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26 ' <br />Standard Assurance to Comply with Older Americans Act <br />Requirements Regarding Client Rights <br />for <br />Agencies Providing In-Home Services through the <br />Home and Community Care Block Grant for Older Adults <br />As a provider of one or more of the services listed below, our agency agrees to notify all <br />Home and Community Care Block Grant clients receiving any of the below listed services <br />provided by this agency of the their rights as a service recipient. Services included in this <br />assurance include: . <br />-1n-Home Aide <br />-Home Care (home health) . <br />-Housing and Home Improvement <br />-Adult Day Care or Adult Day Health Care <br />Not cation will include, at a minimum, an oral review of the information outlined below as well <br />as providing each service recipient with a copy of the information in written form. In addition, <br />providers of in-home services will establish a procedure to document that client rights <br />information has been discussed with in-home services clients (e.g. copy of signed Client Bill <br />of Rights statement). . <br />Client Rights information to be communicated to service recipients will include, at a minimum, <br />the right to: <br />-be fully informed, in advance, about each in-home . <br />service to be .provided and any change in service(s) <br />that may affect the well-being of the participate; <br />-participate in planning and changing any in-home service <br />provided unless the client is adjudicated incompetent; <br />-voice a grievance with respect to service that is or fails <br />to be provided, without discrimination or reprisal as a <br />result of voicing a grievance; <br />. -confidentiality of records relating to the individual; <br />-have property treated with respect; and <br />-be fully informed both orally and in 'writing, in advance <br />of receiving an in-home service, of the individual's rights and obligations. <br />Client Rights will be distributed to, and discussed with, each 'new client receiving one or more <br />of the above listed services prior to the on-set of service. For all existing clients, the above <br />information will be provided no later than the next regularly scheduled service reassessment. <br />Agency Name: Joint Orange-Chatham CommunitX Action 7n <br />Name of Ageninistrator;~ Sandra 1t. Sanchez <br />Signature: _ <br />(Please return o your <br />April 24, 2003 <br />on Aging and retain a copy for your files.) <br />