HomeMy WebLinkAbout090815_ca04w . d, 12
Public Health
615 Sheridan eet
Port Townsend, 98368
N,L.iik,v.JeffersonCountyPublicHealth.orcL
Consent Agenda
July 31, 2015
JEFFERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
AGENDA REQUEST
TO: Board of County Commissioners
Philip Morley, County Administrator
FROM: Jean Baldwin, Director
DATE: f .2,0 (S'
SUBJECT: Agenda Item — Professional Services Agreement — Concerned Citizens
for Individual Employment and Individual Technical Assistance;
July 1, 2015 — June 30, 2016; $36,000.00
STATEMENT OF ISSUE:
Jefferson County Public Health, Developmental Disabilities Division is requesting Board approval of the
Professional Services Agreement — Concerned Citizens for Individual Employment and Individual Technical
Assistance; July 1, 2015 — June 30, 2016; $36,000.00
ANALYSIS STRATEGIC GOALS PRO'S and CONS:
This agreement provides for the placement of clients with developmental disabilities into traditional
employment settings at work sites or in job training, in the community. This contract will also provide a
Pathway to Employment Plan that centers around a personal discovery process related to skills, capabilities
and goals, and assistance with employment vendor selection. The placement may also include vocational
counseling, and job analysis to assist in identification of work objectives and the job process, locating a
suitable community job for the worker; initial placement and post -hire training of the employee, employer,
and or co- workers at the employment site, job restructuring and work site modifications; supporting the
worker, employer, and other interested persons to develop natural workplace supports to ensure stability
on the job; and to assist the worker in obtaining other services as necessary for continued employment.
Follow -along services are included that provide a safety -net service of support, counseling, job analysis,
and supported training to the worker, employer, and other interested parties (parents, unions, etc). The
client will be supported by assessment and consultation services to better identify and address barriers to
employment. Jefferson County Public Health contracts with providers once per year; Providers are chosen
via a formal RFQ process that occurs every four years, as per DDA 2011 mandate.
Community Health
Developmental Disabilities
360- 385 -9400
360- 385 -9401 (f)
Environmental Health
Water Quality
360- 385 -9444
(f) 360- 379 -4487
FISCAL. IMPACT COST BENEFIT ANALYSIS:
This agreement provides for funding not to exceed $36,000.00. The provider shall be compensated at the
rate of $65.00 per unit defined as 50 minutes of direct service, characterized as placement, replacement,
and follow -along services and /or the service of assessment and consultation. All funding for vocational
services is through the Developmental Disabilities Administration with DSHS and is identified in the budget.
RECOMMENDATION:
JCPH management request approval of the Professional Services Agreement — Concerned Citizens for
Individual Employment and Individual Technical Assistance; July 1, 2015 — June 30, 2016; $36,000.00
REVIEWED BY:
P if Morl un Adr i.�trax
hp �� .. ty r Date
SUBCONTRACT FOR PROFESSIONAL SERVICES CI M "� A..,
INDIVIDUAL EMPLOYMENT AND INDIVIDUAL "I'ECIINICAL ASSISTANC .? 4
Agreement Between
JEFFERSON COUNTY PUBLIC HEALTH
AND
CONCERNED CITIZENS CONTRACT SERVICES
This agreement is made and entered into between Jefferson County Public Health (COUNTY) and Concerned Citizens
Contract Services (SUBCONTRACTOR) for provision of Individual Supported Employment to Persons with
Developmental Disabilities in Jefferson County. The term of this agreement is July 1, 2015 through June 30, 2016. This
Contract may be terminated by either party upon 60 days written notice. Termination of this Contract shall not constitute
a breach.
It is agreed Upon by Both Parties as Named
Herein as Follows:
A. PROFESSIONAL SERVICES
Professional services to be provided by SUBCONTRACTOR shall include:
(1) "Individual Supported Employment" or "IE ": services are a part of an individual's pathway to
employment, are tailored to individual needs, interests, abilities, and promote career development. These
are individualized services necessary to help persons with developmental disabilities obtain and continue
integrated employment in the general workforce at or above the state's minimum wage. These services
may include intake, discovery, assessment, job marketing & development, job placement, job replacement,
worksite job training coaching /supports, development of natural supports, and follow -along and record
keeping per Exhibit A — Statement of Work.
(2) "Individualized Technical Assistance" or `°ITA ": services are a part of an individual's pathway to
individual employment. The service of assessment and consultation (in order to identify and address existing
barriers to employment) may be provided by the employment provider, or to the employment provider. This is
in addition to supports received through supported employment services or pre - vocational services for
individuals who have not yet achieved their employment goal per Exhibit. A — Statement of Work.
(3) 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
7IA. 14.070 requires a signed Release of Information or a signed Oath of Confidentiality Form.
(2) SUBCONTRACTOR is required provide background checks, pursuant to RCW 43.43.830 -845, RCW
74.15.030, and Chapter 388 -06 WAC, which state that any prospective employee or volunteer who will or may
have unsupervised access to a vulnerable person with a developmental disability in the course of his or her
employment, or involvement with the business or organization, must have a background /criminal history
clearance before they have unsupervised access. The DSHS Background Check Central Unit (BCCU) must
be utilized to obtain background clearance.
(3) If SUBCONTRACTOR reviews the application and elects to hire or retain an individual after receiving
notice that the applicant has a conviction for an offense that would disqualify the applicant from having
unsupervised access to vulnerable adults as defined in Chapter 74.34 RCW, then DDA shall deny payment
for any subsequent services rendered by the disqualified individual provider.
