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Consent Agenda
June 21, 2016
JEFFERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
AGENDA REQUEST
TO: Board of County Commissioners
Philip Morley, County Administrator
FROM: Vicki Kirkpatrick, Director
Anna McEnery, Developmental Disabilities
DATE: .9-11, /�/
SUBJECT: Agenda Item — Professional Services Agreement — Skookum Contract
Services for Individual Employment and Individual Technical Assistance
Amendment 1; July 1, 2015 — June 30, 2016; Additional $6,206.75 for
a total of $138,491.75
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 Amendment 1; July 1, 2015 — June 30, 2016; Additional $6,206.75 for a total of
$138,491.75
ANALYSIS STFATE'GC GADS PRO'S art+ SON'S:
This Amendment to the professional services agreement with Skookum for Individual Supported
Employment adds $6,206.75 to the agreement's original amount of $132,285 for a total of $138,491.75.
The agreement falls under Vocational Services as part of the Developmental Disabilities agreement with.
DSHS. This agreement provides for the placement of clients from the developrnental 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 Etre 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 --pa rents, 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
chosea0YA1@rf9rMg1tP,FQ process that occurs every four years, as per DDA 2011 mancl4P4ronmental Health
Developmental Disabilities Water Quality
360-385-9400 360-385-9444
360-385-9401 (f) Always working for a safer and healthier community (f) 360-379-4487
FISCAL. IMPACT COST BENEFIT 'IT ANALYSIS:
This Amendment to the agreement provides $6,206.75 of additional funding for a total of $138,491.75. All
other terms and conditions of the agreement remain unchanged. 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 — Skookum Contract Services
for Individual Employment and Individual Technical Assistance Amendment 1; July 1, 2015 — June 30, 2016;
Additional 6,206.75 for a total of $138,491.75
REVIEWE1 BY:
-Oiitip, Morle unty , Admini
ttor Date
Contract Amendment #1
Between
Skookum Corporation
And
Jefferson County Public Health
Developmental Disabilities Program
WHEREAS, Skookum Corporation (Subcontractor) and Jefferson County (County) entered into an
agreement on July 1, 2015 for Professional Services to be provided in connection with the provision of
Individual Supported Employment and/or Individualized Technical Assistance to Persons with
Developmental Disabilities in Jefferson County.
WHEREAS, the parties desire to amend the terms of that agreement.
AGREEDIT IS BETWEEN BOTH PARTIES AS NAMED HEREIN AS FOLLOWS:
The term of the above referenced agreement ends .Tune 30, 2016.
2. The Subcontractor will continue to provide Individual Employment Services; 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, coaching/supports, job replacement, worksite
job training, development of natural supports, and follow -along to maintain a job & and
record keeping
3. Subcontractor shall receive $65.00 per unit for Individual Supported Eniployrnent Se l'vices.
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 hour to the quarter may be
recorded); ten (10) minutes of every "HOUR" of direct service or assigned service level to
one eligible client can be used for documentation and/or meeting times
4. Subcontractor's contract will be increased by $6,206.75 in funding for services rendered
during the term of July 1, 2015 through June 30, 2016. Total compensation under this
Agreement shall not exceed $138,491.75 without express written amendment signed by
both parties.
5. All other terms and conditions of the agreement will remain the same.
Dated this day of
M
, Chairman
Jefferson Board of County Commissioners
By: ,_. _ ...�. _...
Ryan Wiese, Contracts Manager
Skookum Corporation
R
SUL - jNTRACT FOR PROFESSIONAL SERVIt- -)
INDIVIDUAL EMPLOYMENT AITITND INDIN11DUALTECHNICAL ASS1._,YrA.NCE
Agreement Between
JEFFERSON COUNTY PUBLIC HEALTH
AND
SKOOKUM CONTRACT SERVICES
'this agreement is niade and entered into between Jefferson County Public I-lealth (COUNTY) and Skookum Contract
Services, (SLIBCONTRACTOR) for provision of Individual Supported I..."inployinent to Pers0l's With Developmental
Disa bi 1i ties in leffersorl ("ounly. The terill of this agreement is July 1, 2015 through lvine 3,0, 2016, This Contract inny
be tenninated by either party UJ)0n 60 &YS Wril[Cn 110tice,'Vermination of this Conll-,ict shall not constititte 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 supporled Employment" or "I Ell. Services are a part of an individual's padlMly to
colploynient, al'e tailored to individual needs, interests, abilities, and promote, carcer (level olinwilt , 'niese
are individmilized services necessary to help persons with development -al disabilities obtain and continue
integrated employment in [lie general Workforce at or above the slElte,s 11,1il,lilylujil waqige, I'liese services
may include intake, discovery, assessment, job n,iad<,cling & development, job placement, job replacement,
worksite job training coaching/supports, development of natural supports, and follow -along and accord
keeping per FNhibit A - Statement of Work.
