HomeMy WebLinkAbout092616_ca06615 Sheridan Street
Port Townsend, WA 98368
www.JeffersonCountyPublicHealth.org
Consent Agenda
July 29, 2016
JEFFERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
AGENDA REQUEST
TO: Board of County Commissioners
Philip Morley, County Administrator
FROM: Vicki Kirkpatrick, Director
Anna McEnery, Development Disabilities
DATE: ,2(f1 � `z01�
SUBJECT: Agenda Item — Professional Services Agreement — Concerned Citizens
for Individual Employment and Individual Technical Assistance A-2;
July 1, 2015 — June 30, 2017; $29,180.00 for a total of $60,380.00
STATEMENT OF ISSUE:
Jefferson County Public Health, Developmental Disabilities Division is requesting Board approval of the
contract Amendment 2 of the Concerned Citizens contract signed September 8t", 2015. July 1, 2016 — June
30, 2017; Adds $29,180.00 for a total of $60,380.00
ANALYSIS/ STRATEGIC GOALS/PRO'S and CON'S:
JCPH Developmental Disabilities contracted with Concerned Citizens Individual Employment and Individual
Technical Assistance in July 2015 in the amount of $36,000.00 dollars. Amendment 1, which was signed
July 11, 2016, reduced that amount by ($4,800.00) dollars. The Amendment under consideration,
Amendment #2, adds $29,180.00 to the contract for a total of $60,380.00. This Amendment extends the
contract from July 1, 2016 through June 30, 2017. All other terms and conditions of the original agreement
signed September 8, 2015 and its Amendment #1, signed July 11, 2016 by the JC Board of County
Commissioners remains unchanged.
FISCAL IMPACT/COST BENEFIT ANALYSIS:
This amendment adds $29,180.00 dollars to the Concerned Citizens Contract for Individual Supported
Employment and/or Individualized Technical Assistance. The original contract amount was Amended
(Amendment #1) in July of 2016 to reduce original funds of $36,000 by ($4,800.) for a total of $31, 200.
Amendment #2 adds $29,180. to that amount for a total expenditure of $60,380.00. The funds for this
contract are generated by an amendment to the DSHS agreement from Developmental Disabilities
Administration Contract Amendment DSHS 1563-45217, which was approved by the JC Board of County
Commissioners on August 1, 2016.
Community Health Environmental 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
RECOMMENDATION:
JCPH management request approval of Amendment #2 — Concerned Citizens for
Individual Employment and Individual Technical Assistance; July 1, 2016 — June 30, 2017; Adds $29,180.00
to $31,200, for a total of $60,380.00
REVIE EW15115. BIP
Ph or ey, Cou ty min rat
'or Date
Contract Amendment #2
Between
Concerned Citizens
And
Jefferson County Public Health
Developmental Disabilities Program
WHEREAS, Concerned Citizens (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.
The term of the above referenced agreement ends June 30, 2017.
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 Employment Services.
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 $201,180.00 in funding for services rendered
during the term of July 1, 2015 through June 30, 2017. Total compensation under this
Agreement shall not exceed $60,380.00 without express written amendment signed by
both parties.
5. All other terms and conditions of the agreement will remain the same,
'1. day of 12016
By:
, Chairman
Jefferson Board of County Commissioners
[,inda Middleton
Executive Director, Concerned Citizens
Contract Amendment 41
Bet♦veen
Concerned Citizens
And ✓�
Jefferson County Public Health I
Developmental Disabilities Program
WHEREAS, Concerned Citizens (Subcontractor) and Jefferson County (County) entered into a'h,
agreement on July 1, 2015 for Professional Services to be provided in connectiort•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.
IT IS AGREED BETWEEN BOTH PARTIES AS NAMED HEREIN AS FOLLOWS:
The term of the above referenced agreement ends June 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, dcvelopnient of natural supports, and follow -along to maintain a job & and
record keeping
3. Subcontractor shall receive $65.00 per unit for Individual Supported Employment Services.
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 decreased by $4,800.00 in h`a,rnding for services rendered
during the term of July 1, 2015 through June 30, 2016. Total compensation under this
Agreement shall not exceed $31,200.00 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 ( �GtZq _ _, 2016
By.
Chairman
Jefferson Board of County Commissioners
l � . �m
�ancla. Middleton
Executive Director, Concerned Citizens
provedas t fOtm on'
111
Preseeatoi fiee
1 fer arwn rr. Chief civil PA
David Alvarez,
SUBCuNTRACT FOR PROFESSIONAL SERVIC,.0 fAl
INDIVIDUAL EMPLOYMENT AND INDIVIDUAL 1.V"( HNIf°AI ASSISI"ANCI,
Agreement Between
JEFFERSON COUNTY PUBLIC HEALTH
AND-�d
CONCERNED CITIZENS CONTRACT SERVICES <,
This agreement is made and entered into between Jefferson County Public Health (COUNTY) and Concerned Citizens
Contract Services (SUBCONTRACTOR) for provision of Individual Supported Employment to Persons with
Developmental Disabilities in Jefferson County. The term of this agreement is July 1, 2015 through June 30, 2016. This
Contract may be terminated by either party upon 60 days written notice. Termination of this Contract shall not constitute
a breach.
It is agreed Upon by Both Parties as Named
Herein as Follows:
Professional services to be provided by SUBCONTRACTOR shall include:
(1) "Individual Supported Employment" or "IE": services are a part of an individual's pathway to
employment, are tailored to individual needs, interests, abilities, and promote career development. These
are individualized services necessary to help persons with developmental disabilities obtain and continue
integrated employment in the general workforce at or above the state's minimum wage. These services
may include intake, disc�r:rvery, assessment, job rn arket:ing & development, job placen'tent, job rep lacen lent,
worksite job trainincy co-aching/supports, development ofnatural stopports, and follow -along and record
keeping pet iWfllM A Statement of Work,.
(2) "Individualized Technical Assistance" or "ITA": services are a part of an individual's pathway to
individual employment. The service of assessment and consultation (in order to identify and address existing
barriers to employment) rnt.ay be provided by the employment provider„ or to the employment provider. This is
in addition to supports received through supported employment services or pre -vocational services for -
individuals who have not yet achieved their employment goal per Isllilirt r:S1rtelne�rrt of Work.
(3) Program management.
