Whereas both parties are interested in participation in the Consumer (Patient) Directed Personal Assistant Program, both parties agree to the following terms and conditions:

• The Consumer (Patient) understands that Personal Assistant services under the CDPAP will not be paid by the program until all paperwork is completed and returned to the office.
• The Consumer (Patient) must have Medicaid and provide assurances that it remains current.
• Consumers (Patients) who become ineligible for Medicaid benefits and who fail to notify the office of this situation and continue to receive Personal Assistant services during the period of ineligibility will be resonsible for repayment to MEADOWS HOME CARE of any compensation received by the Personal Assistant during said period.
• The Consumer (Patient) will meet the monthly spend down, if applicable.
• The Consumer (Patient) agrees not to employ their immediate family members, defined as: spouse, father, mother, as their Personal Assistant.
• The Consumer (Patient) and his/her agent, or in the case of a minor child, the parent or guardian, takes full and complete responsibility for the recruitment, hiring, training, maintenance and termination of any and all Personal Assistants who provide services.
• The Consumer (Patient) accepts responsibility for securing back-up Personal Assistants in the event that a scheduled assistant is unable to perform or show up for a scheduled shift. It is understood that MEADOWS HOME CARE keeps no list of such back-up Assistants and shall be held handless in the event of accident or injury resulting when the Consumer (Patient) does not receive care during scheduled hours.
• The Consumer (Patient) accepts responsibility for any and all items removed from or destroyed within Consumers (Patients) primary residence or vehicle without Consumer's (Patient's) consent.
• Any arrangements regarding transportation of the Consumer (Patient) as a duty of the Personal Assistant shall be an agreement made strictly between the Consumer (Patient) and the Personal Assistant. It is understood that Meadows Home Care neither condones, nor discourages this activity and accepts no liability in the event of accident or injury.
• MEADOWS HOME CARE will act as the Employer of record for payroll, employee benefits, and insurance, as applicable. In this capacity, we will accept time slips and issue paychecks in the name of each Personal Assistant employed by the Consumer (Patient) for the authorized number of hours per week. Appropriate Federal, State, and FICA withholding taxes will be collected. Personal Assistants will receive year-end W-2 earning statements.
• MEADOWS HOME CARE will compensate the Consumer's (Patient) Personal Assistant(s) only for the authorized weekly hours worked. Should the Personal Assistant(s) work more than the authorized hours per week, the Consumer (Patient) assumes full responsibility for payment to the Personal Assistant(s) of all unauthorized hours of service.
• Inform MEADOWS HOME CARE of any changes in status, including, but not limited to, address, telephone number, CDPAP's name, hours worked and hospitalization.

The signatures below signify understanding and acceptance of this agreement by all parties.