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A. Attendant/Employee’s Name:    First Name   Last Name           
B. Consumer/Employer’s Name: ___________________________________
C. Date of Contract:   Date  
  

ATTENDANT CARE CONTRACT

1.This Attendant Care Contract (“Contract”) is made by Therapeutic Authority Home Health LLC and the Attendant/Employee identified in line B. above who will be employed by the Consumer/Employer identified in line A. above as of the Date of Contract specified in line C. above. Read thoroughly and initial after each section.
Definitions and responsibilities. In order to make this Contract more easily understood, certain terms are defined and various responsibilities are described as follows:

2.The term “Consumer/Employer” means the individual identified in line A. above, who requires Attendant care services in his/her home. Hereafter, the Consumer/Employer will be referred to as “Consumer.” Consumer is the employer of the Attendant/Employee and as such is responsible for directing, managing, scheduling (within the parameters of authorized service hours), and supervising the Attendant/Employee. Consumer is responsible for maintaining and reviewing all timesheets connected with Attendant/Employee’s hours of service for accuracy, and Consumer is responsible for promptly forwarding the same to Services for Independent Living. The Consumer is responsible for keeping the timesheet in their home for monitoring purposes. The Consumer, through the fiscal intermediary, will pay the Attendant/Employee for services authorized in Consumer’s Plan of Care and by this Contract.   Initial here*   

b. The term “Attendant/Employee” means the individual identified in line B. above, who, as a party to this contract, agrees to provide Attendant care services to consumers. Hereafter, the Attendant/Employee will be referred to as “Attendant.” Attendants shall have and maintain the qualifications, credentials, certifications, licenses, and/or training necessary to perform attendant care services described and authorized in Consumer’s Plan of Care before rendering any attendant care services to Consumer. Attendant is not entitled to be paid until and unless he/she has met/maintained all qualifications for rendering attendant care services. Attendant agrees that he/she will accept as payment in full for the services described and authorized in Consumer’s Plan of Care the payments he/she receives pursuant to this Contract. He/she will not seek additional or supplemental payments from Therapeutic Authority Home Health LLC in breach of contractual agreement.   Initial Here*   

The term “attendant care services” or “attendant care” means those services that Consumer needs to have provided to him/her within his/her home in order to achieve independent living within the community. Attendant care services may include but are not limited to helping consumers with eating, dressing, meal preparation, toileting, bathing, grooming, transferring, and specific health maintenance tasks, as well as some incidental housekeeping tasks that insure Consumer’s health and safety, like grocery shopping and laundry. The Attendant care services that Attendant will perform will be described and authorized in the Consumer’s Plan of Care. A copy of the pertinent parts of the Plan of Care will be provided to the Attendant.Initial Here* 

The term “Therapeutic Authority Home Health LLC” means the agency signing this Contract. It is recognized as a vendor of Consumer Directed Services and enrolled as an Organized Health Care Delivery System with the Department of Health and Senior Services, Division of Senior and Disability Services. Therapeutic Authority Home Health LLC is authorized to provide administrative support to consumers and is authorized to enter into payroll service contracts with payroll service companies to provide fiscal intermediary services as set forth below.   Initial Here*   

The term “fiscal intermediary” means a payroll service company, under contract with, Therapeutic Authority Home Health LLC retained to perform “fiscal intermediary services”—those services that an employer must generally perform in connection with paying his/her employee. These include calculating the amount that an employee is to be paid, writing payroll checks (or making direct deposits), withholding and paying state and federal income taxes to the appropriate authorities, withholding and paying Social Security (FICA) and Medicare payments and/or employer’s portions as is required by law or regulations and paying them to the appropriate authorities, and making unemployment/workers compensation insurance payments, as well as withholding/paying those amounts as may be required by law or regulations from time-to-time. The fiscal intermediary will provide the Attendant with a written summary of all deductions and payments made. The fiscal intermediary will prepare and provide Consumer and Attendant with end-of-year tax information and forms within the time prescribed by law, such as W-2’s, so that Consumer and Attendant may comply with all tax filing requirements. The fiscal intermediary will maintain copies of all records required by law or regulations for tax and other purposes, and these shall be the official records documenting the employer/employee (Consumer/Attendant) relationship.   Initial Here*   

