Job Coach Staff in charge Funded by (DARS, of helping you CSB, Waiver): learn/maintain your job Personal Care Provides staff for Services used: Agency Waiver hours Personal Care Consumer Attendant Directed Waiver staff Service Coordinates Employer: Facilitator consumer directed Waiver services Support Arranges active CSB or private: Coordinator DD Waiver Services Type of Waiver: Transportation Driver or service Name of Service Provider for travel Provider (Metro Access, Logisticare, Taxi company): Waiting List Point of contact Priority Tier for Waiting Support for Waiver List: Coordinator waiting list at the CSB Date of last contact:
Job Coach Staff in charge of helping you learn/maintain your job Funded by (DARS, CSB, Waiver): Personal Care Agency Provides staff for Waiver hours Services used: Personal Care Attendant Consumer Directed Waiver staff Service Facilitator Coordinates consumer directed Waiver services Employer: Support Coordinator Arranges active DD Waiver Services CSB or private: Type of Waiver: Transportation Provider Driver or service for travel Name of Service Provider (Metro Access, Logisticare, Taxi company): Waiting List Support Coordinator Point of contact for Waiver waiting list at the CSB Priority Tier for Waiting List: Date of last contact: