Genuine Care Home Health Aid Agency, LLC

Living Assistance Services

POLICY AND PROCEDURAL MANUAL

Updated 02/1/2019

Introduction

This document is an introduction to our organization and provides basic information regarding work rules, the work environment and policies under which we operate. This guide will answer your questions and concerns about the services we provide and provide a complete understanding of the procedures and policy that is in force. Genuine Care Home Health Aid Agency will be referred throughout this manual as, “The Agency.”

The Agency is committed to standards of professional ethics that are in accordance with the Pennsylvania Department of Health, the licensor. These include but are not limited to; employees’ knowledge, skills and the customer service expected by The Agency. As a provider of care in the role of “Caregiver,” you will need to have a clear understanding of The Agency’s primary purpose of providing quality care and complete satisfaction with duties performed as a caregiver and ultimately the satisfaction of those we serve. Our Official Slogan is “GENUINE IS A FRIEND OF MINE.” Our strength as an organization is the mutual satisfaction of those we serve, our caregivers and the communities in which The Agency operates.

The policies outlined are reviewed and revised as needed to meet conditions that may be required to meet the needs of those we serve and those who provide excellent service to them. The Agency reserves the right to at its discretion to modify, supplement or withdraw any of the conditions of this policy and procedures guide and is obligated to advise those we serve and to those who provide their care.

Goals and Objectives

Genuine Care Agency is a Service Entity

The Agency is committed to:

• Provide the finest care to its clients and maintain standards of integrity in every aspect of its operations;

• Accepting responsibility for mutual satisfaction between caregivers and clients;

• Provide each employee with a fair and equitable wage to provide the excellent care which they provide; and

• Provide opportunities for the progress and growth of caregivers.

Caregivers agree to not provide or administer any of the following services to our clients:

• Dispense Medications

• Injections

• Wound Dressings

• Colostomy Care

• Feeding Tube Assistance

• Enemas

• Any Services defined as “medical” by the Commonwealth of Pennsylvania

General Employment Information

These Policies, Rules and Regulations should not be regarded as limitations but are clear statements of the rights and privileges of caregivers. They have been created for the benefit of the caregivers engaged in the care of our clients. Further, they have been developed with a high regard for the rights of caregivers, fellow employees, the management and above all, our clients.

1. Equal Opportunity Employment

Our policy is to seek and employ qualified personnel and to provide equal opportunities for the advancement of employees, including promotions and training, and to administer these activities in a manner which will not discriminate against any person because of race, color, ancestry, religious creed, national origin, sex, marital status, physical condition, sexual orientation, veteran status or age.

2. At Will Employment

The Agency requires that all employees adhere to the standards set forth in this handbook. The statements do not in any way imply an additional contract between The Agency and any of its employees. The Agency operates under a mutual consent between its employees and The Agency. Employees may be terminated at will, at any time with or without previous notice.

3. Americans with Disabilities Act

The Americans with Disabilities Act (ADA) prohibits discrimination against people with disabilities in employment, transportation, public accommodation, communications, and governmental activities (The US Department of Labor – Established in 1990). The Agency strongly supports the policies of the Americans with Disabilities Act and treats all applicants and employees with disabilities as required by the Act. The Agency provides equal opportunity to all persons capable of performing the services provided by The Agency. The Agency provides reasonable accommodations to any person who requires special accommodations to perform their duties. Employees are asked if they require such accommodations prior to employment. The Agency will discretely address and provide for such needs as they are requested and within the means of The Agency.

4. Immigration Reform and Control Act

The Immigration Reform and Control Act of 1986 (IRCA) Public Law 99-603 (Act of 11/6/86), which was passed in order to control and deter illegal immigration to the United States. Its major provisions stipulate legalization of undocumented aliens who had been continuously unlawfully present since 1982, legalization of certain agricultural workers, sanctions for employers who knowingly hire undocumented workers, and increased enforcement at U.S. borders (US Department of Homeland Security). The Agency requires that all employees provide proof of their identity and of their authorization to work in the United States. This information is required to be submitted prior to employment. USCIS Form I-9 OMB No. 1615-0047 or satisfactory evidence of identity is required as proof of US Citizenship and/or right to work in the US. This form is to be completed by the employee and is kept in the individual employee file that is kept under lock and key by The Agency. There are no exceptions to this rule. This form must be signed by the employee and a representative of The Agency. Additionally, all Caregivers must be at least 18 years of age.

5. Harassment

The Agency is obligated and committed to provide a workplace free of unlawful and improper harassment. The Agency has a zero tolerance for unlawful employee harassment based on race, color, religion, sex, age, national origin, marital status, sexual orientation, disability, or veteran status. Any such harassment will not be tolerated by any employee, client or vendor.

Harassment becomes unlawful where 1) enduring the offensive conduct becomes a condition of continued employment, or 2) the conduct is severe or pervasive enough to create a work environment that a reasonable person would consider intimidating, hostile or abusive (Harassment – EEOC). Unlawful harassment includes unwelcome or unsolicited verbal, physical or sexual conduct which is made a condition of employment.

Any employee who has a complaint of harassment at work by anyone involved with The Agency including clients, care recipients, caregivers or visitors should promptly notify The Agency’s owner. The Agency will make a thorough, confidential and impartial investigation of the complaint and will do so immediately upon notification. Statements of harassment must be reported in writing and will be kept confidential. The Agency will take immediate action to investigate the allegations and take corrective action up to and including immediate termination of the offender.

6. Employee Classifications

Part Time: Employees who are regularly scheduled less than thirty-seven (37) hours per week are not eligible for benefits other than certain typed of insurance coverage required by law for all employees of The Agency.

Temporary: The Agency may hire a temporary employee for a specific period for special projects. The employment will terminate at the end of the project at the specified period. Temporary employees are only eligible for benefits that are required by law for all employees of The Agency.

Probationary: All persons newly hired (or rehired) are considered probationary for ninety (90) calendar days of employment by the Agency.

7. Orientation and Training

New employees will be provided with a formal orientation to the company by The Agency. The Agency has established a structured orientation and training program for new employees. Details of the training include every part of this Employee Handbook. Each employee will serve a ninety (90) day introductory period and will work one-on-one with the owner. The introductory period may be extended at the discretion of the owner.

8. Introductory Period

During the introductory or probationary period, employees will be provided with up to four (4) hours per day reviewing and understanding the policies and procedures followed by The Agency. The owner will determine when the probationary employee has a full grasp and understanding of The Agency’s Policies and Procedures. The employees will be paid for this time at their regular rate of pay.

During the introductory or probationary period, employees will be assessed on a weekly basis and the progress of their orientation will be documented. At the end of the probationary period, the progress reports will be reviewed by the owner, the Chief Financial and Compliance Advisor and at times an experienced caregiver will be called upon to evaluate the progress of the employee to determine if the employee has a complete understanding of what is expected of them in the performance of their duties, their comprehension of the Policy and Procedures and The Agency’s rules that relate to their work. At that time a decision will be made as to whether more training is needed, and the probationary period may be extended. The employee will be informed within two days of the review what their status is, probationary or permanent part time or full time employee with no further need for intensive training beyond updates to policies or rules as they occur.

Caregiver evaluations will be conducted quarterly after the probationary period for the first two (2) years from the date of employment. Caregiver evaluations will be conducted semi-annually up to their three (3) year anniversary date of employment. Beyond the third year, performance assessments and evaluations will be performed annually. These reviews will be comprehensive and assess the performance. The reviews are shared with the caregiver in all instances and provide an opportunity for the Agency to assess the validity of current policy, the validity and appropriateness of The Agency’s objectives and how they relate to caregiver satisfaction.

Annual performance reviews will be performed by the owner and shared with the employee. The employee will at that time be given the opportunity to explain any deficiencies that are identified and accept the opinion of the owner when the employee is deemed competent and has adequate knowledge of The Agency’s expectations.

9. Employee Records

All employees are responsible to notify The Agency of any changes to personal information that they provided when hired. Change forms will be provided to employees and can be obtained from the owner. Changes must be in writing and be filed with the owner immediately.

A copy of any current license or certification which includes the certification identification and the authority from which is was obtained. It is the responsibility of the caregiver to keep any licenses they hold current.

Each Employee before being placed on an assignment must provide The Agency with a copy of their Federal Bureau of Investigation (FBI) fingerprint-based record check that has been processed in accordance with Public Law 92-544 and the Child Protective Services Law (Title 23, Pa C.S. Chapter 63). The check must be as of a date less than 1-years before the date of hire. This report must be obtained through:

IdentoGo Center (480096)

4815 Jonestown Road, Ste 201

Harrisburg, PA 17109-1750

Phone number: 877.371.5422

IdentoGo will provide services to cover PA DHS – Employee and Years Contact w/Children. The Agency will provide prospective employees with the web address and Employer Code to obtain the FBI and Child Clearances

Quality Care Supportive Practice will check the LEIE, SAM, DHS, along with state, local and FBI clearances

The cost of the IdentGo FBI and Child Clearances is the responsibility of the Caregiver Candidate.