(4) SUBCONTRACTOR is required pursuant to RCW 74.15.030, 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
vulnerable person with a developmental disability in the course of his or her employment, or involvement with
the business or organization, must have an F.B.I. Fingerprint Check before they have unsupervised access and
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before prospective employer begins working. The DSHS Background Check Central Unit (BCCU) must be
utilized to obtain background clearance.
(5) SUBCONTRACTOR is required to repeat the background /criminal history clearance for all employees or
volunteers who will or may have unsupervised access to a vulnerable person with a developmental disability in
the course of his or her employment, or involvement with the business or organization, every three years. The
DSHS Background Check Central Unit (BCCU) must be utilized to obtain background clearance in
accordance with RCW 43.43.830 -845, RCW 74.15.030 and Chapter 388 -06 WAC.
(6) SUBCONTRACTOR shall comply, as mandated reporters under RCW 74.34.020 (11), with all state and federal
requirements under RCW 74.34.035, .040 Abuse and neglect of Vulnerable Adults; RCW 26.44, Abuse of
Children; the WACs: 275 -26 Division of Developmental Disabilities Services Rules; 296 -24 General Safety
& Health; 296 -62 General Occupational Health Standards; WACs: 388 -828 Developmental Disabilities
Administration, (DDA) Assessment; 388 -845 Home and Community Based Waivers; Definitions 0001;
Criteria for HCBS Services 0030; Basic Waiver Services 0200; Basic Plus Waiver Services 0210; Core
Waiver Services 0215; Community Protection Waiver Services 0220; 0600 -0610 Community Access
Service; Supported Employment Service 2100.
(7) 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.
(8) SUBCONTRACTOR shall comply with the following referenced documents found at DDA Internet site
Is,llll JJ�v v cl lis.w p t va '1 1 &(ILrt9y 1Ig lidA ties under "Counties ":
(1) DDA Policy 4.11, County Services for Working Age Adults;
(2) WAC 388 -850, WAC 388 -828, WAC 388 - 845 -0001, 0030, 0205,0210, 0215, 0220, 0600 -0610,
1200 -1210, 1400 -1410, 2100, 2110;
(3) Criteria for Evaluation;
(9) The DRW Access Agreement with DDA, assures that the COUNTY and SUBCONTRACTORS have
reviewed the Access Agreement. The Access Agreement covers DRW's access to individuals with
developmental disabilities, to clients, to programs and records, to outreach activities, to authority to
investigate allegations of abuse, neglect, and other miscellaneous matters, and it is binding for all providers
of DDA contracted services.
(10) SUBCONTRACTOR shall have written policies regarding sexual harassment and non - discrimination (said
policies must guarantee human /civil rights); regarding a person's right to privacy, regarding safeguarding
personal information and abuse of participants; regarding agency medication procedure; regarding respectful
staff -to- participant interactions (i.e.: including a person's right to be treated with dignity and respect free of
abuse).
(11) 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.
(12) 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
CONCERNED CITIZENS IE /ITA Contract 2015 -2016
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• 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
(13) 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.
(14) SUBCONTRACTOR will encourage participant involvement in policy development.
(15) SUBCONTRACTOR shall update Client Intake Forms every 6 months during the Client Review meeting.
(16) 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 member of immediate family, 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).
(17) SUBCONTRACTOR shall have adequate staffing ratios and patterns to maintain quality and safety.
(18) 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.
(19) SUBCONTRACTOR shall track and analyze incident reports for potential trends and patterns.
(20) Current emergency contact and medical information (medications, diet, allergies, etc.) needed during the
hours of service is readily available for each participant.
(21) The COUNTY and all SUBCONTRACTORS are mandated reporters under RCW 74.34.020(11). All
parties must comply with reporting requirements described in RCW 74.34.035, 040 and Chapter 26.44 and
must adhere to DDA Policy, 6.08 Mandatory Reporting Requirements for Employment and Day Program
Service Providers. All service provider employees, contractors, and volunteers are mandatory reporters and
must report every incident of observed, reported, or suspected abuse, improper use of restraint, neglect,
self - neglect, personal or financial exploitation, abandonment and /or mistreatment of clients.
(22) For Individual Employment where the service provider is also the Client's employer, long term funding
will remain available to the service provider / employer for six months after the employee / DDA Client's
date of hire. At the end of the six month period, if the DDA Client continues to need support on the job,
another service provider who is not the employer of record must provide the support unless the County
issues prior written approval for the service provider to continue to provide long -term supports if needed.
(23) COUNTY, who perform on -site evaluations of subcontractor work sites, will promptly report to DSHS per
DDA Policy 5.13, Protection from Abuse: Mandatory Reporting, if:
(1) They have reasonable cause to believe that abandonment, abuse, financial exploitation or
neglect (as defined in RCW 74.34.020) of a person who has a developmental disability (as
defined in RCW 7 IA. 10.020) has occurred, and,
(2) If they have reason to suspect that sexual or physical assault of such a person has occurred,
they shall also immediately report to the appropriate law enforcement agency.
(24) 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) Accreditation: SUBCONTRACTOR must be able to demonstrate conformance to Commission on
Accreditation of Rehabilitation Facilities (CARF) standards for quality assurance and CARF accreditation.
