Caregiver Application Form With Insurance In Fairfax

State:
Multi-State
County:
Fairfax
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

In conclusion, there are 4 types of caregivers: family caregivers, professional caregivers, volunteer caregivers, and informal caregivers. Each caregiver faces unique challenges, including physical and emotional exhaustion, financial strain, and balancing personal and caregiving responsibilities.

Cover Virginia also operates a statewide customer service call center for Medicaid and the FAMIS Programs at 1-855-242-8282. The call center provides general program information, application status, explanation of coverage and benefits, and assistance in resolving application issues.

If you have experienced a qualifying event, please notify the Benefits Division at DHRBenefitsDivision@fairfaxcounty or (703) 324-3311.

The Department of Medical Assistance Services (DMAS) rebranded Virginia's Medicaid program as Cardinal Care.

Calling your case worker directly or calling the Customer Call Center at 703-324-7500, Monday–Friday, 8 a.m.– p.m.

How to Apply. If you think you could benefit from Medicaid, you can apply online at CommonHelp or contact the Enterprise Call Center at 1-833-522-5582. Language assistance is available. If you'd like more information, learn more about applying for Medicaid.

Virginia Caregiver Training Requirements Home Attendant/Home Health Aide: Must complete a state approved 40-hour curriculum or HHA program of 75 hours and 12 hours CE annually. Certified Nurse Assistants: After completing a state approved CNA school program, CNAs in Virginia must complete 12 hours of CE annually.

Virginia Caregiver Training Requirements Home Attendant/Home Health Aide: Must complete a state approved 40-hour curriculum or HHA program of 75 hours and 12 hours CE annually. Certified Nurse Assistants: After completing a state approved CNA school program, CNAs in Virginia must complete 12 hours of CE annually.

"Caregiver" means an adult who is a single person with a Virginia adjusted gross income of not more than $50,000, or married and the combined Virginia adjusted gross income of both spouses is not more than $75,000 who provides care for a mentally or physically impaired person within the Commonwealth.

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Caregiver Application Form With Insurance In Fairfax