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Materials for CCare Providers

 


 

CCareTools

As of October 2008, CCare tools, forms, and resources can be found in Section C of the Oregon Family Planning Program Manual.


National Voter Registration Act (NVRA) Requirements

As of July 2012, the CCare Enrollment form includes NVRA requirements. See the policy and procedures and the associated forms below:

SEL 503 - Voter Registration Card

SEL 503a - Spanish Voter Registration Card

SEL 504 - Agency Voter Registration Reporting Form

SEL 540 - Signature Stamp Attestation Form

 


 

Out-of-State Birth Certificate Requests     

CCare applicants born in Oregon may request an electronic search for their birth record by submitting a Birth Information Form to their local clinic. See below for more information about Oregon Birth Record Requests.

As of March 1, 2008, the Oregon Reproductive Health Program will order birth certificates from other states to help non-Oregon born CCare applicants document U.S.citizenship. The materials and links below explain this process.

Documents:

  • Flow chart (pdf) - Describes request process
  • State matrix (pdf) - Details state-specific request requirements (Updated 10/13/09)
  • California county matrix (xls) - Details California county-specific request requirements
  • OHAauthorization form(pdf) - Authorizes client's release of certificate to State of Oregon (Required) (Updated 11/12/10)
  • Sample log form (xls) - For tracking birth certificate requests (Recommended) 
     

Links to State Birth Certificate Request Forms     

 

Alabama (pdf) Indiana (pdf) Nebraska (pdf) South Carolina
Alaska (pdf) Iowa (pdf) Nevada (pdf) South Dakota
Arizona (pdf) Kansas (pdf) New Hampshire (pdf) Tennessee (pdf)
Arkansas (pdf) Kentucky (pdf) New Jersey (pdf) Texas (pdf)
California (pdf) Louisiana (pdf) New Mexico (pdf) Utah (pdf)
Colorado (pdf) Maine New York City (pdf) Vermont (pdf)
Connecticut Maryland (pdf) New York State (pdf) Virginia
Delaware (pdf) Massachusetts North Carolina (pdf) Washington (pdf)
Florida (pdf) Michigan (pdf) North Dakota (pdf) Washington DC
Georgia (pdf) Minnesota (pdf) Ohio (pdf) West Virginia (pdf)
Hawaii (pdf) Mississippi (pdf) Oklahoma (pdf) Wisconsin (pdf)
Idaho (pdf) Missouri (pdf) Pennsylvania (pdf) Wyoming
Illinois (pdf) Montana (pdf) Rhode Island (pdf)

 

Links to California County Forms       

 

California Counties- Please check links below for county forms.

Then search California State Website

Alameda (pdf) Kings (pdf) Placer (pdf) Sierra
Call county at
(530) 289-3295
to request forms via fax
Alpine
Call county at
(530) 694-2286
to request forms via fax
Lake (pdf) Plumas (pdf) Siskiyou (pdf)
Amador (State site) Lassen (pdf) Riverside (pdf) Solano (pdf)
Butte (pdf) Los Angeles (pdf) Sacramento (pdf) Sonoma (pdf)
Calaveras (pdf) Madera (pdf) San Benito (pdf) Stanislaus (pdf)
Colusa (pdf) Marin (pdf) San Bernardino (pdf) Sutter (pdf)
Contra Costa Mariposa (pdf) San Diego (pdf) Tehama (pdf)
Del Norte (State site) Mendocino (pdf) San Francisco (pdf) Trinity (pdf)
El Dorado (pdf) Merced (pdf) San Joaquin (pdf) Tulare
Fresno (pdf) Modoc
Call county at
(530) 233-6205
to request forms via fax
San Luis Obispo (pdf) Tuolumne
Glenn Mono (pdf) San Mateo (pdf) Ventura (pdf)
Humboldt (pdf) Monterey (pdf) Santa Barbara (pdf) Yolo (pdf)
Imperial (State site) Napa (pdf) Santa Clara (pdf) Yuba (pdf)
Inyo (pdf) Nevada Santa Cruz (pdf)
Kern (pdf) Orange Shasta (pdf)

 


Links to Other Birth Certificate Request Forms   

 

Puerto Rico

 

  


 

CCare Administrative Rules    

OregonCCare Administrative Rules Effective December 26, 2012 (PDF)

 


 

CCare Workgroup Charter  

 


 

How to Become a CCare Provider    

The OregonContraceptiveCare Program (CCare) is a Medicaid waiver demonstration project approved by the Centers for Medicare and Medicaid Services.  The project provides contraceptive management services to eligible men and women with family incomes up to 250% of the Federal Poverty Level through a contract network of qualified family planning clinic providers.  Contraceptive management services are specific to initiating or obtaining a contraceptive method and maintaining effective use of that method.

 

To become a CCare provider, you must also offer these same services to Oregon Health Plan (OHP) clients and be enrolled as a provider with both CCare and OHP.  

 

You can find out more about CCare on the CCare website and more about being a provider on our provider resources website  

You can read about OHP rules and information on the Department of Medical Assistance Program’s website.

 

1)   To start the enrollment process, read through the Prospective Provider Packet to determine if your clinic can comply with CCare program requirements.  Included is an overview of program requirements, questions to consider before enrolling, the CCare Standards of Care, information about supplies and links to the program manual and other important information and resources.

 

2)   Contact the CCare Provider Liaison, Pi Winslow at 971-673-0227 or at pi.v.winslow@state.or.us for enrollment information and forms.

3)   Next, download and read through our program manual and administrative rules.