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Public Health
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:
l % z r 5
SUBJECT: Agenda Item — Professional Services Agreement — Skookum Contract
Services for Individual Employment and Individual Technical
Assistance; July 1, 2015 — June 30, 2016; $132,285.00
STATEMENT OF ISSUE.
Jefferson County Public Health, Developmental Disabilities Division is requesting Board approval of the
Professional Services Agreement — Skookum Contract Services for Individual Employment and Individual
Technical Assistance; July 1, 2015 — June 30, 2016; $132,285.00
ANALYSISZ STRATEGIC GOALS PRO'S and CON'S:.
The professional services agreement with Skookum for Individual Supported Employment falls under
Vocational Services as part of the Developmental Disabilities agreement with DSHS. This agreement
provides for the placement of clients from the developmental disabilities community into traditional
employment settings at work sites or in job training. 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 -- parents, unions, others 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; feedback to the worker, county and DD field services regarding progress and /or problems.
Follow -along services are included that provide for a safety -net service of support, counseling, job analysis,
and supported training to the worker, employer, and other interested parties (parents, unions, etc).
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
FIS9;ALIMP'A%T &� E EFIT A i'ALY �
This agreement provides for funding not to exceed $132,285.00. The provider shall be compensated at the
rate of $67.00 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.
RECQM EN DATION',
JCPH management request approval of the Professional Services Agreement — Skookum Contract Services
for Individual Employment and Individual Technical Assistance; July 1, 2015 — June 30, 2016; $132,285.00.
REVIEWED BY:
p ley my Administrate r, Date
SUBCONTRACT FOR PROFESSIONAL SERVICES
Agreement Between
JEFFERSON COUNTY PUBLIC HEALTH
AND
S}{OOKDM CONTRACT SERVICES
Tkimogreemunt io made and entered into between JuOfermm�omntyj,ublic I lco\th (COONI'vomd3kookun'i Contract
Services (SUM ��NTRACT0R) for provision of Individual 8 [,upinynem| to Pocmons with Developmental
Disabilities |oJcDrexsom county. The ' mfdkis agreement is July 1,2O|5Uu#mgbJune 30,20WTh1a Contract may
be tenninated by eifllet party Upon 60 days, written notice. Termination Of1his (70111ract shall 110t constitute a breach,
ltis agreed Upon by Both Parties umNamed
Herein as Follows:
A. PROFESSIONAL SERVICES
Professional services Nhu provided hy SUBCONTRACTOR shall include:
(|) "Individual Suppm,led Emmplmymmeotm or "lTI~: mory ices area paT�tofum imdiv\Juo|,m pathway |o
nmPUuymont, are tailored to individual needs, ioceroots, abilities, and promote corcevdevm|mpmard- These
are individualized services necessary to help persons vviCb (level opmmnt,�} dimn6i>i6csmb(oiu m)dov/8imuc
integma|ed employment in Ille geno-al work1bree ut or above the state's 111inill'U111 \Wlge, These services
may include intake, discov,ery, assessirient, job marketing & development, job placement, job replacement,
worksite job training co,,whing/supports, development of natural supports, and follow.-along and record
keeping per .
(2) "Individualized Technical Assistance" or^^lTA". mmrviueo are a part o/mn individual's pathway tm
individual employment. The service ofassessment and omnou!matiou (in order ro iJemti6v mudmJdcsaeximdag,
barriers tu employment) may ho provided by the employment provider, mrio�icemp}*yxaen1providxcl1hioix
iouddidou1osuppo�o received through ouppoMrdenq,|uymzmi services orpoo-voca1iooml services for
individuals who have not yet achieved their employment goal per '
(3) pm8mm management.
B. OBLIGATIONS
SUBCONTRACTOR shall fulfill the following obligations:
(l) SUBCONTR ACTOR shall comply with all state and federal requirements °^. ,~g~d^.m the confidentiality of
Client records. Client imfbrmution is not diyoloaah|eto the publio. Ddooumdum acgubed pursuant to 8Cvv
71 A. 14.070 requires a signed Release of Information or a signed Oath of Confidentiality Form.
(%) SUBCONTRACTOR is required pnu*i6c background checks, pmrmumd 0m RCW 4143.0g0-045, RC9/
—`—
� r�bmwNmrmu
74.15.030, uodChmpCur388-06V\{"whicbxtutetbn[inyDruapuoCiv�*u/p|oYmeu,*olumtcc y
have unsupervised access to u vulnerable person nithodevelopmental disability im the course mfdoorher
-mp|o'—u-' or involvement with the hoiuexa ()I. m� mt have m �a�ig�uum�/cvimimu| history
,
clearance they have unsupervised access.
