Application Caregiver Form With Two Points In Alameda

State:
Multi-State
County:
Alameda
Control #:
US-00458BG
Format:
Word; 
Rich Text
Instant download

Description

This form is a sample of an agreement between an elderly or disabled client and a Caregiver who operates as an independent contractor and provides personnel to assist Client to live at home and to have as much control over the home environment and life as possible under the circumstances. Caregiver's personnel also assist Client with the activities of daily living, scheduling medication, assistance with mobility, accompanying Client on errands and appointments, and such other services as agreed between Client and Caregiver.



In this agreement, Client waives damages for simple negligence of Caregiver, but not gross negligence or misconduct that is intentional or criminal in nature. Courts generally will not enforce waivers of this type of misconduct since such a waiver would be deemed to be against public policy because it would encourage dangerous and illegal behavior.
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  • Preview Personal Care Service Agreement - Caregiver for Elderly or Disabled - Consent
  • Preview Personal Care Service Agreement - Caregiver for Elderly or Disabled - Consent

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FAQ

Maximum Resource Limit Increase: Effective January 1, 2025, the maximum resource limit for CalWORKs applicants and recipients increased to $18,206 for Assistance Units that include at least one member who is age 60 or older or disabled and $12,137 for all other CalWORKs applicants and participants.

If you would like to apply over the phone, call us at (510) 272-3663. If you need an application packet to be mailed to you, call us at (510) 272-3663 or 1-888-999-4772.

MY PHONE: Call 510-577-1800 weekdays from AM - 12 Noon or - PM. Once you dial, when prompted, press “1” for English and then “1” for applying for IHSS and “1” a third time to speak with an intake screener. 2. BY MAIL: Request an application to be mailed to client's home.

To be eligible for IHSS, an individual must be Medi-Cal eligible or must be receiving Supplemental Security Income (SSI) benefits. The IHSS program provides payment for non-medical in-home care for qualified individuals who are unable to remain safely in their homes without this assistance.

You may be eligible for General Assistance if you are: a U.S. citizen or non-citizen legally in the country with no limitation on your stay; a resident of Alameda County for at least 15 days; and. an adult without dependent children or.

“Low” ranges from $76,750 for one person to $109,600 for four. “Very Low” income is classified as a household earning 50% of the median family income. Similarly, “Low” income is 80% of the median, and “Moderate” income is 120% of the median income. Source: Alameda County HCD Income Limits Effective 5/13/2022.

If you would like to apply over the phone, call us at (510) 272-3663. If you need an application packet to be mailed to you, call us at (510) 272-3663 or 1-888-999-4772.

Basic Eligibility Requirements Live in California and plan to stay; Are a United States citizen or immigrant who has been given permission to live in the United States; Have an eligible child(ren) and/or you are pregnant and; One or both parents do not live in the home, are no longer living, or are disabled; or.

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Application Caregiver Form With Two Points In Alameda