Personal Assistant Orientation - Progress...

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Personal Assistant Orientation Second Edition February 2001 ©Progress Center for Independent Living 7521 Madison Street Forest Park, IL 60130 708-209-1500 Voice 708-209-1826 TTY 708-209-1735 Fax [email protected] EMAIL

Transcript of Personal Assistant Orientation - Progress...

Page 1: Personal Assistant Orientation - Progress Centerprogresscil.org/documents/downloads/paorientation.pdf · Personal Assistant Orientation Second Edition February 2001 ©Progress Center

Personal Assistant Orientation

Second Edition February 2001

©Progress Center for Independent Living

7521 Madison Street Forest Park, IL 60130

708-209-1500 Voice 708-209-1826 TTY 708-209-1735 Fax [email protected] EMAIL

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Agenda 1 1) Introductions 1 2) Home Services vs. Nursing Homes 1 3) Progress Center’s PA Referral Program 1 4) Closing Remarks 1

Independent Living and Disabilities 2 Progress Center for Independent Living 2 Progress Center is a: 2 Independent Living... 2 Progress Center embraces disability culture... 2 Services and Advocacy 2 More Services and Advocacy 3 Birth of the Independent Living Movement 4 Myths and Attitude 4 Olmstead Summary 5

Famous People With Disabilities Awareness List 7

Job Description of a Personal Assistant (PA) 9 Personal Assistants can help with: 9 Homemaking 9 Qualifications for Being a Personal Assistant 9 Who needs a PA? 9

Rights and Responsibilities of the Personal Assistant 10 Personal Assistants have the right to: 10 Personal Assistants have the responsibility to: 10

Rights and Responsibilities of the Employer 10 Employers have the right to: 10 Employers have the responsibility to: 10

Hand Washing 11

Body Mechanics 12 5 Rules of Body mechanics: 12

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More body mechanics 13 And yet more body mechanics 14

Checklists and Schedules 15 Personal Care Activities 16 Other Activities 17 Weekly Schedule 18 Employment Contract 19 Employment Experience 22 Personal Assistant Application 23

Interviewing for a Job as a Personal Assistant 24 Phone Interview 24 In-Person Interview 24 If you are hired 24

Forms and Vouchers 25 Sample Form: Employment Verification 26 Sample Form: List of acceptable documents 27 Sample Form: W4 Instructions 28 Sample Form: W4 29 Sample Form: Request for Social Security Number 30 Sample Form: Home Services Documentation of Services 32 Sample Form: IDPA Waiver Program Provider 33 Sample Form: Customer/Provider Agreement 35 Sample Form: Personal Assistant Standards 37

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Agenda 1) Introductions

a) Who are we? b) Why are we here? c) Overview of Progress Center Services

2) Home Services vs. Nursing Homes

a) Deinstitutionalization Legislative Advocacy b) Video c) Group Discussion

3) Progress Center’s PA Referral Program

a) Job Descriptions b) Intake/Application Forms

4) Closing Remarks

a) Questions and Answers b) Thanks for coming!

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Independent Living and Disabilities Progress Center for Independent Living Independent Living Service, Peer Support and Advocacy in Suburban Cook County Progress Center is a: • Community-based, • non-profit, • non residential, • service and advocacy organization, • operated

• for people with disabilities • by people with disabilities.

Independent Living... ... is a way of life that includes values, attitudes and behaviors. ... embraces a philosophy that the person, regardless of their disability, has the potential to exercise individual self-determination. ... is having the right and the opportunity to pursue a course of action. And, it is having the freedom to fail and to learn from one's failures, just as non-disabled do. ... "means that we demand the same choices and control in our everyday lives that non-disabled brothers and sisters, neighbors and friends take for granted. We want to grow up in our families, go to the neighborhood school, use the same bus as our neighbors, work in jobs that are in line with our education and abilities, start families of our own. Just as everybody else, we need to be in charge of our lives, think and speak for ourselves." (A. Ratzka http://www.independentliving.org) Progress Center embraces disability culture... ... the term people with disabilities are increasingly using to describe not only our growing sense of a shared history of social oppression, but also our strategies for coping and thriving, our emerging art and humor, our sense of community, and almost defiant celebration of our differences. (adapted from C. Gill) Services and Advocacy Progress Center directly assists persons with disabilities to establish lives in the community. We serve and support people with disabilities of all ages to increase and maintain independence. We also assist families and communities. • Information and Referral - Information about any disability related topic, and

referral to other resources when needed. • Advocacy - Training, support and direct action to enforce and build disability

rights, both at the individual and systemic level.