TheDS05Background Check C*noal Unit {QC(,,,l)mvust
hu utilized 0o obtain background clearance.
(3) If SUBCONTRACTOR reviews the application and elects to bi,u or retain an individual after receiving
oodoc that the applicant has x conviction for an offense that would disqualify the applicant from having
unsupervised uocoxx to vulnerable adults as defined in Chapter 74.34 T<CW' then DD& uhuU deny payment
for any subsequent services rendered by the disqualified individual provider.
(4) SUBCONTRACTOR is n:guipmd pursuant to R,CW 74.15.030, that if any prospective employee who has not
resided in Washington State during the \uxt three years, and who will or may have ummmpun/iood access to u
vulnerable person with u developmental disability inthe course of his orher employment, oriuvoivomeutwith
the business or organization, must have unF.B]. Fingerprint Check before they have unsupervised access and
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; IZC:W 26.44, Abuse of
Children; the WACs: 275 -26 Division of Developmental Disabilities Services Rules; 296 -2.4 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 HOBS 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) SUBCµONTR.AC.,1°OI� shall t with the lo if Developmental Disabilities Administr ation, (DDA)
Policies: 3.01 Client S ervicePlans ;5,01Criminal History Background
Checks and Safcguarding Personal
Informartion; 5.02 Ncccssatry Supplemental Accotr rnodation ('.NS.A); 5.0'3 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 11se of [�Cstrictivc I'rucedures; 6,08 Mandatory Deporting Requirements f.rr Frnployment and
Day Program Services Providers; 6.13 FamploymcnVDaay 1'rograrm Provider C; ualrlrc flOrls; 9,.07 Hunia:rr
Immunodeficiency Virus (1-11V) and g Acquired Irnmune Deficiency Syndrome (AIDS), 12.01 Incident
Management; 13.04 DRW Access Agreement, and the 1992 Count Guidelines.
(8) SUBCONTRACTOR shall comply with the following referenced documents found at DDA Internet site
Irtrs,,.11e as wv.dslrs t1. f�ar,_v, /cltlaalctrrrr�ty(?tmt Rr rct q,s 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 hanatssment and non-discrimination (said
policies must guarantee luun'aan /civil righta);, regarding ar person's right to privacy, regarding safeguarding
persomal inf6rrrrat.ion and abuse ofpar ticipaauts; regarding agency medication procedure; regarding respectful
staff -trr p<articipant interactions (Le.: including a person's ritgjit to be treated with dignity and respect free ol�"
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
SKOOKUM IE /ITA Contract 2015 -2016
Page 2 of 19
• 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 abou 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 whew The employce, 017 ficer or agent, any member of immediate fiamily, Guardian / decision
maker, or an organization that employs or is about ta,) 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 devOopmenial disabilities must be provided Willi attetation to their health and
safety. SUBCONTRACTOR shall comply wi't'h all awpplicable 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 »SUB 0NT'RAC l`0RS are maanda'led reporters under RCW 74.34,020(1 1). All
parties must comply Willa reporting requirements described in RCW 74.34.035, 040 and Cluipter 26.44 and
must adhere to DDA Policy, 6.08 Mandatory Reporting Requirements for Ennployment 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) Accred_gil onI SUBCONTRACTOR must be able to demonstrate conformance to Commission on
Accreditation of Rehabilitation Facilities (CARF) standards for quality assurance and CARF accreditation.
SKOOKUM IE /ITA Contract 2015 -2016
Page 3 of 19
(b) SUBCONTRACTOR shall protect and maintain all Confidential Information gained by
reason of the Program Agreement against unauthorized use, uccoux' disclosure, modification or loss. This
duty requires the COUNTY to employ reasonable security measures, which includes restricting access to
Confidential Information by:
(l) Allowing access to staff that have uu authorized business requirement to view the Confidential
Information.
CQ Physically securing any omnputem, documents, or other media containing Confidential
Information.
(3) When transporting six (6) to one hundred forty nine (149) records 000tuioio8 Confidential
Information outside a Secure Area do one or more of the following as appropriate:
(a) Use u trusted System
(b) Encrypt the Confidential luhonou1iou,including
(i) Bmui| and/or email attachments
(ii) Confidential information when it ix stored oo portable devices or media including
but not limited tu laptop computers and flash momorydoviooa
(c) containing Confidential Information via Trusted System.
