Follow the steps to fill out the PCG New OLTL DCW form online:

1. Click the ‘Get Form’ button to obtain the form and launch it in an online editor.
2. Begin by entering the Direct Care Worker’s identification information, including their name and address.
3. Select whether this is for a new service, change of existing service, new rate, or change of existing rate by marking the appropriate box.
4. Enter the hourly rate to be paid to the Direct Care Worker, ensuring not to express this rate in 15 minute increments or include employer tax.
5. If applicable, refer to the Maximum Wage Rate Breakdown Sheet if you are a newly referred Common Law Employer, and enter the necessary information.
6. If you have a history of managing Direct Care Workers, consult with Public Partnerships, LLC for assistance in determining the maximum negotiations allowable.
7. Proceed to the signature section: both the Common Law Employer and the Direct Care Worker must print their names, sign, and date the form.
8. If the participant is different from the Common Law Employer, enter the participant's name in the designated area.
9. Once all fields are completed, save any changes, then download and print the form for your records.
10. Mail the completed form to PA OLTL, Public Partnerships, LLC, at the provided address.

Complete your documentation online to ensure timely processing of your forms.