MRCHCAP Att. 3 -- Qualifications Response.docx
DOCX document 17 KB Posted
- Attached to
- MRC HomeCare Assistants
- Solicitation number
- BD-19-1071-AO-CON01-31976
- Issued by
- Suffolk County, Massachusetts
About this file
This document is an Attachment 3 titled "Home Care Assistant Qualifications Response" related to a state and local contract opportunity for Home Care Assistants (HCAs) issued by the Massachusetts Rehabilitation Commission (MRC). The contract seeks independent (individual) care providers selected by MRC consumers to provide home care services. The document outlines the required qualifications for HCA applicants, which include demonstrating sufficient health, physical ability, communication skills, transportation access, scheduling flexibility, math and reading skills, understanding of Universal Precautions, willingness to communicate with the consumer and case manager, and ability to comply with contract and policy requirements. The consumer must initial each qualification to indicate review.
The related state and local contract opportunity is titled "MRC HomeCare Assistants" and is applicable to Suffolk County and the City of Boston in Massachusetts. This solicitation is for independent (individual) care providers selected by MRC consumers, not organizations. No further details on pricing, set asides, incumbents, funding, or other salient information are provided in the given documents.
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Other files
| File | Type | Posted |
|---|---|---|
| Form W9~3.doc | DOC document | |
| MRCHCAP Att. 4 -- Manual Submission Justification Form.docx | DOCX document | |
| MRCHCAP RFR Posted~1.doc | DOC document | |
| Commonwealth Terms and Conditions.doc | DOC document | |
| Electronic Funds Transfer Sign Up Form~8.pdf | ||
| MRCHCAP Att. 1 -- Guide to Universal Precautions.docx | DOCX document | |
| MRCHCAP Att. 2 -- CoverPage.docx | DOCX document | |
| Standard Contract Form~2.doc | DOC document | |
| Supplier Diversity Program Plan Form for POS~3.xlsx | XLSX spreadsheet | |
| Commonwealth Terms and Conditions for Human and Social Services~3.pdf | ||
| CORI Acknowledgement Form - updated Oct17.docx | DOCX document | |
| Contractor Authorized Signatory form~3.rtf | RTF text file | |
| DOR Certificate of Good Standing~4.docx | DOCX document | |
| Prompt Payment Discount Form~22.doc | DOC document |
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Text version
ATTACHMENT 3
HOME CARE ASSISTANT
QUALIFICATIONS RESPONSE
The Home Care Assistant applicant must review the qualifications below with the consumer for whom the applicant wishes to work. The applicant must check off those qualifications that apply. The consumer must initial each of these to indicate that they have been discussed and reviewed.
1. HCA applicant demonstrates sufficient health and physical ability to perform the authorized tasks (consumer may ask for letter from health care provider stating HCA is free from communicable disease) _____YES _____NO Consumer Initials________
2. HCA applicant demonstrates ability to communicate effectively with the consumer (in consumer’s language and/or with communication tools required by the consumer) _____YES _____NO Consumer Initials________
3. HCA applicant has access to transportation sufficient to perform tasks outside of the home (such as grocery shopping) if applicable and to reach consumer’s home in inclement weather (consumer may request to see valid driver’s license) ____YES ____NO Consumer Initials________
4. Applicant has ability to meet consumer’s individual scheduling requirements ____YES ____NO Consumer Initials________
5. Applicant demonstrates sufficient math and reading skills to perform applicable tasks such as handling money, checks and change as needed for grocery shopping or laundry, reading lists, reading/following recipes, completing timesheets and payment vouchers ____YES ____NO Consumer Initials________
6. Applicant has understanding of and willingness to practice Universal Precautions ____YES ____NO Consumer Initials________
7. Applicant shows willingness to communicate directly with the consumer, and as needed with the HCAP Case Manager ____YES ____NO Consumer Initials________
8. Applicant has understanding of, and ability to comply with the requirements set forth in this contract and HCAP policy ____YES ____NO Consumer Initials________
As a respondent to the Home Care Assistant RFR, I certify that I have reviewed the above qualifications with the consumer and answered truthfully to all statements.
Applicant’s Signature: __________________________________Date: ________________
As the HCAP Consumer, I certify that I have reviewed the qualifications with the HCA applicant.
Consumer’s Signature: ________________________________ Date: ________________
HCARFR19 Page 2 of 2
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