Hi All,
This was a group activity during new SC orientation. The group produced a sample Initial Service Plan that Alexa typed up. See attached!
Initial Service Plan
SC met with member in the office requesting assistance with grooming, transportation, and emergency food assistance. Confidentiality forms and consent to release information forms were signed by member.
Intake, ADL, and individual, assessments were completed in the office, as member felt more comfortable meeting in this venue. Member requires assistance with the following ADLs: grooming (fixing hair) and transportation. Member’s daughter typically assists with these needs, but daughter is out of town at this time. Member is considered at risk based on this assessment.
1) SC will support member with identifying resources for assistance with grooming within 1 week.
- Member will identify other family members who may be able to assist with her grooming.
2) SC will support member with identifying and coordinating emergency food assistance within 1 day.
3) SC and member will discuss and identify resources for transportation to assist with grocery shopping within 1 week.
4) SC will assist member with obtaining a replacement Bridge Card within 1 week.
- SC will provide member with contact information to request a replacement card.
5) Next SC appointment is scheduled Tuesday.
6) SC will continue to monitor and assess member’s needs every 30 days, or as needed.
A.L. 3/13/13