Purpose and background information. The purpose of this Contract is to allow the Consumer to interview, hire, direct, manage, schedule (within the parameters of authorized service hours), supervise, and discharge his/her Attendant. Therapeutic Authority Home Health LLC is a vendor of Consumer Directed Services and as such it is authorized by the Missouri Department of Health and Senior Services to provide administrative support and case management for Consumer-Directed Services. Therapeutic Authority Home Health LLC may contract with payroll service companies to act as a fiscal intermediary. The fiscal intermediary will act as an agent for and provide payroll services for Consumer, as explained herein.   Initial Here*   

Consumers will employ Attendants to work in Consumer’s home, at the direction and under the supervision of Consumer, provide the attendant care services described and authorized in Consumer’s Plan of Care. Because of the work arrangement contemplated in this contract, Attendant is an employee of Consumer for purposes of the federal Fair Labor Standards Act, and not an independent contractor. It is, therefore, necessary that consumers, through the fiscal intermediary, withhold and pay all income taxes required by law, as well as all other withholdings or payments that employers generally make in connection with employees in order to comply with applicable laws and regulations.   Initial Here*   

The fiscal intermediary will perform intermediary services as described above and prepare payment for hours worked to Attendant on behalf of Consumer.   Initial Here*   

3. Basis for payment. Attendant agrees to perform the Attendant care services described and authorized in Consumer’s Plan of Care at an initial rate equal to $11.00/hour, which rate may be increased from time-to-time with or without notice to Attendant. Attendants will be paid only for those services described and authorized in Consumer’s Plan of Care, and no others. Medicaid will provide funds to the fiscal intermediary to pay Attendant for authorized attendant care services actually performed for Consumer. Attendants are not permitted to off-set excess hours in one month against scheduled hours in another month, even if this is agreeable to Consumer. Attendant understands that he/she is not entitled to nor will he/she receive as part of his/her payment hereunder, or otherwise, any “fringe” benefits, such as health insurance, sick leave, paid personal days, paid vacations, paid holidays, and the like. However, the Consumer is expected to reimburse the Attendant for providing transportation to the Consumer, if authorized by the Plan of Care.   Initial Here*   
 
4. Method of payment. Therapeutic Authority Home Health LLC will provide Consumer with documents authorizing payment for the services described and authorized in Consumer’s Plan of Care. The documents will set forth the maximum number of hours to be worked during a specific time period; and the applicable time period for performance of the Attendant care services. Therapeutic Authority Home Health LLC will also provide Consumer with timesheets to record Consumer’s name, Attendant’s name, dates and times of services delivered, types of activities performed at each visit, Attendant’s signature for each visit and Consumer’s signature verifying service delivery for each visit.   Initial Here* 
Payroll will be processed bi-weekly. At the end of each payroll period, Consumer will review and approve the completed timesheet and forward the same to Therapeutic Authority Home Health LLC Timesheets must be received by Saturday after the end of a payroll period to be included in the applicable payroll. If Therapeutic Authority Home Health LLC does not receive the timesheets within the prescribed time, then payment will not be processed until the next payroll, and Attendant’s payment will be delayed.   Initial Here*   
It is imperative that Consumer and Attendant accurately record and report services and hours. Falsification or misrepresentation on any timesheet constitutes fraud. Payments made on behalf of the Consumer as a result of inaccurate/false timesheets will be recouped from Attendant and/or Consumer. Any incidents of apparent fraud will be reported to Medicaid and/or other appropriate authorities.   Initial Here*   

5. Conditions and understandings of Contract. The quality, appropriateness, and timeliness of the Attendant care services rendered and reimbursed through this contract are subject to evaluation, through inspection or other means, by Therapeutic Authority Home Health . Additionally, as Medicaid funds are used, in whole or in part, to pay Attendant, the Missouri Department of Social Services and the U.S. Department of Health and Human Services, and/or its/their designee(s), have the right to evaluate, through inspection or other means, the Attendant care services rendered and reimbursed hereunder.   Initial Here*   

