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___ Consent Agenda
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:f1~~~i JEFFERSON COUNTY PUBLIC HEALTH
"l,~~~"'- 615 Sheridan street. Port Townsend' Washington' 98368
!lD''' www.Jeffersoncountypubllchealth.org
July 25, 2011
JEFFERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
AGENDA REQUEST
TO: Board of County Commissioners
Philip Morley, County Administrator
FROM: Jean Baldwin, Director
DATE: 5e-pt-eIn~Y ~f.Q) doll
SUBJECT: Agenda Item - Professional Services Agreement - Concerned Citizens
for IndMdual Employment and Persons to Persons Servlces;
July 1, 2011 - June 30, 2012; $38,887
STATEM,ENT OUS5UE:
Jefferson County Public Health, Developmental DIsabilities DMslon, Is requesting Board approval of the
Professional services Agreement - Concerned CItIzens for IndMdual Employment and Persons to
Persons services; July 1, 2011- June 30, 2012; $38,887
ANALYSIS/STRATE~IC GOALS/I!RO'S and CON'S:
This agreement provides for the placement of dlents with developmental disabilities Into traditional
employment settings at work sites or In job training, In the community. This contract wIll also provide a
Pathway to Employment Plan, which centers around a personal discovery process related to skills,
capabilities and goals and assistance with employment vendor selection. The placement may also Include
vocational counseling and job analysis to assist In Identification of work objectives and the job process,
locating a suitable community job for the worker; Initial placement and post hire training of the employee,
employer, and or co-workers at the employment sIte, job restructuring and work site modifications;
supporting the worker, employer, and other Interested persons to develop natural workplace supports to
ensure stability on the job; and to assIst the worker In obtaining other services as necessary for continued
employment. Follow along services are Included which provide for a safety net service of support,
counseling, job analysis, and supported traIning to the worker, employer, and other Interested parties
(parents, unions etc). Through Community Information and Education, Concerned CItIzens staff will work
with Jefferson County People Arst Chapter to broaden membership, provide training In self-determination
and self-advocacy and coordinate with other members of People Arst Chapter of Younger Adults to develop
a media/public education and outreach plan.
COMMUNITY HEALTH
DEVELOPMENTAL DISABILITIES
MAIN: (360) 38&-9400
FAX: (360) 38&-9401
PUBLIC HEALTH
AlWAYS WORKING FOR A SAFER AND
HWTHIER COMMUNITY
E~RONMENTALHEALTH
WATER QUALITY
MAIN: (360) 38&-9444
FAX: (360) 379-4487
Consent Agenda
FISCAL IMPACT/COST BENEFn ANALYSIS:
This professional services agreement Is covered In the ODD through DSHS, under Vocational Services. The
budget reflects revenue and expense for this vendor.
RECOMMENDATION:
JCPH management request approval of the ProfessIonal Services Agreement - Concerned atlzens for
Individual Employment and PerSons to Persons Services; July 1, 2011- June 30, 2012; $\~t~1-
W#
Date
(Routed to all Public Health Managers)
.'
PROFESSIONAL SERVICES AGREEMENT
Between
JEFFERSON COUNTY PUBLIC HEALTH
And
CONCERNED CITIZENS
INDIVIDUAL EMPLOYMENT And PERSON TO PERSON SERVICES
This agreement is made and entered into between Jefferson COUNTY Public Health (COUNTY) and Concerned
Citizens of Forks (SUBCONTRACTOR) for provision of Individual Supported Employment to Persons with
Developmental Disabilities in Jefferson COUNTY. The term of this agreement is July 1,2011 through June 30, 2012.
Either party upon 60 days written notice may terminate this Contract Termination of this Contract shall not constitute
a breach.
It is Agreed Between Both Parties as Named Herein as Follows:
A. PROFESSIONAL SERVICES
Professional services to be provided by SUBCONTRACTOR shall include:
(I) IndMdual Employment! Person to Person Services - Pathway to Employment Plan facilitation, a
discovery process, detailed action stepsltimelines that will serve as a transition tool towards the
advancement of the individual's pathway as an aid in the implementation of matching program Clients to
appropriate employment services in the community, vocational evaluation, job finding and development, job
placement/replacement in community settings, worksite job training, and development of natural supports,
and follow-along per Exhibit A - Statement of Work.
(2) Community Information and Education-working with the People First Chapter of Jefferson COUNTY per
Exhibit A Statement of Work.
(3) Program management.
B. OBLIGATIONS
SUBCONTRACTOR shall fulfill the following obligations:
(I) SUBCONTRACTOR shall comply with all state and fuderal requirements regarding the confidentiality of
client records. Client information is not disclosable to the public. Information acquired pursuant to RCW
71AI4.070 or RCW 34.05 require a signed Release ofInformatlon or a signed Oath ofConfidentlality Form.
(2) SUBCONTRACTOR is required pursuant to RCW 43.43.830-845, that any prospective employee, who will
or may have unsupervised access to a person with a developmental disability, in the course of his or her
employment, or involvement with the business or organization, must have a Washington State Patrol Criminal
(W.S.P.) Background Check.
(3) SUBCONTRACTOR is required pursuant to RCW 74.15, that if any prospective employee, who has not
resided in Washington State during the last three years, and who will or may have unsupervised access to a
person with a developmental disability, in the course of his or her employment, or involvement with the
business or organization, must have a F.B.I. Fingerprint Check. This fingerprint check must occur before
employment begins working.
(4) SUBCONTRACTOR is required, to repeat the W.S.P. Criminal Background Check every three years. The
W.8. P. Criminal Background Check and the F.B.I. Fingerprint Check must go through the Background
Check Central Unit Office within DSHS in Olympia.
(5) SUBCONTRACTOR shall comply with all state and federal requirements under RCW 74.34, Abuse of
Vulnerable Adults, RCW 26.44, Abuse of Children, the WACs: 275-27 Division of Developmental
Concerned Citizens IEIP2P Contrac120l1-2012
Page 1
.