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• Independent Living Skills - Training on the know-how to live independently, from budgeting to traveling, from personal assistant management to job seeking, and more. Tell us what you want to learn.

• Peer Counseling - Sharing and problem solving about every day issues with people who understand what it's like: other people with disabilities.

More Services and Advocacy • Personal Assistance - Recruitment, training and information about using

personal assistance services. • Travel Training - Training on the use of public transit, under contract with the

Regional Transit Authority (RTA). • Nursing Home Discharge Program - Assistance to people who want to

move from a nursing home back to their community. • Housing - Assistance with housing issues, including enforcement of the Fair

housing Amendments Act (FHAA). • Deaf Services - All of our services tailored to the deaf/hard of hearing

community, as well as TTY distribution and training. • Latino Outreach Project - All of our services, in Spanish or English, tailored

to the Latino Disability Community. • Community Education - Presentations to community groups about

independent living, disability rights and disability culture. • Volunteer Opportunities - The chance to expand horizons and build skills. • Drop-in Center / Computer Access - Informal support, resource library and

access to computers.

NOTHING ABOUT US WITHOUT US!

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Birth of the Independent Living Movement Independent Living is the philosophy of self-empowerment for people with disabilities. Independence does not necessarily mean doing everything for oneself and living by yourself. The concept of Independent Living was born in the early 1970’s in Berkeley, California. A handful of students with disabilities on the campus of Cal-Berkeley saw the inaccessibility of the campus and decided to turn a wrong into a right or rights, as in disability rights. The first Independent Living Center was established in Berkeley, and the Independent Living Movement has been growing ever since. There are 22 Centers for Independent Living in Illinois. There are hundreds across the US. One of the by-products of the Independent Living philosophy is consumer control. What that means is consumers have direct control over the services they select. For example, a consumer who employs a Personal Assistant is the boss in the employer-employee relationship. As in any work environment, it is the employer’s responsibility to direct his/her employee. Consumer control not only encompasses Personal Assistant Services, but it covers a variety of services including: transportation, housing advocacy, individual and community advocacy, and social/recreational activities. This is a refreshing concept, given that society as a whole has the false perception that people with disabilities “need to be taken care of.” One important thing to remember is the language you use. The proper way to refer to a person with a disability is just that: a person with a disability. A person should always be seen as a person. The disability is just something a person has (Example: I have brown hair). By putting descriptions before the word person, the disability is seen first and not the person. Myths and Attitude Myth: Disabled people should stay with their own kind. Forced segregation creates an artificial barrier which makes people uncomfortable and hesitant to interact. The best way to combat any form of segregation is through education. People are afraid of things they do not understand. The only way to find out about anything is by having the desire to learn and ask questions. This starts at a very young age. Children should be encouraged to ask questions. Adults should examine their own behavior and ask themselves if they are setting a good example for children to follow.

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Olmstead Summary Reprinted with permission from Barry C. Taylor and Equip for Equality

Summary of the United States Supreme Court’s Decision in Olmstead v. L.C.

Barry C. Taylor, Legal Advocacy Director Equip for Equality

A. The Integration Mandate of the ADA When Congress passed the Americans with Disabilities Act (“ADA”), it

found that the isolation and segregation of people with disabilities is a serious and pervasive form of discrimination. Following the passage of the ADA, the Department of Justice issued regulations requiring state and local governments to administer their programs in the most integrated setting appropriate to the needs of people with disabilities. The regulations also require that public entities make reasonable modifications to their programs.

B. The Facts of the Olmstead Case Two women with mental retardation and mental illness were patients at a

state-operated hospital in Georgia. Although state treatment professionals for both women had deemed them appropriate for community-based placements, both remained institutionalized. They filed suit under Title II of the ADA alleging that the state had violated the ADA’s integration mandate.

C. The Supreme Court’s Decision 1. Unwarranted Institutionalization Violates the ADA:

The Supreme Court found that the unwarranted institutionalization of people with disabilities is a form of discrimination that is actionable under the ADA. The Court explained that segregation perpetuates unjustified assumptions that institutionalized persons are incapable or unworthy of participating in community life, and also found that institutional confinement severely diminishes individuals’ everyday life activities, including family relations, social contacts, work, educational advancement and cultural enrichment. 2. Three Factors Required for Community Placements:

The Court ruled that the ADA requires States to serve people with disabilities in community settings, rather than in segregated institutions, when three factors are present: • treatment professionals determine community placement is appropriate; • the person does not oppose community placement; and • the placement can be reasonably accommodated taking into account the

resources available to the State and the needs of others who are receiving State-supported services.

