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 Medicaid In Wake
Category:
State:
Multi-State
County:
Wake
Control #:
US-00458BG
Format:
Word;
Rich Text
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FAQ
For eligible Medicaid beneficiaries, Personal Care Services (PCS) provides hands-on assistance, by paraprofessional aides, for the five qualifying activities of daily living (ADLs) which include eating, dressing, bathing, toileting, and mobility.
After you apply It can take up to 45 days for the Department of Social Services (DSS) to decide if you qualify for NC Medicaid. Disability applications can take up to 90 days. You will get a letter in the mail if you are approved or denied.
Fortunately, NC Medicaid, North Carolina's Medicaid managed care program, has coverage for in-home care. Through its Personal Care Services program, NC Medicaid pays for an approved number of hours of attendant care.
North Carolina Residency A photo ID with your NC address listed, or. A utility bill, or. A lease or mortgage agreement, or. Vehicle registration, or. Documentation of employment, or. If you do not have any documentation, you can check a box in ePASS labeled “NC Residency Declaration.”
After you apply Be sure your address and phone number are correct on your application. It can take up to 45 days for the Department of Social Services (DSS) to decide if you qualify for NC Medicaid. Disability applications can take up to 90 days.