(l) To the extent aUmvod by |m*, at the end of the Program Agreement term, or when no longer
needed, the ymhex shall roknn Confidential lof000udon or certify in writing the destruction of
Confidential Information upon written request bydhe other pmrty.
(2) Paper documents with Coufidoudu| luybnniotimn/nuy be recycled dbroou& u*mnh-actcd 111111,
provided the contract with the \ specifies that /he confidentiality mCbzGormaihmu will be
protected and the iu(ouou1ioo destroyed Uxrmwa6 zhm recycling yr*ooms. Paper douummuto
containing CoofidendoJInformation requiring special limmdYimg(e.g'pnXcot dbeukhimOormohuu)
must he destroyed through shredding, pulping, orincineration.
(3) The compromise or potential compromise ofCoufidoudul Information must be reported tothe
DS} P-5 Contact designated on this Prograin Agreement within five (5) business (hiys of
discovery for brcnubcmnflemm than one hundred fi ftv(l5Q) Persons' protected data, and one
(\) hnxinums day *[di000veryo[brmochcmufovmr one hundred filly (l5[) pe,xmna'protected
data. The parties must also take actions to mitigate the risk o[loss and comply with any
nodficu1ionoc other requirements imposed bylaw.
(d) SD0���TRA�OKwJlmm��o4u�o��u���o��mdou�meu m�mu
—~--------
hmited x6iltyto speak, read, write English n� U �uuo gbt n understand and communicate effectively
(zeferooccDD/\ Policy 5.O5, Limited English Profio/ool(LE/")LY/enm).
SUBCL)�4T}lA{�T0R will maintain an
a(iiiiinistrative/oi-gaiiizationaI structure that clearly defines responsibilities; systems and personnel to
maintain accounting records that accuraiely reflect all program revenues and exlicnditures; prepare
monthly statements of activity (ADSA Reports); maintain appropriate client service records and progress
reports; and track key program performance indicators.
(�)
(0 P �tj cjpjgq!,i,, BDBC0Nl}lACTUK has u commitment to support ouo6/uuvu of individuals with
dovc\opnnontu| dioxhUidoo with people who are not dixuh\od and has involved participants with
developmental disabilities io policy development.
(X) 9�t nen _,5.: SUBCONTRACTOR has u history of working co*peoo|vely with comoouobv'humed
m/gouizahwnm including Employers, other Agencies, the CQDy41~y DD Program, the Division of
Vocational Rehabilitation (D\/B), and the Schools.
(h) 11c, SU8CQl�TR ACTOR has a written performance plan that describes its mission,
-
program objectives, expected outcomes, and how and when ubjuctiveovUlhoucoompliuhod,
and will assure the plan is evaluated »t least biennially with revisions based on actual pm1ooniauoe.
(i) internal Conlrol SODC0M]8 ACTOR has sufficient policies and proc*Jures,' Dv establishment
and maintenance of adequate internal control systems. SUBCONTRACTOR will maintain written policy
procedural muouu|a for information systems, personnel, oodu000uutinn/Douooe iu sufficient detail such
that operations can continue should Staffing change or Prolonged mbscnces occur.
�) �1�8 SD8C0]�TR,�{��00vvi]| provide adequate, 4mnli�e�sLafTvvdbakiUo and experience
in ew"fluation, ----------ro[miug,muper*iaiun,couume|imgumdamppor|ofmdmhmp/uhdevelnp,oentu)d[aubUidoa
who "ire earning eugum Pei, the a&uched Statement ofVVurk. 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.
uxnouorm/c/ITA Contract zo|5ao10
Page 4of/v
(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) 1 rnp,tiyrp w,ADd 4ay services must adhere to the Dome 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) SUB CONTR ACTOR shall provide an Individual Employment /Vocational Client Plan aud/or Person
Centered 1`+lr:inning /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 faumily (the team).
2. IniJal plans will be completed within 60 days from dente 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 sarpports) to meet the employment f"�rnal
1) Identification of persons and /or entities (such as family, Division or Vocational Rehabilitation)
available to assist the client in reaching his/her employment employment goal
m) Idene:ification of other accotnrnodalions, 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 disabilitles must be provided with attention to their health and
safety. SUBCONTRACTOR shall comply with all applicable federal, statc 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 DSI IS,IDDA Case
Manager for the individual involved, and then to the COUNT Y Coordinator. This includes serious physical
or emotional harm or potential harm.
