A contract shall be in force between a home nursing or home
services agency and a client. A copy of the contract shall be provided to the
client and a copy shall be maintained in the client file at the agency. If the
agency has both a home services license and a home nursing license, the agency
shall maintain two separate client contracts, one for skilled medical care and
one for non-medical services. The contracts shall be printed in no less than
12-point type, and shall include at least the following elements in the body or
through supporting documents or attachments:
a) Client consent to receive
services;
b) The name, street
address, mailing address and telephone number of the agency;
c) The name, mailing address and telephone
number of the persons designated as the agency manager and/or other individual
beyond the in-home worker to contact in regard to questions, problems, needs or
concerns;
d) A statement describing
the agency license status;
e)
Indication and assurance of compliance by the agency with the requirements of
the Act, including compliance with the Health Care Worker Background Check
Act;
f) The duration of the
contract;
g) The rate to be paid by
the client and a detailed description of services to be provided as a part of
the rate;
h) A description of the
process through which the contract may be modified, amended or
terminated;
i) A description of the
agency complaint resolution process;
j) The billing and payment procedures and
requirements;
k) A statement
regarding the agency's policy on notification of a relative or other individual
in case of an emergency;
l) A
notice as developed and provided by the agency, indicating the responsible
party for the following:
1) Employer of the
in-home/licensed worker;
2)
Liability for the in-home/licensed worker;
3) Payment of wages to the in-home/licensed
worker;
4) Payment of employment
taxes, unemployment insurance, and worker's compensation for the
in-home/licensed worker;
5) Payment
of Social Security taxes for the in-home/licensed worker;
6) Day-to-day supervision of the
in-home/licensed worker;
7)
Assignment of duties to the in-home/licensed worker;
8) Responsibility for hiring, firing and
disciplining the in-home/licensed worker; and
9) Provision of equipment or materials for
the in-home/licensed worker's use in providing services to the
consumer.