3. The State’s Obligations Under Olmstead:

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The Court ruled that a State can meet its obligations under Olmstead if it has a comprehensive, effectively working plan for evaluating and placing people with disabilities in less restrictive settings, and a waiting list that moves at a reasonable pace and which is not controlled by the State’s endeavors to keep its institutions fully populated. The Court did not require States to allocate new money to meet its obligations. In fact, the Court emphasized that since 1981, Medicaid has provided funding for state-run home and community-based care through a waiver program. Finally, the Court’s ruling includes individuals who have not been institutionalized, but are at risk of institutionalization due to a lack of community services.

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Famous People With Disabilities Awareness List Arts: Sports: Bud Abbott Epilepsy Arthur Ashe HIV Positive Sarah Bernhardt Amputee Jim Abbott Orthopedic

Impairment Chris Burke Down Syndrome Muhammad Ali Parkinson’s Disease Richard Burton Epilepsy Roy Campanella Paraplegia Cher Dyslexia Terry Cummings Chronic Heart

Condition Gary Coleman Kidney Disease Tom Dempsey Orthopedic

Impairment Bette Davis Stroke Terry Fox Amputee Sammy Davis, Jr. Visual Impairment Lou Gehrig ALS Patty Duke Mental Illness Carl Hubbell Orthopedic

Impairment Sandy Duncan Visual Impairment Bo Jackson Orthopedic

Impairment Nanette Fabray Hard of Hearing Bruce Jenner Learning Disability Lola Falana Multiple Sclerosis Magic Johnson HIV Positive Annette Funicello Multiple Sclerosis Bobby Jones Epilepsy Danny Glover Epilepsy Hal Lanier Epilepsy Whoopi Goldberg Learning Disability Greg Louganis Learning Disability Margaux Hemingway

Epilepsy Jimmy Piersall Mental Illness

Katharine Hepburn Parkinson’s Disease

Wilma Rudolph Polio

Rock Hudson AIDS Darryl Stingley Quadraplegia Ann Jillian Cancer Darryl Strawberry Substance Abuse Vivien Leigh Mental Illness Marlee Matlin Deaf Politics &

Activism:

Dudley Moore Physical Impairment Alexander the Great

Epilepsy

Mary Tyler Moore Diabetes Napoleon Bonaparte

Epilepsy

Patricia Neal Stroke James Brady Head Injury Anthony Perkins AIDS W.E.B. Du Bois Deaf Richard Pryor Multiple Sclerosis Julius Caesar Epilepsy Dan Rowan Diabetes Gov. Lawton

Chiles (Fla.) Depression

Rod Steiger Depression Winston Churchill Depression Henry Winkler Learning Disability Rep. Tony Coehlo

(D-Cal.) Epilepsy

Ludwig van Beethoven

Deaf Sen. Robert Dole (R-Kan.)

Orthopedic Impairment

Ray Charles Blind Sen. Mike Gravel (D-Ala.)

Learning Disability

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Arts (continued): Politics &

Activism (continued):

Jose Feliciano Blind Sen. Dan Inouye (D-Hawaii)

Amputee

Roy Hamilton Blind Rep. Barbara Jordan (D-Tex.)

Multiple Sclerosis

Walter Jackson Polio Sen. Bob Kerry (D-Neb.)

Amputee

Elton John Epilepsy Sen. Charles Percy (R-Ill.)

Hard of Hearing

Oscar Levant Mental Illness Pres. Ronald Reagan

Hard of Hearing

Freddie Mercury AIDS Pres. Franklin Roosevelt

Polio

Teddy Pendergrass Quadriplegia Sen. Paul Simon (D-Ill.)

Hard of Hearing

Itzhak Perlman Polio Sen. Paul Tsongas (D-Mass.)

Cancer

Cole Porter Amputee Harriet Tubman Hear Injury Robert Schumann Mental Illness Gov. George

Wallace Paraplegia

Diane Schuur Blind Rep. Larry Wynn (R-Kan.)

