The Finger Lakes Independence Center | Making …
VERY IMPORTANTPlease do NOT start working for a new consumer until you know for sure that their Managed Care Provider (DSS Long Term Care, Fidelis iCircle, VNA Homecare or Total Care) has approved their hours. An aide CANNOT be paid for any hours while a consumer is a patient at a hospital or a skilled nursing facility. Aides can ONLY work 12 hours each 24 hour period & 40 hours a week.ALL medical forms must be turned in before you can get paid. Ithaca Free Clinic does monthly physicals & PPD test – contact them at 330-1254. Tompkins County Health Department does MMR shots – contact them at 274-6616. Finger Lakes Independence Center reimburses medical out-of-pocket expenses up to $65 a year (must turn in receipt).Timesheet with activity sheet must be filled out completely (with phone numbers) and must be signed by both consumer and aide. A copy is turned into DSS LTC. The timesheet is a LEGAL DOCUMENT, must be an original – NO COPIES. Timesheets MUST be turned in at least monthly.Paychecks can be picked up between 9:30am and 5pm on payday. Your first paycheck MUST be picked up in person. Checks CANNOT be given out early.Please make sure that you bring a photo ID each time you pick up your paycheck. If you need someone other than you to pick up your paycheck, request in writing must be turned in person BEFORE the payday (Friday). We have a form that you can fill out.Questions ? call Cheryl at FLIC 272-2433Dear Personal Assistant:Below are the rules that pertain to personal assistants who are employed by Medicaid in the Consumer Directed Personal Assistance Program (CDPAP). Please review them to make sure you are meeting your obligations as a consumer directed personal assistant. The activity sheet (on right side of the timesheet) you must fill out for each day you provide aide services for your client – each client has their own activity sheet. If you have any questions or concerns about your role as a consumer directed personal assistant, please feel free to contact DSS Long Term Care, iCircle Care, VNA Homecare, Fidelis or Total Care.Jan Lynch, Executive DirectorFinger Lakes Independence Center _______________________________________________________________________________Duties of the Personal AssistantA Consumer Directed Personal Assistant is someone who is participating as a home care assistant in the Medicaid CDPAP program. Because you are hired by the consumer (or their designated representative), they are responsible for your training, work schedule, supervision and information about all other aspects of their care. Consumer Directed regulations require that a nurse from DSS oversee CDPAP MLTC services, determine the amount of care the consumer requires and enter that information into the Medicaid Management Information System that ultimately authorizes payment to you for your work. If you are experiencing problems with your work (unsafe situation, too much to do, unable to do, not enough to do) speak with the consumer (or their designated representative), and attempt to resolve any issues directly with them. DSS staff nurses are available to both you and the consumer to offer guidance with any problems, and information about other services that are available to the consumer. As a personal assistant in the consumer directed program, you are expected to:Turn in ALL required paperwork PRIOR to starting work for the consumer to Finger Lakes Independence Center (FLIC). These include: CDPAP information sheet, Annual Health Assessment, Form W-4 (withholding), Employment Eligibility Verification (I-9 with documents needed) and medical forms signed by a physician.*** New York State Health Department (Section 766.11) mandates that individuals providing any kind of home care must have a yearly physical examination and the following immunizations or tests for immunity: MMR (Measles and Rubella) vaccines or titers and a yearly PPD Mantoux (tuberculosis) skin test. Proof of Measles only, is not needed if your birth date is BEFORE January 1, 1957.Respect the consumer’s home, possessions, lifestyle and individual choices. Respect the consumer’s confidentiality. All information about the person you are assisting is confidential and is not to be discussed with your family, friends or others. You may not discuss information about the consumer you are assisting with their family and friends, either, without the consumer’s permission. You may discuss the consumer’s personal information with the consumer’s designated representative.The personal assistant is being paid to perform the tasks on the plan of care that is developed by the consumer’s nurse and the consumer. The plan of care is typically posted in the kitchen on the refrigerator, unless the consumer designates a different location. Complete tasks in a responsible, prompt and courteous manner.FLIC does not: supply any supplies (medical or other) that might be needed or pay mileage.Report to work on time; the consumer is relying on you. Work the hours you are scheduled to work unless other arrangements have been made in advance with the consumer. You can only get paid for the number of hours you are authorized to work. If you are unable to complete the tasks you are authorized for in the amount of time allotted, speak with your consumer. They can request a reassessment to change the number hours.With your consumer, arrange for time off in advance. You need to provide them with two-weeks notice before vacations and appointments, etc. There is no paid time off.Maintain a weekly accounting of activities by accurately filling out the activity sheet daily. DSS staff will review activity sheets bi-weekly and they need to reflect what your time sheets report.Maintain your own timesheets and submit for the consumer’s signature, your must keep separated timesheets for each consumer you are working for. Time sheet must have original signatures and all changes need to be initialed by both the consumer and the personal assistant. Do not use “white-out”. Consumers must initial each day worked.You can only work a total of 12 hours a day (no matter how many consumers) and 40 hours a week.Holiday pay – personal assistants will receive holiday pay (time and a half) for working when scheduled on any of the following holidays: New Year’s Day, Memorial Day, July 4th, Labor Day, Thanksgiving and Christmas Day. In the case of illness or emergencies, call the consumer or their designated representative as soon as possible, but no later than one hour before work begins.Protective Services for Adults (PSA) can assist adults with disabilities who are at risk of homelessness or harm (physical, psychological or financial). If you have concerns for the safety of an adult you are assisting, you can contact PSA at 274-5323 Monday – Friday 8:30-4:30 to speak with a caseworker.HOW DOES THE PERSONAL ASSISTANT GET PAID ??The personal assistant must fill in the timesheet daily (write the hours you work on your timesheet after you have completed