S a n F r a n c i s c o C o u n t y

Similar documents
Los Angeles County. Program/s. Who We Serve

UNIVERSAL INTAKE FORM

UNIVERSAL INTAKE FORM

Care in Your Home. North West CCAC

RESIDENT SCREENING SHEET

READ THIS NOTICE CAREFULLY.

APD & MHA RESIDENT SCREENING SHEET

Managed Long Term Services and Supports (MLTSS)

Skilled Nursing Facilities San Luis Obispo and Santa Barbara Counties

WHAT IS PACE? A TRAINING GUIDE FOR OUTREACH & REFERRAL ORGANIZATIONS

After the Hospital Where Do I Go From Here?

Should you have any questions or concerns during the application process, we are available to assist you; please do not hesitate to contact us.

Coordinated Care Initiative Frequently Asked Questions for Physicians

Community Based Adult Services (Adult Day Health Care)

Medi-Cal Managed Care CBAS Program Transition

New to Medicaid? 22 Medicaid Services You Should Know About

2019 Health Net Seniority Plus Amber I (HMO SNP) H0562: 055 Fresno, Kern, Los Angeles, Orange, Riverside, San Bernardino, San Diego, San Francisco

Evaluating Needs* ADAPTED from Seniorhousingnet.com

2015 Summary of Benefits

Oregon Community Based Care Communities Adult Foster Homes Survey

HPSM Medi-Cal Benefits A Guide on How to Get Your Health Care

Dr. Edward Chow, Health Commission President, and Members of the Health Commission

The options for In-Home Assistance are described below.

welcome to our facility

*PLEASE NOTE THAT COMPLETION OF THE PRE-ADMISSION FORM DOES NOT GUARANTEE PLACEMENT AT THIS FACILITY.

SKILLED NURSING & REHAB APPLICATION Name Date of Birth Age Address Street/R.R. Box No.

welcome to our facility

MEDICARE By Peter G. Pan

LONG TERM CARE INTEGRATION

Nursing Assistant

Tewksbury Hospital and T.H.E. FARM: Integrating and Documenting EAAT in an Inpatient Setting

ALZHEIMER S/DEMENTIA RESOURCES FOR FAMILIES

V. NURSING FACILITY RESIDENT PROFILE KEY POINTS

1. PROPOSAL NARRATIVE REQUIREMENTS (Maximum 85 points)

Welcome Baby Prenatal Intake

OAKLAND COUNTY SENIOR RESOURCE DIRECTORY

Long-Term Care Division

Facility Assessment Laguna Honda Hospital and Rehabilitation Center

Benefit Explanation And Limitations

FACT SHEET Low Income Assistance: Cal MediConnect (E-004) p. 1 of 6

California s Duals Demonstration: A Transparent and Inclusive Stakeholder Process. Peter Harbage President Harbage Consulting

DISCLOSURE OF SERVICES

Based on the comprehensive assessment of a resident, the facility must ensure that:

Page Introduction 1. Factors to Consider When Evaluating Whether an Individual Needs to be Screened 1. Pre-Admission Screening Criteria 2

LOS ANGELES DEPARTMENT OF AGING (LADOA) OFFICIAL CONFLICT OF INTEREST CODE SCHEDULE "A" - DESIGNATED POSITIONS

Centralized Intake and Referral Application to Specialty Hospitals

Overview and Current Status of Program of All-inclusive Care for the Elderly (PACE) Dr. Cheryl Phillips, M.D. Chief Medical Officer, On Lok Lifeways

Transitional Care and Preventing Readmissions in San Francisco

Q1 How important is home care availability?

Statistical Portrait of Caregivers in the US Part III: Caregivers Physical and Emotional Health; Use of Support Services and Technology

Community Partnerships

Basic Covered Benefits and Services

NURSING ASSESSMENT AND MONITORING TOOL Member last name First name Middle name Medicaid number

FY 2016 PERFORMANCE PLAN

The Salvation Army Serendipity Adult Day Services

SummerWood of Plymouth. The Arbor Assisted Living Memory Care

Name Telephone. Address. Physician Birthdate Marital Status. Current Medical Conditions. Name Telephone. Address. Address

GERIATRIC SERVICES CAPACITY ASSESSMENT DOMAIN 4 ALTERNATE LIVING ARRANGEMENTS

In Solidarity, Paul Pecorale Second Vice President

CNA OnSite Series Overview: Understanding Restorative Care Part 1 - Introduction to Restorative Care

5. Personal Care Services

EW Customized Living Contract Planning Worksheet, Part I

Caregiver Stress. F r e q u e n t l y A s k e d Q u e s t i o n s. Q: Who are our nation's caregivers?

