HomeMy WebLinkAbout081213_ca04JEFFERSON COUNTY PUBLICHEALm Consent Agenda
6115 Sheridan Street o Port Townsend (> Washington o, 98368
www.jl effersonicountylpublichealth.org
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AGENDA REQUEST
TO: Board of Couinty Commissioners
Philip Morley, County Administrator
M2711111-01METRol
GATE:'.,:
SUBJECT: Agenda Item — Professional Services Agreement with Skookurn
Contract Services for Community Access; July 1, 2013 — June 30, 2014;
$2,160
ffATEMENT F IS
Jefferson County Public Health, Developmental Disabilities Division, requests Board approval of the
Professional Services Agreement with Skookum Contract services for Community Access;
July 1, 2013 — June 30, 2014; $2,160
ANALY—SIS/S TRATEGIC -,GOALS/
PRO'S
- and COWS:
Community Access services are designed for people with developmental disabilities who have retired or are
in post employment and need assistance to address services in the community. Services provided in this
contract will assist individuals with participation in activities, events, and organizations and/or to volunteer in
the local community in ways similar to others of retirement age. Community Access services provide special
assistance, advocacy, individualized education, and activities with the goal of providing options in order to
experience opportunities that increase socialization, support systems, and personal independence through
community, social, recreational, commercial, and or volunteer activities. This agreement provides for one
program client.
FIS CAS. 'I M PACT I COST BENEFIT ANALYSIS:
The provider shall be compensated at the rate of $30.00 per unit as defined as one or more hour of direct
service or assigned service responsibility to one eligible client. The agreement is a subcontract funded
through the biennial agreement with the DSHS Department of Developmental Disabilities contract.
U)MMUMTY 114M-ni ENWRONMENTAL HEALTH
DEVELOPMEN TAL M5ABii-i nES PUBLIC HEALTH WArER QUALFTY
IN (360) 385-9400 ALWAYS WORKING FOR A SAFER AND NlAft (360) 385-9444
FAX, (361 0) 385 9401 HEALTHIER COMMUNITY IFAX; (360) 37,9-4487
Consent Agenda
RECOMMELMATIO
JCPH management request approval of the Professional Services Agreement with Professional Services
Agreement with Skookum Contract services for Community Access; July 1, 2013 — June 30, 2014; $2,160
(Routed to all Public Health Managers)
& W, --
SUBCONTRACT FOR PROFESSIONAL SERVICES
COMMUNITY ACCESS SERVICES
Agreement Between
,JEFFERSON COUNTY PUBLIC HEALTH
And
SKOOKUM CONTRACT SERVICES
This agreement is made and entered into between Jefferson COUNTY Public Health (COUNTY) and Skookum
Contract Services (SUBCONTRACTOR) for provision of Community Access Services to persons with developmental
disabilities in Jefferson County, The term of this agreement is July 1, 2013 through June 30, 2014. 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;
(1) Community Access Services - Opportunities to build relationships, to contribute and to feel a sense of
belonging to the community, to access generic resources with peers without disabilities and volunteer
opportunities in order to enhance versatility, individualized education/self-advocacy skill development
necessary for new tasks in order to address growth and interaction needs of eligible persons per Exhibit A -
Statement of Work.
(2) program management.
B, OBLIGATIONS
SUBCONTRACTOR shall fulfil the following obligations:
(1) SUBCONTRACTOR shall comply with all state and federal requirements regarding the confidentiality of
client records. Client information is not disclosable to the public. Information acquired pursuant to RCW
71A.1.4.070 requires a signed Release of Information or a signed Oath of Confidentiality 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 for Staff every three
years. The W.S. P. Criminal Background Check and the F.B.I. Fingerprint Check must go through the
Background Check Central Unit Office within DSFIS in Olympia in accordance with RCW 43A3.830-845
and RCW 74.15.030,
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 Developmental Disabilities
Administration Services Rules; 296-24 General Safety & Health, 296-62 General Occupational Health
Standards; the DDA 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
Skookuiv-Coot irnunity Access 20194
Complaints, 5.85 Lbnhod English Proficiency (LEP) Clients, 5.06 Client Rights, 5.13 Protections From
Abuse, 5.14 positive Behavior Support, 5.15 Ilse ofRestrictive Pc000dmroo' 6.08 Mandatory Reporting
Requirements for Erupkmymooru and %]uy Program 8orviomn Providers, 6.13 Employment/Day Program
Provider Qualifications, 9.07 Human Immunodeficiency Virus (BK\/) and Acquired Immune Deficiency
Syndrome (AIDS), 12.81 Konidcut Management, 13.04 DRW Access /\greuooem and the 1992 County
(6) SIJB ��lha���npm��m��b�;�������m� �n�
- b��au��vtl��h�} a�u�on^yhQbt�o privacy, �f�rom�oo
|iohoom���uu�aotm� , p/vucy. . `
'- � medication procedure, n:��uu�] staff-to-participant interactions, (i.e.:
abuse of / �, , _` ^
including ' person's and free mfuhume)'
SUBCONTRACTOR shall assure that participants in accordance with Necessary Supplemental (7) 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, ehoU assure that the
participant's family, guardian nradvocate is also informed.
