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Public Health 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: 10 I IWI N1-4-
SUBJECT: Agenda Item — Professional Services Agreement — Concerned Citizens
for Individual Supported Employment; July 1, 2017 — June 30, 2018;
$45,900.00
STATEMENT OF ISSUE:
Jefferson County Public Health, Developmental Disabilities Division is requesting Board approval of the
Professional Services Agreement with Concerned Citizens, to provide Individual Supported Employment
Services; July 1, 2017 — June 30, 2018; $45,900.00.
ANALYSIS STRATEGIC GOALS PRO'S and CON'S:
The Professional Services Agreement with Concerned Citizens, is for Individual Supported Employment
Services. Concerned Citizens will provide employment services that are tailored to individual needs,
interests, abilities of adults with developmental disabilities. These individualized services are necessary to
help adults with developmental disabilities obtain and continue integrated employment in the general
workforce, at or above the state's minimum wage and promote career development.
FISCAL IMPACT COST BENEFIT ANALYSIS:
Funding for the agreement with Concerned Citizens, is through the Developmental Disabilities
Administration with DSHS and is identified in the budget under vocational services.
RECOMMENDATION:
JCPH management requests approval of the Professional Services Agreement — Concerned Citizens for
Individual Employment; July 1, 2017 — June 30, 2018; $45,900.00.
REVIEWED BY:
Phiii Orley, o my Administraor Date
Community Health
Developmental Disabilities
360-385-9400
360-385-9401 (f)
Always working for a safer and healthier community
Environmental Health
Water Quality
360-385-9444
(f) 360-379-4487
SUBCONTRACT FOR PROFESSIONAL SERVICES
INDIVIDUAL EMPLOYMENT
Agreement Between
JEFFERSON COUNTY PUBLIC HEALTH
AND
CONCERNED CITIZENS
This agreement is made and entered into between Jefferson County Public Health (COUNTY) and Concerned Citizens
(SUBCONTRACTOR) for provision of Individual Supported Employment to Persons with Developmental Disabilities
in Jefferson County. The term of this agreement is July 1, 2017 through June 30, 2018. This Contract may be terminated
by either party upon 60 days written notice. Termination of this Contract shall not constitute a breach.
It is agreed Upon by Both Parties as Named
Herein as Follows:
A. PROFESSIONAL SERVICES
Professional services to be provided by SUBCONTRACTOR shall include:
(1) "Individual Supported Employment" or "IE": services are a part of an individual's pathway to
employment, are tailored to individual needs, interests, abilities, and promote career development. These
are individualized services necessary to help persons with developmental disabilities obtain and continue
integrated employment in the general workforce at or above the state's minimum wage. These services
may include intake, discovery, assessment, job marketing & development, job placement, job replacement,
worksite job training coaching/supports, development of natural supports, and follow -along and record
keeping. Specific service deliverables are delineated in Exhibit A — Statement of Work attached hereto.
(2) Program management.
B. OBLIGATIONS
SUBCONTRACTOR shall fulfill the following obligations:
(1) SUBCONTRACTOR shall comply with all state and federal requirements regarding the confidentiality of
Client records. Client information is not disclosable to the public. Information acquired pursuant to RCW
7IA. 14.070 requires a signed Release of Information or a signed Oath of Confidentiality Form.
(2) SUBCONTRACTOR is required provide background checks, pursuant to RCW 43.43.830-845, RCW
74.15.030, and Chapter 388-06 WAC, which state that any prospective employee or volunteer who will or may
have unsupervised access to a vulnerable person with a developmental disability in the course of his or her
employment, or involvement with the business or organization, must have a background/criminal history
clearance before they have unsupervised access. The DSHS Background Check Central Unit (BCCU) must
be utilized to obtain background clearance.
(3) If SUBCONTRACTOR reviews the application and elects to hire or retain an individual after receiving
notice that the applicant has a conviction for an offense that would disqualify the applicant from having
unsupervised access to vulnerable adults as defined in Chapter 74.34 RCW, then DDA shall deny payment
for any subsequent services rendered by the disqualified individual provider.
(4) COUNTY and its SUBCONTRACTOR are mandated reporters under RCW 74.34.020(13) and must
comply with reporting requirements described in RCW 74.34.035, .040 and Chapter 26.44 RCW. If the
County is notified by DSHS that a subcontractor staff member is cited or on the registry for a substantiated
finding, then that associated staff will be prohibited from providing services under this Program
Agreement.
(5) SUBCONTRACTOR is required pursuant to RCW 74.15.030, that if any prospective employee who has not
resided in Washington State during the last three years, and who will or may have unsupervised access to a
vulnerable person with a developmental disability in the course of his or her employment, or involvement with
the business or organization, must have an F.B.I. Fingerprint Check before they have unsupervised access and
before prospective employer begins working. The DSHS Background Check Central Unit (BCCU) must be
utilized to obtain background clearance.
(6) SUBCONTRACTOR is required to repeat the background/criminal history clearance for all employees or
volunteers who will or may have unsupervised access to a vulnerable person with a developmental disability in
the course of his or her employment, or involvement with the business or organization, every three years. The
DSHS Background Check Central Unit (BCCU) must be utilized to obtain background clearance in
accordance with RCW 43.43.830-845, RCW 74.15.030 and Chapter 388-06 WAC.
(7) SUBCONTRACTOR shall comply, as mandated reporters under RCW 74.34.020 (11), with all state and federal
requirements under RCW 74.34.035, .040 Abuse and neglect of Vulnerable Adults; RCW 26.44, Abuse of
Children; the WACs: 275-26 Division of Developmental Disabilities Services Rules; 296-24 General Safety
& Health; 296-62 General Occupational Health Standards; WACs: 388-828 Developmental Disabilities
Administration, (DDA) Assessment; 388-845 Home and Community Based Waivers; Definitions 0001;
Criteria for HCBS Services 0030; Basic Waiver Services 0200; Basic Plus Waiver Services 0210; Core
Waiver Services 0215; Community Protection Waiver Services 0220; 0600-0610 Community Access
Service; Supported Employment Service 2100.
(8) SUBCONTRACTOR shall comply with the following Developmental Disabilities Administration, (DDA)
Policies: 3.01 Client Service Plans; 5.01 Criminal History Background Checks and Safeguarding Personal
Information; 5.02 Necessary Supplemental Accommodation (NSA); 5.03 Client Complaints; 5.05 Limited
English Proficiency (LEP) Clients; 5.06 Client Rights; 5.13 Protections From Abuse; 5.14 Positive Behavior
Support; 5.15 Use of Restrictive Procedures; 6.08 Mandatory Reporting Requirements for Employment and
Day Program Services Providers; 6.13 Employment/Day Program Provider Qualifications; 9.07 Human
Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS); 12.01 Incident
Management; 13.04 DRW Access Agreement, and County Guide to Achieve Developmental Disability
Administration's Guiding Values.
(9) The COUNTY staff who performs on-site evaluations of SUBCONTRACTOR work sites, will promptly
report to DSHS per DDA Policy 5.13, Protection from Abuse: Mandatory Reporting, if:
(a) 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,
(b) 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.