Additionally, the Caregiver must provide The Agency with a report from the Pennsylvania State Police that shows the criminal record of the Caregiver in the database of the Pennsylvania State Police Agency. Form SP 4-164 (12-2017) can be downloaded from the website:

https://www.psp.pa.gov

or may be filed online at:

https://epatch.state.pa.us

Telephone requests for this form may be made by calling 1-888-783-7972.

This request may take up to 4 weeks to process and the cost is $22 and is the responsibility of each Caregiver. A copy of this report will be kept in a confidential personnel file by The Agency. Any Police Record with an offence above a Misdemeanor will result in the rejection of the application for employment by The Agency.

Employees have the right to request and inspect their personnel file, as provided by law, at a mutually convenient time for The Agency, the employee may review and dispute any information contained within their employee file.

NOTE: Any instance of Child Abuse revealed in the IdentoGo Report will result in the rejection of the existing employment of the perpetrator or any future offers of employment with The Agency.

10. Compensation

The agency pays caregivers based on their responsibilities, experience and performance of their job duties. Wages may vary based on job duties. Wages are based on the required skills, the level of skill, the responsibility expected of the caregiver and the training required to perform the jobs adequately and provide excellent customer service.

Each pay range is established and communicated to the caregiver upon their offer of employment. Salary or wage increases are based on progress and ability and are regulated in confidence by the owner.

Employees are paid bi-weekly. Payroll dates are every other Friday and are based on two weeks ended the prior week. If payroll checks are to be mailed or picked up by someone other than the employee, written authorization must be provided.

The Agency’s payroll policy is to administer payroll in accordance with all applicable laws. All required deductions, federal, state and local taxes are withheld as required and submitted to the appropriate authority or tax jurisdiction.

11. Time Keeping

Caregiver time sheets and any other communication must be submitted to the owner on a weekly basis. Time sheets and care notes are due each Monday morning before noon. Caregivers are paid for the actual time that is spent in the homes of clients.

12. Overtime

Overtime must be assigned and approved and in writing in advance by the owner. Any hours worked beyond forty (40) during any week will be paid a rate of time and a half. The work week begins at 12:00 a.m. on Monday and ends at 12:00 p.m. on Sunday.

13. Attendance

Employees are responsible for promptness on assigned work days. It is essential that a caregiver can be depended upon to be at their assignment at the predetermined time. In the interest of our clients, employees are expected to be at their assignments or at the home of the owner when they are scheduled.

If an employee becomes ill while at work or must leave the premises for any reason during working hours, the owner must be notified immediately. Leaving work before the end of the assigned work period is grounds for immediate termination of employment. Text messages or emails are not permitted as notification of leaving work assignments.

14. Performance Reviews

Annual performance reviews will be conducted for each employee based on their date of hire. These reviews provide an objective, consistent and fair way to gauge each employee’s effectiveness by identifying strengths and weakness of job performance. All performance appraisals will be reviewed with each employee and the employee will have an opportunity to provide feedback on the appraisals. A copy of the appraisal will be provided to employees and the original will be retained in the employee file. Performance reviews are the basis for salary adjustments and promotions.

15. Holidays

The Agency observes seven (7) holidays every year. Caregivers who are required to work on holidays are compensated at one and one-half (1.5) times their hourly rate of pay. There are no exceptions. Caregivers are expected to be available on holidays unless prior approval is granted by the owner at the caregiver’s request. The Agency will attempt to accommodate such requests but if our client needs care on these days and the arrangements aren’t available, The Agency is committed to honoring the requests of clients above those of the caregivers and The Agency as well. The holidays observed by this policy are:

New Year’s Day

Memorial Day

The Fourth of July

Labor Day

Thanksgiving Day

Christmas Eve from 5:00 pm

Christmas Day

To receive the holiday, differential pay rate, caregivers are required to work the day before and the day after each holiday if they are scheduled to be in homes providing care to one of our clients. This does not apply to instances where the caregiver is required to be in the office for training or other duties. The Agency will not schedule meetings or other administrative activities before or after any of the holidays.

16. Termination of Employment

Employment with The Agency is based on mutual consent. The caregiver and The Agency have the right to terminate employment. In the event a caregiver is terminated by The Agency for just cause, the caregiver will receive their final paycheck upon returning any property of the Agency.

If a caregiver finds that they must resign from their position with The Agency, a two (2) week notice is required. The notice must be in writing and The Agency will record the date received on the notice. The notice should indicate that the date they will terminated, two (2) weeks prior to the date of their last day of work along with the reason for their separation. Caregivers who resign with appropriate notice are eligible for re-hire.

17. Post-Employment Reference

The Agency will provide only the dates of employment and the position held at the time of their termination. The Agency will provide verification of earnings when requested by the former caregiver in writing. This may be in the form of a final payroll record and not a certified document. The reason for the resignation or termination will never be disclosed to anyone other than a governmental agency that might request it officially as a part of their purpose. The Agency will not disclose whether the caregiver resigned or was terminated by The Agency, only the dates of employment.

18. Worker’s Compensation

Injuries while on duty at The Agency should be reported to the owner immediately. The initial training and orientation of caregivers includes instructions about reporting injuries while at work and precisely how these injuries are reported. The Agency complies will The Pennsylvania Department of Labor and Industry’s requirements regarding Worker’s Compensation.

19. Caregiver Conduct

The Agency is totally committed to its clients and their families. The Agency views this as their top priority. Caregivers are expected to be aware of this policy and their personal responsibility to our clients and to our staff. Everyone gives each the same respect and each caregiver is expected to do the same.

The Agency also recognizes its responsibility to the Communities where they operate. The Agency is committed to an image of integrity and the highest degree of credibility. Caregivers are expected to conduct themselves in a manner which exemplifies this commitment. The Agency holds caregivers responsible for the same values. They must conduct themselves in a manner which outwardly shows their awareness of The Agency’s commitment to its clients and the community.

Our clients are our primary concern above everything. The owner demands the same of everyone affiliated with The Agency. The Agency encourages each caregiver to uphold this policy and to report any conduct of any member of The Agency that does not uphold this policy should be reported immediately to the owner. Any misconduct reported will be held in the strictest confidence and investigated. Unacceptable conduct of anyone affiliated with The Agency including vendors will not be tolerated. The Agency may give verbal or written warnings and depending on the severity of the misconduct of a worker or affiliate, the relationship of that affiliate, vendor or caregiver can include discipline up to the termination of the violator.

20. Tuberculosis Screening

A 2-step (Mantoux) is required for all caregivers prior to their first assignment. The results from a previous test may be submitted to The Agency provided it was done within the past twelve (12) months. A Tuberculosis record is required each year from the date of a caregiver’s last Tuberculosis test. The record will have caregivers attest that they were not in the presence of anyone that has been or was exposed to Tuberculosis over the past year. This will be monitored closely by The Agency and non-compliance will result in the caregiver not being scheduled until a new Tuberculosis test is administered with a negative result.

21. Chest X-Rays

Any caregiver that has tested positive for Tuberculosis must have a chest X-Ray every three (3) years. The chest X-Ray is not required unless the Tuberculosis screening record indicates that the caregiver tested positive for Tuberculosis. If the record shows that a caregiver tested positive at any time, the caregiver cannot be scheduled until the chest X-Ray is performed. The Agency does not provide funding for chest X-Rays, they are the responsibility of the caregiver and are required if the caregiver is to be scheduled to provide home care to any client.

22. Appearance and Dress Code

Caregivers must present a positive image for The Agency and are held to a high regard for personal appearance. All caregivers will present an image of practicing good personal hygiene and wear appropriate attire. Excessive jewelry is not permitted. Caregivers must present a positive appearance as personal appearance is an indicator of a caregiver’s commitment to our clients.

Below are some guidelines that address personal appearance:

 Caregivers are required to wear the ID Badge provided by The Agency

 Neat and clean clothing or scrub wear is acceptable

 Footwear must be clean, comfortable and flat-soled. Open-toed shoes, sandals or high-heels are not permitted

 Personal grooming includes neat and clean hair. Long hair should be tied back and beards or mustaches must be well-groomed

 Caregivers are expected to have clean and appropriately long fingernails for the safety of the clients. Nails if polished should not have chipped polish or be poorly manicured

 Visible body piercings except for earrings are not permitted while caring for a client

 Jewelry should be simple and not excessive; large or dangling jewelry must be removed when working with clients

 Perfumes and colognes are not permitted

 Visible tattoos must be covered where possible

23. Absenteeism and Tardiness

To maintain The Agency’s commitment to its clients of providing the highest quality of care it is essential that caregivers understand that “Punctuality Is an Attitude.” A punctual caregiver is an attentive and committed caregiver. Anything less is a detriment to our commitment and is intolerable by The Agency. Repeated incidences of tardiness are grounds for dismissal or other sanctions deemed appropriate by The Agency based on the situation when it presents.

