Provider Qualifications
Provider Enrollment Application
Criminal History Check (CHC):
Carewell Training Requirement
If you have questions, please contact the ISN Lead Provider Specialist at 503-856-7038 or providercoordinator@goisn.org
PSW Enrollment Application and Agreement (PEAA):
The Provider Enrollment Application and Agreement explains the requirements for being employed as a Personal Support Worker (PSW) and receiving a provider number. Completion of the PEAA is required to become a PSW. Please follow the instructions below to complete this step.
Instructions:
Please fill out and return pages 1,2 and 5. Hint: Make sure your name is on the first page and provide an ink signature on page five.
Return the completed document to:
Department of Human Services
ODDS Contracts and Provider Administration Unit
500 Summer St., NE E-09
Salem, OR 97301
OR
Email: PSW.Enrollment@odhsoha.oregon.gov
Fax: 503-947-5044
Criminal History Check (CHC):
Criminal History Checks are completed by contacting the Lead Provider Specialist. You will need to provide a piece of current identification and update any contact information. An email request will then be sent to you for your approval of the background check. You will need to click on the link and answer the questions through the website provided. Once this is completed, the background check will start to process. Please note that if fingerprints are needed, you will be notified via email.
Lead Provider Specialist
Work Cell: 971-382-2270
Email: providercoordinator@goisn.org
Carewell Training Requirement:
Carewell training is completed through SEIU. Please go to the website below to sign up for a training session in your area. Please note that there are three parts. The first is an in-person session and is required to receive your provider number. Once you receive your provider number, you will be able to complete the last two online trainings.
SEIU Carewell Training Website
Training Email: carewellSEIU503training@risepartnership.com
Customer Service: 844-503-7348