Disabilities Services Rules; 296-24 General Safety & Health, 296-62 General Occupational Health
Standards; the DDD Policies: 3.01 Client Service Plans, 5.01 Criminal History Background Checks and
Safeguarding Personal Information, 5.02 Necessary Supplemental Accommodation (NSA), 5.03 Client
Complaints, 5.05 Limited English Proficiency (LEP) Clients, 5.06 Client Rights, 5.13 Protections From
Abuse, 5.14 Positive Behavior Support, 5.15 Use of Restrictive Procedures, 6.13 Employment/Day
Program Provider Qualifications, 9.07 Human Immunodeficiency Virus (HlV) and Acquired Immune
Deficiency Syndrome (AIDS), 12.01 Incident Management and the 1992 COUNTY Guidelines.
(6) SUBCONTRACTOR shall have written policies regarding; sexual harassment and non-discrimination (said
policies must guarantee human/civil rights), abuse of participants, agency medication procedure, respectful
staff-to-participant interactions, (i.e.: including a person's right to be treated with dignity and respect and
free of abuse).
(7) SUBCONTRACTOR shall assure that participants in accordance with Necessary Supplemental
Accommodation (NSA), Policy 5.02, have been informed of their rights, what services and benefits may be
expected from the program, the program's expectations of them, and if necessary, shall assure that the
participan~s family, guardian or advocate is also informed.
(8) SUBCONTRACTOR shall have a grievance policy that advises participants of grievance procedures and
that the grievance policy is explained to participants and others in accordance with the NSA, DDD Policy
5.02. The grievance policy shall prohibit retaliation for using the grievance process and a non retaliation
statement shall be included in the grievance policy. The grievance policy must also include a mediation
process that encourages the use of advocates, DDD Case Resource Managers & others who are unaffected
by the ontcome.
(9) SUBCONTRACTOR shall obtain and retain in the clients' files signed proof of client's and/or family's
review of all policies, provider expectation and receipt of information abont services and benefits to be
provided by the program. The signed proof required by this section shall be reviewed and renewed with
new documentation on not less than an annual basis.
(10) SUBCONTRACTOR will encourage participant involvement in policy development.
(11) SUBCONTRACTOR shall update Client Intake Forms every 6 months during the Client Review meeting.
(12) SUBCONTRACTOR shall assure that potential conflict of imerest real or apparent will not arise. Such a
conflict will arise when: The employee, officer or agent, any member of immediate family, Guardian I
decision maker, or an organization which employs, or is about to employ, any of the above, has financial or
other interest in the client(s).
(13) SUBCONTRACTOR shall have adequate staffing ratios and patterns to maintain quality and safety.
(14) If SUBCONTRACTOR is found to have a substantiated finding of abuse. neglect, abandonment or
financial exploitation they shall comply with the following APS guidelines:
. Upon receiving documentation of a substantiated fmding of abuse, neglect, exploitation or
abandonment from APS, the regional DDD office will send a copy of the APS substantiation report to
the COUNTY within one working day.
. Upon receiving documentation of a substantiated finding of abuse, the COUNTY will send a letter to
the SUBCONTRACTOR vocational/day program provider within one working day.
1. The contracted provider is required to:
a. Document the steps the agency has taken to protect the vulnerable
person(s) immediately; and
b. Submit a corrective action plan, if needed, to the COUNTY within 10
working days.
Concerned Citizens 1EIP2P Contract 2011-2012
Page 2
2. The COUNTY will respond to the steps taken and the sufficiency of the proposed corrective action
plan within 10 working days. If the corrective action is not accepted the plan will be returned to the
provider for correction and an amended plan will be required within 5 working days.
3. Once accepted, the COUNTY will send the corrective action plan to DDD for final approval. DDD
regional staff will respond as to plan sufficiency and whether any additional information is needed
within 10 working days. The region will send a copy to Central Office.
4. COUNTY and its SUBCONTRACTORS are mandated reporters of abuse and neglect under RCW
74.34.020(1), and must comply with reporting requirements described in RCW 74.34.035, 040 and
Chapter 26.44 RCW. If the COUNTY is notifiad by DSHS that a subcontractor staff member is cited or
on the registry for a suhstantiated finding then that associated staffwill be prohibited from providing
services under this contract.
(IS) SUBCONTRACTOR is required to maintain the following minimum organizational capacity in order to meet
the performance standards set forth in this agreement Failure or inability of SUBCONTRACTOR to meet
any or all of these minimum capacity requirements, as determinad solely by COUNTY, may be cause for
termination of this agreement as provided herein.
(a) Ona1ified Staff. Adequate, qualified staff with skills and experience in evaluation, training, supervision,
counseling and support of adults with developmental disabilities who are earning wages, per the attached
Statement of Work. SUBCONTRACTOR will provide COUNTY with information regarding staff
qualifications upon request
(b) Performance Plan: SUBCONTRACTOR has a written performance plan which descnbes its mission,
program objectives, expected ontcomes, how and when objectives will be accomplished; and that the
plan is evaluated at least biennially and revised based on actua1 performance.
(c) Pardcipants: SUBCONTRACTOR has a commitment to support integration of individnals with
developmental disabilities with people who are not disabled and has involved pardcipants with
developmental disabilities in policy development
(d) Partnershins: SUBCONTRACTOR has a history of working cooperatively with community-based
organizations including Employers, other Agencies, the COUNTY DD Program, the Division of
Vocational Rehabilitation (DVR) and Schools.
(e) Financial and Prol!mtll Man.""ement: Systams and personnel to: maintain accounting records that
accurately reflect all program revenues and expenditures; prepare monthly statements of activity (ADSA
Reports); maintain appropriate Client service records and progress reports; and track key program
performance indicators.
(f) Accreditation: SUBCONTRACTOR must be able to demonstrate conformance to Commission on
Accreditation of Rehabilitation Facilities (CARF) standards for quality assurance and CARF
accreditation.
(16) All services for persons with developmenta1 disabilities must be provided with attention to their health and
safely. SUBCONTRACTOR shall comply with all applicable federal, state and loeaI fire, health and safety
reguJations. Staffing ratios and patterns are adequate to maintain quality and safety.
(17) The Agency shall report any injury or accident, which requires more than simple first aid, and any
extraordinary incident that requires intarvention by the Agency, first to the DSHSIDDD Case Manager for the
individual involved and then to the COUNTY Coordinator. This includes serions physical or emotional harm
or potaotial harm.
I. The initia1 report may be done through documented telephone calls to the COUNTY
Coordinator.
2. The Agency shall suhmit a written follow-up report within 10 days to the COUNTY
Coordinator. The report to the COUNTY Coordinator may be submitted by email,
Concerned Citizens IElP2P Contract 2011-2012
Page 3
fucsimile (FAX) to (360) 385-940 I or by mail to Jefferson COUNTY Public Health, 615
Sheridan St, Port Townsend, W A 98368.
3. Serious and emergent incidents shall be handled in accordance with DSHSIDDD Policy 12.01
Incident Management.
(18) Wrthin 30 days of the effective date of this agreement and at least semi-annually thereafter,
SUBCONTRACTOR will provide financial reports to COUNTY, including all revenues and expenses
generated by SUBCONTRACTOR, in sufficient detail to demonstrate the uses of funds provided under this
agreement.
(19) Make available for inspection, review or audit by COUNTY DD Coordinator at all reasonable times: all work
sites; all client records; records on pruductivity and client wages; and all documents, reports and other data
applicable to this agreement. The COUNTY shall monitor services delivered and conduct at least one on-site
visit with SUBCONTRACTOR during the period of the contract to assure compliance with the DDD State
Work Order.
(20) AUDIT REOUIREMENTS. Independent Audits will be submitted annually to the Jefferson COUNTY DD
COUNTY Coordinator in the following manner:
The SUBCONTRACTOR shall acquire a financial audit by an independent auditing firm to determine at a
minimum the fiscal integrity of the financial transactions and reports of the SUBCONTRACTOR. Copies
of the audit and management letter shall be submitted to the Jefferson COUNTY Public Health Department
within 6 months of the end of the SUBCONTRACTOR's fiscal year.
The SUBCONTRACTOR shall provide an independent audit of the entire organization which:
(a) Is performed by an independent Certified Public Accountant, the Washington State
Auditor's Office, or another entity, by which the COUNTY and the SUBCONTRACTOR
mutually agree.
(b) Provides statements consistent with the guidelines of Reporting for Other Non-Profit
Organizations AlCPA SOP 78-10, and is performed in accordance with generally accepted
auditing standards and with Federal Standards for Audit of Governmental Organizations,
Programs, Activities, and Functions, and meeting all requirements ofOBM Circular A-133 or A-
128, as applicable.
(c) The SUBCONTRACTOR shall submit one (I) copy of the audit and/or the summary and the
management letter directly to the COUNTY immediately upon completion. The audit must be
accomplished by documentation indiceting the SUBCONTRACTOR's Board of Directors has
reviewed the audit
(21) For five years following the end date of this agreement, SUBCONTRACTOR will maintain client records and
books, records, documents, reports and other evidence of accounting procedures and practices which
sufficiently and properly reflect all direct and indirect expenditures of funds provided under this agreement.
Client records shall minimally include statement of client goals, documentation of training provided, training
hours, rontine progress notes and biannual summary progress toward meeting client goals.
(22) Make available for inspection, review or audit by COUNTY DD Coordinator at all reasonable times: all client
records; and all documents, reports and other data applicable to this agreement.
(23) SUBCONTRACTOR shall provide COUNTY with a copy of a signed DSHS Provider Agreement within 30
days of the effective date of this agreement.
(24) SUBCONTRACTOR agrees to assign to COUNTY its Medicaid Billing Rights for services to clients
eligible under Title XIX programs. Written documentation shall be available to COUNTY on request. If
SUBCONTRACTOR contracts directiy with DSHS to provide covered services under Title XIX,
COUNTY agrees that funding intended for those clients shall be excluded from this agreement. If
SUBCONTRACTOR contracts directly with Social Security to provide covered services under a
Concerned Citizens IEIP2P Contract 2011-2012
Page 4
PASS/IRWE, COUNTY agrees that funding intended for those clients shall be excluded from this
agreement.
(25) If the Developmental Disabilities Program Coordinator finds indications of potential non-
compliance during the contract monitoring process or learns that the SUBCONTRACTOR is out of
compliance with any of the terms or conditions of this contract, the following process will be
pursued:
(a) Informal Notification: Infonnal process wherein the COUNTY Coordinator alerts the
SUBCONTRACTOR in writing of the potential non~mpliance and an agreeahle solution is reached
within five (5) days.
(b) Official Notification: If the informal notification does not result in resolution, the official notification
of possible non~mpliance to establish a date, within five (5) working dsys of notification, when
representatives of the COUNTY and the SUBCONTRACTOR shall meet to discuss areas of
contention and attempt to resolve the issues.
(c) Written Summary: Within five (5) working days of such official notification the COUNTY will
provide the SUBCONTRACTOR a written summary of the areas ofnon~mpliance by certified mail.
Notice shall be sent to the address identified in the Agreement
(d) Discussion: Within twenty (20) days of the date of the written summary, a discussion between
COUNTY and SUBCONTRACTOR shall be conducted to resolve areas ofnon~mpIiance or
potential non-compliance.
(e) Should the above procedures fail to resolve the compliance issue, the parties will obtain the services of
the Peninsula Dispute Resolution Center, or another agreed upon resource, and shall share equally in
any retainer fees or other costs of services. If no agreement is reached, the mediator's decision in the
matter will be binding on all parties, excent that in no event will the COUNTY honor a financial
detennination that is greater than the funds allowed the scope of this Agreement
C. REIMBURSEMENTS
(I) For said services rendered under this agreement, COUNTY shall reimburse SUBCONTRACTOR on a unit
rate basis, as follows:
(a) Individual Emnlovment/Person to Person Services: SUBCONTRACTOR will be paid $68.00 per
unit assigned Service Responsibility of regular Program Service, as defined in Exhibit A, Statement of Work.
CommunitY Infonnation and Education Services: SUBCONTRACTOR will be paid designated amount per
payment points for CommunitY Infonnation and Education Services as defined in Exlnbit A, Statement of
Work.
