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OPA-MCE Provider Agreement Form
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OPA-MCE Provider Agreement 
2016-2018
Ohio Psychological Association
Mandatory Continuing Education Office
395 East Broad Street #310
Columbus, Ohio 43215
Phone 888-672-6231 or 614-224-9620
Fax 614-224-6702
mce@ohpsych.org


We, the above named organization, hereinafter identified as PROVIDER ORGANIZATION, agree, if identified by the Ohio Psychological Association-Mandatory Continuing Education office, hereinafter identified as OPA-MCE (where OPA-MCE is acting as a designated agent of the Ohio Psychological Association), that if selected as an approved PROVIDER ORGANIZATION, we will abide by the following requirements and will provide the documents identified in these requirements, for the period of September 1, 2016 - August 31, 2018:

The PROVIDER ORGANIZATION is required to report on courses it has presented within 30 days after a course is completed by sending the Attendance Sheet to OPA-MCE. If partial credit is given, a separate Attendance Sheet must be provided for each different number of CE allowed. The will count as separate courses. The exception to the 30-day reporting rule is courses offered at the end of the biennium—those courses in August 2018. As MCE must report to the State Board of Psychology-Ohio no later than September 30, 2018, providers are required to report on courses given in August 2018 no later than September 15, 2018.

The PROVIDER ORGANIZATION agrees that the Attendance Sheets submitted, which are copies of the originals, will include at least the following information: License # and Name of Attendee.

  • At the top of the Attendance Sheet, the following information MUST be completed: Provider Number, Name of Provider, Course Title, Phone Number, Total Credit Hours, Date of Completion, Name of Primary Instructor, and City/State.
  • Psychologist attendee’s complete name and license number either pre-printed or hand-printed and signature. The OPA-MCE must be able to identify clearly the full name of the individual and license number. A presenter who wants to earn CE should also sign the attendance sheet.
  • If the list includes names of students or professionals other than psychologists, the psychologists MUST BE clearly identified as psychologists with license numbers. This may be accomplished by using a separate registration form for psychologists only. The PROVIDER ORGANIZATION understands it is their responsibility to insure the OPA-MCE knows each psychologist who has attended with their Ohio license number.
  • The PROVIDER ORGANIZATION understands that failure to provide this information will result in the Attendance Sheet being returned with a letter requesting the necessary missing information. The course information will be entered and listed as pending in the computer system, until the information is returned. The fine penalties will begin to accrue, according to the conditions set forth in paragraph 3 (three), until all of the required information is provided.

The PROVIDER ORGANIZATION understands that failure to submit both the completed Course Notification Form and the appropriately completed Attendance Sheet within the 30 days from course completion date will result in financial penalties of $50 for each month after a course completion date, up to 90 days (three (3) months); for each additional month (30 days) past this 90 days, the penalty will be increased to $100 per month. This penalty system will be strictly enforced. 

A special circumstance exists at the end of the biennium for those courses offered in August 2018. Materials for courses held in August 2018, must be sent in no later than September 15, 2018, to satisfy the State Board of Psychology-Ohio reporting requirements at the end of the biennium.

For all other periods, if the PROVIDER ORGANIZATION encounters extenuating circumstances that might prevent timely submission of the form/attendance sheet, the PROVIDER ORGANIZATION is encouraged to contact the OPA-MCE office immediately, so that an alternative plan can be discussed and fines possibly suspended.

The PROVIDER ORGANIZATION agrees to maintain all necessary records of course design, presenters, registration, attendance, and certificate issuance for a period of five (5) years. This information is subject to an announced random administrative audit by OPA-MCE.

The PROVIDER ORGANIZATION recognizes that it is responsible for and agrees to provide only courses that meet the criteria and standards for continuing education of psychologists and school psychologists. 

The PROVIDER ORGANIZATION agrees to add the OPA-MCE to its mailing list, so that the OPAMCE receives all course/session brochures.

The PROVIDER ORGANIZATION recognizes that it is responsible for ensuring that new staff members are aware of and trained in the above requirements in the event of staff turnover.

The OPA-MCE agrees to provide the following:

  • Notification of PROVIDER ORGANIZATION’S acceptance as an approved provider by OPA-MCE
  • Letter of confirmation for Course Notification and Attendance Sheet receipt at the OPA-MCE Office
  • Notification of missing information needed, if applicable, and pending status of course in computer system
  • Notification of impending penalty charges/penalty charges applied (based on course completion date or missing information)
  • Information on all courses for which information is submitted by the PROVIDER ORGANIZATION to registrants of the OPA-MCE.

AGREEMENT


I understand and agree to the above requirements, as identified by my signature below. This agreement will be in effect, if my fee has been paid in full and if it has been counter-signed by the OPA-MCE representative, from September 1, 2016 - August 31, 2018.