(8) SUBCONTRACTOR shall have u grievance policy that:
• negotiates conflicts and advises participants u[ grievance procedures,
• is explained to participants and others in accordance with the NSA, DDA Policy 5,02,
• prohibits retaliation for using the grievance process,
• includes m non retaliation statement,
• assure that advocates are available and encourages participants to bring advocates to help negotiate,
• includes a mediation process that promotes the use ofmonneomewho |o unaffected hythe outcome if
conflicts, remain unresolved (o K]D/\ Case Resource Manager may be included as an alternative
uption)&
• includes u process for tracking and reporting grievances.
SUBCONTRACTOR shall obtain and retain in the clients' files signed proof of client's and/or family's (�) review of all policies, provider unpeo(abnn and receipt of information about services and benefits to be
provided by the prm@ruou' The signed proof required by this section mku|\ be reviewed and renewed with
new documentation on not less than un annual basis.
(18) SUBCONTRACTOR will encourage participant involvement in policy development.
(ll) SUBCONTRACTOR shall update Client Intake Forms every 6 months during the Client Review
(12) SUBCONTRACTOR abmO assure that potential conflict of interest real or apparent will not arise. Such o
ommO\c/ will arise whew The employee, officer or agent, any member of immediate family, Guardian
decision maker, or an organization, n6io6 employs, or is about to employ, any of the above, has financial
or other interest in the o}ieot(m).
(13) SUBCONTRACTOR shall have adequate staffing, ratios and patterns to maintain quality and safety.
(14) All services for persons with developmental disabilities must be provided with mzemdao to their health and
uaQ:ty. SUBCONTRACTOR shall comply with all applicable federal, state and local Qr:' health and safety
o:gulu/inna.
(15) Incidents involving injury, health or safety issues are immediately reported *»D[}&Central Qffioc and the
County (reference DD/\ Policy 6,08. Mandatory Reporting Reqx/remantsfor Employment and Dqy
prmgrmn�Imv/cuoPruviderx). DDA Criteria for uo Evaluation System Page mf8July 1, 2012.
(l@) Incident reports are tracked and analyzed for potential trends and patterns.
Sk,oc)kun1-Cc)tmnundy Access 2014
(17) Current emergency contact and medical information (medications, diet, allergies, etc.) needed during the
hours of service is readily available for each participant.
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 finding of abuse, neglect, exploitation or
abandonment from APS, the regional DDA office will send a copy of the APS substantiation report to
the COUNTY within one working day.
0 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.
I, 'rhe SUBCONTRACTOR 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.
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 DDA for final approval. DDA
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 Linder RCW
74.34. 2+3, 1jb?4.Te ref' Adults (1), and must comply with reporting requirements described in
RCW 74.34.035, 040 and Chapter 26.44 RCW, Abuse of Children, If the COUNTY is notified by
DSHS that a subcontractor staff member is cited or on the registry for a substantiated finding then that
associated staff will be prohibited from providing services under this contract,
(19) 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 determined solely by COUNTY, may be cause for
termination of this agreement as provided herein.
(a) &�redjtat�joE, SUBCONTRACTOR must be able to demonstrate conformance to Commission on
Accreditation of Rehabilitation Facilities (CARF) standards for quality assurance and CART
accreditation. Confidential I nformation gained
(b) Cpnf rqjajir�L'I'he SUBCONTRACTOR shall protect and maintain all Conf
by reason of the Program Agreement against unauthorized use, access, disclosure, modification, or loss.