those hours) and have consumer initial hours worked.You can only be paid for the hours you are authorized to work by Medicaid Long Term Care Agency, if there is a problem the consumer should contact their caseworker. If the consumer who employs you is hospitalized (or in a skilled nursing facility), Medicaid can NOT pay you for any work during that period. Submitting hours worked while consumer is hospitalized or in a skilled nursing facility is FRAUD.At the end of each pay period, the consumer checks the timesheets to be sure they are correct and have not gone over the allowed hour total. Both you and the consumer must sign and date the timesheet. FLIC will give you a list of pay periods for the year (attached). The timesheet is a legal document; both the aide and the consumer are responsible for its accuracy. Timesheets need to be originals – NO COPIES.It is the consumer’s responsibility to mail or deliver the timesheets and activity sheets to FLIC during regular business hours (Monday – Friday 9:00-5:00). They may assign this task to you. The timesheets must be received at FLIC before 5pm on TUESDAY of the pay check week.The FLIC CDPAP coordinator will check the timesheets and notify the consumer if there are errors. On payday, checks can be picked up at FLIC after 9:30am and before 5pm OR they will be mailed on the next business day (usually Monday). Checks CANNOT be given out early. Your first paycheck MUST be picked up in person.If you can not pick up your paycheck and would like someone else to pick it up, we will need a dated and signed note from you on file stating who you would like to pick up your check. You MUST provide this to FLIC IN PERSON prior to the pay date. FLIC has these forms for you.If there is a discrepancy in a paycheck: Check your records to see if there is an errorIf you have made a mistake, or if FLIC made a mistake, contact the CDPAP coordinator at FLIC immediately. Corrections will be done in the next paycheck. 607-272-2433If you work an overnight shift please show on your timesheet like the example below:Aide has worked from 8pm in evening until 8am in morning IN OUT IN OUT Total hoursSundayDATE8pm8am12 WRONG MondayDATE8pm12am4 CORRECTTuesdayDATE12am8am8 CORRECTCDPAP PROGRAM INFORMATION SHEET Finger Lakes Independence Center215 Fifth StIthaca, NY 14850 Personal Information Social Security Number: ______ - _____ - ______ First Name & Middle Initial: ______________________ Last Name: ___________________________ Present Address: _________________________________________ City: _______________________ State: ______ Zip Code: __________ Phone number ( ) _____ - ________ home or cell Referred by: _____________________________________________________________________ Date you can start: _______________________ Ever applied to this company before? □ Yes □ No When? _________________Date: _________________ Signature: ______________________________________For FLIC use:I - 9?2 IDs?W 4?Health info?physical?MMR?PPD?OMIG CHECK?NYS new hire?1/22/16cfbFinger Lakes Independence Center 215 Fifth Street, Ithaca, NY 14850 Phone: (607) 272-2433 FAX: (607) 272-0902REQUIRED Physical Examination (To be completed by Physician)Name: ________________________________________________________________Age:________________ Height:_____________ Weight:_______ Blood pressure:________NormalAbnormalExplainSkin[ ][ ]__________________________Heart/Lungs[ ][ ]__________________________Neck[ ][ ]__________________________Back[ ][ ]__________________________Abdomen[ ][ ]__________________________Extremities[ ][ ]__________________________Neuro/Muscular[ ][ ]__________________________Ears[ ][ ]__________________________The New York State Health Department mandates that individuals providing any kind of home care must have the following immunizations or tests for immunity. Please document administration of vaccines, response to screening tests, or history of test results.Immunization RecordDate CompletedResults PPD Mantoux (Tuberculosis)___________________________Use other side for positive resultsRubella titer or 1 Rubella vaccine___________________________Rubeola (Measles titer or 2 Measles vaccines):__________________________Do not need proof of Rubeola (Measles) if were born BEFORE January 1, 1957I find___evidence or___ no evidence of health impairment that would be of potential risk to individuals receiving services or interfere in the performance of health care duties of this employee.______________________________ _______________________________________________Physician’s Signature Physician’s Address______________________________Physician PRINT name________________________________________________Date of ExaminationPhysician’s Phone Number8/21/15Symptom Check for those who test Positive for TB InfectionTB disease often develops many years after initial infection. Symptoms of TB disease are similar to many other diseases and can seem mild to the client during the 1st few months of disease.It is the persistence of symptoms that are important to note, that is, symptoms for more than 3-4 weeks or a general recurring pattern over several months.While a chest x-ray (CXR) is valuable tool to rule out TB disease when a client first tests positive with your organization, repeated CXRs are not recommended unless there are symptoms of disease. Once a positive skin test has been accurately documented in millimeters in duration, additional skin tests are unnecessary. The client should be given a copy of the skin test result, CXR report and this symptom checklist clearly filled out. Client Name _________________________________________ DOB _________________Original PPD & Date _________________ mm CXR result & date __________________________Recent Medical Exam? _________________ A Recent CXR/CT Chest ? _______________________Symptom CheckDescribeLow-grade Fever or Chills No Yes ______________________________________________Night SweatsNo Yes ______________________________________________Loss of AppetiteNo Yes _____________________________________________Weight Loss No Yes ______________________________________________FatigueNo Yes ______________________________________________Swollen NodesNo Yes ______________________________________________Sore ThroatNo Yes ______________________________________________Chest Pain or SOBNo Yes ______________________________________________Productive CoughNo Yes ?______________________________________________Bloody SputumNo Yes ______________________________________________If any symptom checked “YES”, refer for medical follow-up and Chest X-Ray.New medical problems/Meds? No Yes _________________________________Notes: _______________________________________________________________________________Cleared for continued community contact ? Yes No If “NO”, what follow-up taken: _________________________________________________________Date of Interview ______________ Interviewer Name/sign _______________________________ ................
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