(2) "Individualize(] Technical Assistance" or "ITA": services are a part ofan individual's pathway to
individual employment. The service of assesmiient and consultation (in older to identify and address existing
barriers to employment) may be provided J)y tile employment provider, or to the elliployment provider. This is
in addition to supports received throtqgh suppo)rted eniploymew services or pre -vocational w.rvices f:or
individuals who have not yet achieved their ell-liak,)YInent goal pea- Exhibit A — S1,11tinerit ol[Work.
(3) Program management.
B. OBLIGATIONS
SUBCONTRACTOR shall fulfill the following obligations;
SUBCONTRACTOR shall comply with all state and federal requirements 1,egar(jilig the confidentiality of
Client records, Client inrormation is not disclosable to the public. Information acquired pursuant to RCW
71 A. 14.070 requires a signed Release of Information or a signed Oath of Confidentiality Form.
(2) SUBCONTRACTOR is required provide background cilecks, pursuant to [tCW 43,43,830-845, RCW
74.15.030, and Chapter 388-06 WAC, which state that any prospective employee 01- V011,111tect W110 will Or may'
have unsupervised access to a vulnerable person with as deveiopmerital disability in the course of his Or her
employment, or involvement with the business or organization, ill"St have as back grou 11 d/cril", ilia I history
clearance before they have unsupervised access. The DSI -IS Background Check Central Unit (13CCU) niust
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 1,111SUpervised access to a
vulnenable person with a developmental disability in tile 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
before prospective emplo, _. begins working. The DSHS Background Chc, 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 involvernent 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
requiremews under RCW 74.31,035, .040 Abuse and neglect of Vulnerable Adults; RCW 26.44, Abuse of
Children; 1.he 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 Horne 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) SUBC,'ON"I'RA '"1°OR shall comply with the following, Developmental Disabilities Administration, (DDA)
Policies: 3.01 Client Service Plans; 5.01 Criminal llistor-y 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 Prc�vider°s; 6.13 Employment/Day Program Provider Qualifications; 9.07 Human
Immunodeficiency Virus (1 ,1l V) and Acquired Immune 1}el''iciency 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
laltll m !fir rww.dalr�y.wa..frnvl id'r�0a oarr t3 11 51 pr�,ietrccs 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 prognirns and records, to ouverach 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 as persarn's right to privacy, regrading safeguarding)
personal information and abuse of Participants; regarding agency 'inedic ation procedure; regarding rtspectf°ul
staff -to -participant interactions (i.e:.: including as person's right to be treated with dignity and respect free of
abuse).
(l 1) 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 frorn the program; the prograrn's expectations of them; and, if necessary, shall assure that the
participant's farnily, 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
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• assure that advocate:, ..,e available and encourages participants to briii , advocates to help negotiate
• includes a rraediation, process that promotes the use of someone wvho 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) SUBCONS"ItAt TOR shall obtain avid retain in the clients' files sighed proaaf of che°nt's anti/or family's
review of all policies, provider expecimion, and receipt of information aboul services arae] berrelits to be
provided ]:ay the program. "fl c signed proof required by this section shall be r e vie.wved 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 rraterest real or aplaarerat will rre'at arise. Sarcla a conflict
will arise when: 1"Ire canployce, officer Or agent, ally nacml)cr cal' inamediatc family, Guardian / decision
maker, war art organization that eiriploys or is trbout w employ any of the tal'ove has fiffl ancial or other irrtere'sst
in the client(s).
(17) SUBCONTRACTOR shall have adequate staffing ratios and patterns to maintain quality and safety.
