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Page 2 of 7 5. The purchase and delivery price for all units of service ordered by Purchaser shall be as follows: A unit price of $1.01 per hour for ambulatory participants and $1.06 per hour for semi- ambulatory participants. (This rate is based on the 1990 Special Assistance Rates for Domiciliary Homes which states $724 for ambulatory residents and $760 for semilambulatory based on 30- day month) with the responsibility outlined in this contract. The purchase price shall include all expenses of the service outlined as follows: a. Administrative Requirements: Record maintenance of respite cases to include documentation of number of hours provided and evidence the Program was rendered and an evaluation of the service by the hlient and/or caregiver. b. Any and all expenses incurred by the living center for the provision of the Program. 6. POPULATION TO BE SERVED. Any resident of Cabarrus County who is: a. 60 years of age and older b. Physically and/or mentally impaired individual who cannot be left alone who require constant 24-hour supervision. c. Those who are not eligible for Medicaid (unless individual is not eligible for respite care through the North Carolina Medicaid Program in which event units of service may not exceed a maximum number of units which will be established discretion of the Purchaser based on available funding in the SSBG fund. There shall be no discrimination with regard to race, sex, creed, or national origin. Admission for respite care will be based on caregiver's need and the appropriateness of the services offered oy the Center to meet these needs. Priority is on first-come, first-serve bases. 7. PROCEDURES FOR REFERRAL FROM PURCHASER a. Ail referrals for the direct service provision shall be referred to the Department of Aging. Each case will be evaluated by the Purchaser and referred to the Center for the purchase of the service. b. Caregiver'e requesting respite care will have an initial conference with the Center at least seven days prior to admission. c. Medical evaluation and FL-2 will be completed by the caregiver and the physician and delivered to the Center during this conference. Written procedures for administering medication wi.ll also be delivered per caregiver. Caregiver will also relaease signed permission for any emergency treatment for client d~ring this conference. Other pertinent medical information such as allergies, seizures, behavioral disorder etc., will also be releeeed. d. The Center shall or must be responsible for explanationcsf policies and procedures to caregivere during conference.