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~ 5. Counselinf ia accessing available <br />~ local, regional and state Services. <br />~ 6. Temporary placement of the pa%lent in <br />~: care providinE facilities as <br />! specified in location of services <br />' below. <br /> LOCATION OF <br /> SERVICE: Any of the~e: <br /> 1. Home of the patient (all lundin& <br /> aour~es) <br /> 2. Offices Ortraining location of the <br /> · . service providing agency (all <br /> fund/nE sources) <br /> 3- Adult day care facility (all fundinE <br /> sources) <br /> Domiciliary care facility (SSBG, <br /> Title II/ B and State Caregiver <br /> SUpport Funds under Senate Bill 1559 <br /> only) <br /> 5. Nursing home (Title III 5 and State <br /> Caregiver SuPport funds under Senate <br /> Bill 1559 only) <br /> 6. Hospital approved for respite b~ds <br /> (Title III B and State CaregiveP <br /> Support funds under Senate Bill 1559 <br /> only) <br /> <br /> Respite care services provided <br /> in-home or in a day care Center are <br /> limited to a maximum of (liS) hours of <br /> service per month per caregiver. In <br /> those instances where respite care <br /> will be provided ~n a do~iclliary <br /> care facility, nursinE home, or <br /> hospital the service is linited to 2~ <br /> days per year or 576 hours. Duration <br /> of the service period shall be <br /> unlimited for as lone aa the <br /> caretaker continues to <br /> qualify as a caretaker as defined by <br /> the service ob~ective. <br /> <br /> ASSESS TO SERVICE: Patient and/or caregiver may be referred <br /> by self, physician, family members, <br /> friend or other service provider. <br /> Referral accompanied by name~ address, <br /> and phone nuaber, if available~ of applicant. <br /> <br /> DELIVERY <br /> CHARACTERS: - The specific services to be provided <br /> shall be determined by an appropriate <br /> professional staff member (e.g., <br /> reEistered nurse, social worker, home <br /> economist, etc.) <br /> - An appropriate in-home assessment <br /> shall be ma~e and documented within <br /> ten (10] days of r~£errel. <br /> All contacts must be documented. <br /> An emergency contact person <br /> identified, and maintained on each <br /> <br /> <br />