Amputee

George Shearing Blind Stevie Wonder Blind Science: Agatha Christie Learning Disability Alexander Graham

Bell Hard of Hearing

Joan Didion Multiple Sclerosis Leonardo da Vinci Epilepsy Feodor Dostoevski Epilepsy Thomas Edison Late Deafness Ernest Hemingway Depression Albert Einstein Learning Disability James Joyce Visual Impairment Stephen Hawking ALS John Milton Visual Impairment Alfred Nobel Epilepsy Eugene O’Neill Mental Illness Isaac Newton Mental Illness Sylvia Plath Mental Illness Louis Pasteur Paralysis Leo Tolstoy Mental Illness Socrates Epilepsy Walt Whitman Partial Parlysis Virginia Woolf Mental Illness Christy Brown Cerebral Palsy Vincent Van Gogh Mental Illness Francisco de Goya Deaf Henri Toulouse-Lautrec

Physical Impairment

Robin Williams Mental Illness

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Job Description of a Personal Assistant (PA) Personal assistance may be one of the most important services of independent living for people with disabilities. It allows them to receive assistance with activities of daily living in their homes. Unlike home health agencies, personal assistants are hired and trained by the consumer (person with a disability). Personal Assistants can help with: Personal Care And/or Homemaking Bathing Cooking/Washing Dishes Bladder/Bowel Care Dusting Dressing Grocery Shopping Eating Ironing Grooming Laundry Medication Administration with Permission

Light Secretarial Duties

Range of Motion Exercises Mopping Floors/Vacuuming Transfers

Also Running Errands and Assisting with Transportation Qualifications for Being a Personal Assistant

• Maintain clean hygiene. • Must have excellent communication and listening skills. • Must have reliable transportation. • Must be responsible and punctual. • Must have a positive and caring attitude. • Must be honest.

Who needs a PA? There are many reasons why someone might need a personal assistant. A person may become disabled because of an injury or illness. Age does not play a role in who uses Personal Assistants. Each person who has a disability has different needs. You will learn specifics about disabilities from the people you work for.

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Rights and Responsibilities of the Personal Assistant Personal Assistants have the right to:

• Be treated with respect. • Express concerns regarding work conditions. • Express their feelings about work expectations. • Be paid for services rendered.

Personal Assistants have the responsibility to:

• Be dependable in the work relationship. • Request clarification of anything you do not understand. • Communicate clearly and honestly about feelings. • Perform all agreed upon duties in a thorough and caring manner. • Respect the employer’s personal property (examples: telephone, food). • Treat all information in a confidential manner. • Do not talk about your employer outside the job. • Check with your employer before answering any questions about him or

her – even from family. Politely tell the person asking, “I am not able to answer that, but I can ask my employer to contact you.”

• Inform the employer and the Personal Assistance Coordinator or a Personal Assistance Specialist if you no longer want to work as a PA.

• Return telephone calls to prospective employers, regardless if you are already working. It is common courtesy and allows them to look for another PA.

• Keep track of and report your earnings to the Internal Revenue Service on the 1040 tax form.

Rights and Responsibilities of the Employer Employers have the right to:

• Have time by themselves. • Make their own decisions. • Have their basic needs met. • Determine their own lifestyle and house rules.

Employers have the responsibility to:

• Respect their Personal Assistant. • Communicate clearly and honestly about feelings, needs, expectations. • Explain routines and set schedules. • Explain time sheets, any paper work and pay dates. • Be dependable in the work relationship.

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Hand Washing Hand washing is the best way to prevent the spread of germs which cause infection. Hand washing helps to prevent infection from the PA to the employer and from the employer to the PA. To wash your hands well, use plenty of soap (an antibacterial soap such as Dial or Safeguard is best). Work up a lather by rubbing the hands together. Be sure to wash the entire area, especially between the fingers, around and under the nails. You need to rub with lather for at least 30 seconds. Count slowly as you wash if you need to. Rinse well. Dry carefully with a paper towel. Do not leave the skin wet because this can cause chapping or tiny breaks in the skin where germs can grow. Always wear gloves when you might touch any body fluids such as:

• Blood • Urine • Saliva • Vomit • Mucus • Pus • Feces • Open skin wounds

Always wash your hands:

• After using the bathroom. • Before eating or touching food. • Immediately after accidental with any body fluids. • After taking off gloves.

The 2 most common carriers of infections are:

Your left hand

And Your right hand

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Body Mechanics Body mechanics means the best way to move and use your body to reduce stress and strain on it. 5 Rules of Body mechanics: 1) Lift with the leg muscles, never with the back.

a) Raise and lower heavy objects by bending and straightening the knees. b) Always keep your back straight as possible so it is not used for lifting

heavy objects. 2) Keep the object close to your body (like a bear hug) for greater strength and

stability. 3) Use a wide base of support by placing your feet about shoulder width apart to

allow for better balance and leverage. 4) Use both sides of your body equally when standing, reaching and lifting. This

makes your movements safer and easier. 5) Do only one motion at a time.

a) Lift first and then turn your whole body by moving your feet. Lifting and twisting at the same time can strain muscles.

b) Be sure you have your balance and room to move.