CONCERNED CITIZENS IEATA Contract 2015 -2016
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(b) t ao @tl�c,�,a rtlpaIr�hY.. SUBCONTRACTOR shall protect and maintain all Confidential Information gained 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 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) Use 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) " mA ,. Pijmtsloctipieiits 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 specifies that the confidentiality of information will 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
DSHS Contact designated on this Program Agreement within five (5) business days of
discovery for breaches of less than one hundred fifty (150) persons' protected data, and one
(1) business day of discovery of breaches of over one hundred fifty (150) persons' protected
data. The parties must also take actions to mitigate the risk of loss and comply with any
notification or other requirements imposed by law.
(d) ,l giq,iJ, c,cess 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 (LEP) Clients).
(e) Financial t.t1rl Progra ,111_ �1t,i�g�cll t��tmm 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.
(f) LILm it:3givaants. 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) ,f d�t�t� 1, Mii,ps: SUBCONTRACTOR has a history of working cooperatively with community -based
organizations including Employers, other Agencies, the COUNTY DD Program, the Division of
Vocational Rehabilitation (DVR), and the Schools.
(h) Plan: SUBCONTRACTOR has 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) Internal . C ontrrc)Lsysja,rnM: SUBCONTRACTOR has sufficient policies and procedures for establishment
and maintenance of adequate internal control systems. SUBCONTRACTOR will maintain written policy
procedural manuals for information systems, personnel, and accounting/finance in sufficient detail such
that operations can continue should staffing change or prolonged absences occur.
(j) l Afflrl'i St�ifl`: 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.
CONCERNED CITIZENS IE /ITA Contract 2015 -2016
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(k) Safe : SUBCONTRACTOR will provide evidence that it employs safety protection based on the environment
in which the participant is working or receiving services.
(1) l IMPL(rycar milt ,lord B, ,y g vic es must adhere to the Home and Community Based settings (HCBS) requirements
of 42CFR 441 530(a)(1), including that:
(a) The setting is integrated in the greater community and supports individuals to have full access to
the greater community;
(b) Ensures the individual receives services in the community to the same degree of access as
individuals not receiving Medicaid HCBS;
(c) The setting provides opportunities to seek employment and work in competitive integrated settings;
and
(d) The setting facilitates individual choice regarding services and supports, and who provides them.
(25) SUBCONTRACTOR shall provide an Individual Employment /Vocational Client 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 Employment Program Plan Report Form
for Individual Employment /Vocational Client Plans.
(26) Individual Employment /Vocational Client Plans will include:
1. Information that identifies and addresses the individualized goal and support needs for each
participant. The plan should be developed by the provider in collaboration with the Case Resource
Manager, participant, and his or her family (the team).
2. 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.
3. Copies of the initial and subsequent revised plans will be distributed as appropriate to all team
members.
4. Plans will be reviewed and signed annually.
(27) Individual Employment /Vocational Client Plans will also include the information listed below:
a) Current date
b) Timeline for the plan
c) Client's name: first and last
d) Client ADSA ID
e) Employment goal
f) Preferred (job type) the individual wishes to obtain or maintain
g) The preferred wages /salary the individual wishes to earn
h) The number of hours the individual prefers to work
i) The preferred work shift
J) The individual's skills, gifts, interests, and preferred activities
k) Measurable strategies (action steps and supports) to meet the employment goal
1) Identification of persons and /or entities (such as family, Division of Vocational Rehabilitation)
available to assist the client in reaching his /her employment goal
m) Identification of other accommodations, adaptive equipment, and /or supports critical to achieve
employment goal
(28) 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.
(29) 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.
(30) 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 to the COUNTY Coordinator. This includes serious physical
or emotional harm or potential harm.
CONCERNED CITIZENS IE /ITA Contract 2015 -2016
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The initial report may be done via documented telephone calls to the COUNTY Coordinator.
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 -940, or by mail to Jefferson County Public Health 615 Sheridan
Port Townsend, WA 98368.
Serious and emergent incidents shall be handled in accordance with DSHS /DDA Policy 12.01,
Incident Management.
(31) 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.
(32) 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 the contract to assure compliance with the DDA State
Work Order.
(3 3) A l.J_I 11` ltlatlllllU,',, Ml N C ,,, Independent Audit will be submitted annually to the Jefferson COUNTY DD
COUNTY Coordinator in the following manner:
SUBCONTRACTOR must be able to account for and manage public funds in compliance with Generally
Accepted Accounting Principles "GAAP ". An agency, for -profit or non - profit, who receives in excess of
$100,000 in DDA funds during its fiscal year from the County, shall provide Certified Public Accountant
reviewed or audited financial statements within nine months subsequent to the close of the subcontractor's
fiscal year. Copies of the audit and management letter shall be submitted to the Jefferson COUNTY Public
Health Department within 9 months of the end of the SUBCONTRACTOR'S fiscal year.
The SUBCONTRACTOR shall provide an independent audit of the entire organization which:
(a) Is performed by an independent Certified Public Accountant, the Washington State
Auditor's Office, or another entity the COUNTY and the SUBCONTRACTOR mutually approve.
(b) Provides statements consistent with the guidelines of Reporting for Other Non -Profit Organizations
AICPA 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 two (2) copies 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.
(34) 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.
CONCERNED CITIZENS IE /ITA Contract 2015 -2016
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(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 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 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 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 the scope of this Agreement.
(35) For six 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 of progress toward meeting client goals.
(36) SUBCONTRACTOR will provide COUNTY with Individual Employment Plans (or Person Centered
Plan /Profile), client goals, and a summary of progress toward meeting those goals on a biannual basis.
(37) SUBCONTRACTOR will 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.
(38) SUBCONTRACTOR shall provide COUNTY with a copy of a signed DSHS Provider Agreement within 30
days of the effective date of this agreement.
