Agenda - 06-18-2002 - 8d - Laserfiche WebLink

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zs Standard Assurance To Comply with Older Americans Act Requirements Regarding Clients Rights For Agencies Providing In-Home Services through the Home and Community Care Block Grant for Older Adults As a provider of one or more of the services listed below, our agency agrees b nobly all Home and Community Care Block Grant diems receiving any of Me below listed services provided by this agency of their rights as a service recipient Services in this assurance include: • InHorma Aide • Home Care (home health) • Housing and Home Improvement • Adut Day Care or Adult Day Heath Care Notification will include, at a minimum, an oral review of the information outlined below as wall as providing each service recipient with a copy of the information in written form. In addition, providers of in-home services will establish a procedure to document that diem rights informaton has been discussed with inhome services clients(ep. copy of signed Client Bill of Rights statement). Clients Rights information to be communicated to service recipients will include, at a minimum, Me right to: • be fully informed, in advance, about each in-home ini to be provided and any change and any change in services)that may effect Me wellbeing of the pertained; • participate in planning and changing any nhome service provided unless Me client is adjudicated incompetent; • voice a grievance with respect m service that is or fails b bar provided,without discrimination or reprisal as a result of voicing a grievance; • confidentiality of records relating to the individual; • have property treated AM respect and • be fully informed both orally and in vml ing. in advance of receiving an in-home service, of Me individual's rights and obligations_ Client Rights will be distributed to, and discussed with, each new client receiving are or more of the above listed services prior to Me onset of service. For all eds5ng dients, Me above information will be provided no later than Me next regularly scheduled service reassessment. Agency Name: Toro_ {� Ortinqe C dlrm C. mn , ih/ AL-6GIli Tnc Name of Agency Administrator S(` CY]R] Sunc hez yy° Q NCO Signature T°J/J /�m �l � IEJ /�Ory Date: 2jUy Q ' 2002 (Please return this form to your Area Agency on Aging and retain a copy for your files)