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More body mechanics Incorrect Correct

Lifting Heavy Objects

Carrying Objects

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And yet more body mechanics Incorrect Correct

Lifting an object from the floor

1.

2.

3.

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Checklists and Schedules Your employer may ask you to help him/her to fill out a checklist. It is best to actually do the activity while filling out this checklist. Some things may take longer or shorter to do than you think. By doing this, it will determine how long each activity takes and how often each one is performed. The checklist may look like the following checklists.

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Personal Care Activities Who will

do? S=Self F=Family PA=PA

How long does it take? When: Morning Afternoon Evening Night

Daily (D) or day of week to be performed

M A E N Brushing Teeth Shaving Make-Up Dressing Transfer: Bed Wheelchair Tub/Shower Turning in Bed Medication Eating Exercise Bathing Bowel Program Bladder Program Undressing Preparation for sleep

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Other Activities Who will

do? S=Self F=Family PA=PA

How long does it take? When: Morning Afternoon Evening Night

Daily (D) or day of week to be performed

M A E N Recreation (Fun!) Household Details (Bills, Grocery List, etc.)

Laundry Shopping Meal Preparation:

Breakfast Lunch Dinner

Meal Clean-Up: Breakfast

Lunch Dinner

Cleaning: Bedroom

Bathroom Kitchen

Floors Dusting

Mopping School, Job, Etc. Driving / Mobility

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Weekly Schedule

Monday Tuesday Wednesday Thursday Friday Saturday SundayMorning Up 8:00 Bath Breakfast 9:30

Dust and vacuum

Bath Laundry

Up 7:00 Leave for class 9:00 Pick up at 11:30

Up 8:00 Bath Breakfast 9:30 Dust and Vacuum

Up 7:30 Leave for Church 9:15

Afternoon Lunch 12:30

Assist with Mail

Water Plants

Wash kitchen floor

To Mall Write Bills

Groceries

Evening Dinner 6:00 Fisx snack for football game on TV Start to bed 9:00

Library 7:00

Dinner 5:00 Choir Practice 7:00-9:00 Pick up at 9:15

Dinner out 7:15 Leave 6:30 Bath Start to bed 9:00

Dinner 6:00

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Employment Contract Employment Contract Between:

_______________________________ (Employer Name)

_______________________________ (Personal Assistant Name)

Work Schedule: (Circle the appropriate days)

Mon Tue Wed Thur Fri Sat Sun

Hours to be worked:

From: To:

From: To:

Salary: Per Hour Per Week Per Month

Cash Check Withhold Tax: (Yes or No)

Benefits Provided for PA:

Room: Yes No

Meals: Yes No

Laundry (for live-in PA): Yes No

Utilities included (for live-in PA): Yes No

Utilities the PA must pay for:

Use of Personal Property items: (i.e. vehicle only as employer wants used):

Fringe benefits: (Employer will pay for PA to accompany him or her to theater, restaurant, travel, entertainment: ________________________________________________________________________________________________________________________________________________________________________________________________

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Acceptable Social Behavior:

Swearing: Yes No

Smoking: Yes No

Drugs: Yes No

Drinking: Yes No

Overnight Guests: Yes No

Employer’s Responsibilities: • Employer will not expect PA to stay past the agreed upon time (Except in emergency

situations). • Employer will be ready to work promptly upon the PA’s arrival. • Employer will maintain records on PA’s performance. • Employer will respect the personal assistant. Personal Assistant’s Responsibilities: • Personal Assistant will be on time. • Personal Assistant will perform all duties as outlined by employer. • Personal Assistant will complete the duties by the agreed-upon time. • Personal Assistant will respect the confidentiality of the employer. • Personal Assistant will respect the employer’s personal items. • Personal Assistant will respect the employer. Absences: Both the employer and personal assistant must give at least ____ days advance notice of an interruption to the schedule. In case of an emergency, the employer and the personal assistant must notify each other as soon as possible. Termination: _____ number of days absent will result in termination. _____ number of days tardy will result in termination. Personal Assistant will be reminded _____ times of unacceptable behavior before being terminated. If the PA’s behavior is endangering the employer’s health or safety, the PA will be terminated without notice. Termination Notice: Each party shall give _____ weeks notice before termination except under extreme circumstances as mentioned above. I, _______________________________ have agreed to work under the employ of, ______________________________ as a personal assistant.

