DIVISION OF RESPONSIBILITIES
Whereas both parties are interested in participation in the consumer-directed personal assistant program, both parties agree to the following terms and conditions:
1. The consumer and, as applicable, the consumer’s designated representative shall be solely responsible to manage the plan of care authorized by the MLTC and assuring that each CDPA completely and safely performs the personal care services, home health aide services and skilled nursing tasks included on the consumer’s MLTC approved plan of care.
2. The Consumer or his/her agent is responsible to notify the MLTC within 5 business days of any changes in the consumer’s medical condition or social circumstances including but not limited to, any hospitalization of the consumer or change in the consumer’s address or telephone number.
3. The Consumer understands that personal assistance services under the CDPAP will not be paid for by the program until all paperwork is completed and returned to the office.
4. The Consumer must have Medicaid and provide assurances that it remains current.
5. Consumers who become ineligible for Medicaid benefits and who fail to notify the office of this situation and continue to receive personal assistant services during the period of ineligibility will be responsible for repayment to Priority Home Health Care of any compensation received by the Personal Assistant during the said period.
6. The consumer must notify Priority Home Health Care in advance when transitioning to another insurance to ensure that there is no gap in coverage. Consumers who fail to notify the office will be responsible for repayment to Priority Home Health Care of any compensation received by the Personal Assistant during said period if a gap in coverage occurred.
7. The Consumer will meet the monthly spend down, if applicable.
8. The Consumer agrees not to employ the following: Their immediate family members, defined as: spouse, father or mother of a child under the age of 21, Power of Attorney or Designated Representative as their Personal Assistant.
9. The Consumer or his/her agent, or in the case of a minor child, the parent or guardian, takes full and complete responsibility for the recruitment, hiring, training, maintenance, and termination of any and all Personal Assistants who provide service.
10. The Consumer accepts responsibility for securing back up Personal Assistants in the event that a scheduled assistant is unable to perform or show up for a scheduled shift. It is understood that Priority Home Health Care keeps no list of such back-up Assistants and shall be held harmless in the event of accident or injury resulting when the Consumer does not receive care during scheduled hours.
11. The Consumer accepts responsibility for any and all items removed from or destroyed within Consumer's primary residence or vehicle without Consumer's consent.
12. Any arrangements regarding the transportation of the Consumer as a duty of the Personal Assistant shall be an agreement made strictly between the Consumer and the Personal Assistant. It is understood that Priority Home Health Care neither condones nor discourages this activity and accepts no liability in the event of accident or injury.
13. Priority Home Health Care will act as the Employer of Record for payroll, employee benefits, and insurance, as applicable. In this capacity, we will accept time slips and issue paychecks in the name of each Personal Assistant employed by the Consumer for the authorized number of hours per week. Appropriate Federal, State, and FICA withholding taxes will be collected. Personal Assistants will receive year-end W-2 earning statements.
14. Priority Home Health Care will compensate for the Consumer's Personal Assistant(s) only for the authorized weekly hours worked. Should the Personal Assistant(s) work more than the authorized hours per week, the Consumer assumes full responsibility for payment to the Personal Assistant(s) of all unauthorized hours of service.
15. The Consumer will inform Priority Home Health Care of any change in status including, but not limited to, address, telephone, Consumer’s name, hours worked and hospitalization.
16. No two personal assistants are permitted to work and provide services to me simultaneously, and I acknowledge and agree that the Agency can only bill for services provided to me by one personal assistant at a time. For this reason, while I can employ multiple personal assistants, I acknowledge and agree that I will not schedule two or more personal assistants to work for me on the same day at the same time.