Gross Wages by 0.10 (for 10 %).
This calculation equals the maximum allowable travel time wages for the pay period
Divide the maximum allowable wages by the base rate ($14.65 in 2019 or $15.00 in 2020)
This calculation equals the maximum hours of compensable travel time for the pay period

58. The Role of the Oregon Home Care Commission
HCW Guide Chapter 7 (pgs )

59. The Oregon Home Care Commission’s Role
The Oregon Home Care Commission (OHCC) has five major responsibilities when it comes to you and the work you do. The OHCC:
Defines homecare worker qualifications;
Created and maintains a statewide Registry of homecare workers;
Provides training opportunities for homecare workers;
Serves as the “employer of record” for purposes of collective bargaining.
Trains consumers on how to be successful employers.
Trainer Notes
The Home Care Commission was formed in 2000 by a constitutional amendment. The citizens of Oregon voted to amend the constitution to create the Oregon Home Care Commission in Oregon Home Care Commission (OHCC) is responsible for ensuring the quality of home care services funded by Department of Human Services (DHS) for seniors, people with physical disabilities, those with intellectual and developmental disabilities, and those who experience mental health concerns.
It provides training opportunities for active homecare workers who can be paid for their time when attending training.
The Commission maintains a statewide registry for matching homecare workers and client/employers.
You will use the Registry to be referred for work, keep track of your credential, and sign up for trainings.
You have the option of attending more than 25 free trainings offered by the Commission.
The Commission also provides workers’ compensation coverage when you are doing things on your Task List 59

60. The Registry http://or-hcc.org Training Notes:
The Registry is an online system that matches people looking for work with people looking for workers.
The Registry matches people who are receiving Medicaid services to people who have been approved to provide those services.
The first time, workers click on the Register button. They will need their provider number and must create a user ID and password. Each must have at least 6 characters. (Tip – since user IDs must be unique, try adding numbers in the middle if the name they select is not accepted).
If someone forgets the name and password they made up, call the Home Care Commission, at
Workers must log in to the Registry and fill in all the information in order to be referred for work. The local office will not add any information for you EXCEPT the date of this orientation and your CPR certifications when we view your original cards. You must log in to update your information every 30 days, or you will not be referred for work.
Be sure to check the Help Wanted Ads in the Registry. This is one way to take the initiative in finding work through the Registry
ALSO IMPORTANT -- when no longer looking for work, change the availability page to “not looking”. You can change your status anytime.
Encourage workers to create and add a Personal Statement
Workers can check Help Wanted for employer’s posting positions. It is IMPORTANT to check the details before calling someone.

61.
Select:
Seniors and Adults with Physical Disabilities
Trainer Notes
Each click reveals color portion of slide.
Point out the address field where they should type the address.
They then click on the Seniors and Adults with Physical Disabilities section.
The next slide shows the log in page
To find the RRS, type “ in the address field of your internet browser 61

62. If you forget your login,
Trainer Notes
The first time, workers click on the Register button. They will need their provider number and must create a user ID and password. Each must have at least 6 characters. (Tip – since user IDs must be unique, try adding numbers in the middle if the name they select is not accepted).
If someone forgets the name and password they made up, call the Home Care Commission, at
Workers must log in to the Registry and fill in all the information in order to be referred for work. The local office will not add any information for you EXCEPT the date of this orientation and your CPR certifications when we view your original cards. You must log in to update your information every 30 days, or you will not be referred for work.
The class “Ready*Set*Work is a good one for new workers looking for work. It explains how to use the Registry and all workers with a provider number can be paid once a year for attending whether working or not.
If you forget your login,
call 62

63. Benefits of using the Registry
Sign up for training
Keep track of what classes you have taken.
Keep track of certifications earned related to this work.
Check your criminal history check renewal dates.
To continue to be able to be matched in the registry, Homecare Workers should:
Complete four (4) approved training courses each year.
Complete at least one safety class every two years.
These guidelines are outlined in the Collective Bargaining Agreement

64. Training and Career Development
HCW Guide Chapter 7 (pg. 37)

65. Training Opportunities
Free training is available to HCWs.
Approved classes count toward the yearly training requirement.
Register for classes:
Online: OR-HCC.org By
By phone:
The Oregon Home Care Commission offers over 24 different classes that workers can attend.
Examples:
Diabetes By the Numbers
Helping Caregivers Fight Fraud and Abuse
Keeping It Professional
Heart Healthy
Medication Safety
Preventing Disease Transmission

