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.
Caregiver Form Application With Database In Harris
Category:
State:
Multi-State
County:
Harris
Control #:
US-00458BG
Format:
Word;
Rich Text
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FAQ
The FPL varies based on household size: one person ($19,320), two people ($26,130), three people ($32,940), four people ($39,750), or five people ($46,560). If your household income exceeds 150% FPL, you can still receive medical treatment through Harris Health System but won't qualify for discounted services.
Anyone is eligible regardless of age, income, or immigration status. You must be a Harris County resident.
Provide: Texas I.D. or drivers license stating the person lives in Harris County. Social Security Card. Citizenship(Passport or Birth Certificate) or Green Card. Proof of income (1 months check stubs) Any bills or bank statement (within 60 days) Income tax (if necessary) Medicaid or CHIP card (if necessary)
What is the Harris Health Financial Assistance Program? The Harris Health Financial Assistance Program is a program that is available to Harris County residents whose gross family income, as it relates to family size, falls at or below at or below 150% of the Federal Poverty Level.
Harris Health Financial Assistance Program or the status of my application, is there a phone number to call? For questions call 713-566-6509 (Monday – Friday, 8am – 4pm) to speak to the Eligibility Call Center team member for any questions regarding the Harris Health Financial Assistance Program.
Applicant's household income must be below 200% of the federal poverty line (FPL) and reside in one of the identified high-poverty ZIP codes.
Program Overview In response, Harris County is investing $20.5 million from the American Rescue Plan Act (ARPA) to address economic inequity and reduce poverty. Uplift Harris, the county's first guaranteed income program, will distribute $500 per month for 18 months to eligible households.
More info
This form should be submitted to the applicant's local AAA. Click on the words on the links below and you can enter information directly into the form before printing it!The proposer is required to use the Texas Department of Aging and. A disability statement form is available from the Harris County Tax office. Harris County Public Health provides a variety of low-cost, clinical and preventive health services to meet your essential healthcare needs. The STEAR program is a free registry that provides local emergency planners and emergency responders additional information on the needs in their community. How long must an employee be in a position before they are able to apply for other available positions? Visit the Texas Department of Motor Vehicles or MyPlates websites to see a complete list of specialty plates that are available. As our previous 40th Anniversary blogs pointed out, the creation of Family Caregiver Alliance was not a simple process. Family Courts are located in the Civil Courthouse at 201 Caroline St., Houston TX 77002.