The Multipurpose Senior Services Program may be the Answer to Staying at Home Rather than Going to a Nursing Home

Inpatient Rehabilitation. Scope of Services

Department of Public Health. Coastal Health District Hurricane Registry Application

HEALTH SERVICES POLICY & PROCEDURE MANUAL

Provider Training Matrix Standards for Direct Care Staff and Allowable Tasks/Activities

Medi-Cal Program. Benefit. Benefits Chart

Nazareth Agua Caliente Villa Sonoma

Family Profile. Parent / Caregiver Contact Information First Name: Last name: Initials:

2015 CMS National Training Program Workshop Monika Vega, MSW Harbage Consulting, LLC Representing California s Department of Health Care Services

DUE DATE. All applications must be turned in person by the YOUTH himself/herself by Friday, April 6th, 2018.

Uniform Consumer Information Guide

Home Care Packages Helping you make the right choice it s more you!

Long-Term Care Glossary

A Policy Conversation on Family Caregiving for Older Adults

Uniform Consumer Information Guide

HOW TO GET HELP ON COMMUNITY SUPPORT SERVICES

WakeMed Rehab Hospital Stroke Rehabilitation Scope of Service

Michigan Medicaid Nursing Facility Level of Care Determination

Connecticut LTC Level of Care Determination Form To be maintained in the individual s medical record.

Corporate Information for Patient Referrals & Charges effective 1 April 2017

Community Partnerships

New provider orientation

Information for Dual-Eligible Members with Secondary Coverage through California Regular Medi-Cal (Fee-for-Service)

FACT SHEET Low Income Assistance: Cal MediConnect(E-004) p. 1 of 6

DEPARTMENT OF HUMAN SERVICES SENIORS AND PEOPLE WITH DISABILITIES DIVISION OREGON ADMINISTRATIVE RULES CHAPTER 411 DIVISION 34 PERSONAL CARE SERVICES

Assisted Living Individualized Service Plan (ISP)

Community-Based Social Services Resource Guide

ADULT LONG-TERM CARE SERVICES

AGING & PEOPLE WITH DISABILITIES 4 ADL CA/PS ASSESSMENT POST 10/1/17

Skilled skin care should be provided by an agency licensed to provide home health

Duals Demonstration. An Overview for Home Medical Equipment Providers

See the Key on the back of this sheet for more definitions of the information provided in the list.

Complete Senior Care Enrollment Agreement

Additional Support Services

Staying Healthy Assessment (SHA) Training

Uniform Disclosure Statement Assisted Living/Residential Care Facility

Dr. George C. Simmons Counseling & Support Center 585 Joseph Ave. Rochester, NY (585) (585) fax

Transcription:

BAYVIEW HUNTERS POINT S a n F r a n c i s c o As of 3/11/2015 ADULT DAY HEALTH CENTER 1250 LaSalle Avenue San Francisco, CA 94124-2414 (415) 826-4774 Email: Bayviewadhc@aol.com Bayview Hunter's Point Multipurpose Senior Services, Inc. 1984 Continuous Member Since 2015 CBAS Community Based Adult Services

