SCHEDULE “A”
To comply with the terms of the Consumer Directed Personal Assistance Program and the Local
Department of Social Services Contract:
A: THE CONSUMER AGREES TO:
1. Recruit, interview, hire, train, supervise, schedule, and, if need be, dismiss the Personal
Assistant of their choice within the structure of the service authorization provided by the Local
Department of Social Services.
2. Provide equal employment opportunities to all prospective employees regardless of their
race, creed, color, national origin, sex, disability, marital status and sexual orientation or
affectional preference, in all employment decisions, including but not limited to recruitment,
hiring, upgrading, demotion, downgrading, transfer, layoff, and terminations and all other terms
and conditions of employment.
3. Keep the appropriate staff person, either the Client Coordinator, the Timekeeper or the
Local Consumer Organization Program Coordinator (if applicable) informed of any changes in
status, including but not limited to the Consumer’s address, telephone number and
hospitalization and also each Personal Assistant’s name, address employment status and hours
worked.
4. Process in a timely manner the required paperwork, including the Consumer and Personal
Assistant enrollment documents.
5. Arrange and schedule backup Personal Assistant coverage for vacations, holidays and
absence due to illness.
6. Train the Personal Assistant as to the rights and responsibilities of all involved parties.
7. Accept full responsibility for any personal injury or loss of property that may result from
the action or inaction of the Personal Assistant.
8. Distribute paychecks to each Personal Assistant, or permit the Personal Assistant to
participate in a Direct Deposit payroll distribution system.
9. Insure that each Personal Assistant work the hours indicated on the time sheet and
mediate all payroll/personnel problems.
10. Comply with the New York State Department of Health requirements regarding the
Advanced Directive notification.
11. Comply with the Local Department of Social Service Medicaid Program requirements
that include the completion of an income verification process; the completion of Social Service,
Physician and Nurse Assessments; and the honoring of all surplus income obligations in a proper and timely manner.
B: THE PERSONAL ASSISTANT AGREES TO:
1. Recognize the authority of the Consumer as the Personal Assistant’s source of
employment and supervisor.
2. Respect the Consumer’s health, well-being, privacy and property.
3. Authorize CDPAP Provider Agency to collect and appropriately distribute employmentrelated
information.
4. Comply with the policies and practices of the Local Social Services District.
C: (CDPAP Provider Agency) AGREES TO:
1. Monitor the Consumer’s continued appropriateness for participation in the Consumer
Directed Personal Assistance Program, either directly or indirectly with the assistance of the
Local Consumer Organization Program (as applicable), using all available information, and
notifying the Local Department of Social Services as needed.
2. Process the Consumer’s payroll for each Personal Assistant.
3. Pay the Personal Assistant the appropriate wage for the hours of service indicated on the
Consumer’s time sheet and authorized by the Local Department of Social Services.
4. Coordinate all matters which relate to each Personal Assistant’s withheld taxes and
benefits.
5. Advise and encourage the Consumers to provide equal employment opportunities to all
prospective employees regardless of their race, creed, color, national origin, sex, disability,
marital status and sexual orientation or affectional preference, in all business decisions, including
but not limited to recruitment, hiring, upgrading, demotion, downgrading, transfer, layoff and
terminations, and all other terms and conditions of employment.
6. Facilitate and monitor the completion of all Consumer and
Personal Assistant documents that are required by City, State or Federal Authorities, either
directly or indirectly with the assistance of the Local Department of Social Services.
7. Maintain, either directly or indirectly with the assistance of the Local Social Services
District (as applicable, a record for each Personal Assistant that will include, at a minimum, the
enrollment forms, the annual worker’s health assessments, and the information needed for
payroll processing and benefit administration.
8. Maintain, either directly or indirectly with the assistance of the Local Social Services
District (as applicable), a Consumer record, which includes the Local Department of Social
Service’s service authorizations, the Consumer Agreement, the periodic Nursing Assessment and
other documentation of the effort to monitor the Consumer’s ability to meet their obligations.
9. Evaluate, either directly or indirectly with the assistance of the Local Social Services
District (as applicable), the community resources to make Recruitment Assistance Services as
available as possible.
10. Evaluate community and budgetary resources to facilitate Personal Assistant access to
health facilities capable of providing the required annual worker’s health assessment and other
health-related program requirements.
11. Maintain a Consumer Advisory Committee and a Grievance Committee.
12. Provide statistical and other pertinent information to the various regulatory, legal and
programmatic entities as may be deemed necessary and appropriate.
13. The vendor agrees to comply with the audit findings of an independent auditor regarding
Living Wage and contract compliance. Any non-compliance issues cited by the auditor must be
resolved by the vendor within forty-five (45) days of notification by the department, and
documented by the vendor in a letter to the department confirming that the problem has been
resolved. This will enable the County to assess the level and type of services provided, as well
as the dedication and/or expenditure of the funding provided by the County for those purposes to
date.
Consumer Signature: ![]()
Date: 
Consumer Name (print):
Personal Assistant Signature: ![]()
Date:
PA Name (print):