(39) 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 XIX, COUNTY
agrees that funding intended for those clients shall be excluded from this agreement. If SUBCONTRACTOR
contracts directly with Social Security to provide covered services under a PASS /IRWE, 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 on a unit rate
basis as follows:
(a) 1 ndivodual C r �Ialr yr? i1d /l_�l� wv 'ta 1(r i Technical Assistance Services: SUBCONTRACTOR will be
paid $65.00 per unit assigned Service Responsibility of regular Program Service as defined in Exhibit
A, Statement of Work.
(2) SUBCONTRACTOR will bill COUNTY monthly in arrears and on a monthly basis, on or before the 5th day
of the month, for units of service provided under this agreement. SUBCONTRACTOR will submit a Monthly
DDA Services Report (ASDA) 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
without COUNTY approval.
(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, or for contractual non - compliance issues.
(4) Total reimbursements for fiscal year 2015 -2016 to SUBCONTRACTOR by COUNTY under this contract shall
not exceed $36,000.00 in completion of these services without express written amendment signed by both
parties to this Agreement.
CONCERNED CITIZENS IEATA Contract 2015 -2016
Page 7 of 19
(5) SUBONTRACTOR will access Division of Vocational Rehabilitation (DVR) funding as a resource. Client
services shall not be reimbursed under this agreement when the same services are paid for under the
Rehabilitation Act of 1973, DVR, P.L. 94 -142 (Public Education), or are being funded under PASS /IRWE.
D. MISCELLANEOUS
(1) DSHS Division of Developmental Disabilities (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 through a County Service
Authorization, (CSA) shall be eligible for services reimbursed under this agreement.
(2) The SUBCONTRACTOR'S relation to the COUNTY shall at all times be that of independent
SUBCONTRACTOR. Any and 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, 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.
(5) The SUBCONTRACTOR will not discriminate against any person in the performance of
SUBCONTRACTOR'S services under this Agreement or in the selection and retention of employees or
procurement of materials or supplies on the basis of age, sex, marital status, sexual orientation, religion,
creed, race, color, national origin, honorably discharged veteran or military status, or the presence of any
sensory, mental, or physical disability or the use of a trained dog guide or service animal by a person with a
disability, unless based upon a bona fide occupational qualification.
(6) 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
(7) 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
CONCERNED CITIZENS IEATA Contract 2015 -2016
Page 8 of 19
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.
(8) 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.
(9) 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, offset against funds due
the SUBCONTRACTOR from the COUNTY.
(10) All cost for insurance shall be considered incidental to and included in the unit contract prices and no
additional payment will be made.
(11) 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 SUBCONTRACTOR 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.
(12) All insurance shall be obtained from an insurance company authorized to do business in the State of
Washington. The SUBCONTRACTOR shall submit a verification of insurance as outlined herein within 14
days of the execution of this Agreement to the COUNTY. 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. Any
insurance self - insured retention, deductible or risk retention maintained, or participated in, by the COUNTY
shall be excess and shall be non- contributory to the insurance policies provided by the SUBCONTRACTOR
in order to comply with the insurance requirements of this Subcontract. All policies provided by the
SUBCONTRACTOR in order to comply with the insurance requirements of this Subcontract must be
endorsed to show this primary coverage.
(13) 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.
(14) 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.
(15) 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.
(16) The SUBCONTRACTOR shall comply with the WA 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 SUBCONTRACTOR'S negligence or breach of any of its obligations 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 COUNTY,
their officers, employees and agents, and provided further that if the claims or suits are caused by or result
from the concurrent negligence of:
(a) the SUBCONTRACTOR'S agents or employees; and, (b) the COUNTY, 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
CONCERNED CITIZENS IE /ITA Contract 2015 -2016
Page 9 of 19
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 name, 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
SUBCONTRACTOR'S employees, including all other persons engaged in the performance of any work or
service required of the SUBCONTRACTOR under this Agreement 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) COUNTY reserves the right to terminate this contract in whole or in part, without prior written notice, in the
event that contractual terms are not fulfilled, or if expected or actual funding from the Department of Social
and Health Services Division of Developmental Disabilities is withdrawn, reduced, or limited in any way after
the effective date of this agreement. In the event of termination under this clause, COUNTY shall be liable
only for payment for services rendered prior to the effective date of termination.
(21) 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 COUNTY agrees in writing that all or a portion of
this Contract may be subcontracted to a third -party, then any contract or agreement between the
SUBCONTRACTOR and a third -party subcontractor must contain all provisions of this Agreement and the
third -party subcontractor must agree to be bound by all terms and obligations found in this agreement.
ADOPTED THIS day of mm1 2015
W
David Sullivan, Chairman
Jefferson Board of County Commissioners
Attest, Clerk of the Board
APP VED AS TO FO .M ONLY: t ,
Jefferson County Prosecuting A4ttar 1 y
By " o lc
Middleto n ,
..� dot Executive Director
,
ncerned Citizens Services
CONCERNED CITIZENS IE /ITA Contract 2015 -2016
Page 10 of 19
EXHIBIT A
STATEMENT OF WORK
INDIVIDUAL SUPPORTED EMPLOYMENT/INDIVIDUALIZED TECHNICAL ASSISTANCE
I. WORK STATEMENT
SUBCONTRACTOR shall provide Individual Supported Employment Services /Individualized Technical Assistance for
program clients as described hereinafter. SUBCONTRACTOR shall be reimbursed for such services on a unit of service
basis pursuant to Section C., Reimbursements of this contract.