As of 8/31/2016 CATHOLIC CHARITIES ADULT DAY SERVICES, SAN FRANCISCO 50 Broad Street San Francisco, CA 94112-3003 (415) 452-3500 Email: pclement@catholiccharitiessf.org Web: www.catholiccharitiessf.org Catholic Charities 1990 Continuous Member Since 1988 Spanish Tagalog Call: 415-452-3500 24 Hours Email: btassone@catholiccharitiessf.org Prefer a site visit with client and caregiver. Client gets involved in program and caregiver works with staff on intake evaluation and paperwork completion. Takes about two hours to complete. ADP (Non-Medical Model) Hours & Attendance 8:00 AM to 5:00 PM 8:00 AM to 5:00 PM 8:00 AM to 5:00 PM 8:00 AM to 5:00 PM 8:00 AM to 5:00 PM Average Daily Attendance: 23 Daily Capacity: 28 Long Term Care Insurance Private Insurance ADP Adult Day Program ADCRC Alzheimer s Day Care Resource Center Catholic Charities Adult Day Services San Francisco and the Alzheimer s Day Care Resource Center is a licensed program that provides a safe, therapeutic and friendly environment for older adults and support for family caregivers in San Francisco County since 1991. The program is designed to enhance the participants quality of life and increase their independence. Seniors and adults with disabilities who experience losses in physical function, memory or social support enjoy safe, fun and stimulating activities aimed at socialization, mental and physical stimulation in a supervised, recreational environment while family members are afforded much needed relief from their daily caregiving responsibilities. Ages: 18 or older Average Client Age: 86 Alzheimer s / Related Dementias Behaviorally Impaired HIV / AIDS Lesbian, Gay, Bisexual and Transgender Mental Health Physical Disabilities Traumatic Brain Injury Eating Toileting Transferring (Getting Up) Walking Medical Devices Wheelchair Walker Incontinence Medication Monitoring Non-Ambulatory Art Therapy Care Management Caregiver Education Caregiver Support Groups Community Outings Gardening Therapy Holiday Celebration Music Therapy and Programs Pet Therapy Physical Fitness and Exercise Secured Perimeter

As of 4/6/2018 ON LOK 30 TH STREET PACE CENTER 225 30th Street San Francisco, CA 94131 (888) 886-6565 Toll-Free, Nationwide Mail: 1333 Bush Street San Francisco, CA 94109 Email: ekunz@onlok.org Web: www.onlok.org On Lok Senior Health Services 1984 Continuous Member Since 2003 CBAS Community-Based Adult Services PACE Program for All-Inclusive Care for the Elderly

S a n F r a n c i s c o As of 4/6/2018 ON LOK DR. GEE PACE CENTR, JADE 1333 Bush Street San Francisco, CA 94109 (888) 886-6565 Toll-Free, Nationwide Mail: 1333 Bush Street San Francisco, CA 94109 Email: ekunz@onlok.org Web: www.onlok.org CBAS Community-Based Adult Services PACE Program for All-Inclusive Care for the Elderly On Lok Senior Health Services 2010 Continuous Member Since 2010

As of 4/6/2018 ON LOK DR. GEE PACE CENTER, ROSE 1333 Bush Street San Francisco, CA 94109 (888) 886-6565 Toll-Free, Nationwide Mail: 1333 Bush Street San Francisco, CA 94109 Email: ekunz@onlok.org Web: www.onlok.org On Lok Senior Health Services 1978 Continuous Member Since 2003 CBAS Community-Based Adult Services PACE Program for All-Inclusive Care for the Elderly

As of 4/6/2018 ON LOK POWELL PACE CENTER 1441 Powell Street San Francisco, CA 94133 (888) 886-6565 Toll-Free, Nationwide Mail: 1333 Bush Street San Francisco, CA 94109 Email: ekunz@onlok.org Web: www.onlok.org On Lok Senior Health Services 1978 Continuous Member Since 2003 CBAS Community-Based Adult Services PACE Program for All-Inclusive Care for the Elderly