Prior approval by the owner is required for any absence of any caregiver for any reason. The reason must be communicated to the owner by the caregiver personally at the earliest possible time. Excessive absenteeism is a detriment to The Agency’s commitment to its clients even if communicated in advance as required.

Guidelines:

 Each case has an established schedule that is desired by the client based on their needs

 Caregivers will be punctual

 The owner must be notified of any schedule changes initiated by the client. It is the caregiver’s responsibility to communicate any changes to the owner immediately upon any discussions with the client regarding their desired schedule

 Absences due to personal matters require a minimum of a two (2) hour personal notification to the owner

 Absences beyond one (1) day must be reported each day of the absence under the same rule as a one (1) day absence

 Excused absences of three (3) or more days may require a physician’s release prior to returning to work and in some cases, prior to the caregivers’ being scheduled to work

 No-Shows are not tolerated under any circumstances and are grounds for discipline up to and including termination

 Tardiness of one (1) or more instances along with intermittent absences are grounds for disciplinary action up to and including termination

(1) Determining excessive absenteeism

(a) A pattern (two or more instances) of absence on Fridays or Mondays

(b) Any pattern of absences such as every Tuesday or every weekend

(2) Disregard for the absenteeism policy is grounds for discipline up to and including termination

24. Transportation

If clients request that The Agency provide transportation services for errands and doctor visits, the caregiver is required to provide The Agency with the documents listed in (1) – (a-c)

(1) These documents will be kept confidentially in the employee record of the caregiver *

(a) Caregivers must provide the owner of The Agency with a copy of a current driver’s license

(b) Caregivers must provide the owner of The Agency with a copy of the registration and proof of liability insurance

(c) The Agency requires that the caregiver provide a Motor Vehicle Record obtained from the Department of Transportation using the “Request for Driver Information.”

* These documents are required whether the caregiver is using their personal vehicle or the client’s vehicle

(2) Reporting Automobile Accidents

(a) All accidents occurring during working hours must be reported to the owner

(b) Caregivers should administer care within the scope of their duties as a caregiver for The Agency

(c) Emergency Medical Technicians should be contacted if needed

(d) Local or State Police must be notified and accident reports completed; the only exception is when an accident occurs on private property

(e) Caregivers should if possible, obtain information from witnesses and persons involved in the accident:

(i) Name

(ii) Driver’s license information

(iii) Registration Information

(iv) Vehicle Insurance Information

(f) Caregivers will provide police with any personal information requested and will notify their own insurance provider where applicable

(g) Caregivers must complete a written incident report as soon as possible, preferably by the next business day

(h) The owner will notify The Agency’s liability insurance provider of any such incidence of an accident

(i) The owner will instruct the caregiver who and who not to discuss the incident or accident

25. Confidential Information - HIPPA

Caregivers may be provided with information that is confidential to The Agency. Some of this information is proprietary. Trade secrets and client information is to be kept in the strictest confidence. Clients’ personal information must never be discussed with a caregiver’s family, co-workers or friends. Caregiver’s must ensure that information is not “overheard” by any such parties regarding the Agency or its clients.

Confidentiality extends itself to “Protected Health Information” (PHI) PHI as defined by the Health Insurance Portability and Accountability Act of 1996 (HIPAA; Pub.L. 104–191, 110 Stat. 1936, enacted August 21, 1996) that was enacted by the United States Congress and signed by President Bill Clinton in 1996. It has been known as the Kennedy–Kassebaum Act or Kassebaum–Kennedy Act after two of its leading sponsors. [1][2] Title I of HIPAA protects health insurance coverage for workers and their families when they change or lose their jobs. [3] Title II of HIPAA, known as the Administrative Simplification (AS) provisions, requires the establishment of national standards for electronic health care transactions and national identifiers for providers, health insurance plans, and employers.

26. Release of Information

The owner of The Agency is the only source of information regarding current or past employees and clients. Caregivers are forbidden to provide names or any information regarding co-workers or clients to any outside entity without the express (written) authorization of The Agency. Such inquiries must be reported immediately to the owner of The Agency. Violation of this policy is grounds for discipline up to and including termination.

27. Safety

The Agency strives for the highest level of safety in all services provided. Additionally, the safety of caregivers and others on the premises of the workplace and office is a top priority. The Agency’s is committed to, and adheres to all applicable safety and health standards to prevent hazards to clients and caregivers. Any unsafe circumstances or anything within the work environment that is deemed unsafe by any member of The Agency must be reported immediately to the owner.

28. Solicitation

Solicitation in any form is prohibited at the home of a client. Charitable solicitation is permitted across The Agency only to the extent that it does not disrupt the daily operations of The Agency.

29. Outside Employment

Caregivers are not prohibited from serving another employer but the following restrictions apply:

a. The outside employment does not interfere with job performance

b. The employment is not reflective of adverse behavior of the caregiver

c. The Agency is notified either verbally or in writing by the caregiver

30. Smoking

Smoking is prohibited in the office and within the clients’ homes with or without the client’s permission.

31. Substance Abuse

Use, possession, distribution, or receiving controlled substances or alcohol is never permitted while on duty or in the home of a client or while operating a vehicle during work hours or on the way to an assignment. The Agency has a zero tolerance for substance abuse.

Prescribed medications are permitted when the use of the medication does not affect the performance of regular duties. The office should be advised when caregivers must take a mood-altering substance to function in their duties when in a client’s home. The Agency will approve or disapprove the use of such substances. Caregivers should consider the effects of required medications and how they will affect their performance. The Agency will work with caregivers with any concerns around this issue and will not dismiss a caregiver for following their doctor’s orders, but may require that a physician’s release be provided to The Agency before being scheduled to work.

Caregivers and applicants may be required to submit to a drug screen for pre-employment, random or reasonable suspicion including post-incident testing. Caregivers will be tested at a testing facility selected by The Agency. The Agency will cover the cost of any required drug test. Refusal to submit to a drug screen will result in immediate termination.

a. Pre-Employment Testing

The Agency may require any or all job applicants to submit to a drug or alcohol screen that will be given by an independent medical professional. Employment will be conditional upon a negative test result. Test results will be confidential and will not be shared with any outside entity, except by court order. A positive result will render the applicant ineligible for employment however the applicant may apply again after twelve (12) months.

b. Reasonable Suspicion Testing

A caregiver’s appearance, behavior or symptoms indicative of a caregiver’s being under the influence of a controlled substance will be grounds for a drug and alcohol screen. Possession of drugs or alcohol is also prohibited. The caregiver’s 4th Amendment under the US Constitution is observed by The Agency. The 4th Amendment relates to Unreasonable Search and Seizure. If the suspicious behavior objectively observed occurs, the matter may be turned over to a Local Law Enforcement Agency.

c. Post-Accident Testing

Any work-related accident or violation of safety precautions will require a drug and alcohol test whether an injury occurred or not. Refusal to submit to the test will result in termination.

32. Grievance and Complaint Procedures

Grievances

The Agency requires that any conflicts or issues with working conditions be reported immediately to the owner. The conditions may involve OSHA Standards and relate to the owner, vendors, co-workers or clients. Such conflicts must be reported to the owner immediately. Information on OSHA Standards is available at https://www.osha.gov/law-regs.html. Conflicts are not limited to OSHA Standards and all should be brought to the attention of the owner.

The Agency will make every effort to resolve any conflicts or issues around working conditions. The Agency pledges to evaluate and determine what action should be taken to correct the problem. Conflicts at work can affect performance of duties and must be reported to the owner either verbally or in writing. The owner will instruct caregivers of what steps if any must be taken by the caregiver and The Agency. Grievances will be kept confidential and will be handled in a confidential manner.

