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Standard ~ssurance to Comply with Older Americans Act <br /> :Requirements Regarding Client Rights <br /> for <br /> Agencies Providing In-Home Services through the <br /> Home an~. Community Care Block Grant for Older Adults <br /> : <br /> As a provider of one or more of {he services listed below, our agency agrees to notify all Home and <br /> Community Care Block Grant clients receiving any of the below listed services provided by this agency <br /> of the their rights as a service recipient. Services included in this assurance include: -In-Home Aide .~ <br /> -Home Care (home health) <br /> -Housing and H~me Improvement <br /> -Adult Day Care or Adult Day Health Care <br /> <br />Notification will include, at a minimum, an oral review of the information outlined below as well as <br />providing each service recipient _ivith a copy of the information in written form. In addition, providers' <br />of in-home services will establis~ a procedure to document that client rights information has been <br />discussed with in-home services l:lients (e.g. copy of signed Client Bill of nights statement). <br /> <br />Client Rights information to be c~mmunicated to service recipients will include, at a minimum, the <br />right to: <br /> -be fully informed, in advance, about each in-home service to be provided and any change in <br /> service(s) that may aff~t the well-being of the participant; ~ <br /> -participate in planning imd changing any in-home service provided unless the client is <br /> adjudicated incompetent; <br /> -voice a grievance with respect to service that is or fails to be provided, without discrimination <br /> 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 .~rally and in writing, in advance of receiving an in-home service, of <br /> the individual's rights a~d obligations. <br /> <br />Client Rights will be distributed t~, and discussed with, each new client receiving one or more of the <br />above listed services prior to the I)n-set of service. For all existing clients, the above information will <br />be provided no later than the next regularly scheduled service reassessment. <br /> <br />Agency Name: Cabarms County Department of Social Services <br /> <br />Name of Agency Administrator: <br /> <br />James F. Cook <br /> <br />(Please return this form to your A~ea Agency on Aging and retain a copy for your files.) <br /> <br /> <br />