This duty requires the County to employ reasonable security measures, which includes restricting access
to Confidential information by:
(1) Allowing access to staffthat have an authorized business requirement to view the Confidential
Information.
(2) Physically securing any computers, documents, or other media containing Confidential
Information,
Skookwn-✓oingiunity Access 2014
(3) When transporting six (6) to one hundred forty nine (149) records containing Confidential
Information, outside a Secure Area, do one or more of the following as appropriate:
(a) Using a trusted System.
(b) Encrypt the Confidential Information, including:
(i) Email and/or email attachments
(ii) Confidential information when it is stored on portable devices or media,
including but not limited to laptop computers and flash memory devices,
(c) Send Paper documents containing Confidential Information via Trusted System.
(1) To the extent allowed by law, at the end of the Program Agreement term, or when no longer
needed, the parties shall return Confidential Information or certify in writing the destruction of
Confidential Information upon written request by the other party.
(2) Paper documents with Confidential Information may be recycled through a contracted firm,
provided the contract with the recycler specifics that the confidentiality of information with be
protected, and the information destroyed through the recycling process. Paper documents
containing Confidential Information requiring special handling (e,g,, protected health
information) must be destroyed through shredding, pulping or incineration.
(3) The compromise or potential compromise of Confidential Information must be reported to the
COUNTY within five (5) business days of discovery of breaches of less than 500 person's
protected data. The parties must take actions to mitigate the risk and loss and comply with any
notification or other requirements imposed by law.
(d) Egu4l AccpLs: SUBCONTRACTOR will assures equal access to persons who do not speak or have a
limited ability to speak, read, or write English well enough to understand and communicate effectively
(reference DDA Policy 5,05, Limited English Proficient (L EP) Clients).
(c) E lq_ �L _p_d _ Pro rarer
-99nageane_nt: An administrative/organizational structure that clearly defines
responsibilities, systems 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
StJBCO'NTR.Ac,rOR has a commitment to support integration of individuals with
developmental disabilities with people who are not disabled and has involved participants with
developmental disabilities in policy development.
(g)
gr�hp.%. SUBCONI-RACTOR has a history of working cooperatively with community-based
Drtn _, I
organizations including Employers, other Agencies, the COUNTY DD Program, the Division of
vocational Rehabilitation (DVR) and Schools. describes its mission, program objectives,
L, eLfLo w A written performance plan which
manm�—F!al-
expected outcomes, how and when objectives will be accomplished; and that the plan is evaluated at
least biennially and revised based on actual performance.
0 Qlla L,
flgd �tajf-. SUBCONTRACTOR will provide 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 assure that all
direct service staff are trained and that training is documented. SLIBCONTRACTOR will provide
COUNTY with information regarding staff qualifications upon request.
6) 54flel)L. SUBCONTRACTOR will provide evidence that it employs safety protection based on the
environment that the participant is working or receiving services in.
(20) SUBCONTRACTOR shall provide a Community Access Individual Program Plan and/or Person Centered
planning/profiles delineating individual skills and needs within 30 days of the beginning of` services on all
program clients, The SUBCONTRACTOR shall use the new Community Access Plan Report Form, (see
Attachment A) for Individual Program Plans,
(21) The Community Access Report Plans will include:
1. Information that identifies and addresses the individualized goal and support needs for each
Participant.
2, Plans must consider individualization, integration, and safety and should be developed by the
provider in collaboration with the Case Resource Manager, participant and his or her family (the
tear).
4k,00k'um-(,'oj1i=nity access 2,014
3. Initial plans will be completed within 60 days from date of service authorization and must be
signed by the participant and/or his or her guardian if any.
4. Copies of the initial and subsequent revised plans will be distributed as appropriate to all team
members,
5. Plans will be reviewed and signed annually.
(22) The community Access Report Plans will also include the information listed below:
a) Current date; Time line for the Plan
b) Client's name first and last;
c) Client ADSA ID;
d) '['he client's skills, gifts, interests, and preferred activities.
e) The Community Access goal. The goal need to relate to one or more of the following (per the
County Guidelines):
f) Identify integrated community places where the individual's interest, culture, talent, and gift's can
be contributed and shared with others with similar interests,
g) Identify clubs, associations, and organizations where the individual can be a member and have
decision - making capacities,
11) identify opportunities where the individual can contribute to the community doing new and
interesting things or things the individual enjoys.
i) Building and strengthening relationships between family members and mernbers of the local
community who are not paid to be with the person.
j) The Support Intensity Scale (SIS) subscale that most relates to the goal (Community living;
Lifelong learning; Employment; Health & Safety; Social; and Protection & advocacy);
k) Measurable strategies (action steps and supports) to meet the goal.
