№ lp_2_3_03540
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File size: 26 KB
This is a survey document collecting feedback from caregivers regarding their experience with a therapist and the Intensive Home-Based Treatment service provided to their family.
Note:
Year
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Note:
Year
Topic:
IHBT Fidelity Review
Document Type:
Procedure
Organ / institution:
CIP
Target Audience:
IHBT team members, supervisors, program managers
Description:
Detailed procedure for conducting the Fidelity Review for IHBT teams, including preparation, documentation, site visit, and feedback steps.
Note:
Year
Year:
2021
Region / City:
N/A
Topic:
Behavioral Health, Intensive Home-Based Treatment
Document Type:
Tool
Author:
N/A
Target Audience:
Mental health professionals, IHBT providers
Date of Approval:
N/A
Date of Changes:
N/A
Period of Validity:
N/A
Crisis response policy:
Available
Safety planning policy:
Available
Telehealth Guidelines:
Available
Telehealth Usage:
Complementary
Program Best Practices:
Included
Program:
Caregiver Support Program (CSP)
Document type:
Installation guide
Release:
PXRM2.037
Publication date:
October 2015
Organization:
U.S. Department of Veterans Affairs, Veterans Health Administration
System:
CPRS and TIU
Subject area:
Clinical reminders and interdisciplinary notes
Audience:
Caregiver Support Coordinators and clinical staff
Number of reminder dialogs:
Eight
Related standards:
VHA Enterprise Standard Title “CAREGIVER CERTIFICATE”
Implementation context:
Parent and child interdisciplinary notes
Year:
2018
Region / City:
Arizona
Topic:
Child Safety, Foster Care
Document Type:
Form
Institution:
Arizona Department of Child Safety
Author:
Arizona Department of Child Safety
Target Audience:
Kinship foster caregivers
Effective Period:
Ongoing
Approval Date:
Not specified
Amendment Date:
Not specified
Year:
Not specified
Region / City:
Not specified
Theme:
Legal planning, estate planning, healthcare directives
Document Type:
Informational brochure
Organization:
Preferred Legal Plan
Author:
Not specified
Target Audience:
Caregivers, individuals preparing for potential incapacitation
Period of Validity:
Not specified
Approval Date:
Not specified
Modification Date:
Not specified
Year:
2000
Region/City:
Washington State
Topic:
Family Caregiver Support
Document Type:
Policy and Procedure Manual
Organization:
Area Agency on Aging
Author:
Dana Allard-Webb
Target Audience:
Family caregivers, Area Agency on Aging staff
Effective Period:
Ongoing
Approval Date:
2000
Revision Date:
2007
Note:
Year
Topic:
Caregiver Support
Document Type:
User Guide
Organization:
Instant Care
Target Audience:
Caregivers
Year:
1980–1998
Type:
Questionnaires / Inventories
Subjects:
Depression, Anxiety, Epilepsy, Stigma, Adverse Effects of AEDs, Caregiver Burden
Instruments:
Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), QOLIE-31, Liverpool Stigma Scale, Liverpool Adverse Events Profile (LAEP), Zarit Caregiver Burden Inventory (ZCBI)
Authors:
Beck, Cramer, Jacoby, Baker, Zarit et al.
Population:
Patients with epilepsy and their caregivers
Scoring:
Various Likert scales and total scores indicating severity or burden
Note:
Year
Contextual description of the document:
Timeline for data collection for caregivers and children in a health and wellness program, outlining forms to be completed during different enrollment and age milestones.
Year:
2026
Region/City:
Not specified
Topic:
Transportation reimbursement for caregivers
Document type:
Policy
Organization:
DCYF
Author:
Not specified
Target audience:
Caregivers, caseworkers
Effective period:
Not specified
Approval date:
Not specified
Modification date:
Not specified
Year:
2024
Month:
January
Region:
North Central Texas
Organization:
Area Agency on Aging of North Central Texas
Document Type:
Administrative intake form
Form Number:
2270
Subject:
Caregiver and care recipient identification and service request
Confidentiality:
Information is confidential and shared only to initiate or modify services
Related Guidelines:
2024 Department of Health and Human Services Federal Poverty Guidelines
Target Population:
Caregivers aged 18 or older; caregivers aged 55 or older for specific categories; care recipients aged 60 or older, minors, or adults with disabilities
Services Listed:
Benefits Counseling; Caregiver Education; Emergency Response System; Health Maintenance Supplies; Home-Delivered Meals; Medication Management; Nutritional Supplements; Personal Care; Prescription Assistance; Residential Repair; Respite; Transportation; Utility Assistance
Geographic Scope:
Counties within North Central Texas
Year:
2013
Region / City:
New York, NY
Topic:
Mentoring Programs
Document Type:
Survey
Organization:
Public/Private Ventures
Author:
Herrera, C., DuBois, D. L., Grossman, J. B.