(10) SUBCONTRACTOR shall comply with the following referenced documents found at DDA Internet site
htti)s://www,dshs.wa.gov/dda/county-best-practices under "Counties":
(a) DDA Policy 4.11, County Services for Working Age Adults;
(b) WAC 388-850, WAC 388-828, WAC 388-845-0001, 0030, 0205,0210, 0215, 0220, 0600-0610,
1200-1210, 1400-1410, 2100, 2110;
(c) Criteria for Evaluation;
(11) SUBCONTRACTOR shall meet the definition of Quality Assurance, by adherence to all Program
Agreement requirements and reasonably expected levels of performance, quality, and practice by adherence
to:
(a) DDA Policy 6.13, Employment/Day Program Provider Qualifications,
htt s:/Iwww.dshs.wa. av/ddal olicies-and-rules/ olio-nianual;
(b) County Guide to Achieve Developmental Disability Administration's Guiding Values
(12) The DRW Access Agreement with DDA, assures that the COUNTY and SUBCONTRACTORS have
reviewed the Access Agreement. The Access Agreement covers DRW's access to individuals with
developmental disabilities, to clients, to programs and records, to outreach activities, to authority to
investigate allegations of abuse, neglect, and other miscellaneous matters, and it is binding for all providers
of DDA contracted services.
CONCERNED CITIZENS IE Contract 2017-2018
Page 2 of 21
(13) SUBCONTRACTOR shall have written policies regarding sexual harassment and non-discrimination (said
policies must guarantee human/civil rights); regarding a person's right to privacy, regarding safeguarding
personal information and abuse of participants; regarding agency medication procedure; regarding respectful
staff -to -participant interactions (i.e.: including a person's right to be treated with dignity and respect free of
abuse).
(14) SUBCONTRACTOR shall assure that participants, in accordance with Necessary Supplemental
Accommodation (NSA) Policy 5.02, have been informed of their rights; what services and benefits may be
expected from the program; the program's expectations of them; and, if necessary, shall assure that the
participant's family, guardian or advocate is also informed.
(15) SUBCONTRACTOR shall have a grievance policy that:
• negotiates conflicts and advises participants of grievance procedures
• is explained to participants and others in accordance with the NSA, DDA Policy 5.02
• prohibits retaliation for using the grievance process
• includes a non -retaliation statement
• assure that advocates are available and encourages participants to bring advocates to help negotiate
• includes a mediation process that promotes the use of someone who is unaffected by the outcome if
conflicts remain unresolved (a DDA Case Resource Manager may be included as an alternative option)
• includes a process for tracking and reporting grievances
(16) 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.
(17) SUBCONTRACTOR will encourage participant involvement in policy development.
(18) SUBCONTRACTOR shall update Client Intake Forms every 6 months during the Client Review meeting.
(19) 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).
(20) SUBCONTRACTOR shall have adequate staffing ratios and patterns to maintain quality and safety.
(21) 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.
(22) SUBCONTRACTOR shall track and analyze incident reports for potential trends and patterns.
(23) Current emergency contact and medical information (medications, diet, allergies, etc.) needed during the
hours of service is readily available for each participant.
(24) The COUNTY and all SUBCONTRACTORS are mandated reporters under RCW 74.34.020(11). All
parties must comply with reporting requirements described in RCW 74.34.035, 040 and Chapter 26.44 and
must adhere to DDA Policy, 6.08 Mandatory Reporting Requirements for Employment and Day Program
Service Providers. All service provider employees, contractors, and volunteers are mandatory reporters
and must report every incident of observed, reported, or suspected abuse, improper use of restraint,
neglect, self-neglect, personal or financial exploitation, abandonment and/or mistreatment of clients.
(25) The Employment Phases & Billable Activities document defines the individual Client services that DDA
reimburses. That document is located on the DSHS DDA County Best Practices Web site at
haps://www.dshs.wa.gov/dda/couM-best-practices.
CONCERNED CITIZENS 1E Contract 2017-2018
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(26) 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 ofthese minimum capacity requirements, as determined solely by COUNTY, may be cause for termination
of this agreement as provided herein.
(a) Accreditation: SUBCONTRACTOR must be able to demonstrate conformance to Commission on
Accreditation of Rehabilitation Facilities (CARF) standards for quality assurance and CARF
accreditation.
(b) Confidentiality: SUBCONTRACTOR shall protect and maintain all Confidential Information gained
by reason of the Program Agreement against unauthorized use, access, disclosure, modification or loss.
This duty requires the COUNTY to employ reasonable security measures, which includes restricting
access to Confidential Information through:
(27) Protection of Data: The Contractor agrees to store Data on one or more of the following media and protect
the Data as described. All electronic Data must be encrypted using at least an encryption standard of AES
128 bit. Electronic Data can be on desktops, laptops and other portable devices, servers and external media:
(a) Hard disk drives: Data stored on local workstation hard disks. Access to the Data will be
restricted to Authorized User(s) by requiring logon to the local workstation using a Unique User
ID and Hardened Password or other authentication mechanisms which provide equal or greater
security, such as biometrics or smart cards.
(b) Network server disks: Data stored on hard disks mounted on network servers and made available
through shared folders. Access to the Data will be restricted to Authorized Users through the use
of access control lists which will grant access only after the Authorized User has authenticated to
the network using a Unique User ID and Hardened Password or other authentication mechanisms
which provide equal or greater security, such as biometrics or smart cards. Data on disks mounted
to such servers must be located in an area which is accessible only to authorized personnel, with
access controlled through use of a key, card key, combination lock, or comparable mechanism.
(c) For DSHS Confidential Information stored on these disks, deleting unneeded Data is sufficient as
long as the disks remain in a Secured Area and otherwise meet the requirements listed in the above
paragraph. Destruction of the Data as outlined in Section 5. Data Disposition may be deferred
until the disks are retired, replaced, or otherwise taken out of the Secured Area.
(d) Optical discs (CDs or DVDs) in local workstation optical disc drives: Data provided by DSHS on
optical discs which will be used in local workstation optical disc drives and which will not be
transported out of a Secured Area. When not in use for the contracted purpose, such discs must be
locked in a drawer, cabinet or other container to which only Authorized Users have the key,
combination or mechanism required to access the contents of the container. Workstations which
access DSHS Data on optical discs must be located in an area which is accessible only to
authorized personnel, with access controlled through use of a key, card key, combination lock, or
comparable mechanism.
(e) Optical discs (CDs or DVDs) in drives or jukeboxes attached to servers: Data provided by DSHS
on optical discs which will be attached to network servers and which will not be transported out of
a Secured Area. Access to Data on these discs will be restricted to Authorized Users through the
use of access control lists which will grant access only after the Authorized User has authenticated
to the network using a Unique User ID and Hardened Password or other authentication
mechanisms which provide equal or greater security, such as biometrics or smart cards. Data on
discs attached to such servers must be located in an area which is accessible only to authorized
personnel, with access controlled through use of a key, card key, combination lock, or comparable
mechanism.
(f) Paper documents: Any paper records must be protected by storing the records in a Secured Area
which is only accessible to authorized personnel. When not in use, such records must be stored in
a locked container, such as a file cabinet, locking drawer, or safe, to which only authorized
persons have access.