(18) All services for persons with developineu'tal disabilities must be provided with attention to their lrcalth and
safety. SUBCONTRACTOR shall comply with all applicable federal, state rand '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 COLINTY arnd tall SUBCONTRACTORS are mandated reporters under RCW 74.34,020(l ]). All
parties rrrust comply with reporting requirements described in RCW 74.34.035, 040 and Chapter 26.44 and
must adhere to DDA Policy, 6.08 Mandattary Reporting Requirements for 1^mploya°na:nt and Dray Program
Service Providers. All service provider cruployces, contractors, and volunteers, are mandatory reporters and
must report every incident of observed, reported„ or suspected Gil:>usc, lrnproper 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,
ancilher service: provider who is not the employer ofrecord raaust provide, the support unless the County
issues prior written approval for the service provider to continue to provide long-term supprarts 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 7IA. 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) SLJ13C:(:)NTRAC'fOR, is required to maintain t]ae 1'01low]lrg nrirairrauraa or €r,rrraizatiranrrl capacity in order toraaeel
the pewr(brrnance standards set ft)rth ill this agrecanent. Failure arability of"S] BCO�N ]'10 TOIL to rncel, any
or all of these mininimn calmeit'y require events, as del.ermined solely by (m OU:NTY, may be clause for ternrrnat�ion
of this agreement as provided herein.
(a) Apfrrdrta,t,mo w� SUBCONTRACTOR must be able to demonstrate conformance to Commission on
redit
Accation of Rehabilitation Facilities (CARF) standards for quality assurance and CARF accreditation.
SKOOKUM IE/ITA Contract 2015-2016
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(b)- iii" - lLay� SUi,—JNTRACTOR shall protect and maintain all C.—Mential 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
(j) 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 mernory devices
(c) Sr 1AH-la-merd o c"L I In C I I ts containing Confidential Information via Trusted System.
(1) To the ext 11 c I nt allowed by law, at the cral 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 ai,tv be recycled 1111-01,191) a' cOlIt",10ccl firm,
provided the contract with the recycler specil-ws shat tire of inforinaflon will, be
protected and the information destroyed dlr-()agjj the 1,ecyclijig process, Paper documents
containing Confidential 111fon-nation requiring special handling (e.g; protected health illf'ornialion)
must be destroyed through shredding, pulping, or incineration.
(3) The compromise or potential compromise of Confidential Information must be reported to the
DSTIS Contact designated oil this Program Agreementwithill five (5) business days of
discovery for breaches of less than one hundred filly ( 150) persons' pr,otected; rlrila, and one
(1) btisiness day of discovery of breaches ol' over ()Ile hunfji-ed fifty (150) persom' 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) SUBCONT10CTOlk will assures equal access to persons who do not speak or have a
fiiniaed c,,ibihly to speak, read, or write English well criough to understand and communicate effectively
(reference: DDA Policy 5.05, Limited English Proficient fl E11) Clients).
(e) l'inaficial a n d Progr4in Manavement: S U BCONTR ACTOR will maintain an
adTiiinistrative/(ii-gaiiizationaI structure that clearly defines responsibilities; systems and persormel to
rnaintain accomiting records that accurately reflect all program revenues and expenditures; prepare
monthly staternents of activity (ADSA Reports); maintain appropriate client service records and progress
reports; and track key program performance indicators.
(f) jLarti vints: SUBCONTRACTOR has a commitment to support integration of individuals with
developilienW disabilities with people who are not disabled and has involved participants with
developmental disabilities in policy development.
(g) PaqnSrsjjjjjs SUBCONTRACTOR has a history of working cooperatively with cOmm till ity-based
organizations including Employers, other Agencies, the COUN'FY DD Program, the Division of
Vocational Rehabilitation (DVR), and the Schools.
(h) Perfortnai ice I'law StJl3CON`FRACTOR has a written performance plan that describes its mission,
prograni objeclives, expectc(I outcomes, and describes how and when objectives will be accomplished;
and will assure the ishan is evaluated at least biennially with revisions based Oil 3011al j)Crf0rrnHlICC-
(i) Internal Control S)L'sleirm. S1JjX.'ONTRACTOR has sufficient policies and procedures for establishment
and m .11 a I inten - ance . of adequate internal control systems. SUBCONTRACTOR will maintain written policy
procedural manuals for information systems, personnel, and accounting/finance in sufficient detail such
that, - openridom can contimic should staffing change or ,lbsences occur.