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Duties under this contract will consist of the following:

Personal Care Housekeeping Bathing Cooking Washing Hair Vacuuming Dressing Sweeping Bladder Care Mopping Floors Brushing Teeth Cleaning Bathroom Grooming Cleaning Kitchen Transferring Washing Dishes Re-positioning Dusting Range of motion Polishing Furniture Skin Care Shopping Equipment Cleaning / Maintenance (includes wheelchair, commode, bed)

Laundry (includes ironing)

Assistance with Oxygen use Watering Plants Daily Trash Removal Driving My employment will be for a maximum of _____________ approved hours per week. Hours to be worked will be __________ and I have agreed to work __________ days per week for $__________ per hour. I have received and fully understand the list of guidelines and will follow them to the best of my ability. I further understand that any or all terms of this contract may be subject to renewal or change upon agreement.

___________________________________________ (Personal Assistant)

___________________ (Date)

___________________________________________ (Employer)

___________________ (Date)

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Employment Experience

Employer:

Address: Phone:

Position: Supervisor:

Date Employed: From: To:

Reason for Leaving:

********************************************************************************************

Employer:

Address: Phone:

Position: Supervisor:

Date Employed: From: To:

Reason for Leaving:

********************************************************************************************

Employer:

Address: Phone:

Position: Supervisor:

Date Employed: From: To:

Reason for Leaving:

Applicant’s Statement I certify that all information provided is true to the best of my knowledge. (Signature of Applicant)

(Date)

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Personal Assistant Application

Date:

Name: S.S.#

Address: City:

Phone: Alt. Phone:

Transportation:

Days Available:

M( ) T( ) W( ) Th( ) F( ) Sat( ) Sun( )

Times Available:

AM( ) PM( ) Overnight: Yes( ) No( )

Emergency Backup

Yes( ) No( )

Comments:

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Interviewing for a Job as a Personal Assistant As a Personal Assistant, your name will be put on a referral list and sent out to all of the Center’s consumers. Phone Interview Many people will want to interview you first over the telephone. Be prepared with work references as the employer will want to check them. The consumer will probably ask you many questions. Be honest and straightforward. If they need you to work hours or days you know you will not be able to, you need to say so. If you do not want to perform certain tasks they are requesting (like lifting or bowel programs), state them. To ensure you do not waste the consumer’s or your time, make sure you cover things like “Does the person smoke?” “Does the person have a cat?” In-Person Interview

• Be sure your appearance is neat and clean. • Be on time. Your employer needs someone dependable. Sometimes, their lives are

literally dependent on it. • Be prepared with references. • Be prepared to answer questions.

Remember the employer does not know you and is taking a big risk letting a stranger into their home. Many people may have had bad experiences with previous Personal Assistants such as someone stealing, being abused, not showing up for work or not being on time, etc. If you are hired, it will probably take a while before you earn your employer’s trust. You can start by being honest and respectful. You will want to ask what is expected of you. You will want to know what your duties will be and when you will be working. If you are hired If you are hired, you will want to keep a record of the dates and times you worked. A calendar is strongly recommended so there is never any discrepancies as to when you worked. Remember you must account for your income to the IRS.

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Forms and Vouchers Many of you will be working for people who receive their funding to pay you through the state. This program is called the Office of Rehabilitation (ORS) Home Services Program. ORS are part of the Department of Human Services. It is your employer’s responsibility to fill these forms out with you. You must provide references and a copy of your license/ID and Social Security card. The paperwork must be filled out completely and correctly. There are 3 copies of each form. The top copy goes to ORS always. One form goes to you and one to your employer. The forms must always be signed by both of you. You will use vouchers to record your hours which you must turn in. Along with the first voucher, the paperwork should be turned in also. You should receive your paycheck at your address approximately 3 weeks after you turn in this information. ORS is a separate agency from Progress Center for Independent Living. If you have any questions, contact your local ORS office. In the following pages, you will find samples of the voucher and forms.

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Sample Form: Employment Verification

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Sample Form: List of acceptable documents

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Sample Form: W4 Instructions

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Sample Form: W4

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Sample Form: Request for Social Security Number

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Sample Form: Home Services Documentation of Services

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Sample Form: IDPA Waiver Program Provider

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Sample Form: Customer/Provider Agreement

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Sample Form: Personal Assistant Standards

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