(2) SUBCONTRACTOR will bill COUNTY on a monthly basis, on or before the 5th day of the month, for units
of service provided under this agreement during the preceding month. SUBCONTRACTOR will submit a
Monthly DDD Services Report (ADSA) fonn for its biI1ings. At no time shall the invoices for reimbursement
be suInnitted more than 60 calendar days following the last day of the mooth for which the services were
provided.
(3) COUNTY may, at its option, withhold reimbursement for any month for which required reports have not
been received or are not accurate and/or complate.
(4) Total reimbursements for the fiscaI year of 2011-2012 to SUBCONTRACTOR by COUNTY under this
contract shall not exceed $38,887.00 in completion of these services without express written amendment
signed by both perties to this Agreement. This totaI reimbursement includes any amendment within the fiscaI
year of201 1-2012.
(5) Client services shall not be reimbursed under this agreement when the same services are paid for under the
Rehabilitation Act of1973 (DVR), P.L. 94-142 (Public Education), or are being funded under PASS/IRWE.
Concerned Citizens IEIP2P Conlrllcl20I] -20]2
Page 5
D. MISCELLANEOUS
(1) Pursuant to WAC 275, DSHS Division of Developmental Disabilities (ODD) shall determine individual
eligibility of persons for services delivered under this agreement. DDD shall notify COUNTY of persons
authorized for services reimbursed under this agreement. Only persons referred to COUNTY by DDD shall
be eligtble for services reimbursed under this agreement The SUBCONTRACTOR shall not sublet or assign
any of the services covered by this AGREEMENT withont the express written consent of the COUNTY.
Assignment does not include printing or other customary reimbursable expenses that may be provided in an
AGREEMENT.
(2) The SUBCONTRACTOR'S relation to the COUNTY shall be at all times as an independent
SUBCONTRACTOR and any ofall employees of the SUBCONTRACTOR or other persons engaged in
the performance of any work or service required of the SUBCONTRACTOR under this AGREEMENT
shall be considered employees of the SUBCONTRACTOR only and any claims that may arise on behalfof
or against said employees shall be the sole obligation and responsibility of the SUBCONTRACTOR.
(3) The SUBCONTRACTOR shall not sublet or assign any of the services covered by this
AGREEMENT withont the express written consent of the COUNTY. Assignment does
not include printing or other customary reimbursable expenses that may be provided in
an AGREEMENT.
(4) The SUBCONTRACTOR shall obtain and keep in force during the terms of the
AGREEMENT, or as otherwise required, the following insurance with companies or
through sources approved by the State Insurance Commissioner pursuant to RCW 48:05:
(a) Worker's compensation and employer's liability insurance as required by the State ofWasbington.
(b) Commercial Automobile Liability or Business Use Insurance providing bodily injury and property
demage liability coverage for all owned and non-owned vehicles assigned to or used in the
performance of the work for a combined single limit of not less than $1,000,000 each occurrence
with the COUNTY named as an additional insured in connection with the SUBCONTRACTOR'S
performance of the contract.
(c) General Commercial Liability Insurance in an amount not less than a single limit of one million
dollars ($1,000,000.00) per occurrence and a aggregate of not less than two (2) times the
occurrence amount ($2,000,000.00 minimum) for bodily injury, including death and property
damage, unless a gneater amount is specified in the contract specifications. The insurance
coverage sba11 contain no limitations on the scope of the protection provided and include the
following minimum coverage:
(1) Broad Form Property Damage, with no employee exclusion;
(2) Personal Injury Liability, including extended bodily injury;
(3) Broad Form ContractoalfCommercial Liability - including completed operations;
(4) Premises - Operations Liability (M&C);
(5) Independent Contractors and Subcontractors;
(6) Blanket Contractual Liability.
(5) All employees or subcontractors of SUBCONTRACTOR who are required to be professionally certified by
the State in the performance of services under this agreement shall maintain professional liability insurance in
the amount of not less than one million doliars ($1,000,000). In no case shall such professional liability to
third perties be limited in any way.
Concerned Citizens IElP2P Contract 2011.2012
Page 6
(6) It shall be the responsibility of the SUBCONTRACTOR to insure that any and all persons engaged in the
performance of any work or service required of the SUBCONTRACTOR IDlder this AGREEMENT, shall
comply with the same insurance requiremeots that SUBCONTRACTOR is required to meet.
(7) Failure on the part of the SUBCONTRACTOR to maintain the insurance as required shall constitute a
material breach of contract upon which the COUNTY may, after giving five working days notice to the
SUBCONTRACTOR to correct the breach, immediately terminate the contract or, at its discretion, procure
or renew such insurance and pay any and all premiums in connection therewith, with any sums so expended
to be repaid to the COUNTY on demand, or at the sole discretion of the COUNTY, off set against funds
due the SUBCONTRACTOR from the COUNTY.
(8) All cost for insurance shall be considered incidental to and included in the unit contract prices and no
additional payment will be made.
(9) Excepting the Workers Compensation insurance and any professional liability insurance secored by the
SUBCONTRACTOR, the COUNTY will be named on all certificates of insurance as an additional insured.
The SUBCONTRACTOR shall furnish the COUNTY with verification of insurance and endorsements
required by this AGREEMENT. The SUBCONTRACTOR reserves the right to require complete, certified
copies of all required insurance policies at any time.
(10) All insurance shall be obtained from an insurance company authorized to do business in the State of
Washington. The SUBCONTRACTOR shall submit a verification of insurance as outlined herein within
14 days of the execution of this AGREEMENT to the COUNTY.
(11) The COUNTY will pay no progress payments IDlder Section C until the SUBCONTRACTOR has fully
complied with this section. This remedy is not exclusive; and the COUNTY may take such other action as
is available to them IDlder other provisions of this AGREEMENT, or otherwise in law.
(12) Nothing in the foregoing insurance requirements shall prevent the COUNTY, at its option, from
additionally requesting that the SUBCONTRACTOR deliver to the COUNTY an executed bond as security
for the fitithfuI performance of this contract and for payment of all obligations of the SUBCONTRACTOR.
(13) The SUBCONTRACTOR shall comply with all Federal, State, and local laws and ordinsnces applicable to
the work to be done IDlder this AGREEMENT. This AGREEMENT shall be interpreted and construed in
accord with the laws of the State of Washington and venue shall be in Jefferson COUNTY, WA.