Complaints

Present the complaint to The Agency. Most problems can be resolved by the owner. If the complaint is not resolved at this level, follow the next procedure

Submit a written complaint to the owner; the complaint will be fully evaluated and investigated by the owner who will attempt to resolve the complaint and notify the caregiver within five (5) business days of the receipt of the complaint

If a caregiver is not satisfied with the resolution established to resolve the complaint, caregivers must notify the owner within five (5) business days of their opinion of this resolve

The owner will re-visit the situation and evaluate the corrective action

The owner will be provided with a statement from the caregiver that indicates that the conflict has been resolved

Disciplinary Action Procedures

1. Disciplinary Action

Actions by caregivers who disregard established procedures and rules are grounds for Disciplinary Action. Disregard for these procedures can affect the quality of care provided by The Agency which is a violation of The Agency’s commitment to the highest quality of care to its clients. Most disciplinary actions are addressed by a corrective action plan by The Agency that is fair to the caregiver and to The Agency and provide a resolution to the behavior that prompted such disciplinary action.

The following list of behaviors are not tolerated and will result in immediate termination of the violator:

a. Acts of violence

b. Fighting

c. Theft

d. Abandonment of client

e. Failure to comply with confidentiality standards

f. Possession of fire arms, weapons or explosives on client’s or owner’s property

g. Falsification of records

h. Possession, use, sale, purchase or distribution of any controlled substance, drug paraphernalia or alcohol

i. Gross negligence of client care

j. Unauthorized hours of providing care not scheduled

k. No Call/No Show

l. Conviction of a Felony or Misdemeanor

m. Accepting unauthorized gifts or gratuities

n. Failure to report work injuries or accidents

o. Harassing or threatening a client or co-worker

p. False or malicious statements that present a threat to the integrity of The Agency

q. Any action that is detrimental to the objectives and mission of The Agency

Violations of Agency Policy Not Included in 1 - a through q

1st Offense – A verbal discussion of the details of the incident that prompted the observance of a violation

2nd Offense – Documentation that clearly explains the violation and the results expected by The Agency; results and the cessation of the behavior will be clearly identified in the documentation and the span of time that the caregiver is expected to observe the established corrective action

The Second Offense may result in a probationary period which will be identified in the written notification presented to the caregiver

3rd Offense – The caregiver may be terminated or suspended if the offense is a direct threat to any client or co-worker

4th Offense – Grounds for immediate termination

Client Services Standards

a. Caregivers are expected to represent The Agency and conform with established and communicated standards of excellent client satisfaction.

b. Caregivers should behave as a guest in the home of each client, in a physician’s office, hospital or other facility. Caregivers must never smoke, chew gum, gossip or complain in the presence of the public or clients. Caregivers must refrain from any behavior that is disturbing to the client or the client’s family. Caregivers should project a positive and enthusiastic attitude to the client and to the public.

c. Clients must provide constant attention to the client when specified in the work assignments. Clients must never be abandoned. If the caregiver must leave a client alone to perform errands for the client, the activity must be approved by the owner. Instances where the client requests that the caregiver leave the premises, the caregiver must remain on the property until obtaining authorization from the owner. If caregivers have a personal emergency that requires that they leave their assignment, the owner must be notified and arrangements for a replacement will be determined as soon as possible. Abandonment is a reportable offence for any CNA certification and is grounds for dismissal.

d. Caregivers are not permitted to accept gifts from clients. Also, caregivers are not permitted to examine the personal property of clients without the client’s permission in writing or to have a client endorse a check over to the caregiver or The Agency.

e. Telephone calls are never to be made for the clients without their permission. Talking on cell phones and texting is prohibited and can result in termination.

f. Caregivers are not permitted to have friends, family or unauthorized visitors in the home of the client. Caregivers are not permitted to have their children in the home of the client.

g. Any breaks from duty must be taken only with written permission of the client and authorized by the owner.

h. Non-medical services include companionship, care and protection of clients, housework, meal preparation, bed making, laundry and other similar services are specified in The Agency and client arrangement agreed upon. Caregivers perform these services for the client only.

i. Incident Reports are required to be completed by the caregiver for any accident or incident that the caregiver witnesses. Caregivers are to report incidents to the owner within twenty-four (24) hours of the occurrence of any accident or incident. Actions taken by the caregiver must be included in the written Incident Report. The owner will notify the families of the client of any such incident or accident within twenty-four (24) hours of the reported incident.

j. Accidents occurring while performing job duties require an Accident Report to be prepared in writing and submitted to the owner within seventy-two (72) hours. Failure to provide this report may affect and disqualify the caregiver for Workers Compensation Benefits.

k. The level of care with respect to the extent of personal assistance will be outlined in the assignment record maintained by The Agency. The owner will make every effort to match the clients’ needs with the qualifications or certifications required for the service of the client.

l. Each client will be provided with a notebook where each tour of duty is summarized and recorded. Each caregiver is required to review the past two weeks of client care prior to serving a client they have not serviced before.

m. Caregivers must work the schedule agreed to by The Agency and are not permitted to discuss changes of hours or services with the client. Any changes to the service agreement must be handled by the owner. Limit log entries to pertinent and relevant information regarding the clients’ care. The logs should not include the caregivers’ opinions regarding the status of the client. The client and their families have open access to the caregiver/client logs. No other entity may be provided with this information without written permission by The Agency.

n. In-Service and Continuing Education

Training and educational sessions are conducted on an on-going basis. Caregivers may be called upon to meet and identify areas where a consensus of consistent operations while performing client services. Attendance at these meetings is mandatory unless they are scheduled during a time when a client is being served. Caregivers will be paid their hourly rate for attendance at these meetings. Caregivers will be notified of In-Service Meetings (ISMs). The Agency provides reasonable accommodations for each individual involved in In-Service Training.

o. Additional Requirements

What follows here are the requirements for COMPETENCY of all Caregivers that are assigned to any client to perform any type of service provided by the Agency. Caregivers must become aware of and will be tested on their knowledge of all information provided here as mandated by the Commonwealth of Pennsylvania Department of Health and Human Services.

§ 611.55. Competency requirements.

(a) Prior to assigning or referring a direct care worker to provide services to a consumer, the home care agency or home care registry shall ensure that the direct care worker has done one of the following:

(1) Obtained a valid nurse’s license in this Commonwealth.

(2) Demonstrated competency by passing a competency examination developed by the home care agency or home care registry which meets the requirements of subsections (b) and (c).

(3) Successfully completed one of the following:

(i) A training program developed by a home care agency, home care registry, or other entity which meets the requirements of subsections (b) and (c).

(ii) A home health aide training program meeting the requirements of 42 CFR 484.36 (relating to the conditions of participation; home health aide services).

(iii) The nurse aid certification and training program sponsored by the Department of Education and located at www.pde.state.pa.us.

(iv) A training program meeting the training standards imposed on the agency or registry by virtue of the agency’s or registry’s participation as a provider in a Medicaid Waiver or other publicly funded program providing home and community-based services to qualifying consumers.

(v) Another program identified by the Department by subsequent publication in the Pennsylvania Bulletin or on the Department’s web site.

(b) A competency examination or training program developed by an agency or registry for a direct care worker must address, at a minimum, the following subject areas:

(1) Confidentiality.

(2) Consumer control and the independent living philosophy.

(3) Instrumental activities of daily living.

(4) Recognizing changes in the consumer that need to be addressed.

(5) Basic infection control.

(6) Universal precautions.

(7) Handling of emergencies.

(8) Documentation.

(9) Recognizing and reporting abuse or neglect.

(10) Dealing with difficult behaviors.

(c) A competency examination or training program developed by an agency or registry for a direct care worker who will provide personal care must address the following additional subject areas:

(1) Bathing, shaving, grooming and dressing.

(2) Hair, skin and mouth care.

(3) Assistance with ambulation and transferring.

(4) Meal preparation and feeding.

(5) Toileting.

(6) Assistance with self-administered medications.

(d) The home care agency or home care registry shall include documentation of the direct care worker’s satisfactory completion of competency requirements in the direct care worker’s file. If the direct care worker has a nurse’s license or other licensure or certification as a health professional, the individual’s file shall include a copy of the current license or certification. Documentation of satisfactory completion of competency requirements is transferable from one home care agency or registry to another home care agency or registry, provided the break in the individual’s employment or roster status does not exceed 12 months.

(e) The home care agency or home care registry also shall include documentation in the direct care worker’s file that the agency or registry has reviewed the individual’s competency to perform assigned duties through direct observation, testing, training, consumer feedback or other method approved by the Department or through a combination of methods. The competency review must occur at least once per year after initial competency is established, and more frequently when discipline or other sanction, including, for example, a verbal warning or suspension, is imposed because of a quality of care infraction.

(f) A direct care worker employed by a home care agency or rostered by the home care registry on December 12, 2009, shall achieve compliance with the competency requirements imposed by this chapter by December 12, 2011.

Cross References

This section cited in 28 Pa. Code §611.51 (relating to hiring or rostering of direct care workers); and 28 Pa. Code §611.54 (relating to provisional hiring). ________________________________________

No part of the information on this site may be reproduced for profit or sold for profit.

