HomeMy WebLinkAbout072114_ca15JEFFERSON C01UNTY
BOARD OF COUNTY COMMISSIONERS
AGENDA REQUEST
TO: Board of County Commissioners
Philip Morley, County Administrator
FROM: Jean Baldwin, Director
DATE:
SUBJECT: Agenda Item — Professional Services Agreement with Skookum
Contract Services for Community Access; July 1, 2014 — June 30, 2015;
$7.500-00
STATEMENT OF_ISSUE:
Jefferson County Public Health, Developmental Disabilities Division, requests Board approval of the
Professional Services Agreement with Skookum Contract services for Community Access;
July 1, 2014 — June 30, 2015; $7,500.
ANALYSIS STRATECaIC GOALS/ PRO'S and CON'S:
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 andlor 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.
FISCAL IMP ACTICOST 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.
cOMMUNITY HEALTH PUBLIC HEALTH ENVIRONMENTAL HEALTH
DEVELOPMENTAL MSABILITIES ALWAYS WORKINO POINA SAFER AND WATER QUALITY
MAIN: (360) 385-9400 MAIN: (360) 385-9444
FAX: (360) 385-9401 HEALTHIER COMMUNITY FAX: (360) 379-4487
Consent Agenda
RECOMMENDATION:
3CPH management request approval of the Professional Services Agreement with Professional Services
Agreement with Skookum Contract services for Community Access; 3uly 1, 2014 — June 30, 2015; $7,500,00
REVIEWED BY:
Philip Morley, County Administrator Date
(Routed to all Public Health Managers)
Skookum Community Access Contract 2014-2015
Page I of 15
SUBCONTRACT FOR PROFESSIONAL SERVICES
COMMUNITY ACCESS SERVICES
Agreement Between
JEFFERSON COUNTY PUBLIC HEALTH
And
SKOOKUM
This agreement is made and entered into between Jefferson COUNTY Public Health (COUNTY) and Skookum
(SUBCONTRACTOR) for provision of Community Access Services to persons with developmental disabilities in
Jefferson COUNTY. The term of this agreement is June 1, 2014 through June 30, 2015. 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 fulfill 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
71 A, 14.070 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,BJ. Fingerprint Check must go through the
Background Check Central Unit Office within DSHS in Olympia in accordance with RCW 4143.830-845
and RCW 74.15,030.
Skookum Community Access Contract 2014-2015
Page 2 of 15
(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 Developmental Disabilities
Administration Services Rules; 296-24 General Safety & Health; 296-62 General Occupational Health
Standards; WACs: 388-828 Developmental Disabilities Administration, (DDA) Assessment; 38&845 -
Home and Community Based Waivers; Definitions 0001; Criteria for HCBS Services 0030; Basic Waiver
Services 0205; Basic Plus Waiver Services 0210; Core Waiver Services 0215; Community Protection
Waiver Services 0220; 0600-0610 Community Access Service; Supported Employment Service 2100.
(6) SUBCONTRACTOR shall comply with the following Developmental Disabilities Administration, (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 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; 6.08 Mandatory Reporting Requirements for
Employment and Day Program Services Providers; 6.13 Employment/Day Program Provider
Qualifications; 9.07 Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome
(AIDS); 12.01 Incident Management; 13.04 DRW Access Agreement; and the 1992 County Guidelines,
(7) SUBCONTRACTOR shall have written policies regarding; sexual harassment and non-discrimination (said
policies must guarantee human/civil rights), a person's right to privacy, safeguarding personal information
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),
(8) 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
participant's family guardian or advocate is also informed.
(9) SUBCONTRACTOR shall have a grievance policy that:
• negotiates conflicts and advises participants of 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 a 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 of someone who is unaffected by the outcome if
conflicts, remain unresolved (a DDA Case Resource Manager may be included as an alternative
option)
includes a process for tracking and reporting grievances
(,o) 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 about services and benefits to be
provided by the program. The signed proof required by this section shall be reviewed, and renewed with
new documentation, annually.
(1 1) SUBCONTRACTOR will encourage participant involvement in policy development.
(12) SUBCONTRACTOR shall update Client Intake Forms every 6 months during the Client Review meeting.
(13) SUBCONTRACTOR shall assure potential conflict of interest, real or apparent, will not arise. Such a
conflict will arise when the employee, officer or agent, any immediate family member, Guardian / decision
maker, or an organization that employs or is about to employ any of the above has financial or other
interest in the client(s).