66. Benefits of Training You become more marketable on the Registry.
If you are actively working, you may be paid for your time to attend the class.
After attending training, you may qualify to attend a paid CPR/First Aid class.
You will meet training requirements to be referred on the Registry.
To receive a training newsletter, contact the Home Care Commission at 1– or
visit the OHCC website.
Trainer Notes
“Actively working” means having paid hours in any one or more of the 3 months prior to a class and/or the month of a class.
The Home Care Commission pays the cost of CPR/First Aid training for actively working HCWs who have completed 2 training classes and have a no-show rate of 20% or less. HCC will continue to pay for CPR/First Aid as long as the HCW continues to complete 2 classes per year.
Workers must submit a written application for the CPR benefit.
Workers should NOT sign up for training until they have a provider number, otherwise they will be charged a fee.
Give out OHCC phone number –
Encourage workers to sign up to receive the newsletter via mail or monthly. (Newsletter Sign-Up form)
To find the newsletter on the web – go to oregon.gov and search “Home Care Commission training”

67. Training Stipend Requirements
Register for an approved class.
Fill out and turn in the reimbursement form at the class.
You may receive a stipend to attend a specific training topic one time every 12 months.
You may attend a class at no charge more than once.
Be patient. It takes 6-9 weeks to process payments.
Payment is always the base rate of pay found in the collective bargaining agreement.
Trainer Notes:
January 2017, the base pay increases to $14.50/hour
Training time is not counted toward hours in a voucher!
Training stipends are paid through a different system. Taxes will not be taken out of training pay.
Adding time from training to your time sheet or from hours approved on your voucher and accepting training pay is Medicaid fraud.
It is understandable that people get confused about the payment process, making the mistake of thinking they need to add it into their timesheet.

68. Specialty Trainings and Certifications
Professional Development Certification
Enhanced HCW Certification
Community Health Worker Certification
Trainer Notes:
Professional Development Certificate – available January 2017: You will have the opportunity to earn an additional $.50 per hour above the base rate of pay beginning in January. For PDC, you must:
Complete required classes (refer people to the training newsletter for the list);
Have an active CPR/First Aid certification (must stay current);
Have an 80% success rate on each class assessment (tests your knowledge of info taught during the class);
Have no more than a 20% no show rate for classes;
Complete and turn in the Professional Development Certification application.
Enhanced HCW Certification: Enhanced HCWs can receive a higher rate of pay while working for a consumer with medically driven services and supports. To be eligible to receive the higher rate of pay HCWs must a) successfully complete the Certificate of Training Program for an Enhanced worker AND b) be providing services to someone who qualifies for that type of support based on their needs assessment. The higher rate only applies while working for the specific individual who has medically driven services and supports, as assessment by the case manager (e.g. wound care; insulin injections; ventilator care, etc.).
To apply, you must have:
An active HCW Provider Number;
Complete and pass a readiness assessment
Have current CPR and First Aid Certification
“No-Show Rate no more than 20% at OHCC training classes.
Community Health Worker Certification: Certified community health workers are people who help individuals and communities adopt health behaviors, and usually share the same ethnicity, language, socioeconomic status, and life experience at those he or she serves. They provide information, as well as help with blood pressure checks and other health prevention screenings. You can receive 96+ hours of free training that usually costs someone hundreds of dollars.
Earned professional development recognition
Specialty Trainings and Certifications

69. CPR and First Aid Reimbursement
Oregon Home Care Commission will cover the cost of CPR and First Aid for homecare workers with active provider numbers who:
Have worked as a Homecare Worker in the prior 3 months prior to the request.
Have completed two Oregon Home Care Commission courses in the past 12 months.
Have a “no-show” rate of 20% or less for Oregon Home Care Commission training courses.
Trainer Notes: If a person has had their CPR reimbursed by Oregon Home Care Commission in the past, the re-certification can also be reimbursed if the above criteria is met and you have attended four additional OHCC classes.
You are not paid for your time during the course.

