PA OLTL Program

Procedures & Information

2021 PA OLTL Year End Letter for OBRA & Act 150 Participants 2678 Form Instructions Application For Difficulty Of Care Federal Income Tax Exclusion Application For Difficulty Of Care Federal Income Tax Exclusion, Spanish Application For Tax Exemptions Instructions Application Request Form Instructions CLE Address Phone Change Form CLE Address Phone Change Form Instructions CLE Agreement Instructions Checklist To Complete I-9 Form Child Abuse Release Authorization Instructions Common Law Employer Monthly Reports Instructions For A Non Aging Participant Common Law Employer Monthly Reports Instructions For An Aging Participant Common Law Employer and Participant Services Change Form Consumer Guidebook For Self Directed Services DCW COVID Vaccine Letter DCW Change Of Information Form DCW Change Of Information Instructions DCW Info On Nonwithholding (Rev 419) Instructions DCW Local Services Tax Exempt Instructions DCW Orientation Postcard DCW Pre Service Orientation Information DCW Requalification Letter DCW Requalification Packet DCW Separation Of Employment DCW Unique ID Postcard To Cles DCW Unique Identification Information DOC Instructions Designated Representative Form Difficulty Of Care Training Direct Care Worker COVID 19 Essential Personnel Letter Download the full Hazard Pay Letter Employee’s Non-withholding Application Certificate (REV 419) 2022 Employer Confirmation Of Info Instructions FLSA Letter To Participants Fair Labor Standards Act Live In Exemption Fair Labor Standards Act Live In Exemption, Spanish Fingerprinting Application Instructions Form W 4 Instructions Glossary Of Terms How To Determine DCWs Maximum Wage IRS DOC Q&A For Caregivers Live In Exemption Training Local Services Tax Exemption Form New Direct Care Worker (DCW) Application Request Cover Letter New Direct Care Worker (DCW) Application Request Cover Letter, Spanish New Direct Care Worker (DCW) Application Request Form New Direct Care Worker (DCW) Application Request Form, Spanish New Employer Maximum Wage Sheet OLTL Bulletin For Service Coordinators Office of Long-Term Living (OLTL) Mercer Rate and Wage Study PA Department of Health When to Seek Care PA OLTL – Participant Direction Workgroup Recommendation Ownership Chart NEW PA OLTL Billable Pay Rate Letter PA OLTL Guide For Participants With An Existing Employer Identification Number PA OLTL Pay Schedule A 2024 PA OLTL Pay Schedule B 2024 Payment Change Form Instructions Pharmacy Benefit Physician Panel Requirements Program Rule Reminders Qualified Worker Rate Change Form Qualified Worker Rate Change Form Instructions Qualified Worker Rate Change Form, Spanish Residency Certification Form (CLGS 32 6) Instructions Risk Management Resources SS4 Form Instructions Separation Of Employment Form Instructions State Police Check Instructions Tax Exemption Form Tax Exemption Form, Spanish Vendor Payment Request Form W-2 C Final Letter Worker Compensation Policy Contact Sheet

Trainings & How to Guides

Common Law Employer Monthly Reports Instructions For A Non Aging Participant Lifting Techniques Presentation OLTL Common Law Employer Best Practices Series Direct Care Workers OLTL Participant Directed Models of Service: Overview for Service Coordinators PA Department of Health Handwashing Poster Roles & Responsibilities Of The Common Law Employer Semi-Annual Service Coordinator Orientation & Training Presentation Service Coordinator Training #2 – PPL Web Portal Referral (PDF) Service Coordinator Training #6 – Program Participant Reports (PDF) Service Coordinator Training – Program Participant Reports Service Coordinator Web Portal How-to Guide Workplace Safety Presentation Workplace Safety Safe Lifting And Body Mechanics

Payroll Documents

Guide To Tax Exemptions Guide To Tax Exemptions, Spanish IRS Form W-4 IRS Form W-4 (Spanish) Payment Change Form Payment Change Form, Spanish

Referral & Enrollment Process

CLE Orientation And Skills Training Handbook How Enrollment Works New Participant FMS Referral Form with Options Transfer New Participant Portal Referral Checklist USCIS Form I 9 Instructions, Spanish (FOR REFERENCE ONLY) USCIS Form I 9, Spanish (FOR REFERENCE ONLY) USCIS Form I-9 USCIS Form I-9 Instructions

Time4Care™

Cover Letter Cover Letter DCW FAQ FAQ DCW Overview Overview DCW Quick Guide And How To Download Quick Guide And How To Download DCW

BetterOnline™

DCW Web Portal Guide PA OLTL DCW Web Portal Guide Participant Web Portal Guide