HOME AND COMMUNITY BASED CARE Sample Clauses

HOME AND COMMUNITY BASED CARE. INDUSTRY-WIDE COMMUNICATIONS
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HOME AND COMMUNITY BASED CARE. For each calendar month You receive Home and Community-Based Care, We will pay the Eligible Charges for the Home and Community- Based Care You receive in that calendar month, up to the Home and Community-Based Care Monthly Maximum Benefit. Home and Community-Based Care includes Home Health Care Services, Adult Day Health/Social Care, Homemaker Services, Personal Care Services and Hospice Care Services. The Elimination Period applies to this Benefit. Any amounts We pay under this Benefit will be counted against the Policy Lifetime Maximum Benefit.
HOME AND COMMUNITY BASED CARE. These Benefits are available when You receive care or services in Your home or residence, in the community or when You are confined in a Residential Care Facility. For each day You receive Home and Community-Based Care, We will pay the Eligible Charges for the Home and Community-Based Care You receive on that day, up to the Home and Community-Based Care Maximum Daily Benefit. Home and Community-Based Care includes Home Health Care, Adult Day Care, Personal Care and Homemaker Services. Such services may be provided by skilled or unskilled workers, but will not be paid when services are provided by a Family Member who lives in Your home or residence. You may not receive Home and Community-Based Care Benefits while you are confined in a Nursing Facility. (These benefits are not available in the Nursing Facility and Residential Care Facility Only Insurance Policy.) (a) Home Health Care. Benefits for Home Health Care are only payable if provided by a person who: (i) Is employed by a Home Health Agency; or (ii) Is properly licensed to provide such services, if licensure is required by the jurisdiction where the care or services are performed.
HOME AND COMMUNITY BASED CARE. These Benefits are available when You receive care or services in Your home or residence, in the community or when You are confined in a Residential Care Facility. For each day You receive Home and Community-Based Care, We will pay the Eligible Charges for the Home and Community-Based Care You receive on that day, up to the Home and Community-Based Care Maximum Daily Benefit. Home and Community-Based Care includes Home Health Care, Adult Day Care, and Homemaker Services. (These benefits are not available in the Nursing Facility and Residential Care Facility Only Insurance Policy.) (a) Home Health Care. Benefits for Home Health Care are only payable if provided by a person who: (i) Is employed by a Home Health Agency; or (ii) Is properly licensed to provide such services, if licensure is required by the jurisdiction where the care or services are performed; or (iii) If licensure is not required is acting within the scope of his or her training and experience in providing such services.

Related to HOME AND COMMUNITY BASED CARE

  • Human and Financial Resources to Implement Safeguards Requirements The Borrower shall make available necessary budgetary and human resources to fully implement the EMP and the RP.

  • Home Health Care This plan covers the following home care services when provided by a certified home healthcare agency: • nursing services; • services of a home health aide; • visits from a social worker; • medical supplies; and • physical, occupational and speech therapy.

  • COVERED HEALTHCARE SERVICES This section describes covered healthcare services. This plan covers services only if they meet all of the following requirements: • Listed as a covered healthcare service in this section. The fact that a provider has prescribed or recommended a service, or that it is the only available treatment for an illness or injury does not mean it is a covered healthcare service under this plan. • Medically necessary, consistent with our medical policies and related guidelines at the time the services are provided. • Not listed in Exclusions Section. • Received while a member is enrolled in the plan. • Consistent with applicable state or federal law. We review medical necessity in accordance with our medical policies and related guidelines. Our medical policies can be found on our website. Our medical policies are written to help administer benefits for the purpose of claims payment. They are made available to you for informational purposes and are subject to change. Medical policies are not meant to be used as a guide for your medical treatment. Your medical treatment remains a decision made by you with your physician. If you have questions about our medical policies, please call Customer Service. When a new service or drug becomes available, when possible, we will review it within six (6) months of one of the events described below to determine whether the new service or drug will be covered: • the assignment of an American Medical Association (AMA) Current Procedural Terminology (CPT) code in the annual CPT publication; • final Food and Drug Administration (FDA) approval; • the assignment of processing codes other than CPT codes or approval by governing or regulatory bodies other than the FDA; • submission to us of a claim meeting the criteria above; and • generally, the first date an FDA approved prescription drug is available in pharmacies (for prescription drug coverage only). During the review period, new services and drugs are not covered. For all covered healthcare services, please see the Summary of Medical Benefits and the Summary of Pharmacy Benefits to determine the amount that you pay and any benefit limits.

  • Residence Community Living Standards The Residence Community Living Standards (“RCLS”) forms a part of this Agreement. It details the rights, responsibilities, and privileges of Residents as well as the residence conduct process. Each Resident is responsible for reading, understanding, and adhering to the terms outlined within the RCLS. The Manager and the Institution may amend the terms of the RCLS from time to time and may post the amendments in the Residence. Failure to abide by the RCLS may result in eviction from Residence and termination of this Agreement as per the violations and sanctions outlined in the RCLS, and as stated in section 8.01(d). The RCLS can be found online at: xxx.xxxxxxxxxxxxxxx.xx.

  • Please see the current Washtenaw Community College catalog for up-to-date program requirements Conditions & Requirements

  • Management; Community Policies Owner may retain employees and management agents from time to time to manage the Property, and Owner’s agent may retain other employees or contractors. Resident, on behalf of himself or herself and his or her Guests, agrees to comply fully with all directions from Owner and its employees and agents, and the rules and regulations (including all amendments and additions thereto, except those that substantially modify the Resident’s bargain and to which Resident timely objects) as contained in this Agreement and the Community Policies of the Property. The Community Policies are available at xxxxx://xxxxxxxxxxxxxx.xxx/policies.pdf or on request from the management office and are considered part of this Agreement.

  • Child Care The County will continue to support the concept of non-profit child care facilities similar to the “Kid’s at Work” program established in the Public Works Department.

  • Health Care The Company will reimburse the Executive for the cost of maintaining continuing health coverage under COBRA for a period of no more than 12 months following the date of termination, less the amount the Executive is expected to pay as a regular employee premium for such coverage. Such reimbursements will cease if the Executive becomes eligible for similar coverage under another benefit plan.

  • Health & Safety (a) The Employer and the Union agree that they mutually desire to maintain standards of safety and health in the Home, in order to prevent injury and illness and abide by the Occupational Health and Safety Act as amended from time to time. (b) A Joint Health and Safety Committee (JHSC) shall be constituted in accordance with the Act, which shall identify potential dangers, recommend means of improving the health and safety programs and obtaining information from the Employer or other persons respecting the identification of hazards and standards. The committee shall meet at least every three months or more frequently if the committee decides. The Employer agrees to accept as a member of its Joint Health and Safety Committee at least one (1) ONA representative selected or appointed by the Union from the Employer. Scheduled time spent in such meetings is to be considered time worked for which representative(s) shall be paid by the Employer at his or her regular or overtime rate. Minutes shall be taken of all meetings and copies shall be sent to the Committee members within two (2) weeks following the meeting, if possible. Minutes of the meetings shall be posted on the workplace health and safety bulletin board. (c) The Employer shall provide the time from work with pay and all related tuition costs and expenses necessary to certify the worker representative. Where an inspector makes an inspection of a workplace under the powers conferred upon him or her under the Occupational Health and Safety Act, the Employer shall afford a committee member representing workers the opportunity to accompany the inspector during his or her physical inspection of a workplace, or any part or parts thereof. Where a committee member is not available, the Employer shall afford a worker selected by a Union, because of knowledge, experience and training, to represent it, the opportunity to accompany the inspector during his or her physical inspection of a workplace, or any part or parts thereof. (d) Two (2) representatives of the Joint Health and Safety Committee, one (1) from management and one (1) from the employees, shall make monthly inspections of the work place and shall report to the health and safety committee the results of their inspection. The members of the Committee who represent the workers shall designate a member representing workers to inspect the workplace. Where possible that member shall be a certified member. The Employer shall provide the member with such information and assistance as the member may require for the purpose of carrying out an inspection of the workplace. Scheduled time spent in all such activities shall be considered as time worked. (e) The Joint Health and Safety Committee and the representatives thereof shall have access to Incident/Accident Report Form required in S.51, S.52 and S.53 of the Act and the annual summary of data from the WSIB relating to the number of work accident fatalities, the number of lost workday cases, the number of lost workdays, the number of non-fatal cases that required medical aid without lost workdays, the incidence of occupational injuries, and such other data as the WSIB may decide to disclose. It is understood and agreed that no information will be provided to the Committee which is confidential. This information shall be a standing item recorded in the minutes of each meeting. (f) The Union will use its best efforts to obtain the full co-operation of its membership in the compliance of all safety rules and practices. (g) The Employer will use its best efforts to make all affected direct care employees aware of residents who have serious infectious diseases. The nature of the disease need not be disclosed. Employees will be made aware of special procedures required of them to deal with these circumstances. The parties agree that all employees are aware of the requirement to practice universal precautions in all circumstances. (h) The parties further agree that suitable subjects for discussion at the Union-Management Committee and Joint Health and Safety Committee will include aggressive residents. The Employer will review with the Joint Health and Safety Committee written policies to address the management of violent behaviour. Such policies will include but not be limited to: i) Designing safe procedures for employees, ii) Providing training appropriate to these policies, iii) Reporting all incidents of workplace violence. (i) The Employer shall: i) Inform employees of any situation relating to their work which may endanger their health and safety, as soon as it learns of the said situation, ii) Inform employees regarding the risks relating to their work and provide training and supervision so that employees have the skills and knowledge necessary to safely perform the work assigned to them, When faced with occupational health and safety decisions, the Home will not await full scientific or absolute certainty before taking reasonable action(s) that reduces risk and protects employees. iii) Ensure that the applicable measures and procedures prescribed in the Occupational Health and Safety Act are carried out in the workplace. (j) A worker shall, i) Work in compliance with the provisions of the Occupational Health and Safety Act and the regulations, ii) Use or wear the equipment, protective devices or clothing that the worker's Employer requires to be used or worn, iii) Report to his or her Employer or supervisor the absence of or defect in any equipment or protective device of which the worker is aware and which may endanger himself, herself or another worker, and iv) Report to his or her Employer or supervisor any contravention of the Occupational Health and Safety Act or the regulations or the existence of any hazard of which he or she knows.

  • Benefit to Citizens of Xxxxxxx County The safety of the citizens of Xxxxxxx County is enhanced through this Agreement, which promotes safe boating conditions and reduces costs associated with patrols of recreational waterways.

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