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Standard Assurance To Comply with Older Americans Act <br /> Requirements Regarding Clients Rights <br /> For <br /> Agencies Providing In-Home Services through the <br /> Home and Community Care Block Grant for Older Adults <br /> FY1B <br /> As a provider of one or more of the services listed below, our agency agrees to notify <br /> all Home and Community Care Blocl< Grant clients receiving any of the below listed services provided by <br /> this agency of their rights as a service recipient. Services in this assurance nclude: <br /> In-Home Aide <br /> Home Care (home health) <br /> Housing and Home Improvement <br /> Adult Day Care or Adult Day Health Care <br /> Notification will include, at a minimum, an oral review of the information outlined below <br /> below as well as providing each services recipient with a copy of the information in written form. In addition, <br /> providers of in-home services will establish a procedure to document that client rights information has been <br /> discussed with in-home services clients (e.g. copy of signed Client Bill of Rights statement). <br /> Clients Rights information to be communicated to service recipients will include, at a <br /> minimum, the right to: <br /> be fully informed, in advance, about each in-home service to be provided <br /> and any change in service(s) that may affect the wellbeing of the <br /> participant; <br /> participate in planning and changing any in-home service provided unless <br /> the client is adjudicated incompetent, <br /> voice a grievance with respect to service that is or fails to be provided, <br /> without discrimination or reprisal as a 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 of receiving an <br /> in-home service, of the individual's rights and obligations. <br /> Client Rights will be distributed to, and discussed with, each new client receiving one or more of the above <br /> listed services prior to the onset of service. For all existing clients, the above information will be provided <br /> no later than the next regularly scheduled service reassessment. <br /> Agency Name: Cabarrus County Transportation <br /> Name of Agency Administrator: Bob Bushey <br /> Signature: ,� �' j• , „ Dater <br /> r <br /> (Please return this form to your Area Agency on Aging and retain a copy for your files.) <br /> CLIENT/PATIENT RIGHTS <br /> Attachment number 1 \n <br /> F-4 Page 94 <br />