CONCERNED CITIZENS IE Contract 2017-2018
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(g) Remote Access: Access to and use of the Data over the State Governmental Network (SGN) or
Secure Access Washington(SAW1 will be controlled by DSHS staff who will issue authentication
credentials lea a Unique User ID and Hardened Password) o Authorized Users on Contractor
staff. Contractor will notify DSAS staff immediately whenever an Authorized User in possession
of such credentials is terminated or otherwise leaves the emplgy of the Contractor, and whenever
an Authorized User's duties char a such that the Authorized User no longer requires access to
perform work for this Contract,
(h) Data storage on portable devices or media:
(1) Except where otherwise specified herein, DSHS Data shall not be stored by the
Contractor on portable devices or media unless specifically authorized within the terms
and conditions of the Contract. If so authorized, the Data shall be given the following
protections:
(2) Encrypt the Data with a key length of at least 128 bits
(3) Control access to devices with a Unique User ID and Hardened Password or stronger
authentication method such as a physical token or biometrics.
(4) Manually lock devices whenever they are left unattended and set devices to lock
automatically after a period of inactivity, if this feature is available. Maximum period of
inactivity is 20 minutes.
Physically Secure the portable de ices and/or media by:
(5) Keeping them in locked storage when not in use
(6) Using check-in/check-out procedures when they are shared, and
(7) Taking frequent inventories
(8) When being transported outside of a Secured Area, portable devices and media with
DSHS Confidential Information must be under the physical control of Contractor staff
with authorization to access the Data.
(9) Portable devices include, but are not limited to; smart phones, tablets, flash memory
devices (e.g. USB flash drives, personal media players), portable hard disks, and
laptop/notebook/netbook computers if those computers may be transported outside of a
Secured Area.
(10) Portable media includes, but is not limited to; optical media (e.g. CDs, DVDs), magnetic
media (e.g. floppy disks, tape), or flash media (e.g. CompactFlash, SD, MMC).
(i) Data stored for backup purposes:
(1) DSHS data may be stored on portable media as part of a Contractor's existing,
documented backup process for business continuity or disaster recovery purposes. Such
storage is authorized until such time as that media would be reused during the course of
normal backup operations. If backup media is retired while DSHS Confidential
Information still exists upon it, such media will be destroyed at that time in accordance
with the disposition requirements in Section 5. Data Disposition
(2) DSHS Data may be stored on non-portable media (e.g. Storage Area Network drives,
virtual media, etc.) as part of a Contractor's existing, documented backup process for
business continuity or disaster recovery purposes. If so, such media will be protected as
otherwise described in this exhibit. If this media is retired while DSHS Confidential
Information still exists upon it, the data will be destroyed at that time in accordance with
the disposition requirements in Section 5. Data Disposition.
0) Data Segregation:
(1) DSHS Data must be segregated or otherwise distinguishable from non-DSHS data. This
is to ensure that when no longer needed by the Contractor, all DSHS Data can be
identified for return or destruction. It also aids in determining whether DSHS Data has or
may have been compromised in the event of a security breach. As such, one or more of
the following methods will be used for data segregation.
(2) DSHS Data will be kept on media (e.g. hard disk, optical disc, tape, etc.) which will
contain no non-DSHS data. And/or,
CONCERNED CITIZENS IE Contract 2017-2018
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(3) DSHS Data will be stored in a logical container on electronic media, such as a partition
or folder dedicated to DSHS Data. And/or,
(4) DSHS Data will be stored in a database which will contain no non-DSHS data. And/or,
(5) DSHS Data will be stored within a database and will be distinguishable from non-DSHS
data by the value of a specific field or fields within database records.
(6) When stored as physical paper documents, DSHS Data will be physically segregated
from non-DSHS data in a drawer, folder, or other container.
(7) When it is not feasible or practical to segregate DSHS Data from non-DSHS data, then
both the DSHS Data and the non-DSHS data with which it is commingled must be
protected as described in this exhibit.
(28) Data Disposition:
When the contracted work has been completed or when no longer needed, except as noted in Section 3.
Protection of Data b. Network Server Disks above, Data shall be returned to DSHS or destroyed. Media on
which Data may be stored and associated acceptable methods of destruction are as follows:
Data stored on:
Server or workstation hard disks, or
Removable media (e.g. floppies, USB flash drives,
portable hard disks) excluding optical discs
Paper documents with sensitive or Confidential
Information
Paper documents containing Confidential Information
requiring special handling (e.g. protected health
Optical discs (e.g. CDs or DVDs)
Will be destroyed by:
Using a "wipe" utility which will overwrite the Data at
least three (3) times using either random or single
character data, or
Degaussing sufficiently to ensure that the Data cannot
be reconstructed, or
Physically destroying the disk
Recycling through a contracted firm provided the
contract with the recycler assures that the
confidentiality of Data will be protected.
On-site shredding, pulping, or incineration
Incineration, shredding, or completely defacing the
readable surface with a coarse abrasive
incinerating or crosscut
(29) Notification of Compromise or Potential Compromise. The compromise or potential compromise of DSHS
shared Data must be reported to the DSHS Contact designated in the Contract within one (1) business day
of discovery If no DSHS Contact is designated in the Contract, then the notification must be reported to the
DSHS Privacy Officer at dshsprivacyofficer@dshs.wa.gov. Contractor must also take actions to mitigate
the risk of loss and comply with any notification or other requirements imposed by law.
(30) SUBCONTRACTOR shall provide the following:
(a) Equal Access_. SUBCONTRACTOR will assures equal access to persons who do not speak or have a
limited ability to speak, read, or write English well enough to understand and communicate effectively
(reference: DDA Policy 5.05, Limited English Proficient (LEP) Clients).
(b) Financial and Program Management:_ SUBCONTRACTOR will maintain an
administrative/organizational structure that clearly defines responsibilities; systems and personnel to
maintain accounting records that accurately reflect all program revenues and expenditures; prepare
monthly statements of activity (ADSA Reports); maintain appropriate client service records and
progress reports; and track key program performance indicators.
(c) Participants: 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.
CONCERNED CITIZENS IE Contract 2017-2018
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(d) Partnerships: SUBCONTRACTOR has a history of working cooperatively with community-based
organizations including Employers, other Agencies, the COUNTY DD Program, the Division of
Vocational Rehabilitation (DVR), and the Schools.
(e) Performance Plan: SUBCONTRACTOR has a written performance plan that describes its mission,
program objectives, expected outcomes, and describes how and when objectives will be accomplished;
and will assure the plan is evaluated at least biennially with revisions based on actual performance.
(f) Quality Assurance Pian: SUBCONTRACTOR has a written quality assurance plan that evaluates Client
progress every 6 months by looking at:
(1) Increased wages (by acuity)
(2) Increased number of working hours (by acuity)
(3) The number of new jobs (by acuity)
(4) Job loss and why — retention rates (by acuity)
(5) The percentage employed (by acuity)
(6) Looking at Quantitative -(Data) vs. Qualitative -(Narrative)
(g) Internal Control _Systems: SUBCONTRACTOR has sufficient policies and procedures for establishment
and maintenance of adequate internal control systems. SUBCONTRACTOR will maintain written policy
procedural manuals for information systems, personnel, and accounting/finance in sufficient detail such
that operations can continue should staffing change or prolonged absences occur.
