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Courseling in accessing available <br />local, regional and :fate services. <br />6. Temporary placement of the patient in <br />care providing facilities as <br />specified in location of services <br />below. <br />LOCATION OF <br />SERVICE: Any <br />1. <br />2. <br />3. <br />4. <br />5. <br />6. <br />of these: <br />Home of the patient (211 funding <br />sources) <br />Offices or training location of the <br />service providing agency (all <br />funding sources) <br />Adult day care facility (ali funding <br />sources) <br />Domiciliary care facility ( -ESBG, <br />Title III B and State Caregiver <br />Support Funds under Senate Bill 1559 <br />only) <br />Nursing home (Title"111 B and State <br />Caregiver Support funds under Senate <br />Bit? 1559 only) <br />Hospital approved for re -spite beds <br />(title III S and State Caregiver <br />Support funds under Senate Bill 1559 <br />on!y) <br />Respite care services provided <br />in -hope or in a day care center are <br />limited to a maximum of (48) hours of <br />service per month per caregiver. In <br />these instances where respite care <br />will be provided in a dor. -,,: any. <br />care facility, nursing hone, or <br />hospital - the service iZ 1im iced to c� <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 />ASSESS '"G SERVICE Fat:ent and /or caregiver may be referred <br />by self, physician, - family me.bers, <br />friend or other service provider. <br />Referral accompanied by name, address, <br />and phone number, if available, of applicant. <br />DEL IV`RY <br />CHA= ACT =RS• - The 4pecific services to be provided <br />shall be determined by an appropriate <br />professional staff member (e.g., <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 />:+11 contacts mu3t be documented. <br />An emergency contact person <br />identified and maintained on Parh <br />