(,.'!liahfied Staff, SlJBC'ONTRAC'rM will provide adequate, qualified stall'with skills and experience
ni evaluation, draining, supervision, courlsefing and support ()j,,adjjljs with developmental disabilides
who are C,�alriillp wages, per the allached 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.
SKOOKUM JE/1TA Contract 2015-2016
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(k) Safety: SUBCONTRAC . —,t will provide evidence that it employs safety p _ -�ction based on the environment
in which the participant is working or receiving services.
(1) 1, qaa rla yrrt tam rrrrl cl, qy,wservices must adhere to the Home and Community Based settings (HOBS) 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 HOBS;
(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 TACTOR shall provide: an Individual Employment/Vocational Client l�'l= n and/or Person
Centered planning/profiles delineart:in,g,, individual shills and needs within 30 days of the Iaeginning 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:
I . 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, diarn, 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 1D
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 gigs, interests„ and preferred activities
k) Measurtirtile strategies (a tiora steps and supports) to meet the employment goal
1) Identification of persons and/or entities (Such as faalrrily, Division taf Vocational Rehabilitation)
available to assist the client in reaching his/her employnaent 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 disaabilitres na�ust be provided with attention to their hertlth and
safety. SLJ'1°3CONTRACTOR shall comply with all applicarlrlc federal, state and local fire, health and safety
regulations.
(30) The SUl3CONTRACTOR sht.11l reporlally, injury or aciden't than requires 11'rore thaan simple first aid, and any
extraordinary incident than requires intervention by the SUBCONTRACTOR to the DSHS/DDA Case
Manager flor the individual involved, and them to the t: OUN]"Y Coordirrator. I"his includes serious physical
or emotional harm or potential harm.
SKOOKUM IE/ITA Contract 2015-2016
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I . The initial report may be done via documented telephone calls to the COUNTY Coordinator.
2. The SUBCONTRACTOR shall submit a written follow-up report within 10 days to the
COUNTY Coordinator. The report to the COUNTY Coordinator may be submitted by email,
facsimile (FAX) to 360-385-940, or by mail to Jefferson County Public Health 615 Sheridan
Port Townsend, WA 98368.
3. Serious and emergent incidents shall be handled in accordance with DSHS/DDA Policy 12.01,
Incident Management.
(31) Wiflihi 30 days of" tyre effective date of this agreement and at leirst soil ri-annually thereaficr,
SlA'3CONTRAC l OR will provide (a) company (b) program financial repord.s to COUNTY, including all
re, veraties and expanses generiiied by SU13CONTRA C'1"OR, in sufficient det,.rii to demonsdrate llie ruses offi,inds
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 al;, vement. The COUNTY shall monitorservices 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) AU D.J._6 Rtl yL)lJ!F, ENJ-'S, Independent Audit will be submitted annually to the Jefferson COUNTY DD
COUNTY Coordinator in the following manner:
S1113CONTRAC"I OR mussbe able to account frac and manage public: funds ill cc,,impli<ance with Generally
Accepted Accounting Principles "GAAP", Art agency, fbr-prcadt or non-profit, who receives in excess of
$100,000 in DDA funds dr.n'ing its fscral year fa'om tine County, shaa:ll 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 guidelincs of Reporting for 01her 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) ']'lie SU13t�"0N"l'RAC"P"%', R shall submit two (2) ccgijes of the audit anti/or the sumanary and the
managenlent letter directly to the COUNTY immediately upon completion. Theaudit 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 1E/ITA Contract 2015-2016
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(c) Written Summary: . ..nin ten (10) working days of such officia;r] nota. cion, the COUNTY will
provide the SUBCONTRACTOR a written summary of the ,ircas 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) Shorne] the above procedures flail to resolve the cornpHanco issue°, the paritras will obtain the services of
the Penins rrla Dispute Resolution (,'enter, or another aagreed ral�)orr resource,, Kind shall share equally in
ally retainer tees czar` either costs of services. Ifrto aagreement is reached, the mediator's decision ill tiae
matter will be binding on rill p a:rlies, excpjIl, that rn no event will the County hollor 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., SUI:=StX"'ONTRACTOR will maintain client records and
books, records, documents, reports and other evidence of rrc,countir"g procedures and practices, which
sufficiently and properly reflect all direct find indirect expcnditures� of funds provided under this agreement.