II. PROGRAM DESCRIPTION
A. Program Goals:
I a To support and strengthen Skookum's capacity to provide quality, cost effective individual supported
employment services.
2. To assure that businesses employing individuals with developmental disabilities in Jefferson County
will meet the Employment Quality Indicators from the County Guidelines as adopted by the D.D.
Advisory Board.
1 To provide employment services that are designed to meet specific needs of individuals based on
personal preferences and individualized goals and outcomes.
4, To provide appropriate job matching and necessary vocational support services to assure that program
clients placed in individual community jobs maintain continuous employment for at least one year.
5„ To provide Pathway to Employment Plan facilitation, a discovery process, detailed action
steps /timelines that will serve as a transition tool towards the advancement of the individual's
pathway and as an aid in the implementation of matching program clients to appropriate
employment services in the community.
6, When appropriate, to provide assessment and consultation, in order to identify and address existing
barriers to employment for individuals who have not yet achieved their employment goal, through
consulting and assessment. (This is in addition to supports received through Supported Employment
services or Group Employment services for individuals who have not yet achieved their employment
goal).
7. Clients in an Employment program will be supported to work toward a living wage. A living wage is
the amount needed to enable an individual to meet or exceed his or her living expenses. Clients should
average twenty (20) hours of community work per week or eighty-six hours per month.
8. To identify settings that isolate people from the broader community or that have the effect of
isolating individuals from the broader community of individuals who do not receive Medicaid HCB
services. Clients will not access these settings because they are presumed not to be home and
community- based.
B. Definitions
Individual I:n1R1gyrnenl is an individual job in the community where a traditional employer /employee
relationship exists (i.e. person is hired, paid, and supervised by the employer), and is performed at
locations that are typical employment sites for non - disabled persons, (not in businesses or locations
where the primary purpose is to provide employment or work training for individuals with disabilities).
Individual Employment is for those who have not traditionally held competitive jobs or who have had
interrupted or intermittent employment as a result of a severe disability, and is for people with severe
disabilities who need intensive and/or extended support services to perform work in the community.
CONCERNED CITIZENS IE/ITA Contract 2015 -2016
Page 11 of 19
2. Placeinent is defined as employment in a first job or in multiple jobs arranged by SUBCONTRACTOR
for 90 calendar days. Placements may be: full -time, average weekly work totaling 40 hours or more;
or part-time, average weekly work totaling 12 hours to 40 hours.
1 i 9Isl ,L pInernI is defined as being assisted by the same SUBCONTRACTOR in any subsequent
employment (second, third, fourth job, etc.) for 90 calendar days. Employment may be full -time, part-
time, or other as defined in B.2 above.
4, Placement nient S'e vi ens may include: vocational counseling and job analysis to assist in
the identification of work objectives and the job match process; job development, locating a suitable
community job for the worker; initial placement and post -hire training of the supported employee,
employer and /or coworkers at the employment site; job restructuring and worksite modifications;
supporting the worker, employer, and other interested persons (parents, unions, other employees, etc.)
to develop natural workplace supports and ensure stability on the job; assisting the worker to obtain
other services necessary for continued employment; feedback to the worker, COUNTY and to DDA
Field Services regarding progress and /or problems.
5. 1"ollow aloha Services, begin at the time of placement or replacement and may include: visiting with
the worker, the employer, and other interested parties (parents, unions, etc.) to insure stability on the
job; providing feedback to the worker, COUNTY, and to DDA Field Services regarding progress
and /or problems; counseling the worker and his /her family on vocational issues.
6, l._ e devel;i; oni;ent of a Paillway.to l anl�Ipynient flan, that will serve as a transition tool toward the
advancement of the individual's employment pathway and as an aid in the implementation of
matching program clients to appropriate employment services in the community.
7. .......... �g is defined as facilitating the development of a Pathway to Employment Plan; delineating
individual vocational skills, experiences, preferences, strengths, support needs, skills, goals and
objectives, education on system navigation and the Discovery Process related to vocational skills
and capabilities.
8. [J;rV_tgLi cg���tLimon of the Action Steps that detail tasks timelines and entities responsible for leading to
the community employment will reflect that 75% of the direct service hours with the client will be
at employment sites in the community. The amount of service a client receives will be based on his/her
demonstrated need, acuity level, and work history.
9. Ln �tlwi�lu�ali �d„ 'Nmcci nz_ l ssist�x ec ,�jgryiees, are part of an individual's pathway to individual
employment. The service of assessment and consultation (in order to identify and address existing
barriers to employment) may be provided by the employment provider or to the employment provider.
This is in addition to supports received through supported employment services or pre - vocational
services for individuals who have not yet achieved their employment goal.
C. Program Requirements
1, The SUBCONTRACTOR will clearly communicate to the client and the COUNTY, prior to beginning
service, an expected change in the maximum service hours per month the client can expect to receive. Service
changes will not occur until the client has received proper notification from DDA.
(a)The client's DDA ISP is the driver for service. The CMIS County Service
Authorization and the updated Planned Rates information will not exceed the client's
DDA ISP.
(b)The amount of service the client receives should match with the CMIS County Service
Authorization and updated Planned Rates information.
Page 12 of 19
2. If SUBCONTRACTOR is selected as the client's provider, SUBCONTRACTOR shall provide an Individual
Employment /Vocational Client Plan for client's in service delineating individual skills, experiences,
preferences, strengths, support needs, skills, and goals and objectives within 30 to 60 days of the beginning
of services for the client, in order to promote Individual Employment. (Minimum Individual
Employment /Vocational Client Plan elements are outlined in the reference document called "Criteria for
Evaluation" available on the DDA website.)