SUBCONTRACTOR shall fulfill the following obligations:
(1) SUBCONTRACTOR shall comply with all state and federal requirements regarding the confidentiality of
Client records. Client information is not disclosable to the public. Information acquired pursuant to RCW
7 ]A.14.070 requires a signed Release of Information or a signed Oath of Confidentiality Form.
(2) SI B(,',0N`I`ACTOR is required provide back,gyround checks, pursurant to RCW 43.43.830-.845, IWW
74.1 5,030,and Chapter 38 06 '"wr A(,-', which stat` that any prospective employee or volunteer who will or' nn':ay
have rrri.supervised access to a vulnerable person with a (level opmentaI disability in the course cil�`his or her
employment:, or involvement with the business or organization, must have a back grotancl/c,riminal history
clearance betbrethey have unsupervised access. The DSI IS Background Check Central Unit (BCCU) nau �t;
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 1xn iyhave unsupervised access to a
vulnerable person with a developmental disability in the course of his or her employment, or involvenicrit with
the business or organization, must have an F.B.I. Fingerprint Check before they have unsupervised access and
before prospective ernpl,,,;r begins working. The DSIAS Background Cht—K Central Unit (BCCU) must be
utilized to obtain background clearance.
(5) SUBCONTRACTOR is retp,iired to repoat the h,,-iclagi-ound/ci-iii)iti,,iI history clear;jnce for all employees or
volunwers who will or may have unsupervised access to a vulnerable person with a (,levelopruental 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 Mults; RCW 26.44, Abuse of
Children; the WACs: 275-26 Division of Developmental Disabilities Services J�,tilcs; 296-24 General Safety
& Health; 296-62 General Occupational Health Standards; WACs: 388-828 Developmental Disabilities
Administration, (DDA) Assessment; 388-845 Home and Community Based Waivers; Definitions 0001;
Criteria for 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) SUBCONTRACT(M, shill con-1ply with the Following I)evelopmental Disabilities AdniinisU-a1i0n,(DDA)
folie res: 3.01 Chent Service 114111s; 5.01 (-,ritnimfl 11kaory Background Checks and Safcguarding Personal
5.0.2 Nccessary Supplernenual Accommodalion (NSA); 5.03 (,,Jjcjjt (oiriplainis; 5,05 Limited
English Proficiency (LEP) Clients; 5.06 Client Rights; 5.13 Protections From Abuse; 5.14 Positive Behavior-
Support;
ehaviorSupport; 5.15 Use of Restrictive Procedures; 6.08 Mandatory Reporting Requirements for Employment and
Day Program Services Providers; 6.13 Employment/Day Program Provider Qualifications; 9.07 Human
Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS); 12.01 Incident
Management; 1104 DRW Access Agreement, and the 1992 County Guidelines.
(8) SUBCONTRACTOR shall comply with the following referenced documents found at DDA Internet site
t-j.1ractree_ s; under "Counties":
(1) DDA Policy 4.1 1, 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 rnat-ters, and it is binding for all providers
of DDA contracted services.
(10) SUBCONTRACTOR sh,,,fll have written policies regarding sexn,,11 Ivarassinew and (said'
policies Inust guarantee hunian/civil iighls); regarding
,, a per,Soj),s rjgjjt to privacy, regardhip saft-,guarding
personal inf'onn"'Ition and abuse ofliarlicipams; regardint.,,�, agency tnc(lication procedure, regarding respectful
Staff 10-parlicipaw interactions (i.e,: including a person's right to be Irealed with dignity -and respect free of
abuse).
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 fi-orn the program; the prograrn's expectations of them; and, if necessary, shall assure that the
participant's family, guardian or advocate is also informed.
(12) SUBCONTRACTOR shall have a grievance policy that:
• negotiates conflicts and advises participants of grievance procedures
• is explained to participants and others in accordance with the NSA, DDA Policy 5.02
• prohibits retaliation for using the grievance process
• includes a non -retaliation statement
CONCERNED CITIZENS IE/ITA Contract 2015-2016
Page 2 of 19
• assure that advocates are available and encourages participants to bring auvocates to help negotiate
• includes a mediation process that promotes the use of someone who is unaffected by the outcome if
conflicts remain unresolved (a DDA Case Resource Manager may be included as an alternative option)
• includes a process for tracking and reporting grievances
(13) SUBCONTRACTOR shall obtain and retain in the clients' files signed proof of client's and/or family's
review of all policies, provider expectation, and receipt of information about services and benefits to be
provided by the program. The signed proof required by this section shall be reviewed and renewed, with new
documentation, annually.
(14) SUBCONTRACTOR will encourage participant involvement in policy development.
(15) SUBCONTRACTOR shall update Client Intake Forms every 6 months during the Client Review meeting.
(16) SUBCONTRACTOR shall assure potential conflict of interest, real or apparent, will not arise. Such a conflict
will arise when: The employee, officer or agent, any member of immediate family, Guardian / decision
maker, or an organization that employs or is about to employ any of the above has financial or other interest
in the client(s).
(17) SUBCONTRACTOR shall have adequate staffing ratios and patterns to maintain quality and safety.
(18) All services for persons with developmental disabilities must be provided with attention to their health and
safety. SUBCONTRACTOR shall comply with all applicable federal, state and local fire, health, and safety
regulations.
(19) SUBCONTRACTOR shall track and analyze incident reports for potential trends and patterns.
(20) Current emergency contact and medical information (medications, diet, allergies, etc.) needed during the
hours of service is readily available for each participant.
(21) The COUNTY and all SUBCONTRACTORS are mandated reporters under RCW 74.34.020(11). All
parties must comply with reporting requirements described in RCW 74.34.035, 040 and Chapter 26.44 and
must adhere to DDA Policy, 6.08 Mandatory Reporting Requirements for Employment and Day Program
Service Providers. All service provider employees, contractors, and volunteers are mandatory reporters and
m ust 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 -tern 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 fi-am 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 71A.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) Ac redil oiory SUBCONTRACTOR must be able to demonstrate conformance to Commission on
Accreditation of Rehabilitation Facilities (CARF) standards for quality assurance and CARF accreditation.