(h) Qualified Staff: SUBCONTRACTOR will provide adequate, qualified staff with skills and experience
in evaluation, training, supervision, counseling and support of adults with developmental disabilities
who are earning wages, per the attached Statement of Work. SUBCONTRACTOR will assure that all
direct service staff are trained, and that training is documented. SUBCONTRACTOR will provide
COUNTY with information regarding staff qualifications upon request.
(i) Safe : SUBCONTRACTOR will provide evidence that it employs safety protection based on the
environment in which the participant is working or receiving services.
(j) Integration: Employment and day services must adhere to the Home and Community Based settings
(HCBS) requirements of 42CFR 441 530(a)(1), including that:
(1) The setting is integrated in the greater community and supports individuals to have full access to
the greater community;
(2) Ensures the individual receives services in the community to the same degree of access as
individuals not receiving Medicaid HCBS;
(3) The setting provides opportunities to seek employment and work in competitive integrated settings;
and
(4) The setting facilitates individual choice regarding services and supports, and who provides them.
(k) 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.
(1) Individual Employment/Vocational Client Plans will include:
(1) Information that identifies and addresses the individualized goal and support needs for each
participant. The plan should be developed by the provider in collaboration with the Case Resource
Manager, client, guardian and his or her family (the team).
(2) Initial plans will be completed within 30 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 plan and semi-annual progress reports will be distributed as appropriate to all
team members.
(4) Plans will be reviewed and signed every six (6) months.
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(m) Individual Employment/Vocational Client Plans will also include the information listed below:
(1) Current date
(2) Timeline for the plan
(3) Client's name: first and last
(4) Client ADSA ID
(5) Employment goal
(6) Preferred (job type) the individual wishes to obtain or maintain
(7) The preferred wages /salary the individual wishes to earn
(8) The number of hours the individual prefers to work
(9) The preferred work shift
(10) The individual's skills, gifts, interests, and preferred activities
(11) Measurable strategies (action steps and supports) to meet the employment goal
(12)Identification of persons and/or entities (such as family, Division of Vocational Rehabilitation)
available to assist the client in reaching his/her employment goal
(13) Identification of other accommodations, adaptive equipment, and/or supports critical to achieve
employment goal
(n) SUBCONTRACTOR will provide semi-annual progress reports that describe progress made towards
achieving client's goals, to the County, the Case Resource Manager, participant, guardian and others as
appropriate, within 30 days following the meeting. The report will summarize the progress made
towards the Client's individualized goals.
(o) 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, the Residential Provider, Guardian and then to
the COUNTY Coordinator. This includes serious physical or emotional harm or potential harm.
(1) The initial report may be done via documented telephone calls to DSHS/DDA Case Manager,
the Residential Provider, Guardian and COUNTY Coordinator.
(2) The SUBCONTRACTOR shall submit a written follow-up report within 3 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.
(p) Within 30 days of the effective date of this agreement and at least semi-annually thereafter,
SUBCONTRACTOR will provide (a) company (b) program financial reports to COUNTY, including all
revenues and expenses generated by SUBCONTRACTOR, in sufficient detail to demonstrate the uses of
funds provided under this agreement.
(q) Make available for inspection, review, or audit by COUNTY DD Coordinator at all reasonable times: all
work sites; all client records; records on productivity and client wages; and all documents, reports, and
other data applicable to this agreement. The COUNTY shall monitor services delivered, and conduct at
least one on-site visit with SUBCONTRACTOR during the period of the contract to assure compliance
with the DDA State Work Order.
(r) AUDIT REQUIREMENTS. Independent Audit will be submitted annually to the Jefferson COUNTY
DD COUNTY Coordinator in the following manner:
(1) 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.
CONCERNED CITIZENS IE Contract 2017-2018
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(s) The SUBCONTRACTOR shall provide an independent audit of the entire organization which:
(1) Is performed by an independent Certified Public Accountant, the Washington State
Auditor's Office, or another entity the COUNTY and the SUBCONTRACTOR mutually approve.
(2) Provides statements consistent with the guidelines of Reporting for Other Non -Profit
Organizations AICPA SOP 78-10, and is performed in accordance with generally accepted
auditing standards and with Federal Standards for Audit of Governmental Organizations,
Programs, Activities, and Functions, and meeting all requirements of OBM Circular A-133 or A-
128, as applicable.
(3) The SUBCONTRACTOR shall submit two (2) copies of the audit and/or the summary and the
management letter directly to the COUNTY immediately upon completion. The audit must be
accomplished by documentation indicating the SUBCONTRACTOR'S Board of Directors has
reviewed the audit.
(t) 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:
(1) 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.
(2) 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.
(3) Written Summary: Within ten (10) working days of such official notification, the COUNTY will
provide the SUBCONTRACTOR a written summary of the areas of non-compliance by certified
mail. Notice shall be sent to the address identified in the Agreement.
(4) 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.
(5) Should the above procedures fail to resolve the compliance issue, the parties will obtain the
services of the Peninsula Dispute Resolution Center, or another agreed upon resource, and shall
share equally in any retainer fees or other costs of services. If no agreement is reached, the
mediator's decision in the matter will be binding on all parties, except that in no event will the
County honor a financial determination that is greater than the funds allowed the scope of this
Agreement.
(u) For six years following the end date of this agreement, SUBCONTRACTOR will maintain client records
and books, records, documents, reports and other evidence of accounting procedures and practices, which
sufficiently and properly reflect all direct and indirect expenditures of funds provided under this agreement.
Client records shall minimally include statement of client goals, documentation of training provided,
training hours, routine progress notes and semi-annual summary of progress toward meeting client goals.
(v) COUNTY shall develop and have available an evaluation system to review services. The evaluation
system must have both a Quality Assurance and a Quality Improvement component, and both must
include objective measures. The objective measures at a minimum will include performance indicator
by acuity. that include the number of new 'ohs job loss and reasons for job loss the ercenta e
employed earning minimum wage or better; and the average number of hours worked. The
COUNTY's service evaluation system shall serve as the method where the SUBCONTRACTOR shall
demonstrate that they continue to be qualified providers. A copy of such evaluation system shall be
provided upon request to DDA for review and approval.
CONCERNED CITIZENS IE Contract 2017-2018
Page 9 of 21
(w) 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.
(x) SUBCONTRACTOR shall provide COUNTY with a copy of a signed DSHS Provider Agreement within
30 days of the effective date of this agreement.
(y) SUBCONTRACTOR agrees to assign to COUNTY its Medicaid Billing Rights for services to clients
eligible under Title XIX programs. Written documentation shall be available to COUNTY on request. If
SUBCONTRACTOR contracts directly with DSHS to provide covered services under Title XIX,
COUNTY agrees that funding intended for those clients shall be excluded from this agreement. If
SUBCONTRACTOR contracts directly with Social Security to provide covered services under a
PASS/IRWE, COUNTY agrees that funding intended for those clients shall be excluded from this
agreement.