(14) The SUBCONTRACTOR, by signatore to this Agreement, certifies that the SUBCONTRACTOR is not
presently debarred, suspended, proposed for debarment, declared ineligible, or vollDltarily excluded from
participating in this Agreemeut or any Agreemeut by any Federal department or agency. The
SUBCONTRACTOR also agrees to include the above requirement to all subcontracts into which it enters.
(15) The SUBCONTRACTOR shall comply with the W A State Departmeut of Labor and Industries Minimum
Wage Act, RCW 49.46, acknowledging persons with disabilities participating in job assessments are not
considered employees.
(16) The SUBCONTRACTOR shall indemnify and hold the COUNTY, and their officers employees, and agents
harmless from and shall process and defend at its own expense, including all costs, attorney fees and expenses
relating thereto, all claims, demands, or suits at law or equity arising in whole or in part, directly or indirectly,
from the SUBCONTRACTOR'S negligence or breach ofany ofits obligations IDlder this AGREEMENT;
Concerned Citizens IE!P2P Contract 2011-2012
Page 7
.
provided that nothing herein shall require a SUBCONTRACTOR to indemnify the COUNTY against and
hold hann1ess the COUNTY from claims, demands or suits based solely upon the conduct of the COUNTY,
their officers, employees and agents, and provided further that if the claims or suits are caused by or result
from the concurrent nagligence of (a) the SUBCONTRACTOR'S agents or employees; and, (b) the
COUNTY, its officers, employees and agents, this indemnity provision with respect to (I) claims or suits
based upon such negligence, and/or (2) the costs to the COUNTY of defending such claims and suits, etc.,
shall be valid and enforceable ouly to the extend of the SUBCONTRACTOR'S negligence or the negligence
of the SUBCONTRACTOR'S agents or employees.
(18) Claims against the COUNTY shall include, but not be limited to assertions that the use and transfer of any
software, book, docwnent, report, film, tape, or sound reproduction of material of any kind, delivered there
under, consthutes an infringement of any copyright, patent, trademark, trade name, or otherwise results in an
unfair trade practice or an un1awfu1 restraint of competition.
(19) The SUBCONTRACTOR specifically assumes potentiaIliabi1ity for actions brought against the COUNTY by
SUBCONTRACTOR'S employees, including all nther persons eogaged in the performance of any work or
service required of the SUBCONTRACTOR under this AGREEMENT and, solely for the pwpose of this
indemnification and defense, the SUBCONTRACTOR specifically waives any immunity under the state
industrial insurance law, Title 51 RCW. The SUBCONTRACTOR recognizes that this waiver was
. specifically entered into pursuant to provisions ofRCW 424.115 and was subject of mutual negotiation.
(20) SUBCONTRACTOR shall nut discriminate against any person presenting themselves fur services based on
race, religioo, color, sex, age or national origin.
(21) COUNTY reserves the right to terminate this contract in whole or in part, without prior written notice, in the
event that expected or actua1 funding from the Department of Social and Health Services Division of
Developmenta1 Disabilities is withdrawn, reduced, or limited in any way after the effective date of this
agreement In the event of termination under this clause, COUNTY shall be liable only for payment for
services rendered prior to the effective date of termination.
(22) No portion of this contract may be assigned or subcontracted to any nther individual, firm, or entity without
the express and prior written approval of COUNTY. If the COUNTY agrees in writing that all or a portion of
this Contract may be subcontracted to a third-party, then any contract or agreement between the contractor and
a third-party subcontractor must contain all provisions of this contract and the subcontractor must agree to be
bound by all terms and obligations found in this agreement.
ADOPTED THIS _ day of
.2011.
By:
John Austin, Chairman
Jefferson COUNTY Board of Commissioners
BY~ r9.o.. <.J(n; G.cll.J:r't.f'JIt
Linda Middleton, Execotive DirectOr
Concerned Citizens of Forks
By:
Attest, Deputy Clerk of the Board
By:
Jefferson County Deputy Pro
ONLY: 9./ q,Z-o 1\
. Attorney
Concerned Citizens Individual EmploymentIPerson to Person 2011-2012
Page 8
EXHIBIT A
STATEMENT OF WORK
CONCERNED CITIZENS
INDWIDUAL EMPLOYMENTIPERSON-TO-PERSON
L WORKSTATEMENT
SUBCONTRACTOR shall provide Individual Employment and Person-to-Person Services for program clients; they
wiU provide support for individuals with developmental disabilities in order to enhance their ability to make
informed choices and to realize their full potential and Community Information and Education Services as described
hereinafter. SUBCONTRACTOR shall be reimbursed for such services on a unit of service basis, pursuant to
Section C., Program Reqnirements/Reimbnrsements, of this contract.
IT. PROGRAM DESCRIPTION
A. Program Goals:
1. To support and strengthen Concerned Citizen's capacity to provide quality, cost effective individual
supported Employment services.
2. To assure that businesses employing individuals with developmental disabilities in Jefferson
COUNTY will meet the Employment Quality Indicators from the COUNTY Guidelines as adopted
by the D.O. Advisory Board.
3. To provide employment services that are designed to meet specific needs of individuals based on
persoual preferences and individualized goals and outcomes.
4. To provide appropriate job matching and necessary vocational support services to assure that
program Clients placed in individual community jobs maintain continuous employment for at least
one year.
5. To provide Pathway to Employment Plan facilitation, a discovery process, detailed action
steps/timelines that will serve as a transition tool towards the advancement of the individual's
pathway and as an aid in the implementation of matching program Clients to appropriate
employment services in the community.