(14) SUBCONTRACTOR shall have adequate staffing ratios and patterns to maintain quality and safety,
Skookum Community Access Contract 2014-2015
Page ' 3 of 15
(15) All services for persons with developmental disabilities must be provided with attention to their health and
safety. SUBCONTRACTOR shall comply with all applicable federal, state and local fire, health, and
safety regulations,
(16) Incidents involving injury, health, or safety issues are immediately reported to DDA Central Office and the
COUNTY (reference: DDA Policy 6.0 8, Mandatory Reporting Requirements for Employment and Day
Program Services Provider, DDA Criteria for an Evaluation System Page 3 of 6 July 1, 2012).
(17) Incident reports are tracked and analyzed for potential trends and patterns,
(1 g) Current emergency contact and medical information (medications, diet, allergies, etc.) needed during the
hours of service is readily available for each participant.
(19) 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.
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 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 the plan's sufficiency, and whether or not any additional information is
needed, within to 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, Abuse of Vulnerable 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
DSIIS that a SUBCONTRACTOR staff member is cited, or is on the registry for a substantiated
finding, then that associated staff will be prohibited from providing services under this contract.
(20) 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:
Accreditatiow. SUBCONTRACTOR must be able to demonstrate conformance to Commission on
Accreditation of Rehabilitation Facilities (CARF) standards for quality assurance and CARP
accreditation.
(b) Confident I protect and maintain all Confidential Information gained
Iit , The SUBCONTRACTOR shal
by reason of the PI-ograrn 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:
Skookum Community Access Contract 2014-2015
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(1) Allowing access to staff that have an authorized business requirement to view the Confidential
Information.
(2) Physically securing any computers, documents, or other media containing Confidential
Information.
(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:
W 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 Infon-nation 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 will be
protected and the information will be 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 persons'
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) Eq_qal Acces5-, SUBCONTRACTOR will assure 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 (LEP) Clients).
(e) Emancial and_Prog,rattj-----Management. SUBCONTRACTOR will maintain 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.
p SUBCONTRACTOR 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) ParLnersh jp s. SUBCONTRACTOR has a history of working cooperatively with community -based
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organizations including Employers, other Agencies, the COUNTY DD Program, the Division of
Vocational Rehabilitation (DVR), and Schools.
(h) _performance Plan: SUBCONTRACTOR will have a written performance plan that describes its
mission, program objectives, expected outcomes, and describes how and when objectives will be
accomplished; and will assure the plan is evaluated at least biennially with revisions based on actual
performance.
(i) Qtuiiified Staff-
- -, 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. SUBCONTRACTOR will provide
COUNTY with information regarding staff qualifications upon request,
6) LSafety: SUBCONTRACTOR will provide evidence that it employs safety protection based on the
environment in which the participant is working or receiving services.
(21) SUBCONTRACTOR shall provide a Community Access Individual Program Plan and/or Person Centered
planning/profiles delineating individual skills and needs plan 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,
Skookum Community Access Contract 2014 -2015
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(22) 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
team).
1 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.
(23 )) The Community Access Report Plans will also include the information listed below:
a) Current date: timeline for the Plan
b) Client's name: first and last
c) Client ADSA ID
d) The client's skills, gifts, interests, and preferred activities
c) The Community Access goal. The goal needs to relate to one or more of the following (per
COUNTY'S Guidelines):
i, Identify integrated community places where the individual's interest, culture, talent, and
gifts can be contributed and shared with others with similar interests
ii. Identify clubs, associations, and organizations where the individual can be a member and
have decision-making capacities
iii. identify opportunities where the individual can contribute to the community by
participating in new and interesting activities or activities the individual enjoys
iv. Build and strengthen relationships between family members and members of the local
community, who are not paid to be with the person
v, The Support intensity Scale (SIS) subscale that most relates to the goal (Community
Living, Lifelong Learning, Employment, Health & Safety, Social, and Protection &
Advocacy)
vi. Measurable strategies (action steps and supports) to meet the goal
vii. identification of persons and/or entities available to assist the individual in reaching his
or her long-term goal
viii. Identification of other accommodations, adaptive equipment, and/or conditions critical to
achieve the goal
(24) 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 period,
(25) The SUBCONTRACTOR shall report any injury or accident that requires more than simple first aid and
any extraordinary incident that requires intervention by the SUBCONTRACTOR to the DSHS/DDA Case
Manager for the individual involved, and then report the injury, accident, or extraordinary incident to the
COUNTY Coordinator. This includes serious physical or emotional harm or potential harm.
