Home and Community-Based Services Agreement Sample Contracts

CONTRACT NO. MA-012-23010710
Home and Community Based Services Agreement • February 9th, 2023 • California
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Division of Long Term Care Community-Based Waiver Services
Home and Community Based Services Agreement • May 14th, 2021

This Agreement is between the New York State Department of Health (NYSDOH) and (Provider), who has been approved to provide New York State Home and Community-Based Services (HCBS). The Provider will receive a letter from NYSDOH listing waiver services that this provider is authorized to provide.

Written Agreement
Home and Community-Based Services Agreement • June 8th, 2017

For more information on Home and Community-Based Services (HCBS), please visit http://www.oregon.gov/dhs/seniors-disabilities/HCBS/Pages/index.aspx.

There is a lease or written agreement in place for where you live. This agreement has protections against being evicted or having to move out as well as responsibilities for you as a tenant
Home and Community-Based Services Agreement • August 19th, 2015

For more information on Home and Community-Based Services (HCBS), please visit http://www.oregon.gov/dhs/seniors-disabilities/HCBS/Pages/index.aspx.

The freedoms and protections below can only be limited if there is a risk to you or someone else.
Home and Community-Based Services Agreement • June 16th, 2017

Even if a person wants or requests a restraint, a restraint should only be used after all other methods of keeping the person safe have been tried.

The freedoms and protections below can only be limited if there is a risk to you or someone else.
Home and Community-Based Services Agreement • July 31st, 2020

Even if a person wants or requests a restraint, a restraint should only be used after all other methods of keeping the person safe have been tried.

AGREEMENT BETWEEN THE NEW YORK STATE DEPARTMENT OF HEALTH AND
Home and Community-Based Services Agreement • November 12th, 2008

This Agreement is between the New York State Department of Health (DOH) and (Provider), who is approved to provide New York State Home and Community-Based Services (HCBS). The Provider will receive a letter from DOH indicating the approved waiver services.

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