C. REIMBURSEMENTS
(1) For said services rendered under this agreement, COUNTY shall reimburse SUBCONTRACTOR on a unit rate
basis as follows:
(a) individual E3rnploynient Services: SUBCONTRACTOR will be paid $75.00 per unit assigned Service
Responsibility of regular Program Service as defined in Exhibit A, Statement of Work. The hourly
rate may have to be renegotiated if a number of new clients need services. COUNTY will check in
with SUBCONTRACTOR on a quarterly basis as to the status of the budget and the number of clients
requesting service.
(2) This Agreement shall commence on July 1, 2017 and continue through June 30, 2018 unless terminated as
provided herein. Work performed between July 1, 2017 and the execution of this Agreement that is
consistent with the provisions of this Agreement is hereby ratified.
(3) SUBCONTRACTOR will bill COUNTY monthly in arrears and on a monthly basis, on or before the 5th day
of the month, for units of service provided under this agreement. SUBCONTRACTOR will submit a Monthly
DDA Services Report (ASDA) form for its billings. At no time shall the invoices for reimbursement be
submitted more than 60 calendar days following the last day of the month for which the services were provided
without COUNTY approval.
(4) COUNTY may, at its option, withhold reimbursement for any month for which required reports and/or
invoices have not been received, or are not accurate and/or complete, or for contractual non-compliance
issues.
(5) Total reimbursements for fiscal year 2017-2018 to SUBCONTRACTOR by COUNTY under this contract shall
not exceed $45,900.00 in completion of these services without express written amendment signed by both
parties to this Agreement.
(6) SUBONTRACTOR will access Division of Vocational Rehabilitation (DVR) funding as a resource. Client
services shall not be reimbursed under this agreement when the same services are paid for under the
Rehabilitation Act of 1973, DVR, P.L. 94-142 (Public Education), or are being funded under PASS/IRWE.
D. MISCELLANEOUS
(1) DSHS Developmental Disabilities Administration (DDA) shall determine client eligibility and service referral
are the responsibility of the DDA pursuant to Chapter 388-823 WAC (Eligibility) and Chapter 388-825 WAC
(Service Rules). Only persons referred by DDA shall be eligible for direct Client services under this Program
Agreement. It is DDA's responsibility to determine and authorize the appropriate direct service(s) type. Direct
Client services provided without authorization are not reimbursable under this Program Agreement.
(2) DSHS Developmental Disabilities Administration (DDA) shall notify COUNTY of persons authorized for
services reimbursed under this agreement. Only persons referred to COUNTY by DDA through a County
Service Authorization, (CSA) shall be eligible for services reimbursed under this agreement.
CONCERNED CITIZENS 1E Contract 2017-2018
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(3) The SUBCONTRACTOR'S relation to the COUNTY shall at all times be that of independent
SUBCONTRACTOR. Any and all employees of the SUBCONTRACTOR, or other persons engaged in the
performance of any work or service required of the SUBCONTRACTOR under this Agreement, shall be
considered employees of the SUBCONTRACTOR only, and any claims that may arise on behalf of or
against said employees shall be the sole obligation and responsibility of the SUBCONTRACTOR.
(4) 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.
(5) The SUBCONTRACTOR, by signature to this Agreement, certifies that the SUBCONTRACTOR is not
presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from
participating in this Agreement, or any Agreement by any Federal department or agency. The
SUBCONTRACTOR also agrees to include the above requirement to all subcontracts into which it enters.
(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. The Contractor will participate in the
Worker's Compensation and Employer's Liability Insurance Program as may be required by the
State of Washington;
(b) Commercial Automobile Liability or Business Use Insurance providing bodily injury and property
damage liability coverage for all owned and non -owned vehicles assigned to or used in the
performance of the work for a combined single limit of not less than $1,000,000 each occurrence
with the COUNTY named as an additional insured in connection with the SUBCONTRACTOR'S
performance of the contract.
(c) General Commercial Liability Insurance in an amount not less than a single limit of two million
dollars ($2,000,000.00) per occurrence and an aggregate of not less than two (2) times the
occurrence amount ($2,000,000.00 minimum) for bodily injury, including death and property
damage, unless a greater amount is specified in the contract specifications. The insurance
coverage shall contain no limitations on the scope of the protection provided and include the
following minimum coverage:
(1) Broad Form Property Damage, with no employee exclusion
(2) Personal Injury Liability, including extended bodily injury
(3) Broad Form Contractual/Commercial Liability - including completed operations
(4) Premises - Operations Liability (M&C)
(5) Independent Contractors and Subcontractors
(6) Blanket Contractual Liability
(7) All employees or subcontractors of SUBCONTRACTOR who are required to be professionally certified by
the State in the performance of services under this agreement shall maintain professional liability
insurance/error and omissions liability insurance in the amount of not less than one million dollars
($1,000,000). In no case shall such professional liability to third parties be limited in any way.
(8) It shall be the responsibility of the SUBCONTRACTOR to insure that any and all persons engaged in the
performance of any work or service required of the SUBCONTRACTOR under this Agreement, shall comply
with the same insurance requirements that SUBCONTRACTOR is required to meet.
(9) Failure on the part of the SUBCONTRACTOR to maintain the insurance as required shall constitute a
material breach of contract upon which the COUNTY may, after giving five working days' notice to the
SUBCONTRACTOR to correct the breach, immediately terminate the contract or, at its discretion, procure
or renew such insurance and pay any and all premiums in connection therewith, with any sums so expended
to be repaid to the COUNTY on demand, or at the sole discretion of the COUNTY, offset against funds due
the SUBCONTRACTOR from the COUNTY.
CONCERNED CITIZENS IE Contract 2017-2018
Page 11 of 21
(10) All cost for insurance shall be considered incidental to and included in the unit contract prices and no
additional payment will be made.
(11) Excepting the Workers Compensation insurance and any professional liability insurance secured by the
SUBCONTRACTOR, the COUNTY will be named on all certificates of insurance as an additional insured,
The SUBCONTRACTOR shall furnish the COUNTY with verification of insurance and endorsements
required by this Agreement. The COUNTY reserves the right to require complete, certified copies of all
required insurance policies at any time,
(12) All insurance shall be obtained from an insurance company authorized to do business in the State of
Washington. The SUBCONTRACTOR shall submit a verification of insurance as outlined herein within 14
days of the execution of this Agreement to the COUNTY. All insurance policies obtained by the
SUBCONTRACTOR shall be primary to any equivalent or applicable policies held by the COUNTY. All
insurance policies obtained by the SUBCONTRACTOR shall include a waiver of subrogation rights. Any
self-insured retention, deductible or risk retention maintained, or participated in, by the COUNTY coverage
for third -party liability claims provided to the county, shall be excess and shall be non-contributory to the
insurance policies provided by the SUBCONTRACTOR in order to comply with the insurance requirements
of this Subcontract, All policies provided by the SUBCONTRACTOR in order to comply with the insurance
requirements of this Subcontract must be endorsed to show this primary coverage.
(13) The COUNTY will pay no progress payments under Section C until the SUBCONTRACTOR has fully
complied with this section. This remedy is not exclusive; and the COUNTY may take such other action as
is available to them under other provisions of this Agreement, or otherwise in law.