6. To work with the Jefferson COUNTY People First Chapter to:
. Broaden membership through outreach efforts
· Provide training in self-determination, self-advocacy, and other skills as requested by the
People First Chapter of Older Adults
· Coordinate with the People First Chapter from other COUNTY Chapters within the State
. Develop and implement the goals and objectives of the People First work plan
. Coordinate with members of the People First Chapter of Younger to develop a
sustainability plan
B. Definitions
1. Individual Emolovment is:
an individual job in the community where a traditional employer/employee relationship exists (i.e.
person is hired, paid and supervised by the employer);
Concerned Citizens IE/P2P Contract 2011-2012
Page 9
perfurmed at locations that are typical employment sites for non-disabled peISOns (not in businesses
or locations where the primary purpose is to provide employment or work training fur individuals
with disabilities);
for those who have not traditionally held competitive jobs or who have had interrupted or intermittent
employment as a result of a severe disability;
for people with severe disabilities who need intensive and/or extended support services to perfonn
work in the community.
2. Placement is defined as employment in a first joh or in multiple jobs arranged by
SUBCONTRACTOR for 90 calendar days. Placements may be: full-time, average weekly work
totaling 40 hours or more; or part-time, average weekly work totaling 6 hours to 20 hours.
3. Renlacement is defined as being assisted by the same SUBCONTRACTOR in any subsequent
employment (second, third, fourth job, etc.) for 90 calendar days. Employment may be full-time,
part-time or other as defined in B.2 above.
4. Placement and Reolacement Services may include: vocational counseling and job analysis to assist in
the identification of work objectives and the job match process; job development, locating a suitable
community job for the worker; initial placement and post-hire training of the supported employee,
employer and/or coworkers at the employment site; job restructuring and worksite modifications;
supporting the worker, employer and ntber interested peISODS (parents, unions, other employees, etc.)
to develop natoraI workplace supports and ensure stability on the job; assisting the worker to obtain
other services necessary fur cnntimJed employment; feedback to the worker, COUNTY and to DDD
Field Services regarding progress and/or problems.
5. Follow-along Services begin at the time of placement or replacement and may include: visiting with
the worker, the employer and other interested parties (parents, unions, etc.) to insure stability on the
job; providing feedback to the worker, COUNTY and to DDD Field Services regarding progress
and/or problems; counseling the worker and his/her fiunily on vocational issues.
6. Person to Person Services are:
The development of a Pathway to Employment Plan that will serve as a transition tool towards the
advancement of the individual's pathway and as an aid in the implementation of matching
program clients to appropriate employment services in the community.
7. Planning is defined as facilitating the development of a Pathway to Employment Plan, delineating
individuai vocational skills experiences, preferences, strengths, support needs, skills, goals and
objectives, education on system navigation and the Discovery Process related to vocational skills
and capabilities.
8. Imnlementation of the Action Steps that detail tasks timelines and entities responsible for leading
to the community employment will reflect that 75% of the direct service hours with the client will
be at employment sites in the community.
9. Community Information and Education Services are: coordinating local People First meetings in
Jefferson COUNTY. Providing training in self-determination, self-advocacy, and other skills as
requested by the People First Chapter. Develop a sustainability plan.
C. Program RequlrementslRelmbursements
I. If SUBCONTRACTOR is selected as the Client's provider, SUBCONTRACTOR shall provide a
Pathway to Employment Plan for Clients in Person to Person Services delineating individual skills
experiences, preferences, strengths, support needs, skills and goals and objectives, within 30 to 60
days of the beginning of services for the Client in order to promote Individoal Employment.
Pathways to Employment Planning services shall include a personal discovery process related to
Concerned Citizens IEIP2P Contract 201 1-2012
Page 10
skills, capabilities and goals, education on system navigation, facilitated plan development, action
steps detailing steps, timelines and entities responsible for the accomplisbment of tasks leading to
employment and the implementation of vocational services.
2. If SUBCONTRACTOR filils to provide the minimum number of monthly service hours in Person
to Person for the Client, the COUNTY will advise the Client, Parent/Guardian and/or Residential
Provider the minimum and maximum number of hours the Client should be receiving and the
option of choosing another Employment Provider.
3. The Action Steps of the Pathway to Employment Plan will be reviewed by the chosen
Employment Provider every 6 months, (sooner if needed) in order to assess if it is continuing to
meet the individnal's goals for their pathway to employment.
4. The Action Steps of the Pathway to Employment Plan will reflect that 75% of the direct service
hours with the client will be at employment sites in the community. The focus will be on real
work experience in a community setting delineating individual skills, experiences, preferences,
strengths, support needs and vocational interests.
5. If clients in Individual Employment or Person-to-Person have not oInained paid employment
within six (6) months the COUNTY will assure the following steps are taken.
a. Review of the progress towards employment goals;
b. Consultation with the family/client; and
c. Development of additional strategies with the family/client, COUNTY staff; employment
support staff and the case manager. Strategies may include providing technical assistance,
changing to a new provider, and/or providing additional resources as needed to support the
individual's pursuit of employment The additionaVnew strategies will be documented for each
client and kept in the client's file(s).
6. If, after nine (9) months the client remains unemployed, an additional review will be conducted &
the provider will address the steps ontlined in the previous six month progress. The client may
request to participate in Community Access activities or the client can choose to remain in an
employment program.
7. SUBCONTRACTOR will submit to the Client, COUNTY, DDD Case Management, Residential
Provider, Parent/Guardian Semi-Annnal Progress Reports on each Client The frequency of the
report for this contractoal period will be one every six (6) months after the initial plan, July
through December 2011 with the report due on January 2nd of 2012, January thru June 2012, due
July 1"2012. The Semi-Annual Progress Reports shall demonstrate the implementation strategy
and how the individual is progressing on their Pathway to Employment; indicating the fulfilhnent
of the commitments made concerning the Action Steps of the Pathway to Employment Plan and it
shall describe the reasons for any shortfuil concerning the action steps and proposed steps for
correction. These Reports will enable Case Management to support the need for continning to
authorize Person to Person services and will support the COUNTY to validate continued funding.
8. SUBCONTRACTOR shall schedule a review meeting every 6 months fur all program Clients. The
review meeting shall include an assessment/evaluation of the Action Steps of the Pathway to
Employment Plan (goals and objectives). The Action Steps of the Pathway to Employment Plan
will be updated every 6 months for all program Clients.