Attendant understands and agrees that he/she is not an employee of the State of Missouri or any department, unit, agency, or subdivision thereof. Attendant will not represent that he/she is an employee of the State of Missouri or any department, unit, agency, or subdivision thereof. Attendant understands and agrees that pursuant to this Contract, he/she is employed solely by Consumer.   Initial Here*   

Attendant understands and agrees that this Contract is non-exclusive. Consumers may enter into one or more other Attendant Care Contracts with other Attendants. Consumers may terminate this contract with Attendant and such termination will have no effect on other non-terminated contracts, which will remain in full force and effect. Similarly, Attendants may enter into one or more Attendant Care Contracts with other Consumers. Termination of one or more of such other Attendant Care Contract(s) does not automatically terminate this Contract. The Attendant understands and agrees that this Contract does not guarantee him/her any specific number of hours of work or any hours at all.   Initial Here*   

Attendant understands and agrees that he/she may not act as Consumer’s personal representative in matters regarding financial, and/or budgetary decision making. Attendant understands and agrees that he/she may not act as Consumer’s personal representative in matters regarding medical treatment or health care. Further, an Attendant may not be listed as a Power of Attorney, in any manner, or guardian for the same consumer which Attendant is serving.   Initial Here*   

Attendant understands and agrees that he/she may not be paid for any services rendered to Consumer until a background screening via FCSR has been performed by Therapeutic Authority Home Health LLC and the screening is clear. Further, Attendant understands that if criminal background is disclosed on the application, or otherwise, the potential Attendant is ineligible for employment unless a Good Cause Waiver is in effect and in good standing. Attendants shall not receive any wages for services rendered since they are considered ineligible for employment. The Attendant shall not hold Therapeutic Authority Home Health LLC responsible for any wages for services rendered prior to a background screening or providing services although criminal background information has been disclosed.   Initial here*   

 6. Liability for work related injury/illness. Attendant understands and agrees that Attendant and/or Consumer is/are solely responsible for any injuries or illness Attendant sustains while providing Attendant care services and/or acting within the scope of his/her employment, and that neither Therapeutic Authority Home Health LLC nor the State of Missouri has any liability for such injuries or illness.  Initial Here*    

7. Mandated Reporter. Attendant agrees and understands that he/she is required by law to report suspected abuse, neglect, and/or exploitation as determined under Sections 660.00, 565.188, 208.912, 208.915 and 198.070 RSMo to MISSOURI RESPONSE SYSTEM, 1-800-392- 0210.   Initial Here*   

8. Direction and supervision of Consumer. Attendant understands and agrees that he/she will perform the Attendant care services specified in Consumer’s Plan of Care under the direction and supervision of Consumer, in a manner reasonably satisfactory to Consumer, on such dates and at such times as agreed upon by Attendant and Consumer; however, the service time shall not exceed the number of hours authorized for service.   Initial Here*   

9. Termination for cause. Attendant understands and agrees that Consumer may establish reasonable standards for employment and performance and may discharge Attendant for violation for the same. Attendant understands that Consumer may discharge Attendant for cause with or without prior notice to Attendant. Consumer’s discharge of Attendant for cause is the termination of the Contract.   Initial Here*   

10. Termination by Attendant. Attendant may terminate this Contract, with or without cause, upon seven (7) days written notice to Consumer and Therapeutic Authority Home Health LLC of his/her intention to terminate.   Initial Here*   

11. Contract term. If this contract has not been previously terminated, it shall automatically be renewed on each anniversary date from the Date of Contract specified in line C. above, or it shall be renewed as set forth herein. This perpetual clause of employment shall be in effect unless Consumer has informed Therapeutic Authority Home Health LLC that he/she no longer wishes to employ Attendant or Attendant has informed Therapeutic Authority Home Health LLC that he/she no longer wishes to work for Consumer. If, at the time of an employment review, Therapeutic Authority Home Health LLC determines that Attendant is not presently working for Consumer but is likely to be re-employed in the immediate future, then Therapeutic Authority Home Health LLC , in its sole discretion, may renew this Contract within the terms specified commencing with the date of re-employment. However, should subsequent background screenings reveal any background information, this contract is immediately canceled and all employment through the Consumer Directed Services program is automatically terminated.   Initial Here*   

