Programs that offer an interactive decision support process that helps individuals in need of long term care and their families understand their strengths, needs, preferences and unique circumstances and weigh the pros and cons of available alternatives. The consultation includes a discussion of the factors to consider when making long term care decisions, information about the range of long term care support options available in their community (such as personal care, transportation and medication management) and resources that can help them pay for services. The program also provides decision support to help identify next steps in the process and help in connecting with services, if needed. The service is generally available to older adults and adults of any age who have a disability; can be of benefit to people using their own resources to pay for services; and may be provided over the telephone or in person (at home, at an agency, in a hospital, at a rehabilitation or nursing facility or in another setting of the person's choosing). The objective of the program is to allow people to live as independently as possible in the setting of their choice.

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Programs that provide support services for patients and their families during hospitalization and upon discharge, for people receiving outpatient services, for previous patients and for other people not previously associated with the facility who need the service. Included are consultation and the coordination of available services for the patient's continuing care at home or in a short or long-term care facility; or whatever other support may be needed to help resolve the logistical, social and psychological problems related to the illness.

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Programs that provide a wide variety of social services that are designed to support healthy family development, improve the family's ability to resolve problems (such as poverty, unemployment, ill health, homelessness, substandard housing, educational difficulties, substance abuse, adolescent pregnancy, delinquency and physical and developmental problems) and prevent the need for unnecessary placement of children in foster care, group homes, inpatient substance abuse or mental health treatment programs, residential training schools or other alternative environments when family problems reach crisis proportions. Services may include home visiting services that focus on public health issues (especially prenatal), mental health and substance abuse counselling, home management instruction, success in a child care setting, parenting skills development, stress management, tutoring, pregnancy awareness and AIDS awareness; may be available to the community at large, to families at risk for dissolution or those currently in crisis; and may be offered by a single agency or a coalition of agencies that have agreed to provide services according to a coordinated case plan.

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Programs that develop case plans for the evaluation, treatment and/or care of individuals who have mental, emotional or social problems and need assistance in arranging for services; which assess the individual's needs; coordinate the delivery of needed services; ensure that services are obtained in accordance with the case plan; and follow up and monitor progress to ensure that services are having a beneficial impact on the problem.

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