Admissions Agreement I. Services Second Spring is a Community Recovery Residence. It is designed to provide residential servicesto individuals who have been hospitalized in psychiatric facilities. Nursing and psychiatric servicesare available on site as are vocational and case management services. Second Spring staff workto create smooth transitions. Residents at Second Spring are expected to participate in treatmentwith the goal of increased independence and quality of life. Second Spring staff are trained toassist you in your recovery. Staff also receive training in trauma-informed treatment and cooccurring models. Peer support is also a focus of treatment within the facility. Second Spring is licensed by the State of Vermont as a residential care home and as such mayprovide room, board, personal care, general supervision, recovery programs, vocational services,case management, and medication management. We do not provide full time nursing care. Theseservices are outlined below. The State of Vermont regulates most of the services provided in a residential care home. Theregulations contain much more detail about how care must be provided. You may ask staff to seea copy of those regulations if you wish. a) Room – Under this agreement, you will be provided with a semi-private room with aprivate bath. You may bring personal possessions with you to the home as space permitsunless the possessions infringe on the rights of others or create a fire or safety hazard.Second Spring is an environment that fosters safety; some items, such as knives andweapons, are not permitted. A complete list of these items is included in the admissionpacket. Your possessions will be reviewed by staff on admission to the residence. We will hold your room for you if you are temporarily in the hospital and are expected toreturn here within 30 days. Any instance when a resident is expected to be hospitalized forlonger than 30 days will be reviewed on a case-by-case basis. If we determine that we cannothold your bed until your discharge, we will notify you 30 days prior to discharging you. If youare unable to return to pack your belongings, Second Spring staff will pack and store them foryou for up to 6 months, at which time we will expect your DA to pay for private storage. You will be encouraged to do your personal laundry at Second Spring and we can assist youwith this if you need. We will provide you with clean bed and bath linens. b) Board – You will be provided with three attractive and satisfying meals, in accordance with state regulations and dietary standards, and with consideration of your dietary and medical needs. Residents who are preparing for more independent living will be offered opportunities to cook their own meals with assistance from Second Spring staff. We offer snacks before bed and in between meals. We offer therapeutic diets if ordered by a physician. c) Personal Care – Personal care, consistent with recovery goals and your treatment plans, provided here, as long as your needs do not exceed what we are licensed to provide, includes: Assistance with bathing and personal hygiene including shaving, combing hair, brushing teeth, shampooing, cutting hair. Assistance with eating, such as cutting food. Assistance with toileting, including transferring on and off the toilet, incontinence care. Assistance with dressing. Assistance with movement, including assistance with walking, transporting by wheelchair, transferring from bed to chair. d) General supervision – General supervision, consistent with recovery goals and your treatment plans, here includes: Assistance in arranging necessary appointments. Assistance in obtaining personal needs, including shopping for you if necessary. Assistance in obtaining medication. Assistance with your schedule by reminding you about mealtimes, activities, etc. Monitoring your activities to prevent harm to you which may include surveying your room to ensure there are no contraband items. Assistance with managing your finances, if you request us to in writing. Finances are described in more detail below. Staff will check the contents of all bags coming into the facility to check for contraband to ensure the safety of our residents and to keep you safe. e) Transportation – As a resident of Second Spring, you will be provided regular opportunities to engage in community activities. Staff will provide transportation, consistent with your recovery goals and treatment plan, for such activities and treatment-related appointments. You will not be charged for transportation to community activities or to medical appointments. If you are eligible for Medicaid, we may attempt to utilize available Medicaid transportation if appropriate. Medicaid transportation is available only for necessary medical appointments. f) Nursing Care – State regulations prohibit us from providing full time nursing care, except in limited situations. We offer the following services:, We have a nurse scheduled at least 8 hours each day to review assessments of each resident, oversee the administration of medications, and coordinate care with physicians. On-call nursing is available as needed, for example if you become ill, need a change in your doctor’s orders, or if your ability to care for yourself appears to be deteriorating. If you require hands on care by a nurse, such as changing a dressing or catheter or receiving an injection, such care will be provided if a variance is approved by the Vermont Department of Aging and Independent Living. g) Medication management – All residents of Second Spring will receive medication management. Medications