CONCERNED CITIZENS IE/ITA Contract 2015-2016
Page 3 of 19
(b) (c�rvn d!..' 11i aljty,-,� Stii--ONTRACTOR shall protect and maintain all (-onfidential 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 ti-ansporting six (6) to one hundred forty nine (149) records containing Confidential
Information outside a Secure Area do one or more of the following as appropriate:
(a) Use a trusted System
(b) Encrypt the Confidential Information, including
(i) Email and/or email attachments
(ii) Confidential information when it is stored on portable devices or media including
but not limited to laptop computers and flash memory devices
(c) containing Confidential Information via Trusted Systern.
(1) To the extent allowed by law, at the end of the Program Agreement term, or when no longer
needed, the parties shall return Confidential Information or certify in writing the destruction of
C'onfidenlial Information upon written request by the other party.
(2) Paper documents with Confidenflil Information may be recycled through a contracted firm,
provided the contract with the recycler specilks that the colilgienfiaNy of infi,)rimafion will be
pi,csiected and the inforniadon destroyed through the recychnfr, process. Paper docunnents
containing confidential Infori-nation requirin- special handling (e,g. pidected licalth infbi-11-inflon)
must be destroyed through shredding, pulping, or incineration.
t� el
(3) The compromise or potential compromise of Confidential Information must be reported to the
DSHS Contact designated OD this Program Agreement within five (5) business days of
discovery I'm- breaches of less than one hundred fifty (150) persons' protected clata, and one
(I) business day of discovery of breaches of over one hundred fifty (150) persons' protected
data. The parties must also take actions to mitigate the risk of loss and comply with any
notification or other requirements imposed by law.
(d) 1=q , u, a - I , A 'a,cess , ; , SUBCONTRACTOR will assures equal access to persons who do not speak or have a
limited abifiy�to speak, read, or write English well enough to undei-staml and communicate effectively
(reference: DDA Policy 5.05, Lini-iled English Proficient (LEP) Oien(s).
(e) r-Inancizil . ....a-nd Prop"t-aill SUBCONTRACTOR will maintain an
...... .. ....
a:diiiiiiisti-ative/<)i-L,aiiiiz,,,,itioiiaI structure that clearly defines responsibilities; systems and personnel to
maintain accounting records lhat accurately reflect all progran'i revenues and expenditures; prepare
monthly statements of activity (ADSA Reports); maintain appropriate client service records and progress
reports; and track key program performance indicators.
(f) SUBCONTRACTOR has a commitment to support integration of individuals with
developmental disabilities with people who are not disabled and has involved participants with
developmental disabilities in policy development,
(g) Partnmshilm;: SUBCONTRACTC)R has a history of working coopelat.ively with communily-based
orf,,?,anizadons including Ernpk�)yers, other Agencies, the C0UN'FY DD Program, the Division of
Vocational Rehabilitation (DVR), and the Schools.
(h) I'cjforniancq Plaw SUBCONTRACTOR has a written performance plan that describes its mission,
program I 11 I ", objectives, , , - , , expected outcomes, and describes how and when objectives will be accomplished;
acrid will assllf'e11w plan is evaluated at least biennially with revisions based on actual performance.
(i) jn.te-r! I a] Control Systems_: St.) 13CONI "R ACTOR has sufficient policies and proccdores for establishment
and maintenance of adequate internal control systems. SUBCONTRACTOR will maintain written policy
procedural manuals for information systems, personnel, and accounting/finance in sufficient detail such
that operations call Continue should staffing change or prolonged absences occur.
0)tri l i 0.1 StMT, SUM"ONTRACTOR, will provide adequate, qualified staffvvith skills and experience
in evaluation, . .. .. . . - training, supervision, c�ounseling and support of adults with deveopmental disabilities
who are earning wages, per the attache(IStatement of Work. SUBCONTRAC'FOR will assure that all
direct service staff are trained, and that training is documented. SUBCONTRACTOR will provide
COUNTY with information regarding staff qualifications upon request.
CONCERNED CITIZENS IE/ITA Contract 2015-2016
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(k) �9a :,;, SUBCONTRACTOR will provide evidence that it employs safety protection based on the environment
in which the participant is working or receiving services.
cljj_�y A yjcc5 must adhere to the Home and Community Based settings (HCBS) requirements
of42CFR 441 530(a)(1), including that:
(a) The setting is integrated in the greater community and supports individuals to have full access to
the greater community;
(b) Ensures the individual receives services in the community to the same degree of access as
individuals not receiving Medicaid HCBS;
(c) The setting provides opportunities to seek employment and work in competitive integrated settings;
and
(d) The setting facilitates individual choice regarding services and supports, and who provides them.
(25) SUBCONTRACTOR shall provide an Individual Employment/Vocational Client Plan and/or Person
Centered planning/profiles delineating individual skills and needs within 30 days of the beginning of services
on all program clients. The SUBCONTRACTOR shall use the new Employment Program Plan Report Form
for Individual Employment/Vocational Client Plans.
(26) Individual Employment/Vocational Client Plans will include:
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, if any.
3. Copies of the initial and subsequent revised plans will be distributed as appropriate to all team
members.
4. Plans will be reviewed and signed annually,
(27) Individual Employment/Vocational Client Plans will also include the information listed below:
a) Current date
b) Timeline for the plan
c) Client's name: first and last
d) Client ADSA ID
e) Employment goal
f) Preferred (job type) the individual wishes to obtain or maintain
g) The preferred wages /salary the individual wishes to earn
h) The number of hours the individual prefers to work
i) The preferred work shift
j) The individual's skills, gifts, interests, and preferred activities
k) Measurable strategies (action steps and supports) to meet the employment goal
1) Identification of persons and/or entities (such as family, Division til" Vocational Rehabilitation)
available to assist the client in reaching hisdier employment goal
m) Identification of other acconini dations, adaptive equipment, and/or supports critical to achieve
employment goal
(28) Six month progress reports describing the progress made towards achieving client's goal will be provided
by the service provider to the Case Resource Manager, participant, and/or guardian, if any, within 30 days
following the six-month period.
(29) All services for persons with developmental disabilities n"iustbe provided with attention to their health and
safety. SUBCONTRACTOR shall comply with all applicable federal, state and local fire, health and safety
regulations.