As of 3/23/2017 SELF-HELP FOR THE ELDERLY ADULT DAY SERVICES 408 22 nd Avenue San Francisco, CA 94121-3014 (415) 677-7556 Email: kelviny@selfhelpelderly.org Web: www.selfhelpelderly.org Self-Help for the Elderly 1996 Continuous Member Since 1991 Chinese: Vietnamese Call: 415-677-7563 24 Hours Email: kelviny@selfhelpelderly.org Applicant has to complete an intake form with or without assistance from social worker. Form completion takes about 15-20 minutes. ADHC / CBAS (Medical Model) Hours & Attendance Average Daily Attendance: 68 Daily Capacity: 90 ADP (Non-Medical Model) Hours & Attendance Average Daily Attendance: Inquire Daily Capacity: 30 Medi-Cal Managed Care Contracts for CBAS with: Please inquire Private Insurance CBAS Community-Based Adult Services ADP Adult Day Program ADCRC Alzheimer s Day Care Resource Center We specialize in serving Chinese-speaking seniors with our bilingual/bicultural staff and programming. Ages: 18 or older Average Client Age: 85 Alzheimer s / Related Dementias Behaviorally Impaired Mental Health Mono-Cultural Physical Disabilities Eating Toileting Transferring (Getting Up) Walking Medical Devices Oxygen Devices Wheelchair Incontinence Injections Medicine Administration Medication Monitoring Non-Ambulatory Wandering Adult Education Art Therapy Care Management Caregiver Support Groups Community Outings Music Therapy Nursing Nutrition Occupational Therapy Physical Therapy Speech Therapy

As of 3/10/2017 STEPPINGSTONE GOLDEN GATE DAY HEALTH 350 Golden Gate San Francisco, CA 94102 (415) 359-9210 Email: marielee@steppingstonehealth.org Web: www.steppingstonehealth.org/ North & South of Market Adult Day Health Corporation 1993 Continuous Member Since 1980 Chinese: Shenghainese French Spanish Call: 415-359-9210 x 15 Next Business Day Email: Fionachow@steppigstonehealth.org Please call our intake social worker, Fiona Chow, at 415-359-9210 Ext 15. She will explain to you about the intake procedure in detail. ADHC / CBAS (Medical Model) Hours & Attendance 8:00 AM to 4:30 PM 8:00 AM to 4:30 PM 8:00 AM to 4:30 PM 8:00 AM to 4:30 PM 8:00 AM to 4:30 PM Average Daily Attendance: 50 Daily Capacity: 55 Long Term Care Insurance Medi-Cal Managed Care Contracts for CBAS with: Anthem Blue Cross San Francisco Health Plan Medi-Cal Regular Fee-for-Service Veterans Administration ADHC CBAS Adult Day Health Care Community-Based Adult Services We provide a range of therapeutic treatments at Golden Gate Day Health such as physical therapy, occupational therapy, speech therapy, nutrition services, case management, multicultural celebrations, music therapy, activity, mental health services, skilled nursing care, tai chi, caregiver respite and housing, and other referrals. Ages: 18 or older Average Client Age: 76 *Must sign up for Managed Care Alzheimer s / Related Dementias Behavioral Health Cultural Focus: Chinese, Filipino, African American Diabetes HIV/AIDS Intergenerational Lesbian, Gay, Bisexual and Transgender Post-Stroke / Neurological Substance Abuse Traumatic Brain Injury Veterans Eating Toileting Transferring (Getting Up) Walking Medical Devices Oxygen Devices Wheelchair Behavioral Challenges Incontinence Training Injections Medications Monitoring Activity Program Care Coordination Care & Supervision Community Outings Dietary Services Health Check-Ups Meals Medication Administration Medication Management Music Therapy Occupational Therapy Physical Therapy Psychology / Psychiatry Skilled Nursing Social Work Services Speech Therapy Transportation Vaccination Clinics

As of 6/22/2016 STEPPINGSTONE MABINI DAY HEALTH 55 Mabini Street San Francisco, CA 94107 (415) 882-7301 Email: mollietobias@steppingstonehealth.org Web: www.steppingstonehealth.org/ North & South of Market Adult Day Health Corporation 1984 Continuous Member Since 1984 Korean Spanish Tagalog Vietnamese Call: 415-882-7301 Please inquire ADHC / CBAS (Medical Model) Hours & Attendance Average Daily Attendance: 48 Daily Capacity: 60 Medi-Cal Managed Care Contracts for CBAS with: Please inquire Private Insurance Veterans Administration ADHC CBAS Adult Day Health Care Community-Based Adult Services Though located in the heart of San Francisco, North & South of Market ADHC is proud to feature a beautiful garden with ample walkways, benches and raised garden beds. Our participants represent the rich cultural diversity of the neighborhood and Cantonese, Mandarin, Korean, Vietnamese, Tagalog and Spanish are spoken by staff and participants as well as English. Ages: 18 or older Average Client Age: 76 Alzheimer's / Related Dementias Behaviorally Impaired Mental Health Bathing Dressing Eating Toileting Transferring (Getting Up) Walking Incontinence Injections Medicine Administration Medication Monitoring Wandering Care Management Caregiver Support Groups Community Outings Occupational Therapy Physical Therapy