This material has been drawn directly from the official Pennsylvania Code full text database. Due to the limitations of HTML or differences in display capabilities of different browsers, this version may differ slightly from the official printed version.

Federal Family and Medical Leave Act

The Family and Medical Leave Act (FMLA) provides certain employees with up to 12 weeks of unpaid, job-protected leave per year. It also requires that their group health benefits be maintained during the leave.

FMLA is designed to help employees balance their work and family responsibilities by allowing them to take reasonable unpaid leave for certain family and medical reasons. It also seeks to accommodate the legitimate interests of employers and promote equal employment opportunity for men and women.

FMLA applies to all public agencies, all public and private elementary and secondary schools, and companies with 50 or more employees. These employers must provide an eligible employee with up to 12 weeks of unpaid leave each year for any of the following reasons:

• for the birth and care of the newborn child of an employee;

• for placement with the employee of a child for adoption or foster care;

• to care for an immediate family member (spouse, child, or parent) with a serious health condition; or

• to take medical leave when the employee is unable to work because of a serious health condition.

Employees are eligible for leave if they have worked for their employer at least 12 months, at least 1,250 hours over the past 12 months, and work at a location where the company employs 50 or more employees within 75 miles. Whether an employee has worked the minimum 1,250 hours of service is determined according to FLSA principles for determining compensable hours or work.

Time taken off work due to pregnancy complications can be counted against the 12 weeks of family and medical leave.

A final rule effective on January 16, 2009, updates the FMLA regulations to implement new military family leave entitlements enacted under the National Defense Authorization Act for FY 2008.

Special rules apply to employees of local education agencies. The Department of Labor administers FMLA; however, the Office of Personnel Management (OPM) administers FMLA for most federal employees.

Source: https://www.dol.gov/general/topic/benefits-leave/fmla

Job Restoration:

Upon returning from FMLA leave, eligible employees will typically be restored to their original assignments. Any employee failing to return to work under the guidelines of FMLA will be subject to The Agency’s standard leave of absence and attendance policy.

The Agency will comply to FMLA and Employee’s Enforcement Rights under the Act.

The Agency will honor Military-Related FMLA Leave under the guidelines of the Veteran’s Administration. Caregivers will be asked upon application for employment if they are eligible for and want to have Veteran Status.

Mission, Goals and the Image of Genuine Home Care Agency

The Mission of Genuine Health Home Care Agency is to provide the highest quality of care to individuals who are unable to attend to their personal needs. The Goal of Genuine Home Health Agency is to attain 100% satisfaction by the clients, workers and the communities in which The Agency operates. Equally important is the Image of Integrity that The Agency strives to achieve and is committed to maintain.

The following guidelines have been established to ensure that The Agency maintains with the highest regard; the mission, goals and integrity expected under which The Agency was founded.

• Personal problems have no place in this establishment

• Keep a cheerful and positive attitude

• Be enthusiastic about the service provided by The Agency

• Promote the Image and Slogan: “Genuine Is a Friend of Mine”

• Conduct business affairs with honesty, integrity and adhere to the highest professional standards

• Do not create misconceptions of clients

• Have an attitude of competence, caregivers are carefully selected and the highest quality of care for The Agency’s clients is expected

• Always observe appropriate behavior on the job and away from the job

• Smoking is prohibited when on duty

• Inappropriate language is strictly prohibited

• Always respect the home of The Agency’s clients, wipe your feet when you enter

• Introduce yourself by your full name

• Use the client’s name at every opportunity; clients should be addressed as Mr., Mrs. or a name that the client prefers

• Never argue that the client is wrong, the client is always right

• Listen to complaints and do everything within the scope of your duty to resolve them

• Don’t take the situations that present themselves personally

Genuine Home Care Agency holds the highest esteem for all caregivers as well as clients. The Agency is committed to this principle and never discriminates against any individual or group because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), national origin, age (40 or older), disability or genetic information. The Agency will never discriminate against a person because the person complained about discrimination, filed a charge of discrimination, or participated in an employment discrimination investigation or lawsuit.

Appendix A

The Agency participates and is approved by the Pennsylvania Department of Health (DOH) and the Pennsylvania Office of Developmental Programs (ODP) to provide care to individuals covered under the terms of the Consolidated Waiver Program that is funded, administered and monitored by those governmental agencies. Genuine Home Care Home Health Aid Agency will be affiliated with Dauphin County Case Management Unit, 1100 South Cameron Street, Suite 1, Harrisburg, PA 17104.

What follows are the values and requirements that providers such as us, Genuine Care Home Health Aid Agency, LLC must follow to comply with those requirements. These values and requirements although in some cases are duplicated by the Policy and Procedural Manual of Genuine Home Health Aid Agency, they are presented in this Appendix and under the requirements of the administrators (DOH and ODP) must be disseminated to Clients, Caregivers and the General Public.

At the end of this appendix is a signature line for that provides Clients or Representatives to acknowledge that they have been notified and read the responsibilities of The Agency when providing services to Clients under the Consolidated Waiver that is funded, administered and monitored by the DOH and ODP along with the signature of the Caregiver assigned to the Client attesting that they have read and understand these requirements. Also, at the end of this Appendix there is an attestation by the CEO of The Agency, Chantel Motes, CEO and Owner that The Agency is in compliance with each and all of the requirements set forth in Appendix A.

Values, Philosophy and Requirements of the Consolidated Waiver

A. Positive Approaches is a worldview, a movement, in which all individuals are treated with dignity and respect, in which all are entitled to Everyday Lives.

B. Person Centered Planning is about an individual’s strengths, interests and preferences to achieve a balance of what is important TO the person and FOR the person.

C. The Concept of “Everyday Lives – Values in Action.”

1. Assure Effective Communications

2. Promote Self-Direction, Choice and Control

3. Increase Employment

5. Support Families Throughout the Lifespan

4. Promote Health, Wellness, and Safety

6. Support People with Complex Needs

7. Develop and Support Qualified Staff

8. Simplify the System

9. Improve Quality

10. Expand Options for Community Living

11. Increase Community Participation

12. Provide Community Services to Everyone

13. Evaluate Future Innovations based on Everyday Lives Principles

13.1 Self-determination is for everyone.

• Everyone can make choices.

• Everyone should have control over his or her life.

• Everyone is different and there is value in difference; therefore, supports need to be individualized.

• Everyday Lives are for everyone

1) Incident Management

ODP Incident Management Bulletin # 6000-04-01 Title 55, Human Services Subpart A. Statement of Policy Chapter 6000 Subchapter Q Incident Management

a. INCIDENT CLASSIFICATIONS TO BE REPORTED BY ALL PROVIDERS WITHIN 24 HOURS

• Abuse

• Law Enforcement Activity

• Death

• Missing Person

• Emergency Closure

• Misuse of Funds

• Emergency Room Visits

• Neglect

• Fire

• Psychiatric Hospitalization

• Hospitalization Rights Violation

• Individual to Individual Abuse

• Suicide Attempt

• Injury Requiring Treatment Beyond First Aid

b. INCIDENT CLASSIFICATIONS TO BE REPORTED BY ALL PROVIDERS WITHIN 72 HOURS

• Medication Error

• Restraints *

* MR Bulletin 00-06-09, Elimination of Restraints through Positive Practices.

The purpose of this bulletin is to recommend practices that will assist in the elimination of the need for restraint. Creating a culture of supports that reduces the need for restraints is essential for building an environment that enhances each individual’s quality of life.

The Agency will report incidences of unauthorized restraints as described in Informational Memo 080-12 – Reporting Unauthorized Restrictive Interventions

Restraint Policy

The Agency supports a restraint-free environment. The philosophy of The Agency is to use positive approaches to person centered practices and doesn’t use negative reactions/punishments to stop the undesirable behavior(s). The Agency promotes alternative positive behaviors in accordance with the ISP. Prevention and management improvements of incidents will be achieved through the quality management/risk management policies/procedures. The Restraint Policy of The Agency is:

We will not participate in nor utilize any form of restraints (physical/chemical/mechanical); and will promote positive alternative behaviors.

The Pennsylvania Code § 6000.953. Incident Management Representative.

The Incident Management Representative (IMR) is the person designated by the provider with overall responsibility for Incident Management. This includes the assurance that the activities of the initial reporter and point person have been completed. In addition, the IMR is responsible for the finalization of the incident report within 30 days of the incident. The IMR is responsible to evaluate the quality of incident investigations as described in the Pennsylvania Certified Investigators Manual, Labor Relations Alternatives, Inc.

This material has been drawn directly from the official Pennsylvania Code full text database. Due to the limitations of HTML or differences in display capabilities of different browsers, this version may differ slightly from the official printed version.

The Incident Management Representative (IMR) for The Agency is Chantel Motes, CEO and Owner.