3. SUBCONTRACTOR will provide a copy of the Individual Employment /Vocational Client Plan to the client,
their CRM's, Guardian, the COUNTY, and others as appropriate.
4. Pathways to Employment Planning services shall include a personal discovery process related to skills,
capabilities, and goals; education on system navigation; facilitated plan development; action steps detailing
steps, timelines, and entities responsible for the accomplishment of tasks leading to employment and the
implementation of vocational services.
5. Clients in an employment program will be supported to work toward a living wage. A living wage is the
amount needed to enable an individual to meet or exceed his or her living expenses. Clients should average
twenty (20) hours of community work per week or eighty-six (86) hours per month. The amount of service a
client receives will be based on his /her demonstrated need, acuity level, and work history.
6. If SUBCONTRACTOR fails to provide the minimum number of monthly service hours for the client, the
COUNTY will advise the client, Parent /Guardian, and /or Residential Provider concerning the minimum
and maximum number of service hours the client should be receiving and inform them of the option of
choosing another Employment Provider.
7. SUBCONTRACTOR will contact all clients according to their need, and at least once a month.
8. The Action Steps of the Individual Employment /Vocational Client Plan will be reviewed by the chosen
Employment Provider every 6 months (sooner if needed) in order to assess if it is continuing to meet the
individual's pathway to employment goals.
9. The Action Steps of the Individual Employment /Vocational Client Plan will reflect that 75% of the direct
service hours with the client will be at employment sites in the community. The focus will be on real work
experience in a community setting delineating individual skills, experiences, preferences, strengths, support
needs and vocational interests.
10. SUBCONTRACTOR shall provide an Individual Employment/Vocational Client Plan for clients in
Individual Employment delineating individual skills, experiences, preferences, strengths, support needs, and
goals and objectives within 30 days of the beginning of services for the client in order to promote Individual
Employment. Job coaching and supervision of program clients will be based on goals established in an
Individual Employment /Vocational Client Plan. Client goals, training provided, and progress toward
meeting goals shall be documented in each client record.
11. If clients in Individual Supported Employment have not obtained paid employment at minimum wage
within six (6) months, the SUBCONTRACTOR will assure the COUNTY the following steps are taken:
a, Review of progress toward employment goals
b, Provide evidence of consultation with the family /client
c. Development of additional strategies with the family /client, COUNTY staff, employment support staff,
and the case manager. Strategies may include providing technical assistance, changing to a new provider,
and /or providing additional resources as needed to support the individual's pursuit of employment. The
additional /new strategies will be documented for each client and kept in the client's file(s).
CONCERNED CITIZENS IE /1TA Contract 2015 -2016
Page 13 of 19
12. If a Client has not obtained employment after 6 months, the SUBCONTRACTOR will assure the COUNTY
that the following steps were taken:
0 Review of progress towards employment goals;
0 Provide evidence of consultation with family /client; and
■ Development of additional strategies with family /client, contractor staff, employment staff,
and CRM, is there documentation of these strategies.
13. The client may request to participate in Community Access activities or the client may choose to remain in
an Employment Program. When requesting to participate in the Community Access services, the client
shall communicate directly with his or her DDA Case Manager. The DDA Case Manager is responsible for
authorizing Community Access services,
14. SUBCONTRACTOR will submit to the COUNTY, to the DDA Case Manager, to the Residential Provider,
and Parent/Guardian a six -month Progress Report on each client. The SUBCONTRACTOR will use the
Employment Plan Report Form to report on the six -month progress of the client.
15. The frequency of the Semi - Annual Progress Reports of this contractual period will be one every six (6)
months after the initial plan —July through December 2015 —with the report due on January 2, 2016. The
second will be due — January thru June 2016 —on July 1, 2016.
16. The Semi - Annual Progress Reports shall demonstrate the implementation strategy and how the individual is
progressing on his /her Individual Employment /Vocational Client Plan; indicating the fulfillment of the
commitments made concerning the Action Steps of the Individual Employment/Vocational Client Plan; and
it shall describe the reasons for, if any, shortfall concerning the action steps and proposed steps for correction.
17. SUBCONTRACTOR shall schedule a review meeting every 6 months for all program clients, (a minimum of
twice a year for every client). The review meeting shall include an assessment/evaluation of the Action Steps
of the Individual Employment /Vocational Client Plan (goals and objectives). The Action Steps of the
Individual Employment /Vocational Client Plan will be updated every 6 months, (including at the 12 month
stage) for all program clients, will a special focus on clients who are unemployed.
18. COUNTY shall receive the dates for the 6 -month reviews for program clients one month before the required
meetings.
19. SUBCONTRACTOR will submit a copy of the updated Action Steps of the Individual
Employment /Vocational Client Plan and progress reports to the Client, the DDA case manager, the COUNTY
Coordinator, and Residential Support Staff/ Parent or Guardian.
20. SUBCONTRACTOR will submit six -month Progress Reports & updated Action Steps on each client to the
COUNTY for feedback and approval. Disregarding or lack of follow- through on this step will hold up monthly
billing and continued authorization for funding.
21. The Semi - Annual Progress Reports will show Individual Employment /Vocational Client goals, training
provided, and a written synopsis demonstrating progress toward meeting objectives; or it will describe
reasons for any shortfall concerning the outcomes, and propose actions for correction.