(30) The SUBCONTRACTOR shall report any injury or accident that requires more than simple first aid, and any
extraordinary incident that requires intervention by the SUBCONTRACTOR to the DSHS/DDA Case
Manager for the individual involved, and then to the COUNTY Coordinator. This includes serious physical
or emotional harm or potential harm,
CONCERNEDCITIZENS IE/iTA Contract 2015-2016
Page 5 of 19
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) Within 30 days of the effective date of this agreement and at least semi-annually thereafter,
SUBCONTRACTOR will provide (a) company (b) program financiral reporis to COUNTY, inchidinc, all
revenues and expenses generated by SUBCONTRACTOR, in suff-wiew detail io demonstrate the uses offunds
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 docurnents, reports, and other data
applicable to this agreement. The COUNTY shall monitor services delivered, and conduct at least one on-site
visit with SUBCONTRACTOR during the period of the contract to assure compliance with the DDA State
Work Order.
(33) jj%JQYF_R] t"11:.111 q-_AjL�N'jS Independent Audit will be submitted annually to the Jefferson COUNTY DD
COUNTY Coordinator in the following manner:
SUBCONTRACTOR must be able to account for and manage public funds in compliance with Generally
Accepted Accounting Principles "GAAP". An agency, for-profit or non-profit, who receives in excess of
$100,000 in DDA funds during its fiscal year from the County, shall provide Certified Public Accountant
reviewed or audited financial statements within nine months subsequent to the close of the subcontractor's
fiscal year. Copies of the audit and management letter shall be submitted to the Jefferson COUNTY Public
Health Department within 9 months of the end of the SUBCONTRACTOR'S fiscal year.
The SUBCONTRACTOR shall provide an independent audit of the entire organization which:
(a) Is performed by an independent Certified Public Accountant, the Washington State
Auditor's Office, or another entity the COUNTY and the SUBCONTRACTOR mutually approve.
(b) Provides statements consistent with the guidelines of Reporting for Other Non -Profit Organizations
AICPA SOP 78-10, and is performed in accordance with generally accepted auditing standards and
with Federal Standards for Audit of Governmental Organizations, Programs, Activities, and
Functions, and meeting all requirements of OBM Circular A-] 33 or A-128, as applicable.
(c) The SUBCON'FRA("'FOR shall submit two (2) copies of the audit and/or the summary and the
management lener directly to the COUNTY inirnediately 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-cornpliance during
the contract monitoring process or learris 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-cornpliance and an agreeable solution is reached
within ten (10) days.
(b) Official Notification: If the informal notificatiOD does not result in resolution, the official Dotification
of possible non-cornpliance to establish a date, within ten (10) working days of notification, when
representatives of the COUNTY and the SUBCONTRACTOR shall rneet to discuss areas of
contention and attempt to resolve the issues.
CONCERNED CITIZENS IE/ITA Contract 2015-2016
Page 6 of 19
(c) Written Summary: Within ten (10) working days of such official notitrcation, 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 albovcw procedures fail to resolve the is,sr.re, the pgrtios will obtain the s,ervic" of
the peninsul,r Disl�utrb Resolution Cei0cr,or another agreed rapor'r resarurc.c, and shall s',ahar egtraally in
,bany retainer fc.,es Or other c„osts of services. If no a:greettielit is reached, thc mediator's decision ill tile
raa;;a'ttcr will bebiraa:lin” otr all parties, c,.X.cW th`ri in no event will the Cotnaty laorac 1- a fir7,arrciwrl
determination that is greater than the funds allowed the scope of this Agreement.
(35) For six years following the end date of this agreenaettt, SUBC0N1J AC. J'OR will maintain client records and
books, records, documents, reports and offier evidence of accounting procedures and practiccs;, which
sufficiently and properly reflect all dned and indirect experrdilnres of frsn& provided under this agreement.
Client records shall nainirnaally include, staata:naent ofclierij go,,1ls, doc-tinientat ion of'Craining provided, training
hours,1_00(i]W larograss notes, and sr^rtti-annual suinralary ofproloress toward rnecting 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 prograrns. Written documentation shall be available to COUNTY on request. If
SUBCONTRACTOR csuntracts directly with DSHS to provide covered services under Title XIX, COUNTY
agrees that funding intended for those clients shall be excluded fi-om this agreement. If St,IIICONT�RAt:"'ITR
contracts directly with Social Security to provide covered services under- a PASS/IRWE, COUNTY agrees that
funding intended for those clients shall be excluded fi-om this agreement.
C. REIMBURSEMENTS
(1) For said services rendered under this agreement, COUNTY shall reimburse SUBCONTRACTOR on a unit rate
basis as follows:
(a) 1'rrdrvrrlrrtrl l_r�rla sryrrrcral../lrrclrvic;lrr slr � al; is c Illic ,l As''wst�rrtce °aa rvice SUBt 0N'f .At (')R will be
paid $65.00 per unit assigned Service as dellned in Exhibit
A, Statement of Work.
(2) SUBCONTRACTOR will bill COUNTY monthly in arrears and on a monthly basis, on or before the 5th day
of the month, for units of service provided under this agreement. SUBCON,rRAC1'OR will submit a Monthly
DDA Services Report (ASDA) form for its billings. At no time shall tale ilavoiccs for reinabursement 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 536,000.00 in completion of these services without express written amendment signed by both
parties to this Agreement.
CONCERNED CiTIZENS lE/ITA Contract 2015-2016
Page 7 of 19
(5) SUBONTRACTOR will .,;cess Division of Vocational Rehabilitation (Dvi�) funding as a resource. Client
services shall not be reimbursed under this agreement when the same services are paid for under the
Rehabilitation Act of 1973, DVR, P.L. 94-142 (Public Education), or are being funded under PASS/IRWE.
D. MISCELLANEOUS
(1) I)SHS Division of Dc'velopmcntal Disabflilies (DDA)shall eligibifity of personsfor
services (10 i vcred under If I is agi-ce m el it. DDA shtd f notify COtjN,I,y t,j r pel�,olls a ti l horized f iv services
reirnbursed under this agre'ement, 01fly persons refen-ed to COUNTY by 1.)I -,)A lhrotlz1ph a C011MY 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 eniployces of the SUBCONTRACTOR only, and ally claims that may arise on behalf of or
against said employces .,h,,ffl be the sole obligation and responsibility of the SUBCONTRA CTOR.
(3) The SUBCONTIW,TOR shall not sublei or assign any of tyre services covered by this Agreement without
the express writien consent of the COUNTY. Assignment does not include printing or ()fficr customary
reimbursable expenses that may be provided in an Agreement.
(4) The SUBCONTRACTOR, by signal ure 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 Agrt
rccmenI by any Federal depamerd or agency. The
SUBCONTRACTOR also agrees to inc ludo the above requirement fo all subcontracts into which it enters.
