Living Arrangement definition

Living Arrangement. ☐ Alone ☐ With mother ☐ With relatives ☐ With partner/significant other ☐ With father ☐ With guardian ☐ With spouse ☐ With sibling(s) ☐ With unrelated person(s) ☐ With children ☐ Xxxxxx parent(s) Family Members in the Home Name(s): DOB or Age (circle) M or F M or F M or F M or F M or F Relationship to client: Emergency Contact: (You must also complete a Release of Information form) Name Relationship Phone: Medical Decision-Making Authority for minors Name Name Relationship Relationship Place of Residence: ☐Independent living (alone or w/ family) ☐ Inpatient ☐ Halfway house ☐ Boarding home (adult) ☐ Xxxxxx home (youth) ☐ Residential facility (MH adult) ☐ Correctional facility ☐ Supported housing ☐ Residential treatment/group ☐ Homeless ☐ Nursing home ☐ Assisted Living ☐ ATU (adults only) ☐ Sober living ☐ Group home (adult) ☐ Other residential facility Current Primary Role ☐ Employed (Full time 35+ hours/week) ☐ Employed (part time ≤ 35 hours/week ☐ Unemployed ☐ Military ☐ Retired ☐ Supported Employment ☐ Student (applies to age 0-18 only) ☐ Volunteer ☐ Homemaker ☐ Disabled ☐ Inmate *Please note that these are state designated categories Disabilities: (choose all that apply) ☐ None ☐ Deaf/severe hearing loss ☐ Blind/severe vision loss ☐ Traumatic Brain Injury ☐ Learning disability ☐ Developmental disability #110 / Demographics Form / Administration Gross annual household income $ Number of individuals supported by income: _ Number of dependent children: Does the client receive SSI? ☐ Yes ☐ No Does the client receive SSDI? ☐ Yes ☐ No Educational Status ☐ Pre-kindergarten ☐ Kindergarten ☐ Grade 1 ☐ Grade 2 ☐ Grade 3 ☐ Grade 4 ☐ Grade 5 ☐ Grade 6 ☐ Grade 7 ☐ Grade 8 ☐ Grade 9 ☐ Grade 10 ☐ Grade 11 ☐ Grade 12 or GED ☐ Some college ☐ College degree ☐ Master’s degree ☐ Doctoral degree School Information (if currently in school) Name of school School Address City State Zip Tobacco Status: ☐ Current smoker/tobacco user—every day ☐ Current smoker/tobacco user—periodically ☐ Smoker/tobacco user—current status unknown ☐ Former smoker/tobacco user ☐ Never a smoker/tobacco user ☐ Unknown if ever smoked/used Presence of mental health problem (select one): ☐ Longer than 1 year ☐ One year or less Previous or Current Services (check all that apply): ☐ Juvenile Justice ☐ Adult Corrections ☐ Developmental Disabilities ☐ Special Education ☐ Child Welfare ☐ Substance Abuse ☐ None History of Mental Health Services (check all that apply): ☐ Inpatient Number of prior psychiatric ho...
Sample 1Sample 2
Living Arrangement means a non-institutional environment for a physically disabled adult who lives alone or with family or others.
Sample 1Sample 2
Living Arrangement means an arrangement listed under division (D)(1) of section 5119.41 of the Revised Code. "Living arrangement" includes any owner, operator, employee, or volunteer who provides accommodations, supervision, or personal care services in the living arrangement.
Sample 1

Examples of Living Arrangement in a sentence

  • Availability of Participant Direction by Type of Living Arrangement.

  • State-funded providers who render Respite Services in a Community Living Arrangement meet the physical standards requirements for these homes by maintaining licensure (State of Georgia Rules and Regulations 290-9-37).

  • For CRA services, rendered in a Community Living Arrangement, the provider agency must have a Community Living Arrangement license for each individual residential site from HFR (State of Georgia Rules and Regulations 290-9-37).

  • The provider shall hold the Community Living Arrangement License or Personal Care Home Permit licensed by Healthcare Facility Regulations (HFR) for Community Residential Alternative services for all residential sites housing individuals with Developmental Disabilities.

  • These Daily Rates are statewide for all Habilitation, Individually Designed Living Arrangement services.

  • Drug or alcohol treatment centers (DAA’s) and group living arrangements (GLA’s) which act as authorized representatives for residents of the facilities must use SNAP benefits for food prepared and served to those residents participating in the SNAP except when residents leave the facility in accordance with Section 14.3 Residents of Drug and Alcohol Treatment and RehabilitationPrograms (DAA’s) and Section 14.4 Residents of a Group Living Arrangement (GLA).

  • The Daily Rates schedule for Habilitation, Individually Designed Living Arrangement contains 20 tables with Daily Rates, and each table refers to one of 20 ranges.

  • In order of waiver application eligibility determination date of persons for whom waiver services are necessary to permit discharge from an institution, e.g. persons who reside in ICFs/IID, Nursing Facilities, and Arkansas State Hospital patients; or admission to or residing in a Supported Living Arrangement (group homes and apartments).

  • See 3.2.1.5 Group Living Arrangement for additional information regarding these housing situations.

  • The total number of places available annually for initial admission in any one instrument shall normally not exceed four.3. For initial admission to performance courses, students must satisfy a School of Music Audition.

Related to Living Arrangement

  • Independent living arrangement means placement of (i) a child at least 16 years of age who is in

  • netting arrangement means an arrangement under which a number of claims or obligations can be converted into a single net claim, including close-out netting arrangements under which, on the occurrence of an enforcement event (however or wherever defined) the obligations of the parties are accelerated so as to become immediately due or are terminated, and in either case are converted into or replaced by a single net claim, including ‘close-out netting provisions’ as defined in point (n)(i) of Article 2(1) of Directive 2002/47/EC and ‘netting’ as defined in point (k) of Article 2 of Directive 98/26/EC;

  • Continuing Arrangements means those arrangements set forth on Schedule 1.1(24) and such other commercial arrangements among the Parties that are intended to survive and continue following the Separation Time; provided, however, that for the avoidance of doubt, Continuing Arrangements shall not be Third Party Agreements.

  • Access Arrangement means an arrangement for access to a Covered Pipeline that has been approved by the Relevant Regulator.

  • Arrangement Agreement has the meaning ascribed thereto in the recitals hereof;

  • Travel Arrangements means: (a) transportation: (b) accommodations: and (c) other specified services arranged by the Travel Supplier for the covered trip.

  • Life-of-the-unit, firm power contractual arrangement means a unit participation power sales agreement under which a utility or industrial customer reserves, or is entitled to receive, a specified amount or percentage of nameplate capacity and associated energy from any specified unit and pays its proportional amount of such unit's total costs, pursuant to a contract:

  • Financial Closure or Project Financing Arrangements means the agreements pursuant to which the SPG has sought financing for the Power Project including the loan agreements, security documents, notes, indentures, security agreements, letters of credit and other documents, as may be amended, modified, or replaced from time to time, but without in anyway increasing the liabilities of JDVVNL.

  • Security Management Plan means the Supplier's security management plan prepared pursuant to paragraph 3 of schedule 2 an outline of which is set out in paragraph 2.7 of the Order Form as updated from time to time;

  • Training Agreement means an agreement registered under the provisions of the Industrial and Commercial Training Act 1985.

  • Nursing Care Plan means a plan of care developed by a nurse that describes the medical, nursing, psychosocial, and other needs of a child and how those needs shall be met. The Nursing Care Plan includes which tasks shall be taught, assigned, or delegated to the qualified provider or family.