Section I: Services
A. Outreach & Referral
Useful Forms
Referral form
Referrals: A Month at a Glance
B. The Application Process
Sample Policies
Admission criteria
Application process
Waiting list
Appeal of denial of admission
Tuberculosis Screening
Useful Forms
Application for admission
Medical documentation form
Authorization for release of information
Reference form
C. Intake
Sample Policies
Intake
Confidentiality & Maintaining client files
Useful Forms
Intake & Needs assessment
Statement of Confidentiality
Authorization for Release of Information
Consent for Release of Confidential Information
Emergency Contact Sheet
Budget Sheet
Monitoring of Client Files Acknowledgement
Evaluating Admission & Intake
D. Case Management & Program Services
Sample Policies
Client-Driven Case Management
Case Management Plan Update & Review
Comprehensive Case Management
End Term/Advanced Stage Care
Staff Communication Across Shifts [SLP]
Medications [SLP]
Temporary Absences [SLP]
Service in the Event of a Resident's Death [SLP]
Permanency Planning [TLP]
Home Visits [ILP]
Useful Forms
Client File Checklist
Client Service Plan
Progress Notes Form
Advance Directives
Statement Initiating Standby Guardianship
Nomination of Standby Guardian
Hourly Resident Care & Housekeeping Checklist
Burial Plan Sheet
Case File Audit Form
Evaluating Case Management & Program Services
E. Client Responsibilities
Sample Policies
Code of Conduct
Harm Reduction
Clean and Sober Policy
Drug Testing
Progressive Discharge
Involuntary Discharge
Readmission
Reporting of Child Abuse/Neglect
Staff Access to Resident Rooms
Useful Forms
Behavioral Improvement Action Plan
Warning Notice
Discharge in Progress Form
Client Discharge Form
Evaluating Client Responsibilities
F. Promoting Participant Autonomy
Sample Policies
Client-driven case management
Resident Governance [SLP]
Communication Board [SLP]
Grievances
Useful Forms
Client Self-Report Form
Client Satisfaction Survey
Resident Satisfaction Survey
Resident Satisfaction Survey (Spanish)
Evaluating Promoting Participant Autonomy |