1) Identification of persons and/or entities available to assist the individual in reaching his or her
long-term goal.
m) Identification of other accommodations, adaptive equipment and/or conditions critical to achieve
the goal,
(23) Six month progress reports describing the progress made towards achieving client's goal will be provided
by the service provider to the Case Resource Manager, participant, and/or guardian if any within 30 days
following the six month perio&
(24) The SUBCONTRACTOR shall report any injury or accident, which requires more than simple first aid, and
any extraordinary incident that requires intervention by the SUBCONTRACTOR, first to the DSHS/DDA
Case Manager for the individual involved and then to the COUNTY Coordinator, This includes serious
physical or emotional harm or potential harm.
The initial report may be done through documented telephone calls to the COUNTY
Coordinator.
The SUBCONTRACI"OR shall submit a written follow-up report within 10 days to the
COUNTY Coordinator, The report to the COUNTY Coordinator may be submitted by email,
facsimile (FAX) to 360-385-9401 or by mail to Jefferson COUNTY Public Health 615
Sheridan Port Townsend, WA 98368.
3. Serious and emergent incidents shall be handled in accordance with DSHS/DDA Policy 12.01
Incident Management.
(25) Within 30 days of the effective date of this agreement and at least semi-annually thereafter,
SUBCONTRACTOR will provide (a) company; (b) program 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.
(26) Make: available for inspection, review or audit by COUNTY DD Coordinator at all reasonable times: all work
sites; all Client records; records on productivity 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
SkwkUnj_(.,'�Qmmuni1y Access 2014
visit with SUBCONTRACTOR during the period of this biennium to assure compliance with the DMA State
Work Order.
S. Independent Audit will be submitted annually to the Jefferson COUNTY D�D
(27) AUMEE _REQQ-!B--EMr.N'rS�
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 SUBCONTR-ACTOR shall provide an independent auditor the entire organization which:
(a) is performed by an independent Certified Public Accountant, the Washington State
Auditor's Office, or another entity, which the COUNTY and the Subcontractor mutually agreed
upon.
(b) Provides statements consistent with the guidelines of Reporting for Other Non-Profit
Organizations AICPA SOP i8 -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 of OBM Circular A-133 or A-
128, as applicable.
(c) The Subcontractor shall submit one (1) 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 indicating the Subcontractor's Board of` Directors has reviewed the audit.
(28) if the Developmental Disabilities Program Coordinator finds indications of potential non-compliance
during the contract monitoring process or learns that the Contractor is out of compliance with any of the
terms or conditions of this contract, the following process will be pursued:
(a) informal Notification: Informal process wherein the COUNTY Coordinator alerts the Contractor
in writing of the potential non-compliance and an agreeable solution is reached within ten (10)
days.
(b) official Notification: If the informal notification does riot result in resolution, the official
notification of possible non-compliance to establish a date, within ten (10) working days of
notification, when representatives of the COUNTY and the Contractor shall meet to discuss areas
of contention and attempt to resolve the issues.
(c) Written Summary, within ten (10) working days of such official notification, the COUNTY will
provide the Contractor a written summary of the areas of non-compliance 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 Contractor shall be conducted to resolve areas of non-compliance 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, excel that in no event will the
COUNTY honor a financial determination that is greater than the funds allowed the scope of this
Agreement.
(29) 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.
tiln-Conimunny Access 201 ^4
Client records shall minimally include statement of Client goals, documentation of training provided, training
hours, routine progress notes and semi-annual summary progress toward meeting Client goals.
(30) SUBCONTRACTOR will provide COUNTY with Adult Community Access Plans (or Person Centered
Plan/ profile), client goals and a summary of progress towards meeting those goals on a bi-annual basis,
(31) 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,
(32) SUBCONTRACTOR shall provide COUNTY with a copy of a signed DSHS Provider Agreement within 30
days of the effective date of this agreement.