2) Quality Management Requirements

55 PA Code Chapter 51. OFFICE OF DEVELOPMENTAL PROGRAMS

HOME AND COMMUNITY-BASED SERVICES

Subchapter A. GENERAL PROVISIONS

§ 51.25. Quality Management Plan

(a) A provider shall meet the QM plan criteria developed by the Department.

(b) The provider shall create and implement a QM plan.

(c) The provider shall evaluate the following when developing a QM plan:

(1) The manner in which the provider will meet the Department’s QM plan criteria.

(2) The provider’s quarterly performance review data and available reports in HCSIS and EIM.

(3) The results from provider monitoring and Service Coordinator Organizations monitoring.

(4) Compliance with the requirements in 42 CFR 441.302 (relating to state

assurances).

(5) Incident management data, including data on the incident target under § 51.17 (relating to incident management).

(6) Results of satisfaction surveys and reviews of grievances.

Chantel Motes will ensure that each Client or Client Representative understands these Provisions and that each Caregiver is provided with training to achieve the forgoing requirements regarding Quality Management and the responsibilities of The Agency and Agency Caregivers.

What follows are details that ensure compliance with 55 PA Code Chapter 51

a) Quality Management is a methodology by which organizational performance is continuously measured, evaluated, and improved. individuals and other stakeholders are engaged in designing and improving services

b) The Agency will check the LEIE, SAM, DHS, along with state, local and FBI clearances shown on page 8 of the Policy and Procedure Manual.

c) The Agency will provide Clients a professional and quality managed, organizational service where individuals served are engaged in designing and improving Self-Directed Services as needed. The Quality Management (QM) plan will meet the requirements developed by the Department as outlined in the QM Life Course Framework

d) The Agency will implement the Life Course Framework, with a quarterly review of service data and availability of any reports in HCSIS and EIM

e) Compliance with the state requirements

f) Review of Incident Management data

g) Results of satisfactory surveys and review of grievances.

h) Update plan every 2 years

i) Will maintain records (5) yrs. after service unless otherwise specified

j) Make appropriate corrective action(s) in a timely manner in order to maintain provider qualifications

k) Reviews and Grievances

• Note: Quality Management specific to Genuine Care Home Health Aid Agency is further detailed in Section Number 9 of this Appendix below

3. Regional Emergency/Evacuation Order Plan

In the event of a natural disaster {either natural or manmade} or weather emergency. The Agency has developed a plan to minimize the risk of personal injury and to reduce property damages. Disaster and weather emergencies included but not limited to chemical spills, nuclear accidents, acts of terrorism, severe thunderstorms, winter storms, floods, hurricanes, tornadoes, earthquakes, and blackouts.

4) Behavioral Emergencies

The Agency recognizes that individuals may engage in behaviors that may disturb others, brokers will accommodate and offer a change in environment in order to maintain a community presence and continue services.

The Agency will always wherever possible avoid intrusive acts before implementing restrictive interventions. For each incident requiring a restrictive intervention, The Agency must also make every attempt to anticipate and de-escalate the behavior using less intrusive methods of intervention.

If after considering the individual’s desires, uniqueness, and strengths, the individual and support team determine that restrictions are necessary to ensure the Health and Safety of the individual, the IM Team must approve a Restrictive Procedure Plan that describes the restrictive intervention in its implementation. The team must also incorporate the restrictive intervention and a description of its implementation into the individuals Individual Support Plan (ISP)

5) Provider Qualifications

§ 51.11. Prerequisites for Participation

(a) In addition to the requirements under Chapter 1101 (relating to general provisions) to become an enrolled provider, the provider shall:

(1) Complete the provider enrollment application on a form prescribed by the Department.

(2) Sign an MA provider agreement and an HCBS waiver provider agreement.

55 § 51.4 DEPARTMENT OF PUBLIC WELFARE Pt. I 51-(8365586) No. 461 Apr. 13 Copyright 2013 Commonwealth of Pennsylvania

(3) Submit supporting qualification documents identified on the Department’s web site to the Department or the Department’s designee.

(4) Comply with the approved applicable waiver, including approved waiver amendments, and any other applicable licensing requirements as identified in § 51.4 (relating to incorporation by reference).

(5) Send a complete enrollment package to the Department or the Department’s designee.

(b) New providers shall complete and submit the provider monitoring documentation designated for new providers before being authorized to provide HCBS.

(c) A provider shall be qualified by the Department for each HCBS the provider intends to provide prior to rendering the HCBS.

(d) The provider shall submit any missing supporting qualification documentation materials requested by the Department or Department’s designee within 30 days of notification by the Department.

(e) If missing supporting qualification documentation is not submitted within 30 days of notification, the enrollment application will be considered withdrawn by the Department and will not be processed.

(f) A provider may submit a new enrollment application after the previous enrollment application is withdrawn by the Department.

(g) A provider will not be paid until the provider is qualified and authorized by the Department or the Department’s designee to provide an HCBS.

(h) A provider shall comply with the training requirements as specified in § 51.23 (relating to provider training).

(i) A provider may not influence a participant’s freedom of choice in selecting a new provider.

(j) Subsection (b) does not apply to a provider of HCBS in the Adult Autism Waiver.

(k) This section does not apply to an SSW provider.

The Agency is in full compliance with PA Code Ch51 ODP 55 § 51.11 Prerequisites for Participation and Chantel Motes, CEO and Owner will ensure that adherence to these regulations is observed and upheld.

6) HCSIS and PROMISe Enrollment and Compliance

1) The Agency is enrolled in and is in compliance with and has established accounts in HCSIS and PROMISe™. The Agency has been qualified by the DOH and ODP to add services in HCSIS for each Administrative Entity that will be authorizing services added by Procedure Code

2) These rates have been entered in PROMISe™ and are available for inclusion in each Consolidated Waiver Participants’ Individual Service Plan.

7) Service and Supports Directory Maintenance

When the Agency can bill for services:

1. The Agency’s Service and Supports Directory (SSD) is updated appropriately

2. The Agency’s service or services have already been attached to an Individual’s Support Plan (ISP) and authorized by the Administrative Entity (AE)

3. The Agency has viewed the Service Authorization Notice(s) found in HCSIS > Provider Self Service prior to rendering and billing for an authorized service ODP service and has confirmed that the data elements contained in the ISP are accurate

4. The Agency has already rendered the service per the frequency indicated in each individual’s ISP, and that the service or services rendered are documented in The Agency’s file notes or record keeping system service per the frequency indicated in each individual’s ISP, and that the service or services rendered are documented in The Agency’s file notes or record keeping system

5. Every time a claim is billed, there must be supporting documentation which shows that the service that was billed matches the authorized service from the ISP

6. The Agency is responsible to ensure that the amount, frequency, duration, staffing ratio, and types of services that are billed to PROMISe™ correctly match the authorizations from individual’s ISPs, and The Agency must maintain supporting documentation to substantiate each claim.

7. Claims must be supported by documentation that the services is:

• Provided to a Medicaid-eligible individual (Client)

• Provided by a qualified provider (The Agency)

• Authorized based on assessed need

• Rendered as authorized in an ISP

• Includes:

– Date the service was rendered

– Name of the Client

– Medicaid identification number of the Client

– Name of The Agency and person providing the service (Caregiver)

– Nature, extent or units of service

8. Progress notes must be completed, at a minimum, every 3 months.

9. Progress notes are a summary taken from service notes, observation of service delivery and conversation with the individual and their team.

Chantel Motes, CEO and Owner will ensure that The Agency’s Service and Supports Directives (SSD) are adhered to and that claims are submitted properly.

8) Staff Training for Clients Under the PA Consolidated Waiver

a) 55 PA Code Chapter 51. OFFICE OF DEVELOPMENTAL PROGRAMS HOME AND COMMUNITY-BASED SERVICES

i) Subchapter A. GENERAL PROVISIONS § 51.23. Provider training:

(a) A provider shall implement a standard annual training for the provider and staff.

(b) Before providing a Home Care Based Service to a participant, a provider shall ensure that its staff have met any additional pre- and in-service training requirements as detailed in a participant’s ISP.

(c) A provider shall retain documentation of completion of training for each staff.

(d) A provider shall update annual training to reflect the Department’s current policies and procedures and emerging practices

b) 55 PA Code Chapter 51 regulations specifically require training for all staff in the following areas:

(1) Department policy on intellectual disability principles and values

(2) Training to meet the needs of a participant as identified in the ISP

(3) Quality Management Plan

(4) Identification and prevention of abuse, neglect and exploitation of a participant

(5) Recognizing, reporting and investigating an incident

(6) Participant grievance resolution

(7) Department-issued policies or procedures

(8) Accurate billing and documentation of HCBS delivery

Chantel Motes, CEO of The Agency will ensure that Caregivers and she have the training outlined in 8-a and 8-b before administering care to Clients covered under the PA Consolidated Waiver.

