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Materials for CCare Providers

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.  

To start the enrollment process:

  1. Read through the Prospective Provider Packet (pdf) 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, links to the program manual, and other important information and resources.
  2. Contact the CCare Provider Liaison at 971-673-0227 for enrollment information and forms.
  3. Download and read through our Program Manual and Administrative Rules.

CCare Administrative Rules    

OregonCCare Administrative Rules (pdf) - Effective December 26, 2012

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:

2015 NVRA agency manual (pdf)

SEL 503 - Voter Registration Card (pdf)

SEL 503a - Spanish Voter Registration Card (pdf)

SEL 504 - Agency Voter Registration Reporting Form (new online form)

SEL 540 - Signature Stamp Attestation Form (pdf)

Income Verification Resources

Beginning with October 2012 enrollments, the CCare Program verifies every client's income via the Oregon Employment Division. Please see the two documents below for more information about the process.

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.


Links to State Birth Certificate Request Forms
Alabama Indiana (pdf) Nebraska (pdf) South Carolina
Alaska (pdf) Iowa (pdf) Nevada (pdf) South Dakota (pdf)
Arizona (pdf) Kansas (pdf) New Hampshire (pdf) Tennessee (pdf)
Arkansas (pdf) Kentucky (pdf) New Jersey (pdf) Texas
California (pdf) Louisiana (pdf) New Mexico (pdf) Utah (pdf)
Colorado Maine New York City (pdf) Vermont (pdf)
Connecticut Maryland (pdf) New York State (pdf) Virginia
Delaware (pdf) Massachusetts North Carolina (pdf) Washington (pdf)
Florida 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 Placer (pdf) Sierra
Call county at
(530) 289-3295
to request forms via fax
Call county at
(530) 694-2286
to request forms via fax
Lake (pdf) Plumas 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 Stanislaus (pdf)
Colusa Marin (pdf) San Bernardino Sutter (pdf)
Contra Costa (pdf) Mariposa (pdf) San Diego (pdf) Tehama (pdf)
Del Norte (State site) Mendocino (pdf) San Francisco (pdf) Trinity (pdf)
El Dorado (pdf) Merced San Joaquin Tulare (pdf)
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 Monterey (pdf) Santa Barbara (pdf) Yolo (pdf)
Imperial (State site) Napa (pdf) Santa Clara (pdf) Yuba (pdf)
Inyo (pdf) Nevada Santa Cruz
Kern (pdf) Orange Shasta (pdf)



Links to Other Birth Certificate Request Forms
Puerto Rico (pdf)