70. Continuing Education
In order to be referred on the Registry, you must take four (4) OHCC training classes per year.
Any Oregon Home Care Commission class counts towards the training class requirement except for MoneyWise.
You have one year from receiving your provider number to complete these classes.
At least one of the classes every two years must be a safety class.
Trainer Notes: Refer people to the Commission website at for more info and the list of trainings.
This requirement started with ratification of the contract.
Even if workers don’t think they would look for work, it is a good idea to take training. If they lose work and want to use the Registry, they would not be referred until completing the continuing education requirements.
Workers not using the Registry to find work have NO training requirement (such as workers who only work for family or friends and don’t want to work for others) 70

71. Self Register for Training on the Registry
Trainer Notes:
You can find a list of your completed trainings as well as upcoming classes you are registered for at the Training Tab on your Registry page. You can also go to “Upcoming Training Classes” to self-register for trainings
Also point out the “Help Wanted” tab where they can look for ads to find consumers looking for workers.

72. Oregon Home Care Commission Worker’s Compensation
What to do if you are injured on the job
Oregon Home Care Commission Worker’s Compensation
HCW Guide Chapter 9 (pg. 47 )

73. Workers’ Compensation
Coverage
While performing assigned authorized tasks
Who do I call to report an injury?
(503) (Salem)
What form needs to be filled out by my doctor?
Ask your doctor to complete Form 827
Where do I send these forms?
Fax to SAIF at
Trainer: It’s important to pay attention to the Task List. The services listed in the job description defines what will be covered by Workers’ Compensation. If you are doing something that is found to be outside the scope of the job description it will not be covered if you are injured on the job.
Important!
Filing a claim does not automatically qualify your injury for Workers’ Compensation benefits!

74. Confidentiality… is required by law.
Training Notes:
As an HCW, you will often have access to personal information about your employer. You are legally obligated to keep that information absolutely confidential. Unless your employer gives you specific permission, do not talk about your employer’s personal information to anyone except the employer’s case manager or other APD/AAA office representatives.
You must sign a confidentiality statement in order to work as a homecare worker.
Some things to avoid:
Talking about the person you support when out with friends. Even if you don’t share their name or identifying information, people can figure it out.
Sharing any personal data in any situation. If a “qualified” person (such as a doctor or someone at the bank) asks you for financial or other information, let your employer (the person with a disability) answer. In some situations, they can request you share the information on their behalf for a specific request.
Sharing information about your employer with church members who come to visit.
Be especially careful about sharing personal information such as address, phone, finances, services used/received, and personal identification (SSN, bank accounts, etc).
A good rule of thumb, is if you wouldn’t like someone sharing about you, then don’t share about them!
HCW’s may ask the employer if it is OK to give the consumer/employer phone number to their family so they can be reached in an emergency (if the worker does not have a cell phone).
Hand out the Client/Employer Right to Confidentiality (SDS 0356) and have signed if the form is not signed when the application is turned in.

75. Confidentiality
You must keep consumer/employer information confidential:
Name, address, phone number
Medical conditions
Whether the person is on Medicaid
or other state services
Financial information
Trainer Notes:
Discuss how and when and what to keep confidential. The HCW may have access to a lot of information and must be careful not to discuss any personal information with others. (Getting permission is the key).
SAY:
There may be serious consequences for all persons involved if confidentiality is broken:
Your employer could be embarrassed or humiliated.
Other people could use information you shared about your employer to harm or take advantage of him/her.
Your employer could lose trust in you.
You could lose your job as an HCW.
You could be excluded from future work as an HCW.
Next slide shows the form 75

76. Confidentiality and Your Pay Check
When using your pay stub (Remittance Advice Form) to prove employment, be sure to black out the Medicaid Prime number of the person you support.
There are times when you need to show proof of employment, such as when you want to receive a stipend for attending an OHCC training. When you share a copy of your pay stub (or remittance advice form), please be sure to black out your employer’s name!
If they need further information, verification for loans or other reasons, the number to provide is for the provider relations unit:

77. Tips on keeping things confidential
Do not let anyone but your employer see your voucher. If someone else is delivering it to the office, put it in a sealed envelope.
Do not give your employer’s name as a reference or use on a rental or loan application unless they have given you permission to do so (get it in writing).
Do not talk about your employer to his/her family members – or to yours.
Do not share medical information about the employer with a landlord.
Do not leave your voucher or task list where others can get to it (i.e, on your dining room table, in your car)
Trainer Notes:
Each click reveals line. 77