(33) 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 directly with DSFIS to provide covered services under Title XIX, COUNTY
agrees that funding intended for those Clients shall be excluded from this agreement, If S(JBCONTRACTOR
contracts directly with Social Security to provide covered services under a PASSARWE, COUNTY agrees
that funding intended for those Clients shall be excluded from this agreement.
C. REIMBURSEMENTS
Por said services rendered under this agreement, COUNTY shall reimburse SUBCONTRACTOR $30.00 per
unit of service, as defined in Exhibit 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 DDA Services Report (ADSA) form for its billings. At no time shall the invoices for reimbursement
be submitted more than 60 calendar days following the last day of the month 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 complete.
(4) Total reimbursements for the fiscal year of 2013-2014 to SUBCONTRACTOR by COUNTY under this
contract shall not exceed $2,160,00 in completion of these services without express written amendment signed
by both parties to this Agreement. This total reimbursement includes any amendment within the fiscal year of
2013-20K
D. MISCELLANEOUS
Pursuant tt'r WAC 275, J)SHS Developmental Disabilities Administration (DDA) shall determine individual
eligibility of persons for services delivered under this agreement. DDA shall notify COUNTY of persons
authorized for services reimbursed under this agreement, only persons referred to COUNTY by DDA shall
be eligible for services reimbursed tinder this agreement, The SUBCONTRAC'I"OR shall not sublet or assign
any of the services covered by this AGREEME'NT without 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 of all 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 behalf of
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 without the express written consent of the COUNTY. Assignment does
Skookulli-Cominunity Access 2014
not include printing or other customary reimbursable expenses that may be provided in
an AGREEMENM
(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 of Washington.
(b) Commercial Automobile Liability or Business Use Insurance providing bodily injury and property
damage 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,o00,000.00) per occurrence and a aggregate of not less than two (2) times the
occurrence amount ($2,000,00(i 00 minimum) for bodily injury, including death and property
damage, unless a greater amount is specified in the contract specifications, The insurance
coverage shall 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 Contractual/Commercial 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 dollars ($1,000,000), In no case shall such professional liability to
third parties be limited in any way.
(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 under this AGREEMENT, shall
Comply with the same insurance requirements 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.
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 secured by the
SUBCONTRACTOR, the COUNTY will be named on all certificates of insurance as an additional insured,
The SUBCON,FItACJ'OR, shall furnish the COUNTY with verification of insurance and endorsements
required by this AGREEMENT. The COUNTY 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
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14 days of the execution of this AGREEMENT to the COUNTY. All insurance policies obtained by the
SUBCONTRACTOR shall be primary to any equivalent or applicable policies held by the COUNTY All
insurance policies obtained by the SUBCONTRACTOR shall include a waiver of subrogation rights.
insurance policies and additional named insured endorsements obtained for the SUBCONTRACTOR shall
provide primary insurance coverage and also be non - contributory. Any insurance, self-insured retention,
deductible or risk retention maintained or participated in by the County shall be excess and not contributory
to such insurance policies, All SUBCONTRACTOR'S liability insurance policies must be endorsed to
show this primary coverage.
(12) The COUNTY will pay no progress payments under 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 under other provisions of this AGREEMENT, or otherwise in law.
(13) 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 faithful performance of this contract and for payment of all obligations of the SUBCONTRACTOR,
(14) The SUBCONTRACTOR shall comply with all Federal, State, and local laws and ordinances applicable to
the work to be done under 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.
(15) The SUBCONTRACTOR, by signature to this Agreement, certifies that the SUBCONTRACTOR is not
presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from
participating in this Agreement or any Agreement by any Federal department or agency. The
SUBCONTRACTOR also agrees to include the above requirement to all subcontracts into which it enters.
(16) The SUBCONTRACTOR shall comply with the W.A. State Department of Labor and Industries Minimum
Wage Act, RCW 49.46, acknowledging persons with disabilities participating in job assessments are not
considered employees,
(17) 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 SUBCONTRACTORS negligence or breach of any of its obligations under this AGREEMFNT;
provided that nothing herein shall require a SUBCONTRACTOR to indemnify the COUNTY against and
hold harmless 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 negligence ofi (a) the SUBCONTRACTOR'S agents or employees; arid, (b) the
COUNT'Y, its officers, employees and agents, this indemnity provision with respect to (1) 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 only to the extent 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, document, report, film, tape, or sound reproduction of material of any kind, delivered there
under, constitutes an infringement of any copyright, patent, trademark, trade naive, or otherwise results in an
unfair trade practice or an unlawful restraint of competition.