22. SUBCONTRACTOR shall schedule a review meeting every 6 months for all program clients. The review
meeting shall include an assessment /evaluation of the Individual Employment /Vocational Client Plan's goals
and objectives. The Individual Employment /Vocational Client Plan will be updated every 6 months for all
program clients.
23. SUBCONTRACTOR will submit a copy of the updated Individual Employment/Vocational Client Plan and
progress reports to the client, the DDA case manager, the COUNTY Coordinator, and Residential Support
Staff /Parent or Guardian.
24. All clients will be contacted by SUBCONTRACTOR according to client need, and at least once a month.
CONCERNED CITIZENS IE /ITA Contract 2015 -2016
Page 14 of 19
25. The SUBCONTRACTOR will clearly communicate to the COUNTY and the client prior to beginning service,
or when there is an unexpected change in the maximum service hours per month the client can expect to receive;
and service changes will not occur until the client has received proper notification from DDA.
The client's DDA ISP is the driver for service. The County Service Authorization (CSA) and
updated Planned Rates information will not exceed the client's DDA ISP.
The amount of service hours the client receives should match the County Service Authorization
and Planned Rates information.
26. SUBCONTRACTOR must ensure that every client file has a copy of DDA Client Authorization, a copy of
the participant's Individual Habilitation Plan (ICF /MR), client's Individual Service Plan, Plan of Care
and /or Individual Support Plan (HCBS Waivers) and /or the County Service Authorization /Individual
Service Agreement Plan, as applicable.
27. SUBCONTRACTOR must ensure that Client Goals and Objectives are based on a Person Centered
Plan /Action Steps or an Individual Employment/Vocational Client Plan; that documentation and data
collected, or training reflects the Action Steps or the Individual Employment /Vocational Client Plan; and
that the documentation shows how it has identified and addressed support needs of each participant by
demonstrating methods for providing services based on individual needs that are outlined in a client's
Person Centered Plan /Action Steps or an Individual Employment /Vocational Client Plan; and has
documentation of six -month progress reports that include Client Goals /Action Steps and a summary of
progress toward meeting those goals and objectives.
28. SUBCONTRACTOR must ensure that all Incident Reports are retained in client files; that they have a
policy to retain records at least 5 years; that emergency contact and medical information (medications,
diet, allergies, etc.) needed during the hours of service is available for each participant on the face sheet of
the client file; that the emergency and contact information is updated yearly, or when needed; and that
services are provided in a natural or integrated environment or there is a goal to achieve that.
29. SUBCONTRACTOR will support Clients in an employment program to work toward a living wage. A
living wage is the amount needed to enable an individual to meet or exceed his or her living expenses.
Clients should strive to average twenty (20) hours of work per week or eighty -six (86) hours per month.
The amount of service a client receives will be based on his /her demonstrated need and acuity level.
30. Worker wages shall be commensurate with the local industry accepted norms and comply with applicable
Federal Department of Labor standards.
31. For Individual Employment where the service provider is also the Client's employer, long term funding will
remain available to the service provider / employer for six months after the employee / DDA Client's date of
hire. At the end of the six month period, if the DDA Client continues to need support on the job, another
service provider who is not the employer of record must provide the support unless the County issues prior
written approval for the service provider to continue to provide long -term supports if needed.
32. Recommendations for program participant's termination in Individual Employment or transfer into
another Individual Employment agency must be authorized by the DDA Case Manager, and will be reviewed
in consultation with the COUNTY and others as appropriate. SUBCONTRACTOR will facilitate the
development of a transition plan and schedule. The transition plan will be developed in consultation with the
client, DDA case management, COUNTY, family members and other service providers as applicable and within
10 working days of SUBCONTRACTOR'S recommendation.
33. 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 SUBCONTRACTOR
is required pursuant to RCW 43.43.830 -845 RCW 74.15.030, and Chapter 388 -06 WAC on all staff.
34. SUBCONTRACTOR shall submit a written Program Staff Training Plan to COUNTY for approval or
disapproval within 30 days of the effective date of this agreement, semi - annually thereafter or when
reorganization occurs, which minimally includes SUBCONTRACTOR's procedure to train new direct
service staff. The training must include:
CONCERNED CITIZENS IE /ITA Contract 2015 -2016
Page 15 of 19
• DDA Policies & Competencies (see Section C- Number 36 -39)
• RCW's & WAC's as referenced on page 1 & 2 of the County Contract, 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 Individual Employment /Vocational Client Plans and /or
Person Centered Plans (creating client vocational goals /objectives)
• SUBCONTRACTOR's plan to provide staff that are skilled in applying training
techniques to enhance the work related skills of program clients
• FTE levels job descriptions and organization charts pertaining to program staff
• SUBCONTRACTOR is required to send one direct service staff to a minimum of
16 hours of workshops, trainings and /or conferences about developmental
disabilities and employment, for a total of 16 hours. Should SUBCONTRACTOR
fail to access trainings 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 of $1,072)
35. SUBCONTRACTOR will provide COUNTY with information regarding staff qualifications and documented
training's every six (6) months.
36. 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 LI —Hor /�r trrr r�a��9PL11a C "f ermys: ADA training, APS Reporting Requirements, Client
confidentiality, Current individual instruction and Action Steps /Vocational Plans for each Client with whom
the employee works, DDA Policy 4.11 Working Age Adult (adult services only), DDA Policy 5.06, Client
Rights, DDA Policy 5.13, Protection from Abuse: Mandatory Reporting, DDA Policy 12.01 Incident
Management.
37. 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
38. 'ithi n one rry,anih �� � we wnl 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.