(5) The ST J13CONTRACTOR will not: discriminate against, any Person in the perforinlaTice of
services under this AgreerneW or in thy;: selection acrd retention of employees or
procurellient of materials or supplies On the basis of age, sex, marital Status, Sexual orientation, religion,
creed, race, color, nzaiomfl origin, Imnorably discharged veteran or indilary slatt's, 0r trice PVCWTrcc ()fany
sensory, mental, or physical dis"Illifity Or the use of a trained do,�, puidc ()r sel-vicx aninlal 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 wilh companies or through sourcos 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 all 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 ($1,000,000,00) per occurrence and a aggregate of not less than two (2) times the
Occurrence amount (0$'2,,00,0I ,000.00 minimum) for bodily injury, including death and property
darn,,.ige, unless a greater amount is specified in Hic contract specifications. The insurance
coverage shall contain no limitations on the scol,,w, ofthe protection provided and include the
following minimum coverage:
(1) Broad Form Property Damage, with no employee exclusion
(2) Personal Injury Liability, including extended bodily injury
(3) Broad Form Contractual/Commercial Liability - including completed operations
(4) Premises - Operations Liability (M&C)
(5) Independent Contractors and Subcontractors
(6) Blanket Contractual Liability
(7) All employees or subcontractors of SUBCONTRACTOR who are required to be professionally certified by
the State in the performance of services under this agreement shall maintain professional liability insurance
CONCERNED CITIZENS 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 nnall 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, xaller giving five: enorl,rnp, clays' notice to the,
SUIT ON 1"I�A(,',1 OR to correct the brcach,, irruriediatelyr teraninate the cc.,mtract tit., at its disUctiort„ P"Ocul'e�
or renew suchinsurance 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) Em:-,epling the Workers Compensation insurance and any professional liability insurance secured by the
Sl1BC "ON'F'kA('� 7T')R, the COUNTY will be named on all certificates of insu;trance 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 SUBCON'IILA('T(' R 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 COUN"T"Y. All
insurance policies obtained by the SUBCONTRACTOR shall include a waiver of subrogation riuhts, 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 conraply 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.
(1 3)) The COUNTY will pay no progress payments under Section C until the SUBCONTRACTOR has fully
complied with this section. This remedy is not exclusive; and the COUNTY may take such other action as
is available to them under other provisions of this Agreement, or otherwise in law.
(14) Nothing in the foregoing insurance requirements, shall prevent the COUNTY', at its option, from additionally
requesting that the SLJBCON"'TRACTOR deliver to the COi..iN`I`Y an executed bond as security forthe faithful
performance of this contract and for payment of a]I obligations of the SUBCONTRACTOR.
(15) The St -MC ONTILACTOR shall comply with all Federal, State, and klcal laws and ordinances applicable to
the work to be done kinder this Agreement. This Agreement shall be inte;I-preted 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 Departnient of Labor and Industries Minimum Wage
Act, RCW 49.46, acknowledging persons with disabilities l:a;;1THCil) ating in job assessments are not considered
employees.
(17) The SUBCONTRACTOR shall indemnify and hold the COUNTY, and their officers employees, and agents
harmless f-oni and shall process and def rid at its own expense, including all costs, attorney 'fees and expenses
Iealting thereto, all claims, demands, orsuits at law or equity arising in whole or in part directly or indirectly,
from the SUBCONTRACTOR'S TOR.'S nrwgligence or breach of"any of its obligations under this Agreement;
provided that not:hnrg herein shall a'equire a SU13CONTRAC°"FOR to .indemnify the C:"OLtNTY 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 -
(,,,i) the StJBCONTRAC"'TORS agents or employees; and, (b) the COUNTY, Its officers, employees
and agents, this indemnity provision with respect to (1) claims or suits based upeara such negligeraee,
and/or (2) the costs to the COUNTY of defending such claims and suits, etc., shall be valid and
CONCERNED CITIZENS IE/iTA Contract 2015-2016
Page 9 of 19
enforceable onty ro 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 rnawrial of any kind, delivered there
under, constitutes an infi-ingement of any copyright, patent, tradernark, tl",.add name, or otherwise results in all
unfair trade practice or all unlawful restraint of competition.
(19) The S1.113CON'H0CTW speciflcally assunles potential Jja-Y
I)iJilyforactions brought agaillst the COUN] by
S�J13CONTRA'S erril'lloyces, inchiding all 0111cl, 111c )
47 ,Is cl,L�agccj ill c c fany work ol
service requil-ed ofthe SUBCON'm ACTOR under this Agrecinew, and, solc]y fbr dic purlOsc, 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 4.24.1 15 and was subject of mutual negotiation.
(20) COUNTY reserves the right to tea ninate this conlracl in whole or in pad, without prior written notice, in the
evem tbat connacmal terms are not flullilled, oI, ifcxpected or actual funding from the Department of'Social
and Health Services Division of Developmental Disabilities is withdrawn, reduced, or limited in any way after
the effective date of this agreement. In the event of termination under this clause, COUNTY shall be liable
only for payment for services rendered prior to the effective date of termination.
(21) No portion of this contract may be assigned or subcontracted to any other individual, firm, or entity without
the express and prior written approval of COUNTY. If the COUNTY agrees in writing that all or a portion of
flik Contract may be subcontracted to a third -party, then any contract or agreement between the
SIA3CONTRA(7TOR wand 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:
. .. ................
(
Dav, (i van,Chairman
Jefferson Board of County Commissioners
By�
Attest, Clerk
erk of te Board
APP I" S TO F(A' ONLY:
BY. , rvl/ 'I
.......... .
Jefferson County Prosecuting A
By:
(1,,,l Middleton, Executive Director
Concerned Citizens Services
CONCERNED CITIZENS 1E/JTA Contract 2015-2016
Page 10 of 14
EXHIBIT A
STATEMENT OF WORK
INDIVIDUAL SUPPORTED EMPLOYMENTANDIVIDUALIZED TECHNICAL ASSISTANCE
I. WORK STATEMENT
SUBCON TRACTOR shall provide IndividualSupported l n-tiloymerat Services/1 ndivi dual ized Technical Assistance for
program cheats as described hereinafter. SUBCONTRACTOR OR shall be u-ei111lsui-sed for such services on a unit of service
basis pursuant to Section C., Reimbursements of this contract.