(14) Nothing in the foregoing insurance requirements shall prevent the COUNTY, at its option, from additionally
requesting that the SUBCONTRACTOR deliver to the; COUNTY an executed bond as security for the faithful
performance of this contract and for payment of all obligations of the SUBCONTRACTOR.
(15) The SUBCONTRACTOR shall comply with all Federal, State, and local laws and ordinances applicable to
the work to be done under this Agreement. This Agreement shall be interpreted and construed in accord
with the laws of the State of Washington and venue shall be in Jefferson COUNTY, WA.
(16) The SUBCONTRACTOR shall comply with the WA State Department of Labor and Industries Minimum Wage
Act, RCW 49.46, acknowledging. persons with disabilities participating in job assessments are not considered
employees.
(17) The SUBCONTRACTOR shall indemnify and hold the COUNTY, and their officers employees, and agents
harmless from and shall process and defend at its own expense, including all costs, attorney fees and expenses
reletting theretu, all claims, demands, or suits at law or equity arising in whole or in part, directly or indirectly,
from the SUBCONT'RACTOR'S negligence or breach of any of its obligations under this Agreement;
provided that nothing herein shall require a SUBCONTRACTOR to indemnify the COUNTY against and
hold harmless the COUNTY from claims, demands or suits based solely upon the conduct of the COUNTY,
their officers, employees and agents, and provided further that if the claims or suits are caused by or result
fi•om the concurrent negligence of:
(a) the SUBCONTRACTOR'S agents or employees; and, (b) the COUNTY, its officers, employees
and agents, this indemnity provision with respect to (1) claims or suits based upon such negligence,
and/or (2) the costs to the COUNTY of defending such claims and suits, etc., shall be valid and
enforceable only to the extent of the SUBCONTRACTOR'S negligence or the negligence of the
SUBCONTRACTOR'S agents or employees.
(18) Claims against the COUNTY shall include, but not be limited to assertions that the use and transfer of any
software, book, document, report, fihn, tape, or sound reproduction of material of any ]rind, delivered there
under, constitutes an infringement of any copyright, patent, trademark, trade name, or otherwise results in an
unfair trade practice or an unlawful restraint of competition.
(19) The SUBCONTRACTOR specifically assumes potential liability for actions brought against the COUNTY by
SUBCONTRACTOR'S employees, including all other persons engaged in the performance of any work or
service required of the SUBCONTRACTOR under this Agreement and, solely for the purpose of this
indemnification and defense, the SUBCONTRACTOR specifically waives any immunity under the state
industrial insurance law, Title 51 RCW. The SUBCONTRACTOR recognizes that this waiver was
specifically entered into pursuant to provisions of RCW 4.24.115 and was subject of mutual negotiation.
CONCERNED CITIZENS IE Contract 2017-2018
Page 12 of 21
(20) SUBCONTRACTOR shall not discriminate against any person presenting themselves for services based on
race, religion, color, sex, age, or national origin.
(21) COUNTY reserves the right to terminate this contract in whole or in part, without prior written notice, in the
event that contractual terms are not fulfilled, or if expected or actual funding from the Department of Social
and Health Services Division of Developmental Disabilities is withdrawn, reduced, or limited in any way after
the effective date of this agreement. In the event of termination under this clause, COUNTY shall be liable
only for payment for services rendered prior to the effective date of termination.
(22) No portion of this contract may be assigned or subcontracted to any other individual, firm, or entity without
the express and prior written approval of COUNTY. If the COUNTY agrees in writing that all or a portion of
this Contract may be subcontracted to a third -party, then any contract or agreement between the
SUBCONTRACTOR and a third -party subcontractor must contain all provisions of this Agreement and the
third -party subcontractor must agree to be bound by all terms and obligations found in this agreement.
ADOPTED THIS day of , 2017
By:
Kathleen Kler, Chair
Jefferson Board of County Commissioners
By:
Attest, Clerk of the Board
IU0
Linda Middleton, Executive Director
Concerned Citizens
APPROVED AS TO FORM ONLY:
By: . (I
P flip Hunsucker,hiefivil Deputy Prosecutor
CONCERNED CITIZENS IE Contract 2017-2018
Page 13 of 21
EXHIBIT A
STATEMENT OF WORK
INDIVIDUAL SUPPORTED EMPLOYMENT
I. WORK STATEMENT
SUBCONTRACTOR shall provide Individual Supported Employment Services 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.
Il. PROGRAM DESCRIPTION
A. Program Goals:
To support and strengthen Concerned Citizens capacity to provide quality, cost effective individual
supported employment services.
To assure that businesses employing individuals with developmental disabilities in Jefferson County
will meet the Employment Quality Indicators from the County Guide to Achieve Developmental
Disability Administration's Guiding Values.
3. To provide employment services that are designed to meet specific needs of individuals based on
personal preferences and individualized goals and outcomes.
i. 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.
ii. 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.
iii. 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).
iv. 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.
v. To identify settings that isolate people from the broader community or that have the effect of
isolating individuals from the broader community of individuals who do not receive Medicaid HCB
services. Clients will not access these settings because they are presumed not to be home and
community-based.
B. Definitions
Individual Supported Employment or "IE": services are a part of an individual's pathway to
employment and are tailored to individual needs, interests, and abilities, and promote career
development. These are individualized services necessary to help persons with developmental
disabilities obtain and continue integrated employment at or above the state's minimum wage in the
general workforce. These services may include intake, discovery, assessment, job preparation, job
marketing, job supports, record keeping and support to maintain a job.
CONCERNED CITIZENS IE Contract 2017-2018
Page 14 of 21
2. Placement is defined as employment in a first job or in multiple jobs arranged by SUBCONTRACTOR
for 90 calendar days. Placements maybe: full-time, average workweek of 20 to 40 hours; part-time,
average work week of 12 hours to 20 hours, or less than average work week of 2 to 12 hours.
Replacement 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.
Placement and ftlacement_Services may include: vocational counseling and job analysis to assist in
the identification of work objectives and the job match process; job development, locating a suitable
community job for the worker; initial placement and post -hire training of the supported employee,
employer and/or coworkers at the employment site; job restructuring and worksite modifications;
supporting the worker, employer, and other interested persons (parents, unions, other employees, etc.)
to develop natural workplace supports and ensure stability on the job; assisting the worker to obtain
other services necessary for continued employment; feedback to the worker, COUNTY and to DDA
Field Services regarding progress and/or problems.
5. Follow along Services begin at the time of placement or replacement and may include: visiting with
the worker, the employer, and other interested parties (parents, unions, etc.) to insure stability on the
job; providing feedback to the worker, COUNTY, and to DDA Field Services regarding progress
and/or problems; counseling the worker and his/her family on vocational issues.
6. The development of an Individwil_Employment 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.
Piannin is defined as facilitating the development of a Pathway to Employment Plan; delineating
individual vocational skills, experiences, preferences, strengths, support needs, skills, goals and
objectives, education on system navigation and the Discovery Process related to vocational skills
and capabilities.
Implementation 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.
C. Program Requirements
1. The SUBCONTRACTOR will clearly communicate to the client and the COUNTY, prior to beginning
service, an expected change in the maximum service hours per month the client can expect to receive. Service
changes will not occur until the client has received proper notification from DDA.