The initial report to the COUNTY may be done via documented telephone calls to the
COUNTY Coordinator.
2. The SUBCONTRACTOR 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 99368.
3. serious and emergent incidents shall be handled in accordance with DSHS/DDA Policy
12,0 1, incident Management.
Skookurn Community Access Contract 2014-2015
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(26) 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, iricluding all
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revenues and expenses generated by SUBCONTRACTOR in sufficient detail to demonstrate the uses of funds
provided under this agreement.
(27) 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
visit with SUBCONTRACTOR during the period of this biennium to assure compliance with the DDA State
Work Order.
(28) AUDIT REQ L -R-EMENTS Independent Audit 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:
Is performed by an independent Certified Public Accountant, the Washington State
Auditor's Office, or another entity the COUNTY and the Subcontractor mutually approve,
(b) Provide statements consistent with the guidelines of Reporting for Other Non-Profit Organizations
A)CPA 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 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,
(29) 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: Informal process wherein the COUNTY Coordinator alerts the
SUBCONTRACTOR 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 not 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 SUBCONTRACTOR 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 SUBCONTRACTOR a written summary of the areas of no - 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 SUBCONTRACTOR 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
Skookum Community Access Contract 2011 -2015
Page 7 of 15
mediator's decision in the matter will be binding on all parties, except that in no event will the
COUNTY honor a financial determination that is greater than the funds allowed in the scope of
this Agreement.
(30) 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, routine progress notes and semi - annual summary progress toward meeting client goals.
(31) 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.
(32) 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.
(33) SUBCONTRACTOR shall provide COUNTY with a copy of a signed DS11S Provider Agreement within 30
days of the effective date of this agreement.
(34) 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 DSHS to provide covered services under Title X1X, 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 PASSARWE, COUNTY agrees
that funding intended for those clients shall be excluded from this agreement.
C. REIMBURSEMENTS
(1) For 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) SUB ONTRACTOR 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 inaccurate and/or complete,
(4) Total reimbursements for the fiscal year of 2014 -2015 to SUBCONTRACTOR by COUNTY under this
contract shall not exceed $7,550 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
2014 -2015.
D. MISCELLANEOUS
(l) Pursuant to WAC 275, DSHS 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 under this agreement. 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 not include printing or other custornary reimbursable expenses that may be provided in an
AGREEMENT.
Skookurn Community Access Contract 2014-2015
Page 8 of 15
1
(2) The SUBCONTRACTOR'S relation to the COUNTY shall be at all times as an independent
SUBCONTRACTOR and any or 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
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 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 ($1,000,000.00) 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 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
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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, offset against funds due
the SUBCONTRACTOR from the COUNTY.
Sko*kum Community Access Contract 2014-2015
Page uofl5
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(A) Excepting the Workcrs Cooapcoua1imu buomruuuu and any professional liability ixnuromoc occmod by the
SUBCONTRACTOR, the COUNTY will bo named ou all certificates nf insurance uaao additional insured.
The 6lJBC0NT@ACIOR sboU furnish the COUNTY with vmrd5omiou of insurance and endorsements
required by this A(]REBN4BNT, The C{}DNT`/ reserves the right to require complete, certified copies of
all required insurance policies ut any time.
(lQ)
All iosnzaouo shall be obtained from an insurance company uudzvrizuJ to do hmninenn in the State of
Wuuhjng,tou. The SUBCONTRACTOR shall submit mverification of insurance as mcuiioed herein within
14 days of the cseomziou of this AGREEMENT to the COUNTY. All ivaacuuce policies obtained by the
SUBCONTRACTOR shall hu primary tu any equivalent orapplicable policies held 6ythe COUNTY All
insurance Policies obtained by the SUBCONTRACTOR shall include a waiver of subrogation rights,
(l|)
insurance poliviex and additional named insured endorsements obtained bortke SUBCONTRACTOR shall
provide pr-imuzy insurance covoru@eand also bcoon+mm�ibutry. Any insurance, uel�ivamzodretention,
deductible nr risk retention maintained «r participated ioby the County shall bo excess and not contributory
to such iosuruouepu|icic»� All SUBCONTRACTOR'S liability insurance policies must be endorsed ou
show this Primary coverage,
(12) Tb c COTN�ywill pay n»pm�eau payments under Secdmo C until the SUBCONTRACTOR has fully
complied with this section. This remedy is not exclusive; and the COUNTY couytaL* such other action as
is available to;8eoo under other provisions ofthis AGREBMBNT, or otherwise in law.