39 11'i�a!''fi is r�°rr� ntlr � r� Frr rl' r �rtr�. iw 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.
40. SUBCONTRACTOR will have signed documentation that Staff training took place within the timelines
listed above in Section C- Number 36 -39.
41. Within 30 days of the effective date of this agreement, and semi - annually thereafter, SUBCONTRACTOR
will develop and submit to COUNTY an Individual Employment program operating budget detailing the
projected allocation of contract funds, other sources and amounts of funding, program staffing expenses and
other cost allocations.
CONCERNED CITIZENS IE /ITA Contract 2015 -2016
Page 16 of 19
42. Semi - annually, SUBCONTRACTOR will develop and submit to COUNTY Individual Employment program
financial reports reflecting the actual revenues received and expenses incurred compared to the projected
program budget submitted.
43. The SUBCONTRACTOR will on an annual basis sponsor the surveying of participants, their families, and
their support networks and employers regarding customer satisfaction. The SUBCONTRACTOR will design
Customer /Client survey forms. The SUBCONTRACTOR must send the COUNTY copies of the surveys
received from participants, their families, their support networks and employers.
D. Performance Standards
(1) SUBCONTRACTOR shall provide Individual Employment services that are referred for service by
DSHS /DDA and have been authorized by the COUNTY.
(a) Job development, job coaching, follow -along and replacement services as necessary
for Individual Employment Clients
(b) Individual Employment /Vocational Client Plan must contain Action Steps detailing
steps, timelines and entities responsible for the accomplishment of tasks leading to
employment
(c) Provide the minimum number of monthly service hours for the client
(d) Implement Action Steps that affirm 75% of the direct service hours with the client will be at
employment sites in the community
(2) SUBCONTRACTOR shall provide Individualized Technical Assistance services that are referred for service
by DSHS /DDA and have been authorized by the COUNTY.
(a) A part of an individual's pathway to individual employment
(b) The service of assessment and consultation (in order to identify and address existing barriers to
employment) may be provided by the employment provider or to the employment provider
(c) This is in addition to supports received through supported employment services or pre-
vocational services for individuals who have not yet achieved their employment goal
E. Service Level Guidelines
(1) Client Employment Acuity is determined through the DDA assessment. Acuity reflects conditions typically
related to the individual's disabilities that are not likely to change, and are generally not impacted by outside
factors. Client acuity is determined as either "high", "Medium" or "Low" as defined within WAC 388 -828.
Other considerations are generally related to the job or service environment which may impact the
individual's level of support, regardless of acuity.
(2) Employment Service Levels reflect Client Employment Acuity and other considerations (see
Table One -Base Hours below); the Guidelines typically reflect direct service staff time provided to or on
behalf of the client to pursue or maintain employment. You may be eligible to receive additional add on hours
(see Table Two, Add -On Hours below).
(3) Short-term Employment Supports is a service that allows DDA to approve additional service hours in
addition to the amount of your employment service Base Hours and Add -On Hours for up to three months
when:
a) You are beginning a new job; or
b) There is a planned or unexpected change in your job or job duties; or
c) Your current employment is at risk and short-term supports are needed to assist you in
maintaining your current job.
Page 17 of 19
(4) 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 Individual Employment Plan.
Allowable activities are defined in the Employment Phases and Billable Activities.
TABLE ONE-Base Hours
_ .—.. .
DDA DETERMINES
...... . . .....
YOUR EMPLOYMENT
SERVICE
LEVEL USING THE
FOLLOWING
TABLE:
CLIENT
YOUR
THEN YOUR
AND YOUR
ACUITY
EMPLOYMENT
EMPLOYMENT
EMPLOYMENT
LEVEL
STATUS
SERVICE
SERVICE BASE
IE:
IS:
LEVEL IS:
HOURS PER
MONTH MAY BE:
WORKING
A
0
NONE
NOT WORKING
B
0
WORKING
C
4
LOW
WORKING
E
7
MEDIUM
,,0' WOR(KNO,
------ ... .... .
WORKING
IG
HIGH
NOT WORKING
H
12
Page 18 of 11,
TABLE TWO-Add-On Hours
D D A tui 1. S 'r 6 1, 1, 0 " "INN T A B L l, " lO
DE',TERMINETHE MAXIMUM NLJMBER
OF ADD-ON 11011 16)'O(I AKEELl(jJBL,L
TO RE'CEIVE.
IF YOU ONE
..
YOU MAY BE
OF THE BELOW
ELIGIBLE TO
CONDITIONS AND
RECEIVE UP TO
YOUR
THE
EMPLOYMENT
FOLLOWING
LEVEL IS:
AMOUNT OF
ADD-ON
HOURS:
A
0
- - - - -- - - -
5
�E
G
12
H
. . ..........
14
F. Individual Employment Unit of Service
1. One UNIT of Individual Employment/Individualized Technical Assistance service is defined as one (1)
"HOUR" of direct service or assigned service level to one eligible client. An "HOUR" is at least fifty (50)
minutes of direct service; (partial liow- to the qLMOU may bQ recorded); ten (10) tnintnes of every 1,10tjR"of
direct service or assigned service level to one eligible client can be used for dockinientation and/or illecting times
or ASSIGNED SERVICE LEVEL as defined in Section D, Performance Standard, Number I and 2.
2. Individual Employment service support hours will be based on the client's Individual Employment Level per
WAC.
3. One UNIT of Individual Employment or Individualized Technical Assistance service is $65.00 and is defined
as one "HOUR" of direct service to one eligible client.
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