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2U <br />Standard Assurance to Comply t~-ith Older Americans Act <br />Requirements Regarding Client Rights <br />for <br />Agencies Providing In-Horne Services through the <br />Home and Community Care Block Grant far Older Adults <br />As a provider of one or more of the services listed below, our <br />agency agrees to notify all Rome and Community Care Block Grant. <br />clients receiving any of the below -listed services provided by <br />this agency of the their rights as a service recipient. Services <br />included in this assurance include: <br />-In-Home Aide <br />-Home Care (home health) <br />-Housing and Home Improvement <br />. '-Adult Day Care or Adult Day Health Gare <br />Notification wili~include, at a minimum, an oral review of the <br />infarrnation,outlined below as weal as providing each service <br />recipient with a copy of the information in written form. In <br />addition, providers c'h'in-home services will establish a procedure <br />'to document that client rights information has been discussed with <br />in-home services clients (e.g. copy of signed Client Bill of <br />Rights statement). ~ ~ _ <br />Client Rights information to be communicated to service recipients <br />.will include, at .a minimum, 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 participant; <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 <br />and obligations. <br />Client Rights will be distributed to, and discussed with, each new <br />client receiving one or more of the above listed services prior to <br />the on-set of service. For all existing clients, the above <br />information will be provided no later than the next regularly <br />scheduled service reassessment. <br />Agency Name; Joint Oran a Chatham Communit Action <br />Name of Age dmi istrator: Sandra R. Sanchez <br />Signature: Date: A ri1 12, 2001 <br />(Please recur a th"s-fto your Area Agency on Aging and <br />retain a copy fcr your files.) <br />