II. PROGRAM DESCRIPTION
A. Program Goals:
1 e
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 fi-om 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 employmc.itit 1111''augh
consulting and asscssnacnt. (This is in addition to supports, received through Sul)l;)orted Iurnploymealt
services or Group Enaployme.ntservices lbr individuals who have not yet achieved their employment
goal).
T
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
l,l;ldavaal�3m0 1 ml„1„t�ynlr lui, is an individual job in the community where a traditional employer/employee
rel atio11 1rship exists (i.e. person is hired, paid, and supervised by the employer), and is performed at
locations that are typical employment sites for non -disabled persons, (not in businesses or locations
where the primary purpose is to provide employment or work training for individuals with disabilities).
Individual Employment is for those who have not traditionally held competitive jobs or who have had
interrupted or intermittent employment as a result of a severe disability, and is for people with severe
disabilities who need intensive and/or extended support services to perform work in the community.
CONCERNED C1TiZENS IE/ITA Contract 2015-2016
Pabe 1 1 of 19
2, Phicenient is denned as employment in a first job or inmultiple jobsarranged by SUBCONTRACTOR
. for . .. 90 . calendar- . . days. Placements may be: full-time, average weekly work totaling 40 hours or more;
or part-time, average weekly work totaling 12 hours to 40 hours.
1
3, Replacel.peirni is defined as being assisted by the same SUBCONTRACTOR in any subsequent
employment (second, third, fourth job, etc.) for 90 calendar days. Employment may be full-time, part-
time, or other as defined in B.2 above.
Plncelnenl and Rel 'L cc
4a�gqnpj 3g, vj—s may include: vocational counseling and job analysis to assist in
the identification of work objectives and the job 114atcl, p1`occss; job development, lot gat. np, a, suhable
community job for the worker; initial placement and post-hh-c traillirll1, t,f tlic s,rjpported ernpIoyee,
employer and/or coworkers at the employment site; job and worksile mod 0) cation s;
supporting the worker, employer, and other interesled l.)ersons (parcrws,, unions, other cillployces, cu,)
to develop natural workplace supports and ensure sta[A ity on (lie job; assistinp, the worker to ol-itain
other services necessary for continued employment; feedback to the worker, COUNTY and to DDA
Field Services regarding progress and/or problems.
5,begin at the tirne of placernent or replacement and may include: visiting witht I the I1awlI- worker, - the employer, - I 1. and other interested parties (parents, unions, etc.) to insure stability on the
job; providing feedback to the worker, COUNTY, and to DDA Field Services regarding progress
and/or problems; counseling the worker and his/her family on vocational issues.
6, The
iia. -1�1)�&Iy m2l-P! serve an that will see as a transition tool toward the
.. ... in
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. - ig 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 systern navigation and the Discovery Process related to vocational skills
and capabilities.
8, 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. lndivkfii,aflzed Technic,,nI As stat I
-.1--.– . .. .............. ---L are part of an individual's pathway to individual
The service of assessment and consuluition (in order to identify and address existing
barriers to ernl.-floyinent) may be provided by the employment provicler or to the employment provider.
This is in ndcfilion to supports received throug
,,h supported elyiployment services or pre -vocational
services for individuals who have not yet achieved their employment goal.
C. Program Requirements
16 The SUBCONTRACTOR will clearly communicate tothe 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.
I
(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.
I Sul 11- '11,
Authorization and updated Planned Rates information.
CONCERNED CITIZENS 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 services frar the client, in order to promote Individual Ernploynrent. (Mininuurnr Individual
Emplc.�FurueratlV'cre utrrrraaal Client Plan elements are outlined in the reference documcni called "Criteria for
Evaluation" available on the DDA website.)
3. SUBCONTRACTOR will provide a copy of the Individual Employment/Vocational Client Plan to the client,
their CRM's, Guardian, the COUNTY, and others as appropriate.
4. Pathways to Employment Planning Services shall, include to personal discovery prtacess r elaced to skills,
cap"'Ibilifits, and goals; education ort system lttaviga'tion, ltacilhated plan development; action steps detailing
steps, tilvelines, and CTItrtres rc.+spon',ilfle f¢rr the ac,c,omplisla,rlcrrloftasks leading, to cj,n11)4aynticnt 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 Employrnent/Vocational Client Plan will reflect that 75% of the direct
service hours with the client will be at employment sites in the community. The focus will be on real work
experience in a community setting delineating individual skills, experiences, preferences, strengths, support
needs and vocational interests.
10. SUBCONTRACTOR shall provide an Individual I�1aap'loyrnc11t/"Vocatio11al Clicrat Plan for clients in
Individual Employment delineating individual skills, experiences, preferences, Strengths, supporl'rrceds, au'rd
goals and objectives within 30 days of the beginning of services for (lie clicrnt in order to pr'omole. Individual
Employment. Job coaching and supervision of proprnm clients will he based 01) glrrals established in an
Individual Employment/Vocational Client Plan. C;lierat goals, t.rairaing provided„ rand progress toward
meeting goals shall be documented in each client record.
11. If clients in Individual Supported Employment have not obtained paid employment at minimum �Narge
within six (6) months, the SUBC.'ONTRM-11"OR 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. Devealoprriew of additional s'tr�utegies with the fami'ly/client, COUNTY staff, crilpltryraaent Support staff,
and the cw5e maria e,r°, Strategies may include providing technical assistance, changing to a new provider,
and/or providing additional resources as necded to support the individu a.l's parrsrrit cif emplcryrrrcant, "1"lase
additional/new strategies will be documented for each client and kept in the client's file(s).
CONCERNED CITIZENS IE/ITA 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 of consultation ^aaarth f�fljrrily/cheni; and
• Development of additional strategics walla firimily/chent, contractor staff, employment staff,
and CRM, is there documentation of these strategies.
13. The clicni ni�.,iy i,equest to participate in Community Access activities m tile chorli may Choose to renlain in
ani F',mploymcrit Program. When requesdrig to parlicipatc ill tile: Conin,mnily Access sel'vices,the che'll
SIMH communicale directly with his or her DDA Caw Manager. The, DDA Case Manager is responsible for
authorizing Community Access services.