(13) y4ntbiug in the foregoing insurance requirements nbaJ| prevent the COUNTY, at its option, from
additionally requesting that the SUBCONTRACTOR deliver 10 the COUNTY uo executed bond oosecurity
for the faithful performance »f 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 workto6edone under this AGREEMENT. This AGRRB01BNTshall be interpreted and construed in
accord with the laws of the: State «f Washington and venue shall 6eiu Jefferson COUNTY, WA,
(15) Tbe8DBCpNTRACT0K.uy signature w this AGREEMENT, certifies that the SUBCONTRACTOR is
not presently debarred, uuspunded, prnP»u»d for debarment, declared ineligible, or voluntarily excluded
fi-om participating in this AGREEMENT or any Agreement by any Federal department or agency, The
SUBCONTRACTOR also agrees to include the above requirement znall subcontracts into which it enters.
(16) The sUBCONTRACTOR shall comply with the WA State Department ofLabor and Industries Minimum
wo�e Aoz. &CVV49,46, acknowledging persons vvhb disabilities participating in job uoom»mouto arc out
cons iden:demployees-
(I T) The SUBCONTRACTOR sbmD indemnify and hold the COUNTY, its officers, employees, arid agents
6 d«b�\pruc�naaadd��udus5DBCQ�T�4C3�&'�uwu�xp�ouu ��[udio�ul�cootu
bormens onm.xo , ,
attorney tees, and expenses relating thereto, all claims, demands, or suits at law or equity arising i^ whole or
im part, directly wr indirectly, from the SUBCONTRACTOR'S negligence o/ breach uf any ef its obU0atious
under this AGREEMENT; 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 COLNTY, its officers, employees, and agents, and provided further that if the claims or suits
are caused hyor result bnm the concurrent oe�&gcocen[(u) the G08CONT0�^CTO�`Sm@eumoc
employees; and, (b) the COUNTY, its officers, employees, and agents, this indemnity provision with respect
to(l)u|aimmor suits based upon such negligence, and/or (Z) the costs tu 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 aeg|i8enocnf the SUBCONTRACTOR'S agents uzemployees.
(l8) Claims against the COUNTY shall include, but not be limited to assertions that the use arid transfer of any
software, book, document, report, film, tape, or sound reproduction of rnaterialof any kind, delivered there
under, constitutes an illfringement of any copyright, patent, trademark, trade name, or otherwise results in an
unfair trade practice oruu unlawful restraint nfcompetition.
Skuokum Community Access Contract 2014-2015
Page 10of15
(19) 'The SUBCONTRACTOR specifically assumes potential liability for actions brought against the COUNTY by
SUBCONTRACTOR'S employees, including all other persons engaged in the performance of any work or
service required of the SUBCONTRACTOR under this AGREEMENT arid, solely for the purpose ofthis
indemnification and defense, the SUBCONTRACTOR specifically waives any immunity under the state
industrial insurance law, Title 5l RCW. The SUBCONTRACTOR recognizes that this waiver was
specifically entered into pursuant xo p,o'iuivu» nfRCVV4,24,ll5 and was subject ofmutual negotiation.
{20} SDBC0NTRAC70Rohullmatdiucdmin�aomg«instmnypcmnmp«csentiu8c6enooc|vuofonacrvioeu6uncdun
race, religion, color, sex, age, or national origin.
(ll) COUNTY reserves the right ,o terminate this contract io whole nrbmpart, without prior written notice, in the
event that contractual terms are not hdfilled,or actual funding from the Department u[ Social and Health
Services Developmental Disabilities Administration is withdrawn, reduced, or limited in any way after the
effective date of this agrecroeot� Iu the event o{u`rmioutiom under this clause, COUNTY shall he liable only
for payment for services rendered prior to the effective date oftermination,
(22) No portion of this contract may he assigned nr subcontracted tuany other individual, firm, orcodtyvvit6out
the express and prior written approval ofCOUNTY. If the COUNTY agrees b, writing that all oru portion of
this AGREEMENT may be subcontracted to a third-party, then any contract or agreement between the
omntructorundotbbd-purtynubcomzuctorxuuatcuotaiuoD&novinionamy/hiuAGRJEE&1INTuuddzudzird'
purtysuh000zmc1ormustugree tohe bound hy all terms and obligations found in this AGREEMENT,
ADOPTFD TF118____ day mf 12014
By: By
John Austin, Chairman
Jefferson County Board of Commissioners
By:
Deputy/Clerk of the Board
A P PRV E D JA' TOIF -70NLY: ILI
Jefferson . COUNTY Prosecuting torney
10
Skon6um Contract Services
Skookurn Community Access Contract 2014-2015
page 11 of 15
EXHIBIT A
STATEMENT OF WORK
COMMUNITY ACCESS
I. WORK STATEMENT
SUBCONI'RACTOR 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
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 team 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,
T 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
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
an opportunity to access volunteer opportunities in order to enhance versatility
an opportunity for self advocacy and skill development for new tasks, and to contribute to the
community
11
&ko*kmm Community Access Contract 2014-2015
Page \2wf15
C' Program Requirements
l, SUBCONTRACTOR shall provide Community Access Services. These services, as defindd in Section
ILB above & are in the Community Access Billable Activities Form, (see Attachment B).