78. You Are A Mandatory Reporter
You must report abuse or suspected abuse of an elder, child, resident of any age in a nursing facility, or an individual who receives services through a Community Mental Health or Community Developmental Disabilities program.
Trainer Notes:
Homecare Workers are Mandatory Reporters of abuse. An elder is an adults 65 and over.
This is 24 hours a day/on the job and off. In addition, workers have an obligation to report abuse of adults with disabilities. Not doing so could result in the HCW being accused of being neglectful.
Reports should go to the local office or can go to the state Office of Adult Abuse Prevention and Investigations (OAAPI) at SAFE (7233)
It’s the law!
HCW Guide Chapter 8 (pgs )

79. You Are A Mandatory Reporter – It’s the law!
HCWs are mandatory reporters 24 hours per day, 7 days per week for:
elder abuse,
abuse in a nursing facility for residents of any age;
Individuals with I/DD or mental health conditions; and
Any children
If you do not report suspected abuse you could lose your HCW provider number.

80. When Reporting Abuse….. 1-855-503-SAFE (7233)
Your identity is kept confidential.
You are protected from civil and criminal liability when reporting suspected abuse in good faith.
If you do not report abuse as required, there are serious consequences. You can be:
Arrested;
Fined up to $2,000;
Sued;
Be terminated as a Medicaid provider
Reports should go to the local office or can go to the state Office of Adult Abuse Prevention and Investigations (OAAPI) at SAFE (7233)

81. Abuse Includes: Abandonment Financial exploitation Neglect
Physical abuse
Verbal and emotional abuse
Sexual abuse
Involuntary seclusion
Wrongful use of a physical or chemical restraint
Self-neglect
Fraud
DEFINE:
Abandonment — Leaving or deserting an older adult or person with disabilities who cannot care for himself or herself and depends on the care provider for help. Examples: Not showing up or showing up late for a period of time that will endanger the consumer’s health, safety and welfare.
Financial exploitation — Illegally or improperly using another person’s money or resources for personal profit or gain. Examples: Forging the client’s signature, using the client’s credit cards or taking the client’s personal items or medication. To protect yourself from accusations of financial exploitation, you should never borrow money from your employer and you should keep receipts for all purchases you make for your employer. For tasks such as shopping, you may want to keep a written record of money received from your employer and the change returned to him or her. Financial abuse is about wrongful taking of the consumer’s property, money, and resources. It can happen in a few different ways. A consumer might make unusually large contributions to charities or suddenly change their banking practices, will, or other financial documents. They might also add new names on bank signature cards or talk about missing money or expensive possessions. How  about keeping the change when shopping for the consumer, or taking furniture, TVs that the consumer does not use.
Neglect — When the person responsible for caring, supervising, or protecting a consumer does not make a reasonable effort, the physical  and emotional health of the consumer is at risk. This is called neglect, and it can cause serious injury, discomfort, or loss of personal dignity. The consumer might be dehydrated or show signs of not eating enough. You might also see basic necessities missing from the home, such as food, water, or heat. The consumer may not be getting the medication they need or be left alone   for long periods  Maybe give a shout-out for abandonment. Abandonment is serious form of neglect where the care of the consumer is forsaken or the caregiver deserts the consumer. The time is long enough to cause harm or a serious risk of harm.
Physical abuse — Using excessive force or physical assault, such as hitting, slapping, biting, pinching or shoving a person. Physical abuse can also include restraining a consumer with something like rope or forcing drugs or medication on them . A consumer who is being physically abused may have visible  signs, such as bruises, burns, cuts, or other injuries, that cannot be explained. They might also show signs in their behavior, such as postponing or canceling medical appointments. Rough-handling can be an example.
Verbal and emotional abuse — Using derogatory names, phrases or profanity; ridiculing, harassing, coercing, threatening or intimidating a person; or anything that denies a person’s civil rights or that results in emotional injury. Example: Threatening by using “or else” statements. Changing behavior and mood, developing new fears, being upset when the abuser arrives, being overly worried about what the abuser wants, becoming uncommunicative, and showing fear when the abuser is present.
Sexual abuse — Sexual abuse is sexual contact to a   consumer who does not—or is unable to—consent. Sexual abuse includes rape, unwanted touching, nudity, and photography. Sexual harassment or showing a consumer sexual materials, such as pornography, is also sexual abuse. Use of social media to show images of a consumer unclothed, may be considered sexual exploitation.
Involuntary seclusion: It is used for the convenience of the caregiver or to discipline an adult. It may include confinement or restriction of an adult to his or her room or a specific area or placing restrictions on an adult’s ability to associate, interact, or communicate with other individuals. Examples: Not letting the individuals talk to someone on the phone; making an individual go to his or her room when he or she does not want to.
Wrongful use of a physical or chemical restraint: This means restraining someone, either with medication or physically, particularly when a licensed health professional hasn’t conducted a thorough assessment before implementing a licensed physician’s prescription for the restraint; less restrictive alternatives haven’t been evaluated before the use of the restraint; or the restraint is used for convenience or discipline. Examples: Giving a consumer a medication that makes him sleepy so you can do other things; Tying a rope around a consumer and his or her wheelchair so he or she won’t fall out of it.
Self-neglect — When a person cannot understand the consequences of his or her actions or inactions that affect his or her basic well-being and may lead to self harm or endangerment.
ASK:
When could the homecare worker be considered the abuser?
Examples:
Mismanaging money,
Withholding treatment or medications, refusing to do a task
Restraining the consumer
Leaving a dependent person with no caregiver,
Speaking harshly to the employer
If a homecare worker is thought to be the perpetrator, he/she will be investigated and the provider number could be terminated
Refer workers to the “HELPING CAREGIVERS FIGHT FRAUD & ABUSE” training for more information.

