Complete the information below and a completed verification letter will be emailed to the address you provide. By completing and submitting this form using JotForm, you will also automatically be sending an email to yourself. Please note that the Trust does not guarantee the privacy of information that you submit to the Trust using JotForm.

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Issued: 03/23/2020

Effective: 03/23/2020 – End of Executive Order No. 20-12

To our Public Safety Officers,

The person bearing this letter:

provides essential support as an in-home care provider, paid through the Oregon Department of Human Services. The Oregon Department of Human Services is an “Essential Business or Operation" within the meaning of Governor Brown’s COVID-19 Executive Order No. 20-12 issued on March 23, 2020 and the guidance issued by the Oregon Health Authority. As such, the Oregon Department of Human Services is continuing to authorize in-home support services. Because the person bearing this letter is an in-home care provider, s/he is permitted under the terms of the Executive Order 20-12 to travel to and from work. The Executive Order specifically permits travel for the care of elderly, disabled and other vulnerable individuals.

Therefore, should any shelter-in-place, travel or curfew restrictions be in place, it is requested that the bearer of this letter be allowed to continue their care provider related tasks, including travel to and from their place of employment, owing to the essential nature of such work.

Please call the office of the Oregon Homecare Workers Benefit Trust and Supplemental Trust at 844-507-7554 if you have any questions.