9) Quality Management

The Agency will provide Clients a professional and quality managed, organizational service where individuals served are engaged in designing and improving Self-Directed Services as needed. The Quality Management (QM) plan will meet the requirements developed by the Department as outlined in the QM Life Course Framework.

1. Life Course Framework

The Agency will implement the Life Course Framework, with a quarterly review of service data and availability of any reports in HCSIS and EIM

• Compliance with the state requirements

• Review of Incident Management data

• Results of satisfactory surveys and review of grievances.

• The Agency will check the LEIE, SAM, DHS, along with state, local and FBI clearances and https://www.secureepls.com/exclusion-databases/medicheck for all staff

 Anything other than a clear record and check will result in immediate separation with that staff member

• The Agency will check

• Claims/Fiscal Management

• Update plan every 2 years

• Will maintain records (5) yrs. after service unless otherwise specified

• Make appropriate corrective action(s) in a timely manner in order to maintain provider qualifications

2. Grievance Policy

a) It’s the policy The Agency to have a system to address grievances

b) All staff are expected to maintain sensitivity to individual’s needs and perspective

c) Complaints are heard respectfully in a non-judgement manner by whoever hears it first, they must present it confidentially to Chantel Motes at (717)554-1019 or [email protected] who shall determine a course of action to be followed

d) Facts are gathered from all sides before a decision is reached

e) An investigation into the matter shall be completed with (21) days. If more time is needed, Chantel Motes, CEO will notify prospective parties of requested time needed and why

f) The individuals will be notified of results in writing

g) If the Client is not satisfied with the internal investigation, written complaints may be sent to the Secretary of the U.S. Department of Health and Human Services

3. Individual’s Rights

1) To receive quality services in accordance with authorized and approved services

2) To have services provided in accordance with the guiding principles of Self-Determination

3) To be free from abuse, neglect, and mistreatment

4) Freedom to report abuse, neglect by a caregiver or support service provider or support broker will not have their services terminated or face a negative consequence for being honest

5) Individuals will not be discriminated against because of race, color, gender, origin, disability, age, or natural origin

6) To be treated with respect and dignity and not be subjected to verbal, psychological or physical abuse by individual or family members

7) Refuse to provide services that are not in ISP

8) Provide services in a safe, hazard free environment

9) File a grievance after an attempt to resolve issue fail and problem persists

4. Billing

The Agency and Program Manager are required to verify that consumers are authorized to receive services rendered are accurate and valid.

The Agency adheres to sound fiscal and internal business controls and will ensure the accuracy and integrity of the data collected for billing and other operational needs.

5. Progress Notes

The Agency will review and submit monthly progress notes into the data base for services rendered. The Agency will make sure all progress notes include the Outcomes Statement and all the dates of service that were provided within the month. The Agency will provide a brief objective summary of the activities performed with the Client during the month as related to the Client’s Outcome. The Agency and the Client or Guardian must sign both the Progress Notes and Timesheets before submission for payment.

6. Submission of Time worked

This policy is to ensure uniform and consistent submission of time worked in order to comply with the Agency’s regulation. Timely submission of time worked is imperative to maintain accurate and efficient utilization and billing records.

7. Fraud and Abuse

Examples of fraud and abuse are: falsifying or altering claims or records, up coding incorrect coding, double billing, billing for services not rendered or authorized,

Failing to maintain appropriate records or any issues resulting in overpayment, embezzlement or theft, failure to return funds not authorized and falsifying timesheets.

8. Reporting Fraud and Abuse

If a Caregiver suspects fraud or abuse by any member of The Agency they must report it to Chantel Motes, CEO and Owner immediately.

9. Lost/damaged property

If properties are lost/damaged during provision of services, individuals/brokers are required to inform Chantel Motes, CEO through written documentation.

10. Records Management

The utilization of personal and confidential information about you and how it can be managed, disclosed and accessed:

• Usage for treatment, payment health care operation-within our practice such as sharing, employing, applying, utilizing, examining, and analyzing info that identifies you

• Disclosure - requiring authorization for outside care by stakeholder requiring releasing, transferring or providing access to information about you.

• It is your right to revoke any and all release of, or access to your personal health care in writing.

• You may not revoke the authorization to the extent we have relied on that authorization

•

11. Quality Care as a mandated reporter will under law:

a. Disclose personal and confidential healthcare info without written authorization only in circumstances such as (abuse, court proceedings, safety/health risks, workers compensation)

Rights and Responsibility of Clients:

• Request restrictions

• Receive confidential communication by alternate means and locations

• Right to amend

• Right to an accounting

• Right to a paper copy

Provider Requirements:

• Required by HIPAA to maintain the privacy of your personal and confidential health care info. And to provide you with a notice of our legal duties to you.

• We reserve the right to change our operational privacy practices and practices explained in this notice. Unless we notify you of such changes, however, we are required to abide by the terms currently in effect.

• Will maintain records on file for (5) yrs. After the date of last service unless otherwise authorized

• If we revise our policies/procedures, we will present you with a new revised notification for your review and signature

12. Back-Up Plan

A Back-Up Plan is required under the conditions of the PA Consolidated Waiver. This policy is in place to ensure the continuation of care as dictated by the Individual Service Plan of each Client that is being served by The Agency under the PA Consolidated Waiver.

a. Section 3.8 - ODP ISP Manual: Provider Back-up Plans

Providers are obligated to render services according to the approved and authorized ISP. A back-up plan is the strategy developed by a provider to ensure the HCBS the provider is authorized to provide is delivered in the amount, frequency, and duration as referenced in the individual’s ISP. These back-up plans are developed with the unique needs and risk factors of the participant in mind and discussed and shared with the individual and team. A provider shall develop and provide detailed information on the back-up plan in accordance with 55 Pa. Code §51.32 when individuals are supported in their own private residence or other settings where staff might not be continuously available. The ISP should include a backup plan to address contingencies such as emergencies, including the failure of a support worker to appear when scheduled to provide necessary services when the absence of the service presents a risk to the participant’s health and welfare. Back-up plans are then discussed and updated if necessary, during the ISP plan year or during the next ISP meeting. SCs should monitor that the individual is receiving the appropriate type, amount, duration, and frequency of services to address the individual’s assessed needs and that support desired Outcome Statements as documented in the approved and authorized ISP. If services are not rendered per the ISP due to the individual not being available because they are in hospital/rehabilitation care for an extended period, the provider should notify the SC and AE immediately. Individuals that self-direct their services already complete a DP #1009 emergency back-up designation form. The following represents ODP criteria for all other back-up plans:

• The name and phone number of the provider to be called if the worker does not show up.

• The name and phone number of the primary caregiver, and two natural support persons that may be called in the absence of a primary caregiver if the individual cannot get in touch with the provider.

• A description of what things need to occur if no one is available to assist the individual (the individual’s urgent needs and any actions that need to take place).

SC documentation requirements for back-up plans:

The SC will document within the Crisis support section of the ISP that all back-up plans for providers rendering services to the individual were reviewed to ensure that the plan meets ODP criteria, a copy of the plan was given to the individual and shared with the SC for inclusion in the ISP, and where the original plan can be located (ie: individual file located at Provider agency).

The Agency will comply with every aspect of The ISP Manual regarding a Backup Plan. A copy of the unique ISP regarding the Backup Plan will be provided to the Client with specifics within Section 3.8 of the ISP Manual.

13. Conflicts of Interest

The Agency will never engage in any Conflicts of Interest involving unbiased decision making by The Agency, or Caregivers or involvement of the owner of The Agency with other provider agencies that are not in accordance with ethical standards of financial and professional conduct. The organizational structure of The Agency does not involve opportunities for conflicts of interest with other agencies or providers. The Agency is a sole proprietorship with 100% ownership by Chantel Motes, CEO and owner. The next level of the organization is Caregivers that are employees that are hired on a permanent, temporary, part- or -full time basis. They are obligated to The Agency only to the extent of their ability to perform their duties and work their agreed to schedules. These employees are not restricted from working for other agencies and if they do it is not a Conflict of Interest.

If a conflict of interest over the course of business is determined to occur, the Agency will self-disclose a conflict of interest to the Department in writing immediately.

14. Damage of Participant’s Property

The Agency will address replacing property that was lost or damaged or pay the participant the replacement value for the lost or damaged item, if confirmed by the Department or the Department’s designee through a review of the circumstances that a participant’s personal property was lost or damaged by The Agency or the Caregiver while providing an HCBS to the participant.

