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 ☐ ▇▇▇▇▇▇ 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) ☐ ▇▇▇▇▇▇ 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 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 hospitalizations: ☐ Other 24-hour ☐ Partial ...
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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.
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Examples of Living Arrangement in a sentence

  • Support services are those services identified in the assessment and planning process to address specific goals, mitigate health and safety issues and facilitate skill development that enables a child to live successfully in the home and community Supported Living Arrangement - supports provided to children usually with roommates, by staff of contracted provider agencies or individuals to develop and maintain skills needed to live independently in the home and community.

  • Self-Directed Facility-Based Work Services Self-Directed Supported Living Arrangement Services Self-Directed Daily Living Skill Training (through the Self-Directed Support Program (SDS) for the benefit of eligible developmentally disabled participants identified by COUNTY.) These services are more particularly described in Section 1 of Schedule A.

  • Using Range 8 of the Daily Rates schedule for Habilitation, Individually Designed Living Arrangement as reflective of both the authorized range and the number of direct service hours delivered, and assuming three residents were present in the home, the applicable per diem rate per resident would be $141.56.

  • Group Living Arrangement (adult care programs only) - residential communities which may or may not be subsidized by Federal, State or local funds but which are private residences housing an individual or group of individuals who are primarily responsible for their own care and who maintain a presence in the community but who may receive on-site monitoring.

  • When a youth aged 16 and older has a court approved plan of APPLA (Another Planned Permanency Living Arrangement) and the plan is for the child to stay with the ▇▇▇▇▇▇ family until age 18, the plan may be formalized by a written agreement (Long Term ▇▇▇▇▇▇ Care Agreement (LTFCA).

  • Using Range 10 of the Daily Rates schedule for Habilitation, Individually Designed Living Arrangement as reflective of the authorized range, the Qualified Vendor is authorized to provide between 190 and 210 hours of direct service per week.

  • Marriage or Other Joint Living Arrangement Between RESIDENTS - If RESIDENT marries or desires to live with another person who also resides at CWH, RESIDENTS may choose to occupy an Independent Living Unit and shall thereafter pay the Monthly Maintenance Fee equal to the double occupancy rate for the Independent Living Unit they jointly occupy.

  • C.6.3.3 In addition to FTMs held at the time a child is removed, FTMs are also required at the following junctures: when families are at-risk of children entering ▇▇▇▇▇▇ care and when the agency is considering a goal of Another Planned Permanent Living Arrangement (see APPLA policy).

  • Independent Living Services: Habilitation, Individually Designed Living Arrangement.

  • I understand and agree to the terms set out in the Program’s Living Arrangement Policy and also to obtaining a suitable replacement custodian for my child if my child remains in Canada following the conclusion of the School Year or educational program for which my child is participating.

Related to Living Arrangement

  • Alternative living arrangement means a structure in which households live in distinct bedrooms, yet share kitchen and plumbing facilities, central heat and common areas. Alternative living arrangements include, but are not limited to: transitional facilities for the homeless; Class A, B, C, D and E boarding homes as regulated by the State of New Jersey Department of Community Affairs; residential health care facilities as regulated by the New Jersey Department of Health; group homes for the developmentally disabled and mentally ill as licensed and/or regulated by the New Jersey Department of Human Services; and congregate living arrangements.

  • 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 Effective Time; provided, however, that for the avoidance of doubt, Continuing Arrangements shall not be Third Party Agreements.

  • Ridesharing arrangement means the transportation of persons in a motor vehicle where the transportation is incidental to another purpose of a volunteer driver and includes ridesharing arrangements known as carpools, vanpools, and buspools.