2. SUBCONTRACTOR shall provide at) Individual Program Plan und/°r Person Centered
planning/profiles delineating individual skills and needs within 3O days mythe beAimmin�ofservices
with all program clients. The SUBCONTRACTOR will use the new Community Access Plan Report
Form (sue Attachment A), which will serve as an aid in matching program clients to appropriate
services io the community; and will serve as u transition too[ towards the advancement of the
individual's increased personal independence in the community; an opportunity to build relationships;
»u contribute and to feel asense of belonging uo the community, while accessing volunteer
opportunities imorder tw enhance versatility and develops skills necessary for new tasks,
1 SD�C0l�T��CT�[\ubuOycbx6u6:aaix-mumuthrcviemo{zmeodmgs6u,aOprmAromopa¢ioipau<u.Tbe
review shall include an assessment uf the need for continued community access services and an
evaluation mfthe Individual Program plan goals and objectives iothe form ufa Semi-Annual Progress
Report, The SUBCONTRACTOR shall use the new Community Access Plan Report Form, (see
Attachment /\)no 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 his or her goals;
training provided and omrkteo mymwpnin showing progress toward meeting objectives orudescription
of the reasons for any shortfall concerning the outcomes and proposed actions for correction.
5. COUNTY shall receive the dates for the, 8-morAh reviews for program clients one month before the
required meetings.
6, SUBCONTRACTOR will submit to the COUNTY, DDA Case Management, Residential Provider,
Parent/Guardian a Semi-Annual Community Access Plan Report Form on each client.
7, The SUBCONTRACTOR will use the new Community Access Report Form, (see Attachment A)to
report mothe semi-annual progress ofthe client.
Q, The frequency u[the Semi-Annual Progress Reports for this contractual period will be one every six
(b) ouuutbs after the initial plan, July through December 2014 with the report due on January 2nd of
20l5' the second due date will be January thru June 2U|5, due July l*20l5.
g, Services shall promote the use ofnatural supports, which means personal associations and
relationships typically developed in the community that enhance the quality and security oflife for
people, including but not limited to firiendships 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.
10. Community Access services will focus om activities that are typically experienced hy the general
public, Support to participate in segregated activities and/or specialized activities will not be
nuim6»zncd. Services will occur individually oriougroup of no more than 2 individuals with similar
interest and needs.
\|, Services shall provide support m those, individuals wishing to seek volunteer activities; such ayusing
public transportation, assisting with referrals to the appropriate agencies, and other agreed upon
vocationally related goals iu preparation for Volunteering.
12
Skoobonm Community Access Contract 2014~2015
oom,d���mmyu��d�o dur�opuJ�eoe schedule otm�ivhjcs based
�2 I�c r,mv�o�r�.uu, p""~^.. _
' om the client's needs and interests as connected mn their Individual Program plan.
13 The Provider ebuUassess and document iu�e Commoo�y'�oueuay� «
mR�poFmrmoachpa�icipant^*
' transportation needs, The Provider shall assist each participant to access public or specialized
transportation for some activities sponsored os a part of Community Access services. Itio expected that
public or specialized transportation will be utilized, except as detailed in the transportation plan. The
cost oftransportation is included imthe fee for service that a Provider receives.
l4. Program participants must bcauthorized for service hy the Developmental Disabilities Administration
(DDA) and referred uo the COUNTY.
l5�A client receiving Community Access services will not receive Employment services simultaneously.
16, /\ client receiving Community Access services may at any time choose to pursue work and to receive
individual Employment services.