Client records shall ininiinarlly include statement of client goals, documentation o'ftrarrnrng provided, training
hours, routine progress notes and serrd-annual sumn'rary ol'progress toward rnectinl 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 COUN'T'Y its Medicaid Billing Rights for services to clients eligible
under Title XIX programs. Written docurnentatiaan shall be available to COUNTY on request. If
SUBCONTRACTOR contracts dire°oily with DSHS to provide covered services under Title XIX, COUNTY
agrees that funding intended for those clients shall be exchided 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
(I) For said services rendered under this rr , , anent, COUNTY slraall reirrrburse S'LIBCONI"RACTOR oat a unit rate
basis as follows:
S66—. /
(a) Individual:tr°rlr9ryrl,l, Art,m�xtf(rwArclrrar]r a.3 Ieel%Grtczr,V t ti�lwt rr scr r s SI.JI'3C0']wl"IRAt"°1"OIC will be
paid per unit assigned Service Responsibility ol`rergular 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 tile month, for units of service provided under this agreement. SUBCONTRACTOR will subrrait a Monthly
DDA Services Report (ASDA) l'orin 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 $132,285.00 in completion of these services without express written amendment signed by both
parties to this Agreement.
Page 7 of 1 35
(5) SUBONTRACTOR will __,;ess Division of Vocational Rehabilitation (D. _) 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.
(1) DSHS Division of Developmental Disabilities (DDA) shall determine individual eligibility of persons for
services delivered under this aoreement. DDA shall notify COUNTY of persons authorized for services
reimbursed utider this agrecrncnt, Only persons r cfc,rred to COUNTY by DDA tlrrough 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 clairns 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 debannent, declared ineligible, or voluntarily excluded frorri
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 dic basis of age, sex., marital status, somial orientation, religion,
creed„ race, color, national origin, honorably discharged veteran or milhary status, or the Iiresence 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 narned 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 arnount ($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 _.,an one million dollars ($1,000,000). In no ca� nall 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
perfornance 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
rnaatcri<al breach of contract upon which the: CO(JNTY' may, after giving five working days trotice to the
SUBC:.(aNTRAS" 1" ' R to correct the breach, imrnediaately ternainate the contract or, al its discrelio�n, procure
or renew such insurance and pay any and 111 prep lums in connection therewilll, w'illa ally 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 Coirrpoisartion insurance and any professional liability insurance secured by the
SUBCONTRACTOIC, 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 (')btained f"i•om an insurance company authorized to do bushaess in the State of
Washington. The SUBCONTJ�Ai` TOIL 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 po'eveltt the COUNTY, at its option, fi°om additionally
requesting; that the SUBCONTRACTOR deliver to f.hc COUNTY an executed bond as security for the faitliful
performance of this contract and for payment of all obligations of the SUBCONTRACTOR.
(15) 11lie SUBC ,ON"1"'RAC;'d TOR shall comply with all Federal, State, and local laws and ordinances applicable to
the work it) be done tinder 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 nand 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 pmcess and defend at its own expense, including gall costs, attorney tae's and expenses
relating thereto, all clai.nta,, dernands, 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 SUBCONT to indemnify the COUNTY against and
hold harmless the COUNTY froaaa claims, dermands 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) tlae S()BCONI'l�Ai'"I'Ol� "S ,igeaats or employees, and, (b) the ('O(,JN'TY, its ofbccrs, employees
.and agems, this indemnify provi�siorl Nvith respect �to (I,) claims or �stnts I)asetl upon such negligence,sand�loi,° ("a) t1te: costs to, the C''mOUN"I"Y of dcfonding; such clai ns and suits, etc., shall be valid and
SKOOKUM IE/ITA Contract 2015-2016
Page 9 of 19
enforceable only — the extent of the SUBCONTRACTOR'S negli, Ce 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, docinnent, report, film, tape, or sound reproduction of material of any kind, delivered there
under, constitutes an infringement of any copyright, piMit, tradernark, 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 emFiloyees, including all other persons engaged in the perforinance of any work or
service required of the SUBCONTRACTOR under this Agreenient and, solely for the 13W -pose 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
fterthe 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-pany, then any contract or agreement between the
SUBCONTRACTOR and a thud -party subcontractor must contain all provisions of this Agrecinent and the
third -party subcontractor must agree to be bound by all terms and obligations found in this agreement.