82. Financial activities
If shopping or handling your employer’s money, keep receipts and accurate records.
Trainer Notes:
Discuss handling money or doing shopping. Keep receipts; get employer to initial or sign whenever HCW takes money for shopping or gets reimbursed for things. You can provide homecare workers with a tool to track receipts etc. if they are responsible for handling money. (one is given in the KEEPING IT PROFESSIONAL Training)
The case manager can refer their employer to local money management agencies.
Discuss shopping and when and how an Oregon Trail card with the worker’s name can be obtained 82

83. Safety First HCW Guide Chapter 9 (pgs. 42-47)
Trainer Notes:
Whether you are new to working as a HCW or you have provided services for years, here’s a quick refresher on a few key safety issues to promote health while on the job.
The precautions you take might depend upon the amount of contact you expect to have with your employer. Standard precautions include the use of one or more of the following practices:
Hand washing;
Use of latex or other protective gloves;
Masks, eye protection and/or face shield;
Proper environmental cleaning, such as using a bleach-based cleaner or mixture of bleach with water to kill infectious germs (bleach kills all germs including bacteria, viruses and fungi. Anti-bacterial cleaning agents are only designed to stop bacteria);
Proper handling of soiled supplies or assistive devices;
Minimal handling of soiled linen; and
Proper disposal of needles.
Universal precautions are guidelines to protect health care workers and employers from exposure to HIV (the virus that causes AIDS), hepatitis B and other blood-borne germs. Following these guidelines, health care workers treat blood, certain body fluids and tissue from all employers as if they were infectious.
Under universal precautions, health care workers wear protective equipment such as face masks and latex, vinyl or nitrile disposable gloves to avoid exposing skin or mucus membranes to infected fluids.
Other ways health care workers protect themselves include washing hands, not recapping needles after an injection, and disposing of needles and other sharp tools in puncture-proof containers. These procedures also protect employers from exposure to homecare workers’ body fluids.
**There is more specific information in the safety manual provided with your materials.
Safety First
HCW Guide Chapter 9 (pgs )

84. Current safety classes include:
Preventing Disease Transmission (PDT)
Protect Against Sprains and Strains (PASS)
Taking Responsibility in Personal Safety (TRIPS)
COMPASS
A Spanish Version of the Safety Manual is available.
Call to request a copy.
OHCC Safety Manual:

85. Use standard precautions
Germs are most often transmitted through bodily fluids (blood, vomit, urine, saliva).
Decrease the transmission of germs by ALWAYS using gloves or masks.
Use standard precautions with everyone, not just people who you suspect are ill.
See the HCW Safety Manual for more information.
This is sometimes called Universal Precautions.
Germs can also be airborne – from coughing, sneezing, etc. Tuberculosis is an example of an airborne disease.
Ask -- What are some kinds of barriers that a homecare worker might use?
Gloves
Trainer Notes:
Breathing barriers for doing rescue breathing
Masks when working around someone who has an airborne disease
Gowns when cleaning up body fluids
Recommend attending the Preventing Disease Transmission training
Safety Manual Pg. 34 85