(19) The SUBCONTRACTOR specifically assumes potential liability for actions brought against the COUNTY by
S[JBCONTRACTOR'S employees, including all other persons engaged in the performance of any work or
service required of the SUBCONTRACTOR under this AGREEMI Nl'and, solely for the purpose 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 of RCW 4.24,115 and was subject of mutual negotiation.
(20) SUBCONTRACTOR shall not discriminate against any person presenting themselves for services based on
race, religion, color, sex, age or national origin,
(21) CO(JNTY reserves the right to terminate this contract in whole or in part, without prior written notice, in the
event that expected or actual funding from the Department of Social and Health Services Developmental
Sk0()k,u111_(,on1uwnity Access 2014
Disabilities Administration is withdrawn, reduced, or limited in any way after the effective date of this
agreemea 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 other individual, firm, or entity without
the express and prior written approval of COUNTY, If the COUN'ry 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 . . ..... . --.--,2013.
By: — – ---------
John Austin, Chairman
Je , on Coun r of Commissioners
v n, Pr
Skookurn Contract Services
Attest:
Carolyn Avery
Clerk of the Board
FQ N ONLY:
R' DAS
AP n
y: A
B
. ...........
Jefferson County Civil Deputy l'roseca Attorney
Skookwn-CWII�jiunily Access 2014 10
EXHIBIT A
STATEMENT OF WORK
COMMUNITY ACCESS
WORK STATEMENT
SUBCON'rRACTOR shall provide Community Access services for program clients as described hereinafter.
SUBCONTRACTOR shall be reimbursed for such services on a unit of service basis, pursuant to Section E.,
Reimbursements, of this contract.
11. PROGRAM DESCRIPTION
A. Program Goals
I Transfer or reduction of specialized supports as a result of increased personal independence and/or
community support systems,
2 Frequent opportunities to participate in community social, recreational, commercial, and/or
volunteer/contribution activities also utilized by peers/community members without disabilities.
3, Assisting individuals to participate in activities that promote individualized skill development,
independent living and community integration.
4. Activities that provide individuals with opportunities to develop personal relationships with others
in their local communities and to learn, to practice and apply life skills that promotes greater
independence and community inclusion.
5. Development of social contacts, friendships, and support systems with people without disabilities.
6, Frequent outings, on an individual basis away from their home setting.
7. An opportunity to acquire supplemental training in a volunteer/job situation to enhance versatility
and individualized education/self-advocacy skill development necessary for new tasks, in order to
address growth and interaction needs.
B. Definitions
CALL mgLity-Ac-c-o .11L
an opportunity to experience choice, power, and status in the community
an opportunity to build relationships, to contribute and to feel a sense of belonging to the
community
opportunities to learn, to practice and apply life skills that promotes greater independence and
community inclusion
an opportunity to access generic resources with peers without disabilities
all opportunity to access volunteer opportunities in order to enhance versatility
o an opportunity for self advocacy and skill development for new tasks and to contribute to the
Community
Skookunl-Comm,unity Access 2014 11
C. Program R,equireruents
1. SIJBCONTRACTOR shall provide Community Access Services. These services, as defined in
Section 11.8 above & in the Community Access Billable Activities Form, (.see Attachment B).
2 SUBCONTRACTOR shall provide an Individual Program Plan and /or Person Centered
planning/profiles delineating individual skills and needs within 30 days o'fthe beginning of
services on all program clients. The SUBCONTRACTOR will use the new Community Access
plan Report Form, (see Attachment A) & will serve as an aid in matching program clients to
appropriate services its the community and as a transition tool towards the advancement of the
individual's increased personal independence in the community„ an opportunity to build
relationships, to contribute and to feel a sense of belonging to the community, while accessing
volunteer opportunities in order to enhance versatility and develops skills necessary for new tasks.
3. SUBCONTRACTOR shall schedule a six -month review of meetings for all program participants.
The review shall include an assessment of the need for continued community access services and
an evaluation of the Individual Program plan goals and objectives in the form of a. Semi- Annual
Progress 'Report. The SUBCONTRACTOR shall use the new Community Access Plan Report
Form, (see Attachment A) to report on the semi- annual progress of the client.