ADOPTED THIS le—day of 2015
By: — ---- -
D /I iolevr rc
V � � L i� �;11",C �aHAiall
W" "A'
Jefferson Board of County Commissioners
By: l
-------- - — 1V&L,'-- --
—
Aost, Clerk of
AP 11 bf�' V F 1) AS TO F(IT" I M ONLY:
.... . . .......
By�
Jefferson County Prosecuting Atto y
Skookum 0,nitrad, Services
SKOOKUM IEATA 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 ,.
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 communityjobs 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 cor mrunity work per week or eighty-six hours per month.
&
To identify settings that isolate people from the broader community or that have the effect of
isolating individuals frorn 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
cornmunity-based.
B. Definitions
hr¢livir;sn�ml l 71;1,1lorrrpIt 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.
SKOOKUM IEATA Contract 2015-2016
Page I 1 of 19
2. [.1 ka.cen-jej.11 is dei_uas employment in a first job or in multiple jobs nged 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. fi a.likticernent is defined as being assisted by the same SUBCONTRACTOR in any subsequent
employment (second, third, fourth job, etc,) for 90 calendar days. Employment rnay be full-time, part-
time, or other as defined in B.2 above.
4. Placcirient and Replacement Services may include: vocational counseling and job analysis to assist in
the identification of work objectives and the job malch process; job cjevcloljnjeni, locating a suitable
community job for the worker; initial placement Lind post-hire training of the so)")ported employee,
employer and/or coworkers at the employment site; job �tMd, worksite modifications;
supporting the worker, employer, and other interested persons (parents, killions, oiller cinployces, etc,)
to develop natural workplace supports and ensure stability on the job; assiming 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 ollreplacement and Ill,, visiting with
ow qloll&�erviccs begin at the 011le ()f pi,,Iceynew or ly ilIcIlide.
the worker, the eniploycr, and other interested parties (parctlts, etc.) to insure stability on The
job; providing J,`eTdback to the worker, COUNTY, and its Des DA. field Services regarding progress
I
and/or problems; counseling the worker and his/her family on vocational issues.
6, 1 lie de, domient ofa Pall wayjg E`,inp
l,qyo, ent Plan 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.I 1! r-1M.J l is defined as facilitating the developinent of a 'Pathway to Employment Plan; delineating
P.9
individiu,al 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. it q2tpll1gqation ofthe 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
dernonstrated need, acuity level, and work history.
9. lndiVidLK`ili/0d TCChlliCal Assistance services are pail 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 eniployment provider,
]'Ns is in addition to supports received through supported cnlpjttylnent 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, all 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 IEATA Contract 2015-2016
Page 12 of 19
2. If SUBCONTRACTOR is selected as the client's provider,„ SUBCONTRACTOR RAI; TOR sl°mall provide ant Individual
Employment/Vocational Client Plan for client's in service delineating individual skills„ exper rarica:s,
preferences, strengths, support needs, skills, and goals and ob ectives within 30 to 60 darys of tire. beginning
of services for the client, in order to promote Individual l?
12. If a Client has not obtainu_ dmployment after 6 months, the SUBCONTRr. . OR will assure the COUNTY
that the following steps were taken:
• Review of progress towards employment goals;
• Provide evidence of consultation with family/client; and
® Development of additional str�,rtegies 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 parti¢ ip atc 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 Form to report on the six-month progress of the client.