The client's DDA Person Centered Service Plan; (PCSP) is the driver for
service. The CMIS County Service Authorization and the updated Planned
Rates information will not exceed the client's DDA PCSP.
ii. The amount of service the client receives should match with the CMIS County
Service Authorization and updated Planned Rates information.
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 days of the beginning of
services for the client, in order to promote Individual Employment. (Minimum Individual
Employment/Vocational Client Plan elements are outlined in the reference document called "Criteria for
Evaluation" available on the DDA website.)
CONCERNED CITIZENS IE Contract 2017-2018
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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. SUBCONTRACTOR's employment services, may include a personal discovery process related to skills,
capabilities, and goals; education on system navigation; facilitated plan development; action steps detailing
steps, timelines, and entities responsible for the accomplishment of tasks of vocational services leading to
employment.
5. Clients in an employment program will be supported to work towards a living wage. A living wage is the
amount needed to enable an individual to meet or exceed his/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 per WAC 388-
828.
6. Prior to beginning service or prior to an expected change in service, the provider will clearly communicate
to the Client and the County 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.
7. The amount of service the Client receives should match with the CMIS CSA and updated Planned Rates
information
8. SUBCONTRACTOR will provide an individualized plan to identify Client's preferences. Minimum plan
elements are outlined in the reference document "Criteria for an Evaluation." A copy of the Client's
individualized plan will be provided to their CRM, guardian and others as appropriate.
9. All Clients will be contacted by SUBCONTRACTOR according to Client need and at least once per month.
10. If Clients in Individual Employment, have not obtained paid employment at minimum wage or better
within six (6) months, COUNTY will assure that the SUBCONTRACTOR will take the following steps:
i. Review the progress toward employment goals;
ii. Provide evidence of consultation with the family/Client; and
iii. Develop additional strategies with the family/Client, county staff, employment support
staff and the case manager. Strategies may include providing technical assistance,
changing to a new provider, and/or providing additional resources as needed to support
the individual's pursuit of employment. The additional strategies will be documented for
each Client and kept in the Client's file(s).
11. If after twelve (12) months the Client remains unemployed, SUBCONTRACTOR will assure that an
additional review will be conducted. SUBCONTRACTOR will address steps outlined in the previous six
(6) month progress report in the next six month progress report.
12. For Individual Employment where the SUBCONTRACTOR 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.
13. 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.
CONCERNED CITIZENS IE Contract 2017-2018
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14. SUBCONTRACTOR shall provide an Individual Employment/Vocational Client Plan for clients in
Individual Employment delineating individual skills, experiences, preferences, strengths, support needs,
vocational interests and goals and objectives within 30 days of the beginning of services for the client in
order to promote Individual Employment. Job coaching and supervision of program clients will be based on
goals established in an Individual Employment/Vocational Client Plan. Client goals, training provided, and
progress toward meeting goals shall be documented in each client record.
15. SUBCONTRACTOR must ensure that Client Goals and Objectives are based on a Person Centered Plan or
an Individual Employment/Vocational Client Plan; that documentation, data collected, training reflects the
goals and objectives; shows how it has identified and addressed support needs of each participant by
demonstrating methods for providing individualized services outlined in a Client's Plan.
16. The Progress Report shall demonstrate how the individual is progressing on his/her goals and objectives, in
order to assess if they are continuing to meet the individual's pathway to employment goals of the
Individual Employment/Vocational Client Plan and the Progress Report shall describe the reasons for any
shortfall concerning the action steps and propose steps for correction.
17. SUBCONTRACTOR will submit to the COUNTY, to the DDA Case Manager, to the Residential Provider,
and Parent/Guardian a semi-annual Progress Report on each client. The SUBCONTRACTOR will use the
new Employment Plan Report Form to report on the semi-annual progress of the client.
18. SUBCONTRACTOR shall schedule a review meeting every six (6) months for all program clients, (a minimum
of twice a year for every client). For every new client a meeting will be scheduled every six (6) months after
the initial plan.
19. SUBCONTRACTOR shall schedule dates for the six (6) months reviews to COUNTY, DDA, Client and
guardian one month before the required meetings.
20. SUBCONTRACTOR shall provide an updated Semi -Annual Progress Report for every program client at or
before the six (6) month review meeting. The Progress Report shall demonstrate how the individual is
progressing on his/her goals and objectives, in order to assess if they are continuing to meet the individual's
pathway to employment goals of the Individual Employment/Vocational Client Plan and the Progress
Report shall describe the reasons for any shortfall concerning the action steps and propose steps for
correction.
21. The Semi -Annual Progress Reports with updated Action Steps, 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.
22. SUBCONTRACTOR will submit a copy of the updated Semi -Annual Progress Report with updated Action
Steps of the Individual Employment/Vocational Client Plan to the Client, the DDA case manager, the
COUNTY Coordinator, and Residential Support Staff/ Parent or Guardian within two weeks of the semi-annual
meeting.
23. SUBCONTRACTOR will submit Semi -Annual Progress Reports with updated Action Steps on each client to
the COUNTY for feedback and approval. Disregarding or lack of follow-through on this step will hold up
monthly billing and continued authorization for funding.
24. All clients will be contacted by SUBCONTRACTOR according to client need, and at least once a month.
25. The client may request to participate in Community Access activities or the client may choose to remain in
an Employment Program. When requesting to participate in the Community Access services, the client
shall communicate directly with his or her DDA Case Manager. The DDA Case Manager is responsible for
authorizing Community Access services.
26. 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.
CONCERNED CITIZENS IE Contract 2017-2018
Page 17 of 21
27. SUBCONTRACTOR must ensure that every client file has a copy of DDA Client Authorization, a copy of
the participant's Individual Habilitation Plan (ICF/MR), client's DDA Person Centered Service Plan, Plan of
Care and/or Individual Support Plan (HCBS Waivers) and/or the County Service Authorization/Individual
Service Agreement Plan, as applicable.
28. SUBCONTRACTOR must ensure that all Incident Reports are retained in client files; that they have a
policy to retain records at least 5 years; that emergency contact and medical information (medications,
diet, allergies, etc.) needed during the hours of service is available for each participant on the face sheet of
the client file; that the emergency and contact information is updated yearly, or when needed; and that
services are provided in a natural or integrated environment or there is a goal to achieve that.
29. Worker wages shall be commensurate with the local industry accepted norms and comply with applicable
Federal Department of Labor standards.
30. Recommendations for program participant's termination in Individual Employment or transfer into another
Individual Employment agency must be authorized by the DDA Case Manager, and will be reviewed in
consultation with the COUNTY and others as appropriate. SUBCONTRACTOR will facilitate the development
of a transition plan and schedule. The transition plan will be developed in consultation with the client, DDA
case management, COUNTY, family members and other service providers as applicable and within 30 working
days of clients request to change agencies.
31. SUBCONTRACTOR must ensure there is a legal requirement and a clear delineation for staff
qualifications and proof of background criminal history clearance in accordance with SUBCONTRACTOR
is required pursuant to RCW 43.43.830-845 RCW 74.15.030, and Chapter 388-06 WAC on all staff.