4. The Semi -Annual Community Access Plan Report shall demonstrate the implementation strategy,
client goals and how the individual is advancing towards meeting the outcomes of their goals,
training provided and a written synopsis showing progress toward meeting objectives or a
description of the reasons for any shortfall concerning the outcomes and proposed actions for
correction.
6. COUNTY shall receive the dates for the 6- month reviews for program Clients one month before the
required meetings.
6, SUBCONTRACTOR will submit to the COUNTY, DDA Case Management, Residential
Provider, I'arent/Guardian a Semi - Annual Community Access Plan. Report Form on each Client..
i The SUBCONTRACTOR, will use the new Community Access Report Form, (see Attachment A)
to report on the semi - annual progress of the client.
S. The frequency of the Semi - Annual Progress Reports for this contractual period will be one every
six (6) months after the initial plan, July through December 20 13 with the report due on January
2nd of 2014, the ;second due date will be January thru June 2014, . due July 1" 2014, .
9, Services shall prornote the use of natural supports, which means personal associations and
relationships typically developed in the community that enhance the quality and security of life for
people, including but not limited to friendships reflecting the diversity of the neighborhood and
the community, associations with fellow students in community classes and associations
developed through participation in clubs, organizations and civic activities.
40. (:"ommunity Access services will focus on activities that are typically experienced by the general
public. Support to participate in segregated activities and/or specialized activities will not be
reimbursed. Services will occur individually or in a group of no rrsore than 2 individuals with
similar interest and needs.
l 1. Services shall provide support to those individuals wishing to seek volunteer activities„ such as
using public transportation, assisting with referrals to the appropriate agencies and other agreed
upon vocationally related goals in preparation for volunteering.
S1tb karxrr '. °�xraxxnum�u�y, CC0s20d4 1.2
The provider shall provide coordination of activities to develop a diverse schedule of activities
based on the Client's needs and interests as connected to their Individual Program plan.
13, The Provider shall assess and document in the Community Access Plan Report Form each
participant's transportation needs, The Provider shall assist each participant to access public or
specialized transportation for some activities sponsored as a part of Community Access services. it
is expected that public or specialized transportation will be utilized, except as detailed in the
transportation plan. The cost of transportation is included in the fee for service that a Provider
receives.
14. Program participants must be authorized for service by the Developmental Disabilities
Administration (DDA) and referred to the COLNTY
15. A client receiving Community Access services will not receive Employment services
simultaneously.
I& A client receiving Community Access services may at any time choose to pursue work and to receive
Individual Employment services.
SUBcoNTRACTOR must ensure there is a legal requirement and a clear delineation for staff
qualifications and proof of background criminal history clearance in accordance with RCW
43,43.830-845 and RCW 74,15-030 on all staff.
SUBCONTRACTOR shall submit a written Program Staff Training Plan to COUNTY for approval
or disapproval within 30 days of the efTective date 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,
• DDA Policies & Competencies (see Section C'- Number 17-20),
• RCW's & "WAC's referenced on page I & 2 of the County Contract under Section B,
Obligations,
• agency policies & procedures,
• skills on how to instruct/teach Clients,
• skills on how to document data collection, daily/weekly notes & 6 month reports in
Client files,
• skills on how to write Community Access Client Plans and/or Person Centered Plans
(creating Client goals/objectives).
(b) SUBCONTRACTOR's plan to provide staff that are skilled in applying training techniques to
enhance the work related skills of program clients;
(c) FTE levels, Job descriptions and organization chart pertaining to program staff.
(d) SUBCONTRACTOR's plan to enhance staff skills through participation in at least 48 hours of
annual training's, in-services, and/or workshop opportunities that are relevant to personnel
working directly with program clients.
19. SUBCONTRACTOR will provide COUNTY with information regarding staff qualifications and
documented training's upon request.