SKOOKUM IEATA Contract 2015 -2016
Page 5 of 19
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 (late of this <agte•.ernent and at least semi - annually Ilicreratler,
S'I.:GBCCtN "'l °RAC,, "1`0l will pa°ravicle (a) coaatputrr (b) program financial reports to ('C)LtN °N "Y, is claatliat0 all
revenues and expenses generated by SUBC�ONTRAC': "'1"t�)1�, 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. 1 he COUNTY shall monil.or 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.
(33) ,(11311 It l; i Dll l I N I'S. Independent Audit will be submitted annually to the Jefferson COUNTY DD
COUNTY Coordinator in the following manner:
°~ [JBCONTRACI`C; R must be able to account For and manage public funds in compliance with Generally
Accepted Accounting Principles "GAAP ". An algency, for- lirofit or non- prollt, who a °eceives in cxcess 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 R shall subrnit two (2) copies of the audit and /or the summary and the
management letter directly to the C "OLKIW 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.
SKOOKUM JE /ITA Contract 2015 -2016
Page 6 of 19
(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 'frail to rcsoNc, the compliance isstoe,, tlae parties will obtain the services of
the Peninsula Dispute Resolulion Center, or another agreed upon resource, aaacl shall share; equally in
any retainer fees or rather costs of services, It'no agrecillent is reached, (lie mediators decision in the
inalter wall be binding on all laaa Lacs, w la,t Owl ill no event will Ilre County honor a financial
detennination 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 rellecl all direct and indirect exlaenditurcs of funds provided under this agreement.
Client records shall minimally include statement o'felient 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
SUBCONTItAfi 1 "Gilt 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 SUBCONI RAC'i -OR
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 on a unit rate
basis as follows 0
S.00R
(a) Individual Iwn tlal yztacratllr a;� „avo aa.lira d 1 qglInic U Assi _'"_stdlaa c ,` ctrvicq�.,: SUBCONTRACTOR will be
paid ” "" : 1)er 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
art "the month„ for units of service provided under this agreement. SUBCONTRACTOR will submit a Monthly
DDA Services Report (ASDA) form for its billings, A1: no time shall the invoices for reimbuasetnent 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 $132,285.00 in completion of these services without express written amendment signed by both
parties to this Agreement.
SKOOKUM IE /ITA 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 PASSARWE.
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 a f'per:sons authorized for services
reimbursed under this agreement. Only pei sons referred to f.t lUN3'"Y 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 surpphes 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 o'f"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
SKOOKUM IE /ITA 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 Ahe COUN' "IY, at its option„ from addilionally
requesting that the SI.JBCONTRAC "I Old deliver to the COUNTY an esecn ed 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 SUBCONTRAC' 1`01 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 sl'iall 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 pail, 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
SKOOKUM 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 potenthil liability for actions brought against the COUNTY by
S1,J13 .ONT10C:'"I'f1R'S erriployces, including all other persons engaged in tile performance of any work or
service required of l:he SUBCONTRACTOR under this Agreement rand, solely liar 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, brut., 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 , 2015
By: B
David Sullivan, Chairman
J a, rust ent
Jefferson Board of County Commissioners Skookum Contract Services /n�w
Attest, Clerk of the Board
AI?P It 'EL) AS TO Rlv1 ONLY:
By W_
Jefferson Count y I rosecut. a t(orney
SKOOKUM 1E /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.
H. PROGRAM DESCRIPTION
A. Program Goals:
1. 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.
3. 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
1, Indi;vidLiatl l;e;ufalc y rte�tt is tt11 i��clivicluai joie irl tine t',orNklti °]r111ity wvilel'e a t� °aditaortrtl eml l¢tyerlemialffee
reNtionship exists (i.e. person is hired, paid, ,utd supervised i.)y the employer), and is per formed at
locations that "'Ire typical rtml _)ioyn °rent sites for non - disabled persons, (not in busina,sscs or lotrrticalls
Nviwre the primary Purpose is to provide eniploymtwnt 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.
SKOOKUM IE /1TA Contract 2015 -2016
Page I1 of 19
2, Macement 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.
3. RePkica' m rtt is defined as being assisted by the same SUBCONTRACTOR in any subsequent
employment (second, third, fourth job, etc.) for 90 calendar days. Employment maybe full -time, part-
time, or other as defined in B.2 above.
