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["Harbor Reginal Center ",null,null,null,null,null,"These selections are for column F in the Log Form. Please choose all applicable Alternative Services provided, listed from the 08/31 DDS directive, and enter in column F on the Log Form from the drop down menu (i.e. a, d, h, etc.)","These selections are for column F in the Log Form. Please choose all applicable Alternative Services provided, listed from the 08/31 DDS directive, and enter in column F on the Log Form from the drop down menu (i.e. a, d, h, etc.)"]
["Alternative Services Engagement Log with Individual Served",null,null,null,null,null,"a. Supports related to minimizing the exposure to or impact of COVID-19 on the client;"]
["IMPORTANT NOTE: This is a Macros document, please select \"Enable Content\" for the funtions to work.",null,null,null,null,null,"b. Completion of an individual assessment of skills, preferences, and service needs for the client;"]
["*All fields are required",null,null,null,null,null,"c. Completion of an individualized service plan to provide needed services for the client;"]
["Please complete the log & return to:",null,"HRCCommunityServices@harborrc.org",null,null,null,"d. Alternative services delivered to the client via telephone, video or other electronic communication;"]
[null,null,null,null,null,null,"e. Delivery of supplies or other items to the client’s home needed to provide services or supports;"]
["Service Code",null,null,null,null,null,"f. Use of self-guided training and educational materials supplied to the client by the provider intended to support the client’s service;"]
["Vendor Name",null,null,null,null,null,"g. Skills training to individuals within the client’s household who are specifically designated to support the client;"]
["Vendor Number",null,null,null,null,null,"h. Alternative services provided in-person at the client’s home, in a community setting, or at the provider’s facility, modified to comply with the most protective state or local COVID-19 safety guidelines in effect at the time the service is to be delivered. (Provider staff must be trained on COVID-19 safety precautions prior to the  delivery of in-person services.)"]
[null,null,null,null,null,null,"i. Supports for transition to the Self-Determination Program; and"]
[null,null,null,null,null,null,"j. Other modifications to nonresidential services that are approved by the client that further or achieve his or her service needs."]
[]
["Individual's Last Name","Individual's First Name","Individual's UCI","Service Coordinator","Date of Discussion with Individual/Authorized Representative","Choose ALL Applicable Alternative Services provided from the drop down menu (Descriptions are on the second page/sheet).","Participants in Meeting","Description of Consumer's Input"]

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["These selections are for column F in the Log Form. Please choose all applicable Alternative Services provided, listed from the 08/31 DDS directive, and enter in column F on the Log Form from the drop down menu (i.e. a, d, h, etc.)"]
["a. Supports related to minimizing the exposure to or impact of COVID-19 on the consumer;"]
["b. Completion of an individual assessment of skills, preferences, and service needs for the consumer;"]
["c. Completion of an individualized service plan to provide needed services for the consumer;"]
["d. Alternative services delivered to the consumer via telephone, video or other electronic communication;"]
["e. Delivery of supplies or other items to the consumer’s home needed to provide services or supports;"]
["f. Use of self-guided training and educational materials supplied to the consumer by the provider intended to support the consumer’s service;"]
["g. Skills training to individuals within the consumer’s household who are specifically designated to support the consumer;"]
["h. Alternative services provided in-person at the consumer’s home, in a community setting, or at the provider’s facility, modified to comply with the most protective state or local COVID-19 safety guidelines in effect at the time the service is to be delivered. (Provider staff must be trained on COVID-19 safety precautions prior to the  delivery of in-person services.)"]
["i. Supports for transition to the Self-Determination Program; and"]
["j. Other modifications to nonresidential services that are approved by the consumer that further or achieve his or her service needs."]