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5. Counseling in accessing available <br />local, regional and state services. <br />6• Temporary placement of the patient in <br />care providing facilities as <br />specified in location of services <br />OCATIOH OF below. <br />SERI Y:- Any of these: <br />1. Home of the patient (all funding <br />sources) <br />2. Offices or training location of the <br />service providing agency (all <br />funding sources) <br />3. Adult day care facility (all funding <br />sources) <br />4. Domiciliary care facility-(SSBG, <br />Title III B and State Caregiver <br />Support Funds under Senate Bill 1559 <br />only) <br />5. Nursing hove (Title "111 B and State <br />Caregiver Support funds under Senate <br />Bill 1559 only) <br />6. Hospital approved for respite beds <br />(Title III B and State Caregiver <br />Support funds under Senate Bill 1559 <br />only) <br />Respite care services provided <br />in -home or in a day care center are <br />limited to a maximum of (48) hours of <br />service per month per caregiver. In <br />those instances where respite care <br />will be provided in a domiciliary <br />care facility, nursing home, or <br />hospital-the service is limited to 24 <br />days per year or 576 hours. Duration <br />Of the service period shall be <br />unlimited for as long as the <br />caretaker continues to <br />qualify as a: caretaker as defined by <br />the service objective. <br />A55FSS TD 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 number, if available, of applicant. <br />DELIVERY <br />CHARACT£R5: - 'The specific services to be <br />provided <br />shall be determined by an a <br />professional staff member (e.gaPriate <br />registered nurse, social worker, home <br />economist, etc.) <br />An appropriate in -home assessment <br />shall be made and documented within <br />ten (10) days of referrel. <br />All contacts must be documented. <br />An emergency contact person <br />identified and maintained on PAnh <br />