9. SUBCONTRACTOR shall provide a Vocational Client Plan for clients in Individual Employment
delineating individual skills experiences, preferences, strengths, support needs, skills and goals and
objectives, within 30 days of the beginning of services for the client in order to promote Individual
Employment Job coaching and supervision of program clients will be based on goals established in
Concerned Citizens IElP2P Contracl 201 1-2012
Page 11
a Vocational Client PIan. Client gnals, training provided and progress toward meeting goals shall be
documented in each client record.
10. SUBCONTRACTOR will submit Semi-Annual Progress Reports & updated Action StePs on each
Client to the COUNTY for feedback and approval. Disregarding or lack of follow through on this
SteP will hold up monthly billing and continued authorization for fimding.
II. SUBCONTRACTOR will submit to the COUNTY and DDD Case Management Semi-Annual
Progress Reports on each Client, indicating the fulfillment of the comminnents made concerning
the Vocational Client Plan and Outcomes. The frequency of the report for this contractual period
will be one every six (6) months after the initial plan, July through December 201 I with the report
due on January 2nd of2012, the second due date will be Januarythru June 2012, due July I~ 2012.
12. SUBCONTRACTOR will submit a copy of the updated Action Steps of the Pathway to
Employment Plan and progress reports to the Client, the DDD case manager, the COUNTY
Coordinator and Residential Support Staff; Parent or Guardian.
13. The Semi-AnnnaI Progress Reports will show Vocational Client goals, training provided and a
written synopsis showing progress toward meeting objectives or a description of the reasons for
any shortfaIl concerning the outcomes and proposed actions for correction.
14. SUBCONTRACTOR shall schedule a review meeting every 6 months for all program clients. The
review meeting shall include an assessment/evaluation of the Vocational Client PIan's goals and
objectives. The Vocational Client PIan will be updated every 6 months for all program clients.
IS. SUBCONTRACTOR will submit a copy of the updated Vocational Client Plan and progress reports
to the Client, the DDD case manager, the COUNTY Coordinator and Residential Support Stafl;
Parent or Guardian.
16. SUBCONTRACTOR must ensure that; every CUent file has a copy ofDDD Client authorization
and referral (CSA), that a copy of the participant's Individual Habilitation Plan (ICFIMR),
Individual Service Plan, Plan of Care and/or Individual Support PIan (HCBS Waivers) and/or the
COUNTY authorization/individual service agreement plan as applicable is in the Client file.
17. SUBCONTRACTOR must ensure that: Client Goals and Objectives are based on a Person
Centered Plan/Action StePs or a Vocational Plan, that documentation and data collected or training
reflects the Action StePs or the Vocational Plan and the documentation shows how it has identified
and addressed support needs of each participant by demonstrating methods for providing services
based on individual needs are outlined in a Client's Person Centered Plan! Action Steps or a
Vocational Plan and has documentation of six month progress reports; that include Client
Goals! Action StePs and a summary of progress meeting those goals and objectives every 6
months.
18. SUBCONTRACTOR must ensure that: all Incident Reports are retained in Client files, they have
a policy to retain records at least 5 years, emergency contact and medical information
(medications, diet, allergies, etc.) needed during the hours of service is available for each
participant on the face sheet of the Client file, that the emergency and contact information is
updated yearly or when needed and that services are provided in a natural or integrated
environment or there is a goal to achieve that.
19. SUBCONTRACTOR will support Clients in an employment program to work towards a living
wage. A living wage is the amount needed to enable an individual to meet or exceed his or her
living expenses. Clients should strive to average twenty (20) hours work per week or eighty-six
(86) hours per month. The amount of service a client receives will be based on hislher
demonstrated need and acuity level.
20. Worker wages shall be commensurate with the local industry accepted norms and comply with
applicable Federal Department of Labor standards.
Concerned Citizens IEIP2P Contract 201 1 -2012
Page 12
21. Recommendations for program participant's termination in Individual Employment or transfer into
another Individual Employment agency must be authorized by the DDD Case Manager, and will be
reviewed in consultation with the COUNTY and others as appropriate. SUBCONTRACTOR will
fucilitate the development of a transition plan and schedule. The transition plan will be developed in
consultation with the client, DDD case management, COUNTY, family members and other service
providers as applicable and within 10 working days of SUBCONTRACTOR'S recommendation.
22. SUBCONTRACTOR must ensure there is a legal requirement and a clear delineation for staff
qualifications and proof of background crlmlnal history clearance in accordence with RCW
43.43.830-845 and RCW 74.15-030 on all staff.
23. SUBCONTRACTOR shall submit a written staffing plan to COUNTY for approval or disapproval
within 30 deys of the effective dete of this agreement, semi-annually thereafter or when
reorganization occurs, which minimally includes: (a) SUBCONTRACTOR's procedure to train new
direct service staff. training must include all skills listed in StaffHourslPhases, (see Section C-
Number 26-29), (b) SUBCONTRACTOR's plan to provide staff that are skilled in applying training
techniques to enhance the work-related skills of program clients; (b) FTE levels, job descriptions and
organization chart pertaining to program staff. SUBCONTRACTOR will provide COUNTY with
information regarding staff qualifications and documented training's upon request
24. SUBCONTRACTOR's shall submit a written plan to enhance staff skills through participation in at
least 48 hours of annual training's, in-services, andlor workshop opportunities that are relevant to
personnel working directly with program clients in Individual EmploymentIPerson to Person.
25. COUNTY needs to review the Training Plan for new & old Staff that includes all Policies &
Competencies, referenced above & RCW's & WAC's referenced on page I & 2 of the COUNTY
Contract under Section B. Obligations, agency policies & procedures, how to instroctlteach
Clients & documentation, (creating Client vocational goa1slobjectives, Person Centered Plans, data
collection, daily/weekly notes & 6 month reports), Client Plans for all Program Staff and have
signed documentation that Staff training took place within the timelines listed below in the Staff
Training/Qualifications List.
26. SUBCONTRACTOR must assure that new staff are informed specifically of all agency
policies/procedures and have documentation that assures all direct service staff 18 years of age or
older are trained in the following DDD Policies Prior to Worklnrz with Clients: ADA training,
APS Reporting Requirements, Client confidentia1ity, Current individuallnstruction and Action
StepsIVocational Plans for each Client with whom the employee works, DDD Policy 4.11
Working Age Adult (edult services only), DDD Policy 5.06, Client Rights, DDD Policy 5.13,
Protection from Abuse: Mandatory Reporting, DDD Policy 12.01 Incident Management.
