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Missouri Department of Health and Senior Services: Home Care Plan and Participant Choice Statement Mobile App

A very specific mobile application designed for the department of health and senior services, this app contains information on home and community based service care plan and participant choice statement. Use any mobile device to get participants to initial in the app and acknowledge services provided. Identify critical risks and log them in the app. Participant can sign in the app and expedite information.

  • Lendlease
  • The Cooperative
  • PG&E
  • Red Bull
  • Mirvac

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Take a peek inside the Missouri Department of Health and Senior Services: Home Care Plan and Participant Choice Statement Mobile App

Included Features

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Included Fields

Customize to add, remove, or edit any of the fields below.

  • Ico textbox

    Participant Name

  • Ico textbox

    DCN

  • Ico textbox

    County Name

  • Ico statictext

    I, and/or an individual of my choosing, have discussed the results of the assessment with - the A...

  • Ico statictext

    The participant must initial next to each section Indicating they have read and understood the in...

  • Ico textbox

    Plan).

  • Ico dropdown

    I wish to receive HCBS through the:

  • Ico textbox

    Initial

  • Ico textbox

    When choosing Consumer-Directed Model (CDS) for Personal Care Assistance, I understand that I mus...

  • Ico textbox

    I understand I have the right to choose any willing and qualified HCBS provider.

  • Ico textbox

    I understand the choices I have made, and I have been given the opportunity to have anyone of my ...

  • Ico textbox

    I understand my services must be provided in accordance with a current plan of care.

  • Ico textbox

    I agree to notify the provider when I am not satisfied with the care provided by the aide.

  • Ico textbox

    I agree to notify DSDS staff at

  • Ico textbox

    (Regional Evaluation Team) - any time there is a change in my.

  • Ico textbox

    I understand that I can request DSDS staff at

  • Ico textbox

    (Regional Evaluation Team) to assist in the development of the person centered care plan at any t...

  • Ico textbox

    I have not experienced any undue influence on the care planning process (i.

  • Ico textbox

    I have reviewed my rights and responsibilities and understand what I must do as a participant of ...

  • Ico statictext

    IDENTIFIED supports and services (other than the authorization of DSDS HCBS) as a means to, live ...

  • Ico statictext

    Below are identified critical risks and needs for other supports and services identified and disc...

  • Ico textbox

    Enter Critical Risk and click the + sign

  • Ico textbox

    Referred To

  • Ico textbox

    Needs

  • Ico textbox

    Provided By/Referred To

  • Ico textbox

    I understand that any risks identified during the assessment process were discussed.

  • Ico textbox

    I understand I can call the toll free hotline at 1-800-392-0210 to report abuse, neglect, or expl...

  • Ico signature

    Participant Signature

  • ...and More!

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