14. SUBCONTRACTOR will submit to the COUNTY, to the DDA Case Manager, to the Residential Provider,
and Parent/Guardian a six-month Progress Report on each client. The SUBCONTRACTOR will use the
Employment Plan Report Form to report on the six-month progress of the client.
15. The frequency of the Semi-Annual Progress Reports of this contractual period will be one every six (6)
months after the initial plan—July through December 2015—with the report due on January 2, 2016. The
second will be due—January thru June 2016—on July 1, 2016.
16. The Semi-Annual lImpress Reports sliall demonstrate the implementation strategy and bow the individual is
progressing on his/her Individual Fin1floyrneni/Vocational Client Plan; indicating the fulfillment of the
commitments made concerning the Action Steps of the Individual Employment/Vocational Client Plan; and
it shall describe the reasons for, if any, shortfall concerning the action steps and proposed steps for correction.
17. SUBCONTRAC]"OR shall schedule a review rnecting every 6 months r()r all program clients, (a rnjnirbuln of
twice a yeai foi- every client). The review meeting shall include ,in asscssrncnt/cvaluation of the Adion Steps
of the Individual Ernployrnew/Vocational Client Plan (goads and objectives), The Action Steps of the
Individual Ernploymew/Vocationrd Client Plan will be updated every 6 Molitils, (including at the 12 month
stage) for all program clients, will a special focus on clients who are unemployed.
18. COUNTY shall receive the dates for the 6-month reviews for program clients one month before the required
meetings.
19. SUBCONTRACTOR, will submit a copy of the updated Action Steps of the Individual
Ernployment/Vocational Client Plan and progress reports to the Client, the DDA case manager, the COUNTY
Coordinator, and Residential Support Staff/ Parent or Guardian.
20. SUB(',ONTRACTOR will subinit six-month Progress Reports & updated Action Steps on each client to the
COUNTY for 1�edb,,,wk and approval, Disregarding or lack of follow-through on Illis step will hold up monthly
billing and continued authorization for funding.
21. The Semi -Annual Progress Reports will show Indivklual Employrnein/Vocational Client goals, training
provided, ,and a writwil synopsis demonstrating progress toward MCetiT1[,1 ot�jcctives; or it will describe
reasons for any shortfall concerning the outcomes, and propose actions for correction.
22. SLA3CONTRACTOR shall schedule a review inceling every 6 nionths 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 Ernployrnent/Vocational Client Plan will be updated every 6 months for all
program clients.
23. SUBCONTRACTOR will submit a copy of the updated Individual Employment/Vocational Client Plan and
progress reports to the client, the DDA case manager, the COUNTY Coordinator, and Residential Support
Staff/Parent or Guardian.
24. All clients will be contacted by SUBCONTRACTOR according to client need, and at least once a month.
CONCERNED CITIZENS 1E/1TA Cojitract 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. SUBt"° ON"1 RAS. l""M must ensure dhat evccy client fila h"r�, a copy of DDA Client Authorization, a copy of
the part iciparit's individual Ilahrhtmion Plan (10"MR) client's Individual Service Plan, Ppaar of ('are
aan(Yor Individmil Support I°"pan (14CBS Waivers) and/or tire, C.'era,rarty Service Alltiroriaaatioii/Itrdivida;ral
Service Agreement Plan, as applicable.
27. SUBCONTRACTOR must ensure that Client Goals and t?J�je ctives are based on a Person Centered
Plan/Action Steps or an Individual Employonent/Vora lional Client Plan; that docume elation and data
collected, or fraining 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
doctiment-inion of six-month pre .gress reports that include Client Goals/Action Steps and a summary of
progress toward meeting those goals and objectives.
28. SUBCONTRAC:",'TM must ensure thaat all Incident lCe.ports acre retaiined in client files; that they have a,
policy to reudil records at least 5 years; that entergenc,y contact an(] medical information (medicaatitrlls„
diet, allergies, etc.) needed during the hours ofservice is available: lirr each participant oar t:he fir C shect 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. SUIS 1.)NTRACTOR 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 nraet or exceed his or her living, exPcr'ases.
Clients should strive to average twenty (20) hours of work per week or eighty-six (86) horn's per month.
The amount of service a chenf receives will be based on his/her demonstrated need and acuity level.
30. Worker wages shall be cornmensurate with the local industry accepted norms and comply with applicable
Federal Department of Labor standards.
3 1. 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 hidivklual Ernploymerrt agency inust be nufhorized by the F)DA Case Maanaagpr, and will be�, reviewed
in consultaat'son with the C:"OI INTy alld withers arra arppropriaatc, Stj[ICC NTI%ACTOR will faacilitate the
development of a transifion p laan nand schedule. 1"he tnarnsition plan will be developed in con wultation with the
client„ LPDA case nranaagge ment, C::.'OUN'FY, I"sarrily inernhers and olher service providersas applicable and within
10 working days of SUBCONTRACTOR'S recornmendation.
33ST_fBC 0N"f RAC:" 1 CIRmust e usury there: is ,t legal ree uilefnent and a clear delineation Tor staff
qualifications and prool'ofback�greaund� criininal history clearance in accordance with 'SUBCON"pRACTOR
i requiredp pursuant to l;iC�"W 43.43,830-845 R.CW' 74.15.030,, aand C.'hapfer~ 38.8-06 'WAC` or°a Ball staff":
34. SUBCONTRACTOR shall submit a written Program Staff Training Plan to COUNTY for approval or
disapprrtrvatl within 30 days of the effective alaatae of this age„rue axreaet <,e.nri-annually tpaeae rRc ror �,t�laen
reorganization occurs, which minimally includes SUB CONTR AC'"I"OR's procedure to traain new direct
service staff. The training must include:
CONCERNED CITIZENS IE/iTA Contract 2035-2016
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 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 ofprograrn clients
• FTE levels job descriptions and organization charts pertaining to program staff
• SUBCONTRACTOR is required to send one direct service staff to a minimum of
16 hours of wcirkshops, and/or conferences ahwd develoINIMM11
dis'abifides and employllicul, fi)j, a towl of 16 hours. Should SIJ13( 'ONTRACTOR
fail to access trainings for direct service, staff, the SUBCONTRA(,"I"OR will
reimburse the COUNTY at the rate of 65.00 an hour for every hour of training not
accessed for staff (for not more than a total of $1,072)
35. SUBCONTRACTOR will provide COUNTY with inforination regarding staff qualifications and documented
training's every six (6) months.
