Health Service Coordination and Care Policy Name* First Last It is the policy of Aveyron Homes, Inc. to meet the health service needs of each person being served as defined and assigned in each person’s coordinated service and support plan (CSSP) or CSSP addendum.*TrueFalseWhen discovered, Aveyron Homes Inc. will promptly notify the person’s legal representative, if any, and the case manager of changes in a person’s physical and mental health needs affecting health service needs assigned to the program in the person’s CSSP or CSSP addendum.*TrueFalseIf Aveyron Homes Inc. has reason to know that the change has already been reported, it is not necessary to report.*TrueFalseProgram Coordinator, Program Director, Health Care Coordinator must document all health changes, including when the notification of the health changes was given to the legal representative and case manager, on the Health Needs Change Notice.*TrueFalseWhen assigned the responsibility for meeting the person’s health service needs in the person’s CSSP or the CSSP addendum, Aveyron Homes Inc. will maintain documentation on how the person’s health needs will be met, including the procedures to follow.*TrueFalseAre these the procedures to follow in the person’s health service need? 1.) Provide medication assistance or medication administration according to the safe medication assistance and administration policy; 2.) Monitor health conditions according to written instructions from a licensed health professional; 3.) Assist with or coordinate medical, dental and other health service appointments; or 4.) Use medical equipment, devices or adaptive aides or technology safely and correctly according to written instructions from a licensed health professional.*TrueFalseNameThis field is for validation purposes and should be left unchanged.