32. SUBCONTRACTOR shall submit a written Program Staff Training Plan to COUNTY for approval or
disapproval within 30 days of the effective date of this agreement, semi-annually thereafter or when
reorganization occurs, which minimally includes SUBCONTRACTOR's procedure to train new direct
service staff. The training must include:
• DDA Policies & Competencies
RCW's & WAC's as referenced under Section B, Obligations.
• Agency policies & procedures
• Skills on how to instruct/teach clients
• Skills on how to document data collection, daily/weekly notes & 6 month reports in
client files
• Skills on how to write Individual Employment/Vocational Client Plans and/or
Person Centered Plans (creating client vocational goals/objectives)
■ SUBCONTRACTOR's plan to provide staff that are skilled in applying training
techniques to enhance the work related skills of program clients
• FTE levels job descriptions and organization charts pertaining to program staff
• SUBCONTRACTOR is required to send four direct service staff to a minimum of
15 hours of workshops, trainings and/or conferences about developmental
disabilities and employment, for a total of 15 hours. Should SUBCONTRACTOR
fail to access trainings for direct service staff, the SUBCONTRACTOR will
reimburse the COUNTY at the rate of 75.00 an hour for every hour of training not
accessed for staff (for not more than a total of $1,125)
33. SUBCONTRACTOR will provide COUNTY with information regarding staff qualifications and documented
training's every six (6) months.
34. 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 Prior to Nlorkft with Clients: ADA training, APS Reporting Requirements, Client
confidentiality, Current individual instruction and Action Steps/Vocational Plans for each Client with whom
the employee works, DDA Policy 4.11 Working Age Adult (adult services only), DDA Policy 5.06, Client
Rights, DDA Policy 5.13, Protection from Abuse: Mandatory Reporting, DDA Policy 12.01 Incident
Management.
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35. 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
36. Within one month r�femployment: SUBCONTRACTOR must ensure that direct service staff received
training and are knowledgeable in the following areas: Overview of DDA Policies including: DDA Policy
3.01 Service Plans, DDA Policy 5.03 Client Complaints, DDA Policy 5.17 Physical Intervention
Techniques, DDA Policy 6.13 Employment/Day Program Provider Qualifications, DDA Policy 13.04
DRW Access Agreement, DDA Policy 15.03 Community Protection Standards for Employment/Day
Programs and all reporting requirements related to these DDA Policies.
37. Il''i(hin six months of empioti1ment: SUBCONTRACTOR must ensure that direct service staff received
training and are knowledgeable in the following areas: Program skill development, DDA Policy 5.02
Necessary Supplemental Accommodation, DDA Policy 5.14 Positive Behavior Support, DDA Policy 5.15
Use of Restrictive Procedures, DDA Policy 9.07 HIV and AIDS and Program Skill Development.
38. SUBCONTRACTOR will have signed documentation that Staff training took place within the timelines
listed above in Section C -Number 36-37.
39. Within 30 days of the effective date of this agreement, and semi-annually thereafter, SUBCONTRACTOR
will develop and submit to COUNTY an Individual Employment program operating budget detailing the
projected allocation of contract funds, other sources and amounts of funding, program staffing expenses and
other cost allocations.
40. Semi-annually, SUBCONTRACTOR will develop and submit to COUNTY Individual Employment program
financial reports reflecting the actual revenues received and expenses incurred compared to the projected
program budget submitted.
41. The SUBCONTRACTOR will on an annual basis sponsor the surveying of participants, their families, and
their support networks and employers regarding customer satisfaction. The SUBCONTRACTOR will design
Customer/Client survey forms. Upon request, the SUBCONTRACTOR will send the COUNTY copies of the
surveys received from participants, their families, their support networks and employers.
D. Performance Standards
(1) SUBCONTRACTOR shall provide Individual Employment services that are referred for service by
DSHS/DDA and have been authorized by the COUNTY.
a. Job development, job coaching, follow -along and replacement services as necessary
for Individual Employment Clients
b. Individual Employment/Vocational Client Plan must contain:
(a) Action Steps detailing steps, timelines and entities responsible for the
accomplishment of tasks leading to employment,
(b) Provide the minimum number of monthly service hours for the client,
(c) Implement Action Steps that affirm 75% of the direct service hours with the
client will be at employment sites in the community.
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E. Service Level Guidelines
(1) Client Employment Acuity is determined through the DDA assessment. Acuity reflects conditions typically
related to the individual's disabilities that are not likely to change, and are generally not impacted by outside
factors. Client acuity is determined as either "High", "Medium" or "Low" as defined within WAC 388-828.
Other considerations are generally related to the job or service environment which may impact the
individual's level of support, regardless of acuity.
(2) Employment Service Levels reflect Client Employment Acuity and other considerations (see
Table One -Base Hours below); the Guidelines typically reflect direct service staff time provided to or on
behalf of the client to pursue or maintain employment. You may be eligible to receive additional add on hours
(see Table Two, Add -On Hours below).
(3) Short-term Employment Supports is a service that allows DDA to approve additional service hours in
addition to the amount of your employment service Base Hours and Add -On Hours for up to three months
when:
(a) You are beginning anew 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.
(4) The expectation is that all hours reported are documented specific to the client authorized
and relate to the goals and supports outlined within the client's Individual Employment Plan.
Allowable activities are defined in the Employment Phases and Billable Activities.
TABLE ONE -Base Hours
DDA DETERMINES YOUR EMPLOYMENT SERVICE LEVEL USING THE
FOLLOWING TABLE:
CLIENT YOUR THEN YOUR AND YOUR
ACUITY EMPLOYMENT EMPLOYMENT EMPLOYMENT
LEVEL STATUS SERVICE SERVICE BASE
IE: IS: LEVEL IS: HOURS PER
MONTH MAY BE:
NONE
LOW
MEDIUM
HIGH
WORKING I A 1 0
NOT WORKING B 0
WORKING C 4
NOT WORKING I D 1 7
WORKING I E 1 7
NOT WORKING I F 1 9
WORKING I G 1 11
NOT WORKING I H 1 12
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TABLE TWO -Add -On Hours
DDA USES THE FOLLOWING TABLE TO
DETERMINE THE MAXIMUM NUMBER
OF ADD-ON HOURS YOU ARE ELIGIBLE
TO RECEIVE.
IF YOU MEET ONE
YOU MAY BE
OF THE BELOW
ELIGIBLE TO
CONDITIONS AND
RECEIVE UP TO
YOUR
THE
EMPLOYMENT
FOLLOWING
LEVEL IS:
AMOUNT OF
ADD-ON
HOURS:
A
0
0
B
C
5
D
7
E
5
is
7
G
12
H
14
F. Individual Employment Unit of Service
(1) One UNIT of Individual Employment/Individualized Technical Assistance service is defined as one (1)
"HOUR" of direct service or assigned service level to one eligible client. An "HOUR" is at least fifty (50)
minutes of direct service; (partial 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 or ASSIGNED SERVICE LEVEL as defined in Section D, Performance Standard, Number 1 and 2.
(2) Individual Employment service support hours will be based on the client's Individual Employment Level per
WAC.
(3) One UNIT of Individual Employment service is $75.00 and is defined as one "HOUR" of direct service to one
eligible client.
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