36. StA CON'FkACTOR must assure that new sla arc informed specifically of all agency policies/procedures
1 11 rf
and have docurnentation that assures all direct se, vice staff'18 years of age or ()Jder are trained in the
1611owing DDA Policies 1'rior to J41oi with (7ienls,, ADA APS Reporting Requirements, Client
91!
confaticntiahl y, Currew individual instruction and Aclion SlepsNocadona',d Plans for each Client will, whom
1he cinployce woiks, F)DA Policy 4. 11 Workin-Age Adult Ojdult services only), DDA Pcificy 5.06, Client
Rights, DDA Policy 5.13, Protection froin A V i I )use: MaTidatory Keporknl;, 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, 1,11ilhin (Me Mj,,nvhrJ tqgp!: 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 Ernploymenj/1)ay Program Provider Qualifications, DDA Policy 13.04
DRW Access Agreement, DDA Policy 15,03 Community Prowflon Standards for Employrnent/Day
Programs and all reporting requirements related to these DDA Policies.
9. Wy1h,iti-,vix mot lhs d)`(,w1/VW,'1nf'w: SUBCONTRACTOR must ensure that direct service staff received
training and are knowledge able in flic following areas: Program skill development, DDA Policy 5.02
Necessary Supplen,icrital 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
wi 11 develop ind submit to COLJNTY sant Individual F'Imlfloyment program ope1.,11ing budgel detailing the
projected
d allocation ofcontnafunds, other sources and arnotints of funding, prograin sj�,,I,ffing expenses and
other cost allocations.
CONCERNED CITIZENS IE/ITA Contract 2015-2016
Page 16 of 19
42. Semi-annually, SUBCONTRACTOR will develop and submit to COUNTY 11,urvidual Employment program
financial reports reflecting the actual revenues received and expenses incurred compared to the projected
program budget submitted.
43. "Flic SUBCONTRACTOR will on an annual basis sponsorthe surveying cuflrauticrpa.ru°rte, their lnrr'railies, and
their support networks and employers reparding customer satisfaction. l'he SUBCONTRACTOR will design
Customer/Client survey forms. The SUBCONTRACTOR must send the COUNTY copies of the surveys
received fi-om 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 pant of an inch iduaWs pathway to individual en,rployrnc°rat
(b) The service of assessrnent nand ccrrrsultation (in order to icl(ant.ify and address existing barriers to
employment) may beprovided by the ernplr,aymcrrt prs:rvicler or to the c.tr�al�aloyrnent 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 ire dividmal's disabilitles that are not likely to chance, and are generally not irropnacted by outside
factors. Chew acuity is delernlined as either "High", " Mcdium"° or'"I "LOW" as defined "00011 WAC 388..925.
Other considerations are gelaer,atly related to the job or service cnvirr;anrrrerat wlaicla may impact the
individual's level of support, regardless of acuity.
(2) 11rnployrnent'Service levels reflect Client Employment Acuity and other c,orrsr(,Ierations (see
Trifle One -Bose Hours below); the. Guidchncs typically reflect direct � ��crvre��ac stab-tirrre provided to or on
behalfa'a'fthe client to pursue or maintain ernploynrent. You maybe cligil.ale to rcceive addit:ional add on hours
(see Table Two, Add -On Ilours below).
(3) Short-term Employment Supports is a service that allows DDA to approve additional service hours in
addition to the amount of your employment service Base Hours and Add -On Hours for up to three months
when:
a) You are beginning a new job; or
b) There is a planned or unexpected change in your job or job duties; or
c) Your current employment is at risk and short-term supports are needed to assist you in
maintaining your current job.
Page 17 of 19
(4) The expectation is that all hours reported are documented specific to the client authorized
and relate to the goals and supports outlined within the client's Individual Employment Plan.
Allowable activities are defined in the Employment Phases and Billable Activities.
...DDA.... DETERMINES YOUR I"IMPLOYM17NT SE'RVICr�USING Ttm
FOLLOWING TABLE-.
CLIENT
YOUR
THEN YOUR
AND YOUR
ACUITY
EMPLOYMENT
EMPLOYMENT
EMPLOYMENT
LEVEL
STATUS
SERVICE
SERVICE I3ASE
IE:
IS:
LEVEL IS:
HOURS PER
�._
MONTH MAY BE:
........---- . . . ................
WORKING
A
0
NONE
NOT WORKING
B
0
—
— - - — - - - - - -- — - —
WORKING
— -------- --
C
4
LOW
,I40T WORKING
ORKING
D
WORKING
.. . . . ..... .
MEDIUM
Of(KING
-f7-
�q
.. . . .......
WORKING
G
. .....
II
HIGH
. . . . .. . ....
NOT WORKING
. ......... . ..
H
12
CONCERNED CITIZENS IE/ITA Contract 2015-2016
Page 18 of 14
TABLE TWO -Add -On Hours
DDA '()SES"IH E J-'01,1..
AVING TAB LE—l'O
DETERMINET'III" MAN'IMUM NUMBER
OFADD-ON HOURS YOU ARE E'IJ(3J13I,E*
TO RECE"I VE.
IF MEET '"6_NE
_V_O U- , M__ _A_Y B-E
OF THE BELOW
ELIGIBLE TO
CONDITIONS AND
RECEIVE UP TO
YOUR
THE
EMPLOYMENT
FOLLOWING
LEVEL IS:
AMOUNT OF
ADD-ON
HOURS:
A
0..__.............W.
. . . . . ........
0
D
3
E
F
7,
G
12
H
14
F, Individual Employment Unit of Service
I. One UNIT of Individual Employment/Individualized Technical Assistance service is defined as one (1)
1 10MV ofdireci service or assigned service level to one eligible cheTI(. An `HOUR" is at least fifty (50)
lr9hlwes of,directservice; (pal-tijil hourto the quartermay be recorded); ten (10) 111iflUtes 01'evc1Y ""OUR" Of
direct service orwssig,,ned service level to otic 6giNe client be used for doc,111jerji-ation andlor meeting limes
or ASSIGNED SERVICE LEVEL as defined in Section D, Performance Standard, Number I and 2.
1 Individual Employment service support hours will be based on the client's Individual Employment Level per
WAC.
3, One UNIT of Individual Employment or Individualized Technical Assistance service is $65.00 and is defined
as one "HOUR" of direct service to one eligible client.
Page 19 of 19