12. Confidentiality. Attendant understands that Consumer is entitled to have his/her personal and health care information treated with confidentiality. Attendant agrees to protect and maintain Consumer’s confidentiality. Under no circumstances will the Attendant discuss or disclose any Consumer’s personal or health care information without legal authorization. Consumer’s right to confidential treatment of personal and health care information survives the termination of this Contract.   Initial Here*

13. Non-discrimination. The parties to this Contract agree that they and each of them will refrain from discrimination on the basis of race, religion, nationality, sex, age, familial status, color, disability, or any other basis not permitted by law.   Initial Here*   

14. Hospital stays. The Attendant shall not provide services to the Consumer during the Consumer’s hospital stay. Should services be provided, the Consumer is solely responsible for paying the Attendant and Therapeutic Authority Home Health LLC shall not reimburse for those services. Should an Attendant receive wages during the Consumer’s hospital stay, Therapeutic Authority Home Health LLC shall exercise the legal right to recoup the entire amount as identified by the Department of Health and Senior Services and/or Missouri Health Net. Additionally, the Attendant and Consumer will be referred to the Central Registry Unit and/or Office of Attorney General for an investigation of record falsification. The hours that are not used during the Consumer’s hospital stay may be made up during the same month only if the Consumer demonstrates need.   Initial Here*   

15. Miscellaneous provisions. This Contract shall be interpreted in accordance with and governed by the State of Missouri laws. The place of contract is the county where Therapeutic Authority Home Health LLC has its principal office.   Initial Here*   

16. Unannounced Visits: Therapeutic Authority Home Health LLC has the responsibility of ensuring the health, safety, and welfare of the Consumer. Additionally, Therapeutic Authority Home Health LLC has the responsibility to monitor the provision of services in the plan of care and other services as needed to live independently. Considering these responsibilities and the nature of this program, Therapeutic Authority Home Health LLC maintains the right to make random, unscheduled, and/or unannounced visits at the residence of the consumer during the regular working hours of the attendant as specified on the timesheets submitted by the consumer.   Initial Here*   

17. Subsequent background screenings. State law mandates an initial background screening for every potential attendant. Additionally, a subsequent background screening is performed upon the attendant’s request to work for additional consumers. If the background screening identifies background history, regardless of the timeframe, the attendant’s employment is terminated with each and every consumer for whom they are working.   Initial Here*   
The invalidity or unenforceability of any portion or provision of this Contract shall not affect, impair, or render unenforceable any other portion or provision. It is intended that each provision herein that is invalid or unenforceable as written be valid and enforceable to the fullest extent possible. Under no circumstances may Attendant assign his/her obligations, duties, or rights pursuant to or connected with this Contract to any other person or entity. All understandings, agreements, offers, representations, and/or writings made by the parties to this Contract prior to the Date of Contract specified in line C. above are hereby merged in this contract and are of no force and effect unless specifically set forth in this contract.   Initial Here*   
The captions in this Contract are for convenience only and are not to be construed as substantive parts of this contract.   Initial Here*   
This contract shall not be modified except in writing signed and dated by both parties except: 1) the Contract may be renewed pursuant to paragraph 10 above without an additional writing; and 2) Attendant’s compensations for services may be increased from time-to-time as authorized by law or regulation without notice or in writing signed by both parties.   Initial Here*   
At the time of termination of this contract, whether for cause, end of term, or otherwise, Attendant agrees to promptly deliver to Therapeutic Authority Home Health LLC, any and all records, materials, directives, memos, or other documents that pertain to this Contract, Consumer, or Therapeutic Authority Home Health LLC , including but not limited to all originals and/or copies of Consumer’s Plan of Care (in whole or in part), confidential Consumer information, medical care directions and/or physician/medical care instructions, completed or incomplete timesheets, and the like, except that Attendant may retain Attendant’s payroll records and tax information.   Initial Here*   
At the time of termination of this contract, whether for cause, end of term, or otherwise, Attendant agrees to promptly provide Consumer with current timesheet information so that the last payroll for Attendant may be completed.   Initial Here*   

18. Signatures. BY SIGNING BELOW YOU ACKNOWLEDGE YOU HAVE READ THIS CONTRACT, YOU ACCEPT IT, UNDERSTAND IT, AND AGREE TO ITS TERMS.