86. Handwashing is the best way to avoid spreading germs
Always wash your hands:
After you arrive at the employer’s home.
Before you prepare food.
Before and after assisting with meals.
After you go to the bathroom.
Before and after you assist your employer to the bathroom.
Before you leave your employer’s home.
Trainer Notes:
Discuss other times to wash hands:
Anytime you:
Sneeze or cough.
Touch your nose, mouth or genitals.
Handle garbage.
Handle animal litter.
Clean the house.
Touch anybody’s blood, urine, feces, vomit, semen, vaginal fluid or any other body fluid. 86

87. Wearing gloves
Your employer’s health plan may pay for disposable gloves needed for personal care. You can also get some from the local office so that you are never without gloves.
Trainer Notes:
Discuss how to get an initial supply of gloves and masks
Gloves should always be worn when touching body fluids, potentially infected materials, and for cleaning. A good rule to follow is:
If it’s wet – wear gloves!
It is worthwhile to bring your own protective supplies because:
You may need more than the employer has available
The employer may not have any
Using protection will help you:
Avoid injury and/or illness
Avoid missing days of work
Avoid spreading germs to your employer or from one employer to another
Do NOT wash and reuse gloves that are disposable
Discuss or demonstrate how to use and remove gloves:
If the gloves are contaminated or dirty – do not touch your skin or other objects with your gloved hand
Pinch one glove just below the wrist and pull partially off, turning inside out
With the partially gloved hand, pinch the other glove just below the wrist and pull inside out and completely off
Touching only the clean interior, pull off the remaining glove
Wearing work gloves for housekeeping tasks are also important. You’ll need to provide those yourself. 87

88. Medication Safety Know the Five Rights
Right Person
Right Medication
Right Amount
Right Route
Right Time
Trainer Notes:
If you agree to help someone with medications as part of your job duties, it’s important to check the five rights before helping. Taking medications the wrong way is very dangerous and can cause serious medical complications or even death.
Read the label every time you help!
Read the bottle carefully and follow the instructions. For instance, if a medication bottle reads “Do not crush,’ don’t crush it. If your employer insists, it’s OK to say you don’t feel comfortable doing this because it is unsafe and encourage him or her to call the physician or pharmacy.
If possible, get as much information as you can about the medication to prevent errors:
When and how it should be taken (with food, before meals, without grapefruit juice, whether it can be chewed.
What to do if a dose is missed;
Potential side effects and what to do;
How the med may interact with other medications being taken (ex. Vitamins and OTC meds);
How to safely dispose of unused medications
Read the label every time you help!

89. SEIU, Local 503 Website: www.seiu503.org
SEIU as the Homecare Workers Union represents workers and helps to negotiate wages, benefits and working conditions with the State.
For more information, please feel free to call SEIU’s Member Resource Center at
For questions about health benefits and paid time off, contact the Homecare Worker Supplemental and Benefits Trust by calling
or visit: or
Trainer Notes:
SEIU as the Home Care Workers Union represents workers and helps to negotiate wages, benefits and working conditions with the State. The Union also shares with our lawmakers how important this program is for providers, and people who receive services. SEIU also helps with member benefits associated with being a Homecare Worker. For example: Life Insurance, Cell phone discounts, group legal insurance etc. For more information on any of these subjects, please feel free to call the number provided below.

90. Additional Benefits
You may be eligible for other benefits through the SEIU Homecare Worker Trust.
For information call
Trainer Notes:
Some workers will qualify under Medicaid as those benefits have expanded
Some workers may be able to buy health insurance through the health care exchange
The union can explain eligibility for the health plan offered by the Trust

91. Resources Oregon Department of Human Services (DHS) www.oregon.gov/DHS
Oregon Employment Department Metro Valley/Unemployment Insurance (UI) Center
Other UI center locations:
Adult Protective Services(APS)
Child Protective Services (CPS)   
Internal Revenue Service (7 a.m. to 10 p.m. Monday–Friday) Oregon Department of Revenue