4. Plntcemctlt at I Re qflact,xtient Services may include: vocational counseling and job analysis to assist in
the identification of work objectives and the job tnnatch process; job development, locanling, an tiunl' able:
community job for the worker; initial placement and, post -hire 'franning of tine supported ennployee,
employer and /or coworkers at the employment she- job 'restrocniring and worlcsite 1'11odificalions;
supporting the worker, employer, and other interested person, (parents, anions, other employees, etc.)
to develop natural workplace supports and ensure slarbility on the job assisting the worker to mlbtain
other services necessary for continued employment; l�edback to the worker, COI IN`I "Y and to DDA
Field Services regarding progress and /or problems.
5. Follow along Services begin at tile time, 01''pl<tccg'ncnt or re'placcnnent and may include: visiting with
the worker, the employer, and other lnteres�l�ed parties (ptnrennls, unions, etc.) to irnsti e stability on tine
job; prntvit:ling, feedback to the worker, COC?NTY, and to DDA Field Service's regarding progress
and/or problems; counseling the worker and his /her family on vocational issues.
6. µ11c do vetl7nngtl of a1 1'a1t,pyn tyt' 1 mga,lia_nrnt ont,,.)'lan 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, l''Banntitn 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, 1nnlIt nrrelnt tion, 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. Individualized Technical r' ,9sJ,lnt¢nce sery,IM are part of an individual's pathway to individual
employnnennto 1`hc .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 elnplogy ment services or pre- vocatit'nm'd
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.
SKOOKUM IE /ITA Contract 2015 -2016
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 erviccs for the cliew, in order to promote Individual l;m,ployment. (Mininium Individual
Ir,rr:l)k)yariermt /Vocationtd! Client Plan elements are outlined ill the reference document cal led "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 h °naployrnent Planning services shall include a personal discovery process related to skills„
a apalailities, and goals; education on system navigation; facilitated plan de.velolinient;; 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 Individuarl %;ai:pi,loyaaicn't /Voc &ttionaal Client 1']rmn for clients in
Individual Employment delineating individual skills, experiences, preferences, strengths, sullpoa"t needs, all(]
goals and objectives within 30 days of the beginning of services for the client. ill order to pr °01110tc Individual Employment. Job coaching and supervision of prograran clients will be based ()n goals cslaabl:ished rr�t our
Individual Employment /Vocational Client Plan. Client goals, training provided, and progress t,owarrd .
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. Develtapmem of additional strategies with the luumily /client, Ct,,,1Ctl" TY staff, ca °nployinent support staff,
and the arse manager. Strategies may include providing lechrricar] assist.a'ance, changing to a new provider,
and/or providing additional resources as tacedecl to srxpp� t'ar•t the ir,adpvi(°3t1,11's� pa�ars�uit ofemployment. Tl��ae
additional /new strategies will be documented for each client and kept in the client's file(s).
SKOOKUM 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:
• Review of progress towards employment goals;
• Provide evidence ofeonsultation with lhmaly /client; and
• Developmentofaddnaonal 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 regraesting 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 new
Employment Plan Report Fonn 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 demonstrazte the implementation strategy and how the individual is
progressing on his /her Individual Employment: /Vocational Client Plan; indicating the fulfillment cd' 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. SUI`;ICiINTRACTOI shall schedule a review meeting every 6 months for all program clients, (a minimum of
twice as your for every client).. The review a�nee'ting shall include an assessment /evaluation of the Action Steps
of the Individual Ernployment/Vocational Client Plan (goals and objectives), The Action Steps of the
Individual Employment /Voca°adonal Client Plan will be (ipdated 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 coley of the updated Action Steps of the Individual
Employment: /Vocattional Client Plan and progress reports to the Client, the DDA case manager, the COUNTY
Coordinator, and Residential Support Staff/ Parent or Guardian.
20. will stabinit: six -month Progress Reports & updated Action Steps on each client to the
COL:.ON I Y fior feedback and approval. Disregaardin,p,, 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/Vocaational Client goals, training
provided, and a writlen synopsis demonstrating progress toward meeting obJect:ives; or it will describe
reasons for any shortfall concerning the outcomes, and propose actions for correction.
22. SLJRCON'1`RA(:TOR shall schedule a review meeting every 6 months for all program clients. The review
meeting shrill inelrrde an assessment /evaluation of the Individual I�rnl Ioyment /Voc<atioa,tarl 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.
