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Wisconsin Department of Public Instruction CHILD AND ADULT CARE FOOD PROGRAMREIMBURSEMENT CLAIM (ADULT CARE COMPONENT) PI1489A (Rev. 1215) INSTRUCTIONS: Use this form as a worksheet and submit the
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The adult care component is a section of a care plan that focuses on providing care and support for adults in need of assistance with activities of daily living.
Caregivers, healthcare professionals, or family members responsible for the care of the adult individual are required to fill out the adult care component.
The adult care component can be filled out by providing detailed information about the adult's medical history, current health status, medication regimen, and any special care needs.
The purpose of the adult care component is to ensure that the adult individual receives appropriate care and support to meet their physical and emotional needs.
Information such as medical history, current health status, medication regimen, dietary restrictions, and any specific care needs must be reported on the adult care component.
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