Common Contracts
1 similar Responsibility Agreement contracts
RESPONSIBILITY AGREEMENTResponsibility Agreement • April 30th, 2021
I, (insert member name), and (insert CM agency and/or PA agency) have entered into a formal responsibility agreement. The provider agency has discussed the Aged and Disabled policy 501.29 Rights and Responsibilities with me. I understand that as a member on the ADW program, I must meet the member responsibilities which includes maintaining a safe environment for my worker or those who enter the home and maintain compliance with the ADW program.