15. Transition of Clients

When a participant selects another willing and qualified provider to replace The Agency, both providers shall cooperate with the Department or the Department’s designee, the participant and the participant’s SCO or SCA during the transition between providers.

The Agency shall ensure the following:

(1) Participation in transition planning meetings to aid in the successful transition to the new willing provider.

(2) Cooperation with visitation schedules identified during the transition meeting.

(3) Arrangement for transportation of the Client to support the visitation schedule.

(4) Closing of open incidents in HCSIS.

(5) Undue influence is not exerted when the Client is making the choice to a new willing and qualified provider.

If the Agency is no longer willing to provide an HCBS to a Client, The Agency shall provide written notice at least 30 days prior to the date of discharge to the Client, the Department, the Department’s designee and the SC when the provider is not the SCO or SCA.

The Agency will provide written notification that includes the following:

a) The HCBS The Agency is unwilling or unable to provide.

b) The HCBS location where the HCBS is currently provided.

c) The reason The Agency is no longer willing to provide the HCBS to the Client.

d) A description of the efforts made to address or resolve the issue that has led to the Agency's becoming unwilling or unable to deliver the HCBS to the Client.

e) Suggested time frames for transitioning the delivery of the HCBS to a selected willing and qualified provider.

f) The Agency's name and Master Provider Index number.

g) the Agency shall continue to provide the authorized HCBS during the transition period to ensure continuity of care until a willing and qualified provider is selected unless otherwise directed by the Department or the Department’s designee.

h) The Agency shall provide written notification to the Department or the Department’s designee if the provider cannot continue to provide the HCBS until another willing provider is selected due to emergency circumstances.

i) A selected willing provider shall cooperate with transition planning activities including participation in transition planning meetings.

j) A current SCO provider shall cooperate with transition planning activities including utilization of HCSIS transfer functionality and participation in all transition planning meetings that occur during the transition period.

k) The Agency shall provide available records to the selected willing provider within 7 days of the date of transfer.

16. Accessibility of Intellectual Disability Services for Individuals Who Are Deaf

The following criteria will be utilized to determine whether an individual is deaf:

1. As a result of a hearing impairment, the person is unable to understand or communicate verbal expressions at a level commensurate with his or her intellectual ability, even when wearing hearing aids;

2. OR As a result of a hearing impairment, his or her primary language is Sign Language.

The following are examples of communication assistance that may be made available based upon the individual’s needs by County MH/ID Programs, Administrative Entities, Supports Coordination Organizations and providers of intellectual disability services to facilitate communication with individuals who are deaf:

1. Access to Video phone equipment,

2. Assistive Technology, such as adapted telephones like videophones, captioned telephones and telecommunication devices for deaf persons (TTYs),

3. Communication Access Realtime Translation (known as CART or realtime captioning),

4. Video Remote Interpreting,

5. Closed caption decoders,

6. Highly visual communication tools, checklists, schedules and materials,

7. Open and closed captioning on TV,

8. Staff or interpreters proficient in sign language

• Sign Language Interpreters (includes but is not limited to: certified interpreters and certified deaf interpreters),

• Transliteration AND

• Exchange of written notes.

An individual’s need for communication assistance can be determined in various ways which include, but are not limited to: An assessment completed by a speech-language pathologist, a formal communication assessment selected by ODP for individuals who meet the criteria for such an assessment, or a determination by the Individual Support Plan team of the individual’s need for communication assistance to be provided on an interim basis pending the completion of an assessment. Assessments are very important for determining the long-term needs of participants. The need for an assessment, however, should not delay the provision of communication assistance (such as an interpreter for a meeting). For this reason, the service can be authorized in the Individual Support Plan and provided on an interim basis pending the completion of an assessment when the Individual Support Team determines that communication assistance is necessary.

When a need for communication assistance is identified; the County MH/ID Program, Administrative Entity, Supports Coordination Organization or provider must provide an opportunity for individuals to request the type of communication assistance of their choice. Primary consideration must be given to the choice expressed by the individual unless different communication assistance is recommended in the deaf individual’s most current communication assessment. Each such entity must have written protocols in place within 60 days of the effective date of this bulletin for staff to request and obtain the necessary communication assistance.

When it has been determined or assessed that an individual needs a Sign Language Interpreter, in general it is not recommended that family members or friends who meet these criteria be utilized to fulfill this need. Individuals have the right to interact directly with County MH/ID Programs, Administrative Entities, Supports Coordination Organizations and providers. Family members and friends also have the right to focus on their role as team members and informal supports for the individual. There are some situations, however, when it may be acceptable to use a family member or friend who is Sign Language Interpreter including when:

1. The family member or friend is rendering a paid waiver service at the time where it is expected that he or she will perform this function as part of the service. For example, a family member who is a Sign Language Interpreter is rendering Home and Community Habilitation as authorized in the Individual Support Plan.

2. As part of this service the family member is working on assisting the individual with grocery shopping. It may be necessary for the family member to interpret for the individual when the individual needs to interact with the cashier;

3. An emergency situation arises where the safety and welfare of the public or the individual is of paramount importance; OR

4. Other Sign Language Interpreters have been offered and refused and both parties have agreed to the family member or friend. County MH/ID Programs, Administrative Entities, Supports Coordination Organizations and providers are not responsible for providing communication assistance for any function that is covered in the individual’s Individualized Education Plan (IEP).

5. When scheduling an appointment for Medical Assistance covered (non-waiver) services, individuals or staff who assist them should ask the Medical Assistance provider for an interpreter. If there is difficulty getting an interpreter, individuals or staff should ask for further assistance in obtaining an interpreter:

If the individual receives physical or behavioral health services through fee-for-service (ACCESS), the individual or staff should

either send an e-mail to [email protected], or call the Office of Medical Assistance, Bureau of Fee-for-Service Programs at 1-866-872-8969, choose Option #7, and leave a message. If the individual uses a Medicaid Managed Care Organization (MCO) for physical or behavioral health, the MCO should be contacted for assistance. In the case of physical health, contact the Special Needs unit of the MCO.

If these contacts do not resolve the problem, the individual or staff should contact the ODP Deaf Services Coordinator. These resources should be utilized as individuals who are deaf have the right to interact directly with their Medical Assistance providers, have staff with clearly defined roles as supportive informants or advocates and confidentiality when they do not want their staff to be present at these appointments County MH/ID Programs and Administrative Entities

County MH/ID Programs and Administrative Entities are required to pay for necessary communication assistance any time these programs and entities need to communicate with an individual who is deaf for the following purposes:

1. Engaging in any of the activities required through the Mental Health and Intellectual Disabilities Act of 1966. This includes but is not limited to enrolling and determining eligibility for the individual to receive intellectual disability services through ODP;

2. Providing base-funded services; AND

3. Engaging in any of the activities required by or related to the Administrative Entity Operating Agreement; including when the Administrative Entity delegates or purchases any administrative functions from another entity.

County MH/ID Programs may utilize base funds while Administrative Entities may utilize Waiver administration funds to cover communication assistance costs (including costs incurred by Supports Coordination Organizations to provide communication assistance). County MH/ID Programs are responsible for ensuring that contracted providers that provide base funded services meet applicable ADA requirements for individuals who are deaf.

Attestation

Genuine Care Home Health Aid Agency, LLC

I, Chantel Motes, CEO and Owner of the Agency have read and understand the requirements for participation with the Pennsylvania Consolidated Waiver administered by the Pennsylvania Department of Health and the Pennsylvania Office of Developmental Programs. I will comply with each of the requirements outlined in Appendix A to the Procedure Manual for the Agency that apply to Compliance with the requirements of the Agency for participation in the Consolidated Waiver to the extent of Providing and Billing for Services to Clients participating in the Consolidated Waiver.

__/__/___ (Date)

__________________________ (Signature) ________________________________(Witness)

Chantel Motes, CEO and Owner ____________________ (Witness Name Printed)

I, ________________________ (client or representative name printed) have been informed of the responsibilities and conditions under which Genuine Home Health Aid Agency, LLC may provide services and bill the Commonwealth of Pennsylvania for services covered under the Consolidated Waiver that is administered by the Pennsylvania Department of Health and the Pennsylvania Office of Developmental Programs.

Caregiver

__/__/___ (Date)

___________________________ ___________________________

Signature Name Printed

I, ________________________ (Caregiver name printed) have been informed of the responsibilities and conditions under which Genuine Home Health Aid Agency, LLC may provide services and bill the Commonwealth of Pennsylvania for services covered under the Consolidated Waiver that is administered by the Pennsylvania Department of Health and the Pennsylvania Office of Developmental Programs.

Participant – Client

__/__/___ (Date)

___________________________ ___________________________

Signature Name Printed