SKOOKUM 1E /1TA 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 1 labilitation Plan (ICF /MR), client's Individual Service Plana, Plan of Care
and/or Individual Support Plan (H'CBS 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. SLIBCON'TRAt..T Ili must ensure that all Incident Repor't's are retained in client Iilcs; that they have a
policy to rewin records at least 5 years, that emergency contact a nd inedical inkx- martion (niedic.ations,
diet, ;allergies, etc.) needed during the honrr.s of service., is available for each partieipant 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 weak 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. SUBf'.ONTRAC I 'OR must ensure these is rt lcgaI requrirenicni a °and a cleat' delineation for staff
qualifications and proof of background criminal history clearance in accordance with SUBCONTRACTOR
is required pursuant to RCW 13.43,830 -845 RCW 74 1.5.0310, 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:
SKOOKUM lE /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 five direct service staff to a minimum of
16 hours of workshops, trainings acrd /or corslerences about developmental
disabilities and employment, for a total of 80 fours Should SUB CON °11�ACTOR
fail to access trainings for direct service staff, the SUBCONTRACTOR will
reimburse the COUNTY at the rate of 67.00 an hour for every hour of training not
accessed for staff (for not more than a total of $5,360)
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 ,","rr "or° trr l%=r � /cr�A �r /fir f /r'eraa, : ADA training, APS Reporting Requirements, Client
confidemialky, Current indivicCmal instruction and Action Sleps/Vocational Plans for cac'h Client with +, hom
the employee works, DDA Policy 4.11 'Working Age Adtrll (adult sci— vices only), DDA Policy 5.06, Client
Rights, DDA Policy 5, 1 3, Protection from Abuse: Mandatory Deporting,„ 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. l r //e rr rrfac„ rro n /,Pr (.;`c rrr trrl,arrrew: 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 Proglwll Provider Qualifications, DDA Policy 13.04
DI W Access Agreement, DDA Policy 15.03 Community Protection Standards for Employment /Day
Programs and all reporting requirements related to these DDA Policies.
39. 1Vilhrinr srl,- morn lrr �'_��rrr/��r? rr�� ^r�ad.: SUBCONTRACTOR must ensure that direct service staff received
Iraioring and are knowledgeable in the fallowing areas: Program skill developntent„ DDA Policy 5.02
Necessary Supple mental 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
wiI'I develop and submit to COLON "I "Y an Individual I "rralt'loyment program, operating budggo detailing the
projected alloc,,,aicm of contract funds, either sources and amounts of funding, progran, staffing expenses and
other cost allocations.
SKOOKUM 1E /1TA 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 'AC' 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
"fable One-Base Hours below); the Guidelines typically reflect direct service staff time provided to or on
behalf ofthe 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.
SKOOKUM IEATA Contract 2015 -2016
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 I)E']'[,'RMINF,,,S
YOUR EMPI_,OYMINTSI3'RVICE
LEVE), IJSING! 1-141",
FOLLOWING
TABLI�:`;
CLIENT
YOUR
THEN YOUR
AND YOUR
ACUITY
EMPLOYMENT
EMPLOYMENT
EMPLOYMENT
ILEVEL
STATUS
SERVICE
SERVICE BASE
IE:
IS:
LEVEL IS:
HOURS PER
MONTH MAY BE:
WORKING
A
0
NONE
NOT WORKING
B
0
. .... .
WOR KING .....
C . ..........
4
LOW
_77—
WORKING
E
7
ME DIUM
NOTWORKING,
9',
WORKING
G
Il
HIGH
NOT WORKING
H
12
Page IS of 19
TABLE TWO-Add-On Hours
I)t I-JSFS'fHF"]OLt,OWINGTABI,ETOW
171111"IRMINE 111J."MAX[MUM N` 13I :1
Of-'ADD-ON 1,10( JRS YOU
ARE ELIGIBI-LE
TO RECEIVE,
IF YOU MEET 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
B
0
5
O.
7777",
[7,
5
F,
G
12
. .......... . .
F. Individual Employment Unit of Service
1. One UNIT of Individual Employment/Individualized Technical Assistance service is defined as one (1)
"IJOUIC" of direct service or assigiied service, level to one eligible client, An '110UIV is at least, fifty (50)
minutes of Greet service; (p,ardal hour to the quarter may be recorded); teal (10) Irlinutes ofevery 1-101JR" of
direct service or assigned service level to one eligible client can be used for doctinientation and/or mecting 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. 4 (.1r, COW
3. One UNIT of Individual Employment or Individualized Technical Assistance service is S&7-00 and is defined
as one "HOUR" of direct service to one eligible client.