15. The fi-equency 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. TheSemi-Annual Progress Reports shall demonstrate the implementation strategy and how the individual is
progressing on his/Pier Individual I'ai�tnployment/Vocvitional 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 RAC°l"OR shall schedule a review meeting, every 6 months for all program clients, (a minimum of
twice a year for every cheat).. The review meeting shrill include an assewsnienilevaluation of the Action Steps
of the Individual Emliloyment/V'ocational Client Plan (goals and objectives). The Action Steps of the
Individual Employment/Vocational Client Plan will be updated every 6 inonIhs, (including at the 12 month
stage) for all prograrn 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
Employrnent/Vocational Client Plan and progress reports to the Client, the DDA case manager, the COUNTY
Coordinator, and Residential Support Staff/ Parent or Guardian.
20. SUBCONTKAl.. IC: R will stamiit ,dx-month Progress Reports & updated Action Steps on each client to the
COUNTY Y 1'or"Ie,edback 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.
SKOOKUM 1E/1TA Contract 2015-2016
Page 14 of 19
25. The SUBCONTRACTO,. ,rill clearly communicate to the COUNTY and t,. .dent 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 TSP.
• The amount of service hours the client receives should match the County Service Authorization
and Planned Rates information.
26. SUl C. 0N'l'RAC'I"Old saris] ensure that every client file has ar copy of'ICDA Client Authorization, a copy of
theparticipant's ]ndividual 1-9abilital:ion flan (ICF/MR), a.licni's Individual Service flan,„ flan o fCare
and/or Individutal Support Plan (I-ICBSWaivers) tan(l/or tiae C"ounl;y Service Alt I hor- i zation/ I nd ividua I
Service Agreement Plan, as applicable.
27. SUBCONTRAC7OR must ensure that C"licnt Goals ara(J Ol)Jectives are based on a person Centered
Plan/Action Steps or an Individual I:w:mp'loy7aaccat/Vocrati(,Iiaatl Client Plan; that docuilientation and data
collected, or training reflects the Action Steps or the Individual Employnaell t/Vocational Client. Plan; and
that the documentation shows how it has identified and addressed supportneeds of cach 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. SUBCONTICAC"'fOIC must ensure than all Incident ICeports are rctaineryd in clietat; 'files; that they have a
policy to retail,) records at least 5 years; that enaerf;ency contact and medical information (medications,
diet, allergies„ etc,) needed during the ]sours of service, is available fctr eaaclr p�u ricil�arrat, on the face slnect 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. SUB CONTRA CTO 1� will support Clients in an ernploymerat progrann to ivortonMd°arcl a living wage. A
living wage is the aur' aunt 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 ,acuil:y 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
wr iiten approval for the service provit'le.r- to continue to provide long -terra,) supports if needed.
32. Recommendations for program participant's termination in Individual Employment or transfer into
another Individual E'niployntent agency must be authorized by the DDA C°asc anagcr„ and will be reviewed
in consultaadon Nvith the COUNTY and other -s aas ,appropriartc. SUBCON'T'RACTOIt Will Iacilit,ate tyle
development of a traansidon plan and schedule. The transition plana will be developed its consLiltat.ion with t:l°re
client,, DDA case management, COUNTY, fiamily members and other set -vice providers as applicable and within
10 working days of SUBCONTRACTOR'S recommendation.
33. SUBC'Ci N I"RAC"D°OR must ensure there is a legal requireraaent and a clear delineation for staff
qualifications and proof of background crinainal history clearance in accordance with SUBCONTRACTOR
is required pursuarnt to RCW 43.13.830-845 l C`W 74.15.030„ and Chapter 388-06 WAC:.' on all star':
34. SUBCONTRACTOR shall submit a written Program Staff Training Plan to COUNTY for approval or
disapproval within 30 clays of the effective date of this af.,reenaent, semi-annually thereafter or when
reorganiz.,,,iflon occurs, which minimally includes SUBCON"T RACTOR's procedure 'to train new direct
service staff. The training must include:
SKOOKUM lEATA Contract 2015-2016
Page 15 of 19
• DDA Policies & Competencies (see Section C -Number 36-39)
• RCW's & WAC's as referenced on page I & 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 Ernployment/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 require(I 1(,) send five direct service slaff to a minimum Of
16 hours of workshops, trainings and/or coliflerencesabout developmental
disabilifles and employment, or a lotal ol'80 hour's, Should SUBCON]"RACTOR
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 flijor to ff'orkki_g_lAJ(h C'livn.ts: ADA training, APS Reporting Requirements, Client
Coll ridentiaNy, Currew indNidual instruction and ActionStcps/w')eaJ0n,,,,d Plans forcach Client with whom
the e)nployee works, DDA Policy 4.11 Working Age Adult (adult servic" only), DDA Policy 5.06, Client
Rights, DDA Policy 5,,13, Protection llroni Abusc� Mandatory RePorthlg, DDA Flolicy 12.01 Incident
Management.