As of 3/10/2017 STEPPINGSTONE MISSION CREEK DAY HEALTH 930 Fourth Street San Francisco, CA 94158 (415) 974-6784 Email: brianalewis@steppingstonehealth.org Web: www.steppingstonehealth.org/ North & South of Market Adult Day Health Corporation 2006 ADHC CBAS Adult Day Health Care Community-Based Adult Services Mission Creek Day Health is a beautiful, new, 8,000 sq. ft. ADHC located in the newly developed Mission Bay neighborhood, right on the water. We are partnered with Mission Creek Senior Community housing. We serve a diverse population of adults and seniors with mental and physical disabilities who speak a variety of languages, such as Cantonese, Mandarin, Korean, Russian, Spanish, Tagalog and English. We offer translation services on site. There is a large outdoor courtyard with a view of the water. Continuous Member Since 2007 Russian Spanish Tagalog Call: 415-923-0245 24 Hours We have a central intake social worker who performs initial screening. We use a one-page referral form with agency/hospital/provider referrals. Program social worker will make home visit & schedule assessment days. ADHC / CBAS (Medical Model) Hours & Attendance Average Daily Attendance: 50 Daily Capacity: 60 Medi-Cal Managed Care Contracts for CBAS with: Please inquire Private Insurance Veterans Administration Ages: 18 or older Average Client Age: 77 Alzheimer s / Related Dementias Behaviorally Impaired HIV/AIDS Lesbian, Gay, Bisexual and Transgender Mental Health Physical Disabilities Substance Abuse Traumatic Brain Injury Bathing Eating Toileting Transferring (Getting Up) Walking Medical Devices Oxygen Devices Wheelchair Incontinence Injections Medicine Administration Medication Monitoring Non-Ambulatory Wandering Adult Education Art Therapy Care Management Community Outings Gardening Therapy Money Management Nursing Occupational Therapy Pet Therapy Physical Therapy Podiatry Speech Therapy

As of 6/22/2016 STEPPINGSTONE PRESENTATION DAY HEALTH 301 Ellis Street San Francisco, CA 94102 (415) 923-0245 x 18 Email: nicoleclause@steppingstonehealth.org Web: www.steppingstonehealth.org/ North & South of Market Adult Day Health Corporation 2001 ADHC CBAS Adult Day Health Care Community-Based Adult Services Presentation Day Health is located in San Francisco s Tenderloin neighborhood and is partnered with Presentation Senior Community. The population we serve reflects the rich diversity of the neighborhood with Cantonese, Mandarin, Tagalog, Russian, Korean and English speaking participants and staff. Ages: 18 or older Average Client Age: 77 Continuous Member Since 2002 Korean Russian Tagalog Call: 415-923-0245 Next Day Our central intake social worker performs initial screening. We use a one-page referral from with agencies/hospitals/providers who make referrals. Social worker makes home visits and schedules assessment days. ADHC / CBAS (Medical Model) Hours & Attendance 9:00 AM to 2:00 PM 9:00 AM to 2:00 PM 9:00 AM to 2:00 PM 9:00 AM to 2:00 PM 9:00 AM to 2:00 PM Average Daily Attendance: 45 Daily Capacity: 60 Medi-Cal Managed Care Contracts for CBAS with: Please inquire Private Insurance Veterans Administration Alzheimer s / Related Dementias Behaviorally Impaired HIV/AIDS Lesbian, Gay, Bisexual and Transgender Mental Health Physical Disabilities Bathing Eating Toileting Transferring (Getting Up) Walking Medical Devices Catheter Colostomy Feeding Tube Oxygen Devices Wheelchair Incontinence Injections Medicine Administration Medication Monitoring Non-Ambulatory Wandering Adult Education Art Therapy Care Management Caregiver Support Groups Community Outings Nursing Occupational Therapy Pet Therapy Physical Therapy Podiatry Speech Therapy