Target Audience:
Caregivers/Parents of Youth in Mentoring Programs
Period of Validity:
Not specified
Approval Date:
Not specified
Date of Changes:
Not specified
Document Type:
Caregiver Agreement Form
Program:
Enhanced Foster Care (EFC)
Service Type:
Family-Based Foster Care Treatment Service
Related System:
MiSACWIS
Subject:
Child Eligibility for Enhanced Foster Care Services
Participants:
Identified Caregiver(s), Assigned Foster Care Agency, EFC Clinical Case Manager, EFC Supervisor, PAFC Director
Required Information:
Child Name, Date of Birth, MiSACWIS Person ID, Caseworker, Foster Parent Name and Address
Content Elements:
Caregiver Qualifications, Completed Training, Scheduled Training, Transition Plan, Behavior Management Techniques, Service Level Engagement, Educational Participation, Crisis Management Tasks
Compensation Basis:
Daily Rate Above Standard Determination of Care
Rate Levels:
Level I, Level II, Level III, Adapted Rate
Signatures Required:
EFC Clinical Case Manager, Caregiver(s), EFC Supervisor, PAFC Director (if waiver required)
Waiver Condition:
Exception Authorization or Confirmation of Pressley Ridge Treatment Parenting Model Completion
Target Population:
Children in General Foster Care with Intensive Behavioral or Emotional Needs
Note:
Year
Topic:
Duchenne muscular dystrophy, caregiving
Document Type:
Questionnaire
Target Audience:
Caregivers of children with Duchenne muscular dystrophy
Jurisdiction:
New Zealand
Legislation Referenced:
Education (Pastoral Care of Tertiary and International Learners) Code of Practice 2021
Relevant Clauses:
53 and 76
Regulatory Authority:
NZQA
Document Type:
Application Form
Purpose:
Assessment and approval of residential caregivers for international learners
Intended Applicants:
Homestay carers, designated caregivers, temporary accommodation supervisors
Issuing Body:
[Name of Education Provider]
Subject:
Residential care arrangements for international learners
Key Requirements:
Safety check and police vetting for household members aged 18 and over
Information Collected:
Personal details, household composition, medical information, accommodation details, learner arrangements, referees
Declaration:
Applicant confirmation of accuracy and completeness of information
Approval Requirement:
Governing board approval and independent legal advice recommended prior to use
Year:
2026
Region / City:
United States
Subject:
Child welfare survey participation
Document type:
Lead letters and fact sheets
Organization / Institution:
Administration for Children and Families; RTI International; University of North Carolina at Chapel Hill; Washington University in St. Louis
Author:
Christine Fortunato, Ph.D.
Target audience:
Caregivers, legal guardians, emancipated youth, young adults
Survey period:
12-month selection period
Incentives:
Monetary compensation and gift certificates for child participants
Methodology:
In-person interviews and caseworker data collection
Confidentiality:
Participant information kept private as permitted by law
OMB Control Number:
0970-0202
Year:
2024
Topic:
Instructional feedback and high-leverage practices in education
Document type:
Educational guidance material
Practice framework:
High-Leverage Practices (HLP)
Practice number:
HLP 22
Related practices:
HLP 8, HLP 16
Educational level:
K–12 education
Focus area:
Teaching and learning processes
Intended audience:
Teachers and educators
Publisher:
Council for Exceptional Children and CEEDAR Center
Associated organizations:
TTAC Region 4, CEEDAR Center
Referenced disciplines:
Special education, inclusive education
Content includes:
Definitions, examples and non-examples, usage guidance, references
Year:
2026
Region / City:
Ontario, Canada
Subject:
Stakeholder Feedback
Document Type:
Feedback Form
Organization:
Independent Electricity System Operator (IESO)
Author:
Independent Electricity System Operator (IESO)
Target Audience:
Stakeholders involved in the Long-Lead Time RFP
Effective Period:
Feedback due by February 11, 2026
Approval Date:
January 28, 2026
Modification Date:
N/A
Context:
A feedback form for stakeholders regarding the Long-Lead Time RFP, seeking responses on various policy considerations, project eligibility, and additional feedback on proposed updates.