will be administered by the nursing staff or by delegated staff operating under the direction of our nurses. h) Personal needs – We provide the following personal needs items as part of the monthly charge. You will be responsible for items not on this list. For residents who are eligible for SSI, the personal needs funds available are discussed in the next section of thisagreement. We provide: Toilet paper, toothpaste, toothbrushes, soap, shampoo, combs, brushes and general first aid supplies. A limited number of over-the-counter medication will be maintained, including antacids, laxatives and pain relievers available. These will be available to you if ordered by your primary care physician. II. Charges and Finances a) The monthly charge for room, board, and services is $635.00 due by the third day of eachmonth. This is less than the standard monthly rate set by the state for individuals receivingSSI (Supplemental Security Income). This rate typically increases annually alongside SSIpayment increases. b) Non-payment of charges will be cause for discharge in accordance with state regulations.We may discharge you after 30 days’ notice (or less if we can locate another placementwith which you agree). c) If you plan to move from the facility, we request that you give us a 30-day notice of yourintent to do so. If you move out of the facility without notice, we may charge you up to30 days after you leave. d) If you are required to leave this home, either because we transfer you to another facilityor because of a change in your condition which makes it impossible to remain here, wewill provide you with a refund for payment made for days in which care was not provided.The refund will be provided within 15 days of discharge. e) Residents who are eligible for SSI shall be allowed to keep, before paying the monthlycharge to the home, a minimum of $168.00 for their personal needs. III. Rights and Responsibilities a) Residents retain all civil rights while residing here. State regulations list specific rights of all residents of residential care homes. That list is attached to this agreement and other copies are available upon request. We will explain these rights before or at the time of admission. b) If you are not satisfied with services or conditions in the home, we want you to tell us about it so we can try to resolve the concern. Our grievance procedure is included in your intake packet and will be reviewed with you. c) The rules of the facility are reviewed as part of the admission process. A list of rules and protocols is included in your intake packet. d) This facility uses many approaches to create and maintain safety of residents. A morecomplete explanation is included in your intake packet. IV. Program Participation Agreement Second Spring is a recovery program. Your recovery team will work with you to create an individualized recovery plan. The goal is to assist you in developing and implementing a plan that will work toward your successful return to your community. We ask that you: a) Respect the rights of all people – staff, fellow residents, and members of the community alike. b) Be an active participant in treatment planning. c) Comply with your treatment plan while you reside at Second Spring. If it is determined through a recovery team meeting that you are not able to, or do not wish to,participate in your agreed upon recovery plan, Second Spring may provide you with a 30-daydischarge notice. Barring other legal agreements and court orders, you also have the right toterminate this agreement voluntarily with 30 days’ written notice if you feel the program is notworking to your benefit. V. Assistive Community Care Services Agreement Second Spring agrees to serve you under the Medicaid Assistive Community Care Services (ACCS)program as long as you are verified ACCS eligible and need Level III Residential Care HomeServices. Second Spring charges a flat room and board rate and your eligibility for ACCS will notaffect this rate. For as long as you are verified ACCS eligible you will be responsible for paying Second Springdirectly for your room and board at the rate of $635.00 per month. You will retain a PersonalNeeds Allowance of at least $168.00 per month. For as long as you maintain ACCS eligibility Second Spring will bill the Medicaid ACCS program foryour Level III care services covered by the program at the daily rate established by the Medicaidprogram. The home will bill the Medicaid ACCS Program at this rate for each day of serviceprovided to you. As of the date of this agreement, that rate is $42.25 per day. A day of serviceis a day on which you are ACCS eligible, reside at the home, and have not been absent for theentire 24-hour day or admitted to another facility. Under the terms of the Medicaid ACCSprogram, the home may not ask or require you or anyone else to pay the home for days you areabsent from the home. Covered services are the following services, up to the Level III level of care: help with activities ofdaily living; medication assistance, monitoring, and administration; 24 hour on-site assistivetherapy; restorative nursing; nursing assessment; health monitoring; case management; androutine nursing tasks. These service terms are equivalent to terms included in the ResidentialCare Home licensing regulations. Second Spring agrees that your room and board, plus the funds Second Spring receives from theMedicaid ACCS program, will be the sole and complete payment to Second Spring for requiredservices. Second Spring requests that you immediately inform us if you become aware of a change in yourMedicaid status.