17 1�mul\��inootuutiy5od with emp|mym000|services after nine (9) months ioumennp\nynucntproAmnm,
' fu\johmuur�h) �bcu]�ntmuyc6mmm�Comnzuoi1�'�cc�sop�rvic��
(an unsuccessful , .
18 6�}BC(��IB»�CTO�{meontcnsme&ereiso legal requirement and au\�r delimcmxiom�rntut�
'
qualifications umdprmmfofbuckgroondcrimioa)6igmzyu\euoaooeiuuccwrduocevphbRCW43.43.830-
845 and RCW74,l5'038ou all staff.
���b�t ��nym���ffT�o�gPl��COUNTY for approval �
lA SD��um�x,m�,v^ ,
� mvulwNa�30 days of�e e��ve��of�iuu��me�,�mi��u����u��or when
disapproval
reorganization � (o) SUBCONTRACTOR's procedure tn train new direct service staff, training must include,
• lDDA Policies & Competencies (see Section C-Numherl7-20)
• RCW'a&V//\C'm referenced nmpage | &2ofthe County Contract under Section B.
Obligations
• agency policies &procedures
• skills ou how 1u 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
uWuutgouUs/ohjoucivou)
(o) S0BC(NT&AC70R'o plan »oprovide staff who are skilled buapplying training techniques tn
enhance the work related skills of program clients
(d) FTE levels, job descriptions, and organization chart pertaining to program staff
(^) SUBCONTRACTOR ic required t*send one direct service staff N uxuinimum of 16 hours of
w/or&vbopu.traininga, and/or conferences about developmental diomhUiticn. Should
SUBCONTRACTOR fail m access tramiugs for direct service staff, the SUBCONTRACTOR
will reimburse the COUNTY at the rate of 65.00 an hour for every hour of training not
accessed for staff (for not more than a total mf$l'040)
20. SUBCONTRACTOR will provide COUNTY with information regarding staff qualifications and
documented uaiuioog`u upon request,
13
Skookurn Community Access Contract 2014-2015
Page 14 of 15
21, SUBCONTRACTOR must assure 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 Working with C1 fonts: ADA training, APS Reporting Requirements,
client confidentiality, cur-rent individual instruction and Action Steps/Vocational Plans for each client
with whom the employee works; DDA Policy 4.11 Working Age Adult (adult services only); DDA
Policy 5.06 Client Rights; DDA Policy 5.13 Protection from Abuse, Mandatory Reporting, DDA
Policy 12.0 Incident Management.
22. SUBCONTRAcToR must ensure that new direct service staff demonstrate the following
competencies:
1) Values that support the abilities of individuals
2) Effective Communication — The ability to effectively listen and to make oneself
understood
3) Planning methods
4) Crisis Prevention and Intervention
23. Within onc, tn(.rnth_o _mplo n?ent: SUBCONTRACTOR must ensure that direct service staff received
L e
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
Fmployment/Day Programs; and all reporting requirements related to these DDA Policies,
24, �ithinsiy months o em to �meni: 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 FIlV and AIDS and Program Skill Development.
25. SUBCONTRACTOR will have signed documentation that staff training took place within the timelines
listed above in Section C-Number 17-20,
26. 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,
27. 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.
Z�
14
Skookum Community Access Contract 2014-2015
Page 15 of 15
D. Performance Standards
1. SUBCONTRACTOR 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
Client Acuity is determined through the DDA assessment. Acuity reflects conditions typically
related to individual disabilities 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
without disabilities. Allowable activities are defined in the Community Access Billable Activities,
(see Attachment B).
3. 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.
—%41fyrkTir-rV A d"I"ESS- A qq1('.NF1)SFRV1CF LEVEL - Monthly Support HOURS
k- "Jr I tv ax)
ACUITY LEVEL
Monthly Support Hours
Level A
Up to 3 hours
Level B
Up to 6 hours
Level C
Up to 9 hours
Level D
Levcl E
Level F
Up to 12 hours
Up to 15 hours
Up to 18 hours
Level G
Up to 20 hours
F, Community Access Unit of Service
one UNIT of Community Access service is defined as one (1) or more "HOUR" of direct service or
ASSIGNED SERVICE LEVEL to one eligible client. A UNIT is defined as a "HOUR" which is at
least fifty (50) minutes of direct service; (partial hour to the quarter may be recorded), ten (10)
minutes of every HOUR" can be used for documentation and/or meeting times.
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 252 units of service per fiscal year at $30,00 a unit
for up to two clients,
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