Because Health Care is a Right, Not a Privilege
 

Respite Policies and Tools

POLICIES AND PROCEDURES

Interfaith House-Chicago IL
4th Street – Salt Lake City UT
McInnis House – Boston MA

REFERRAL/SCREENING FORMS

Homeless Health Care–
Los Angeles CA
Seattle WA
McInnis House –
Boston MA
Harmony Health Recovery Center -
Houston TX

INTAKE/ADMISSION

Client Agreement/Contract
      Homeless Health Care – Los Angeles CA

Admission/Intake Forms
Seattle WA
      Respite Client Info 3-1-06
      Respite Client Admit-Discharge 3-1-06.
Samaritan House - Denver CO
Homeless Health Care – Los Angeles
McInnis House – Boston MA
            Admission Check List
            Intake and Assessment
            Routine Admission Orders

Health Diagnosis/Assessments (Medical, Psychosocial, etc.)
      Homeless Health Care – Los Angeles CA
            Assess – Employ LA
            Assess – Social LA
            Assess – Psych LA
            Assess – Med Drug LA
            Assess – Legal LA
      Harmony Health Recovery Center - Houston TX
            Psychiatric Eval
            Medical Dx

FORMS USED DURING STAY

Treatment Plan
McInnis House – Boston MA

Vital Signs Sheet
McInnis House – Boston MA

Status report/Progress Notes
      Seattle WA
            Respite Nursing Encounter Log P1 3-1-06
            Respite Nursing Encounter Log P2 3-1-06
            Respite MH Encounter Log P1 3-1-06
            Respite MH Encounter Log P2 3-1-06
      Colorado Coalition – Denver CO
      McInnis House – Boston MA

Discharge Outcomes Form/Discharge Summary
      Homeless Health Care – Los Angeles CA
      McInnis House – Boston MA

MISCELLANEOUS

Job Descriptions for Respite Staff
      Colorado Coalition – Denver CO
            Nurse
            Case Manager

DISCLAIMERS

Copyright Status: Unless stated otherwise, these documents and files are in the public domain, and can be freely downloaded and reproduced.
Endorsement: While these tools reflect current standards, inclusion of materials in this collection in no way implies recommendation or endorsement of a particular item.
Liability: Neither The National Health Care for the Homeless Council nor any of its employees assumes any legal liability or responsibility for the accuracy, completeness, or usefulness of any information, apparatus, product, or process disclosed, or represents that its use would not infringe privately owned rights.