20. 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 DDA Policies Prior to Worki
n�L _..gv 1A Clients: A training,
APS Reporting Requirements, Client confidentiality, Current individual instruction and Action
steps/Vocational Plans for each Client with whom the employee works, DDA Policy 4.l 1
Working Age Adult (adult services only), DDA Policy 5.06, Client Rights, DDA Policy 5,13,
Protection from Abuse: Mandatory Reporting, DDA Policy 12,01 Incident Management,
Sk0,kUM_('
,ojx tnuviity Aocegs 2014 13
21. SUBCONTRACTOR must ensure that new direct service staff demonstrate the following,
competencies:
I ) Values that support the abilities of individuals
2) Effective Communication —The ability to effectively listen and to make one's self
understood
3) Planning methods
4) Crisis Prevention and Intervention
22. A ,Lih
Ln.one rn9_n _t_h_0Le_1n_P_10_Y_nLMt: SUBCONTRACTOR must ensure that direct service staff
received training and are knowledgeable in the following areas: Overview of DDA Policies
including: DDA Policy 3.01 Service Plans, DDA Policy 5.03 Client Complaints, DDA Policy
5.17 Physical intervention Techniques, DDA Policy 6. 13 Employment/Day Program Provider
Qualifications, DDA Policy 13.04 DRW Access Agreement, DDA Policy 15.03 Community
Protection Standards for Employment/Day Programs and all reporting requirements related to
these DDA Policies,
23, 1fithLn.!Lx SUBCONTRACTOR must ensure that direct service staff
received training and are knowledgeable in the following areas: Program skill development, DDA
Policy 5,02 Necessary Supplemental Accommodation, DDA Policy 5.14 Positive Behavior
Support, DDA Policy 5.15 Use of Restrictive Procedures, DDA Policy 9.07 HIV and AIDS and
Program Skill Development.
24, SUBCONTRACTOR will have signed documentation that Staff training took place within the
timelines listed above in Section C-Number 17-20.
25. Within 30 days of the effective date of this agreement, and annually thereafter,
SUBCONTRACTOR will develop and submit to COUNTY a Community Access program-
operating budget detailing the projected allocation of contract funds, other sources and amounts of
funding, program staffing expenses and other cost allocations. Within 30 days of the effective date
of this agreement and at least semi-annually thereafter, SUBCONTRACTOR will provide
company and program operating 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.
26. Every 6 months, SUBCONTRACTOR will develop and submit to COUNTY, Community Access
financial reports reflecting the actual revenues received and expenses incurred compared to the
projected program budget submitted per Section C.7, along with the overall operating budget.
D. Performance Standards
1. StIBCONTR-ACTOR shall provide Community Access services for four program clients who are
authorized for service by DSHS/DDA and have been referred by COUNTY,
E. service Level Guidelines
1. Client Acuity is determined through the DDA assessment. Acuity reflects conditions typically
related to the individuals disability that are not likely to change, and are generally not impacted by
outside factors. Client acuity is determined as "High", "Medium" or "Low" as defined within
WAC 388-828.
2. Service Level Guidelines reflect Client Acuity and other considerations, (see Table below); the
assigned support levels typically reflect direct service staff' time provided to or on behalf of the
client on an individual basis, to participate in age appropriate community activities similar to those
Sk,K1kt1M_Con,1j11tmity Access 2014
14
without disabilities. Allowable activities are defined in the Community Access Billable Activities,
(see Attachment B).
The expectation is that all hours reported are documented specific to the client authorized and
relate to the goals and supports outlined within the client's Community Access Plan,
COMMUNaY ACCESS- ASSIGNED
SERVICE LEVEL HOURS
ACUITY LEVEL
Support Hours
Le-vel A
---- — - ----
Up to 3 hours
Up to 6 hours
- — ----- —
Ee��l C
— - --- . .. .. .....
Up to 9 hours
...... .....
_. _. _ . . . ........... . . .. .
L�V�ly
......
Up to 1.2 hours
_-F - - — - — -- - - - . .......
ve I
Up to 15 hours
to 18 hours
Level G
Up to 20 hours
F. Cominunity Access Unit of Service
1. One UNIT ofCornmunity Access service is defined as one (1) or more "HOUR" of direct service or
assigned service responsibility to one eligible Client. A UNIT is defined as a 1-101. R" which is up
to one (1) hour of direct service or ASSIGNED SERVICE RESPONSIBILITY is defined.
2, Community Access service support hours per month will be based on the client's Community Access
Acuity Level per WAC.
3, SUBCONTRACTOR will provide a maximum of'72 units ofservice per fiscal year at $30.00 a unit
for up to one client,
sWokUjn_(,'ojjjnwnity Access 2014 is