Home Care Independence Forms Consumer Directed Service available through local community agencies that receive DAAS funding for support of services to the aging is a method of service delivery that promotes and enables the consumer (called a Participant) to recruit, hire, train, supervise, and, when necessary, terminate the employment of chosen Personal Assistants who provide them personal and home management services in their home settings. Files Vendor Agreement7.1.15.doc Vendor Agreement application/msword • 42 KB - December 01, 2015 Health Care (Providers) DAAS101_Long.pdf DAAS-101 Client Registration Form PDF • 109.9 KB - June 25, 2015 Health Care (Providers) CDS-NCDAAS-Self-AssessmentForm2113.pdf Participant Self-Assessment Form PDF • 20.14 KB - June 25, 2015 Health Care (Providers) CDS-Assessmentform.pdf Service Assessment/Reassessment Form PDF • 27.05 KB - June 25, 2015 Health Care (Providers) CDS-Appointment-Representative.pdf Appointment of Representative For Participant PDF • 18.59 KB - June 25, 2015 Health Care (Providers) CDS-HOMECARE-INDENROLLMENTFORM4.pdf Participant Enrollment Form PDF • 86.07 KB - June 25, 2015 Health Care (Providers) CDS-BackupPOC.pdf CDS Plan of Care/Budget PDF • 9.08 KB - June 25, 2015 Health Care (Providers) CDS-HOMECARE-INDParticipantBILLOFRIGHTS2.pdf Participant Bill Of Rights PDF • 23.3 KB - June 25, 2015 Health Care (Providers) CDS-EmploymentApplication2113.pdf Employment Application and Criminal Record Check Consent Form PDF • 19.6 KB - June 25, 2015 Health Care (Providers) CDS-ParticipantReferralForm-FMS2113.pdf Participant Referral Form for FMS PDF • 15.78 KB - June 25, 2015 Health Care (Providers) CDS-ChangeOrderFormFMS2112.pdf Change Order Form for FMS PDF • 12.96 KB - June 25, 2015 Health Care (Providers) CDS-BackgroundCheckPolicy.pdf CDS Criminal Background Check Policy PDF • 18.94 KB - June 25, 2015 Health Care (Providers) CDS-FISCALAGENTAGREEMENT.pdf Fiscal Management Service Agreement PDF • 60.79 KB - June 25, 2015 Health Care (Providers) CDS-EmploymentAgreement.pdf Employment Agreement PDF • 117.47 KB - June 25, 2015 Health Care (Providers) CDS-HOMECARE-INDPersonalAssistantBILLOFRIGHTS2.pdf Personal Assistant Bill of Rights PDF • 21.83 KB - June 25, 2015 Health Care (Providers) CDS-SelfDeterminationEmployeeTimecard.pdf Self Determination Employee Time Card PDF • 141.52 KB - June 25, 2015 Health Care (Providers) CDS-SelfDeterminationTimecardInstructions.pdf Self Determination Timesheet Instructions PDF • 93.79 KB - June 25, 2015 Health Care (Providers) CDS-PayrollScheduleE.pdf Payroll Schedule PDF • 185.93 KB - June 25, 2015 Health Care (Providers) CDS-FaxCoverSheet-SelfDeterminationClients.pdf Fax Coversheet for Self-Determination Clients PDF • 68.7 KB - June 25, 2015 Health Care (Providers) CDS-LetterofInquiryforExtraWork.pdf Letter of Inquiry to Personal Assistants Who May Want Extra Work With Other Recipients PDF • 76.81 KB - June 25, 2015 Health Care (Providers)
Home Care Independence Forms Consumer Directed Service available through local community agencies that receive DAAS funding for support of services to the aging is a method of service delivery that promotes and enables the consumer (called a Participant) to recruit, hire, train, supervise, and, when necessary, terminate the employment of chosen Personal Assistants who provide them personal and home management services in their home settings. Files Vendor Agreement7.1.15.doc Vendor Agreement application/msword • 42 KB - December 01, 2015 Health Care (Providers) DAAS101_Long.pdf DAAS-101 Client Registration Form PDF • 109.9 KB - June 25, 2015 Health Care (Providers) CDS-NCDAAS-Self-AssessmentForm2113.pdf Participant Self-Assessment Form PDF • 20.14 KB - June 25, 2015 Health Care (Providers) CDS-Assessmentform.pdf Service Assessment/Reassessment Form PDF • 27.05 KB - June 25, 2015 Health Care (Providers) CDS-Appointment-Representative.pdf Appointment of Representative For Participant PDF • 18.59 KB - June 25, 2015 Health Care (Providers) CDS-HOMECARE-INDENROLLMENTFORM4.pdf Participant Enrollment Form PDF • 86.07 KB - June 25, 2015 Health Care (Providers) CDS-BackupPOC.pdf CDS Plan of Care/Budget PDF • 9.08 KB - June 25, 2015 Health Care (Providers) CDS-HOMECARE-INDParticipantBILLOFRIGHTS2.pdf Participant Bill Of Rights PDF • 23.3 KB - June 25, 2015 Health Care (Providers) CDS-EmploymentApplication2113.pdf Employment Application and Criminal Record Check Consent Form PDF • 19.6 KB - June 25, 2015 Health Care (Providers) CDS-ParticipantReferralForm-FMS2113.pdf Participant Referral Form for FMS PDF • 15.78 KB - June 25, 2015 Health Care (Providers) CDS-ChangeOrderFormFMS2112.pdf Change Order Form for FMS PDF • 12.96 KB - June 25, 2015 Health Care (Providers) CDS-BackgroundCheckPolicy.pdf CDS Criminal Background Check Policy PDF • 18.94 KB - June 25, 2015 Health Care (Providers) CDS-FISCALAGENTAGREEMENT.pdf Fiscal Management Service Agreement PDF • 60.79 KB - June 25, 2015 Health Care (Providers) CDS-EmploymentAgreement.pdf Employment Agreement PDF • 117.47 KB - June 25, 2015 Health Care (Providers) CDS-HOMECARE-INDPersonalAssistantBILLOFRIGHTS2.pdf Personal Assistant Bill of Rights PDF • 21.83 KB - June 25, 2015 Health Care (Providers) CDS-SelfDeterminationEmployeeTimecard.pdf Self Determination Employee Time Card PDF • 141.52 KB - June 25, 2015 Health Care (Providers) CDS-SelfDeterminationTimecardInstructions.pdf Self Determination Timesheet Instructions PDF • 93.79 KB - June 25, 2015 Health Care (Providers) CDS-PayrollScheduleE.pdf Payroll Schedule PDF • 185.93 KB - June 25, 2015 Health Care (Providers) CDS-FaxCoverSheet-SelfDeterminationClients.pdf Fax Coversheet for Self-Determination Clients PDF • 68.7 KB - June 25, 2015 Health Care (Providers) CDS-LetterofInquiryforExtraWork.pdf Letter of Inquiry to Personal Assistants Who May Want Extra Work With Other Recipients PDF • 76.81 KB - June 25, 2015 Health Care (Providers)
Vendor Agreement7.1.15.doc Vendor Agreement application/msword • 42 KB - December 01, 2015 Health Care (Providers)
DAAS101_Long.pdf DAAS-101 Client Registration Form PDF • 109.9 KB - June 25, 2015 Health Care (Providers)
CDS-NCDAAS-Self-AssessmentForm2113.pdf Participant Self-Assessment Form PDF • 20.14 KB - June 25, 2015 Health Care (Providers)
CDS-Assessmentform.pdf Service Assessment/Reassessment Form PDF • 27.05 KB - June 25, 2015 Health Care (Providers)
CDS-Appointment-Representative.pdf Appointment of Representative For Participant PDF • 18.59 KB - June 25, 2015 Health Care (Providers)
CDS-HOMECARE-INDENROLLMENTFORM4.pdf Participant Enrollment Form PDF • 86.07 KB - June 25, 2015 Health Care (Providers)
CDS-HOMECARE-INDParticipantBILLOFRIGHTS2.pdf Participant Bill Of Rights PDF • 23.3 KB - June 25, 2015 Health Care (Providers)
CDS-EmploymentApplication2113.pdf Employment Application and Criminal Record Check Consent Form PDF • 19.6 KB - June 25, 2015 Health Care (Providers)
CDS-ParticipantReferralForm-FMS2113.pdf Participant Referral Form for FMS PDF • 15.78 KB - June 25, 2015 Health Care (Providers)
CDS-ChangeOrderFormFMS2112.pdf Change Order Form for FMS PDF • 12.96 KB - June 25, 2015 Health Care (Providers)
CDS-BackgroundCheckPolicy.pdf CDS Criminal Background Check Policy PDF • 18.94 KB - June 25, 2015 Health Care (Providers)
CDS-FISCALAGENTAGREEMENT.pdf Fiscal Management Service Agreement PDF • 60.79 KB - June 25, 2015 Health Care (Providers)
CDS-EmploymentAgreement.pdf Employment Agreement PDF • 117.47 KB - June 25, 2015 Health Care (Providers)
CDS-HOMECARE-INDPersonalAssistantBILLOFRIGHTS2.pdf Personal Assistant Bill of Rights PDF • 21.83 KB - June 25, 2015 Health Care (Providers)
CDS-SelfDeterminationEmployeeTimecard.pdf Self Determination Employee Time Card PDF • 141.52 KB - June 25, 2015 Health Care (Providers)
CDS-SelfDeterminationTimecardInstructions.pdf Self Determination Timesheet Instructions PDF • 93.79 KB - June 25, 2015 Health Care (Providers)
CDS-FaxCoverSheet-SelfDeterminationClients.pdf Fax Coversheet for Self-Determination Clients PDF • 68.7 KB - June 25, 2015 Health Care (Providers)
CDS-LetterofInquiryforExtraWork.pdf Letter of Inquiry to Personal Assistants Who May Want Extra Work With Other Recipients PDF • 76.81 KB - June 25, 2015 Health Care (Providers)