27. SUBCONTRACTOR must ensure that new direct service staff demoustrate the following
competencies:
I) Values that support the abilities of individuals
2) Effective Communication - The ability to effectively listen and to make ones self
understood
3) Planning methods
4) Crisis Prevention and Intervention
28. Within one month of emolovment: SUBCONTRACTOR must ensure that direct service staff
received training and are knowledgeable in the following areas: Overview ofDDD Policies
including: DDD Policy 3.01 Service Plans, DDD Policy 5.03 Client Complaints, DDD Policy
5.17 Physical Intervention Techniques, DDD Policy 15.03 Community Protection Standards for
EmploymentlDay Programs and all reporting requirements related to these DDD Policies.
29. Within six months of emolovment: SUBCONTRACTOR must ensure that direct service staff
received training and are knowledgeable in the following areas: Program skill development, DDD
Policy 5.02 Necessary Supplemental Accommodation, DDD Policy 5.14 Positive Behavior
Concerned Citizeos IEIP2P Contract 2011-2012
Page 13
Support, DDD Policy 5. I 5 Use of Restrictive Procedures, DDD Policy 9.07 HIV and AIDS and
Program Skill Development
30. WIthin 30 days of the effective date of this agreement, and semi-annually thereafter,
SUBCONTRACTOR will develop and submit to COUNTY an Individual Employment program
opemting budget detailing the projected allocation of contract funds, other sources and amounts of
funding, program staffing expenses and other cost allocations.
31. Semi-annually, SUBCONTRACTOR will develop and submit to COUNTY Individual Employment
program financial reports reflecting the actua1 revenues received and expenses incurred compared to
the projected program budget submitted.
32. The SUBCONTRACTOR will on an annual basis sponsor the surveying of participants, their
families, and their support networks and employers regarding customer satisfuction. The
SUBCONTRACTOR will design Customer/Client survey forms.
33. Reimbursement for Community Information and Education services will be provided at the
completion of the following payment points:
A. The People First Advisor will coordinate and support up to twenty (20) local People First
meetings in Jefferson County. The purpose of these meetings is to broaden membership
through outreach efforts aimed at future members, provide training in self-determination, self-
advocacy, mentoring and other skills as requested by the Chapter, develop and implement the
goals and objectives of a People First Work Plan, coordinate with the State People First
Chapter and other County Chapters within Jefferson County and the State.
A minimum of four (4) individuals with disabilities must be in attendance in order to bill for any
meeting at $150 per meeting. Payment includes mileage.
Payment Point and Documentation:
$3000
$3000
2011-2012
TOTAL
A separate (minimum of one page) report to contain minntes of each local People First meeting
that includes date, time and length of meeting, location of meeting, topics discussed and any
decisions made. Sign-in sheet of attendees.
B. People First Advisor will work with members of the People First Group to provide outreach,
& education at a Jefferson County Event. $150 a day for at least 3 hours of time, or $300 a
day for at least 6 hours of time. Up to 4 long events.
Payment Point and Documentation:
$1200 2011-2012
$1200 TOTAL
A separate (minimum of one page) report about the Jefferson County Event must include date,
time, and length, result of the event and a sign-in sheet of volunteers/attendees.
C. People First Advisor will create a Sustainability Plan that will include the following:
> Commirment from Agency to fund Jefferson County People First after June 30 2012
> Availability of Grants to fund People First Activities
> Explore the availability & commitment of V olunteer Advisors to support P.l ~ Activities
> Create Educationffrsining Plan for Volunteer Advisors
May bill at $30.00 an hour for up to 30 hours of time with SustainabiIlty PIan.
Payment Point and Documentation:
$900
$900
2011-2012
TOTAL
Concerned Citizens IEIP2P Contract 2011-2012
Page 14
Submit one invoice that includes date & hours of time spent. Invoice should Include a. copy of the
Sustainabillty Plan.
D. Performance Standards
1. SUBCONTRACTOR shall provide Individual Employment setvices that are referred for
setvice by DSHS/DDD and have been authorized by the COUNTY.
(a) Job development, job coaching, follow-along and replacement setvices as necessary for
Individual Employment clients;
2. SUBCONTRACTOR shall provide Person to Person setvices that are referred for setvice
by DSHS/DDD&1d have been authorized by the COUNTY.
(a) Person-Centered Pathwa.y to Employment Plan, Action Steps detailing steps, timeIines
and entities responsible for the accomplIshment of tasks leading to employment.
(b) Provide the minimum number of monthly setvice hours in Person to Person for the
ClIent.
(c) Implement Action Steps that affinn 75% of the direct setvice hours with the clIent will be
at employment sites in the community
3. SUBCONTRACTOR shall provide Community Information and Education Services.
(a) The COUNTY will only Pl\Y for setvices that meet the designated pa,yment points.
(b) ThcCOUNTY will discontinue financial support for People First Activities, if the
funding is required for direct setvices for clIents with developmental disabilities in
Jefferson COUNTY;
E. IndlvidnaI Employment/Person to Person/Communlty Information and Educatiou Uult of
Serviee
1. One UNIT of Individual EmploymentJPerson-to-Person setvice is defined as one (1)
"HOUR" of direct setvice or assigned setvice responslbi1Ity to one elIgible Client. An
"HOUR" is defined as 50 minutes of direct setvice or ASSIGNED SERVICE
RESPONSIBILITY; which is defined as placement, replacement and folIow-along setvices
available to be provided in a setvice month.
2. One UNIT of Community Information and Education Services is defined as one (I)
"SERVICE" or ASSIGNED SERVICE RESPONSIBILITY which is defined as II
d""I81'"fM pa.yment point in II setvice month.
3. One UNIT of Individual EmploymentiPerson to Person setvice is $68.00 and is defined as
one "HOUR" of direct setvice to one elIgible clIent. One UNIT of Community Information
and Education Services is a designated pa.yment point and is defined as one "SERVICE".
Concerned Citizens IEIP2P Contract 2011-2012
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