37. SUBCONTRACTOR must ensure that new direct service staff dernonstrate 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. 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 Employrnent/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. kPithh? six inowhs f) enf: SUBCONTRACTOR must ensure that direct service staff received
_... . ........ .. . . . . j —
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 ,,md submit to COUNTY an Individual Employment program operating budget detailing the
projected allocation of contract funds, other sources and: amounts of fundhig,program staffing expenses and
other cost allocations.
SKOOKUM IE/ITA Contract 2015-2016
Page 16 of 19
42. Semi-annually, SUBCOI...(ACTOR will develop and submit to COUNTI ..fividual Employment program
financial reports reflecting the actual revenues received and expenses incurred compared to the projected
program budget submitted.
43. 1"he. SUBCONTRACTOR will on an annuaul basis sponsor tiuesurveying of participants, their f<ui'ailies, and
tlrcirr support networks and employers ret are'ling e:rrste'a'mer's=st:isfaction. the SUBCONTRACTOR will design
Customer/Client survey forms. The SUBCONTRACTOR must send the COUNTY copies of the surveys
received fi-orn 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 751K 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 idenliN and address existing barrier's to
employment) may be provided by the ernplo.),inent provider• of to the cniployrncnt provider
(c) This is in addition to supports received through supported employnient services or pre-
vocational services for individuals who haare not yet achieved their employualcnt gyral
E. Service Level Guidelines
(1) Client Employment Acuity is determined through the DDA assessment. Acuity reflects conditions typically
rclaated to thea individual's disabilities that are not likcly ki change, and are generally not inapacte,d by outside
factors. Client acuity is det�ernnined ati cithrer "l lit lr'" " ediurn" or "l ow" 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 Lavels reflect Client Eniployrnent Acuity and other considerations (see
/abler One -Bette 11"raiwy below), the Guidelines typically reflect direct service staff time provided to or on
behalfof the client to pursue or rnafiltain employment, Youm,ry be eligil:rlc, 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 arnount 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 IE/ITA 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
DI_)A YOUR EMI-11,,OYMI""--'N'I'Si.'RVICI�I.EVEL USING TFIE,
FOLLOWING
ABI E:
. .......... ...
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
WORKING
C
4
LOW
N01 WOft K I (I
WORMNG
E
7
N(_yr I WORK]NG_
F
WORKING
(J
11
HIGH
. ....... ...
12
Fror,57A
Page 18 of 19
TABLE TWO -Add -On Hours
DDA USPS T11E Fo[,LOWINGTABLLTO
DETE R M IN E-11-1 I'll MAXIMUM
NUMBER
01'ADD-ON IiOUIZS
YOU ARI` I--11]GIBLE
TO RECI IVE,
IF YOU MEET ONE
YOU MAY BE
OFTHE BELOW
ELIGIBLE TO
CONDITIONS AND
RECEIVE UP TO
YOUR
THE
EMPLOYMENT
FOLLOWING
LEVEL IS:
AMOUNT OF
ADD-ON
HOURS:
A
0
_0
C
5
5
F
G
12
.. . . . . .........
H14
F. Individual Employment Unit of Service
1', One UNIT of Individual Employment/individualized Technical Assistance service is defined as one (1)
110UR" ofelirect set -vice or assjgjje(l service level to one eligible client. An 'TIOUR" is at least fifty (50)
minutes of direct service; (padh 11110,111, to the quarler may be recorded); tell (10) ruinutes of every 'TIOUR" of
dif,ect service or assioned service levael to one eligible client can lie used for dociiital,ic)il,,iiiland
(imes
t'
or ASSIGNED SERVICE LEVEL s 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. 90
3. One UNIT sal"I nd ividua I Employment or Individualized Technical Assistance service is`1defined
ae "
s ons, '"I of direct service to one eligible client.
7 V_
eta'' "s