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OREGON INDEPENDENT CHOICE PROGRAM CASH BENEFIT PREAUTHORIZATION FOR AUTOMATIC WITHDRAWAL FROM CASH BENEFIT ACCOUNT Payroll Agent: Acumen Fiscal Agent, LLC. 5416 E. Baseline Rd., Suite 200 Mesa, AZ
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01
Gather necessary information such as personal details, contact information, and medical history.
02
Contact the Oregon Department of Human Services to request an application for the Independent Choice Program.
03
Fill out the application thoroughly, providing detailed information about your needs and why you are requesting assistance.
04
Submit the application along with any required documentation, such as medical records or proof of income.
05
Wait for a response from the Oregon Department of Human Services regarding your application status.

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Individuals who require assistance with daily living activities due to a disability or medical condition.
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People who want to have more control over their care and support services.
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Family members or caregivers who are looking for resources to help support their loved ones.
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The Oregon Independent Choice Program is a program that allows individuals with disabilities to receive long-term care services in a home or community-based setting.
Individuals with disabilities who qualify for long-term care services and wish to receive care in a home or community-based setting are required to file the Oregon Independent Choice Program.
To fill out the Oregon Independent Choice Program, individuals with disabilities can contact their local Area Agency on Aging or the Department of Human Services for assistance.
The purpose of the Oregon Independent Choice Program is to give individuals with disabilities the option to receive long-term care services in a more independent and community-based setting.
Information required to be reported on the Oregon Independent Choice Program includes personal details of the individual receiving care, the type of care needed, and the chosen caregiver.
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