HomeMy WebLinkAboutConcerned Citizens, Amendment No. 3 - 022321 Y�' '✓l d
`til j � )d 3:)-I Contract Amendment#3 RECPLI,
CC *UP Between
Concerned Citizens
And
Jefferson County Public Health
Developmental Disabilities Program
WHEREAS, Concerned Citizens (SUBCONTRACTOR) and Jefferson County (COUNTY) entered into
an entered into an agreement from September 13, 2019 through June 30, 2021 for Professional Services
to be provided in connection with Early Intervention Services for East Jefferson County children age
birth to three years and their families.
WHEREAS,the parties desire to amend the terms of that agreement.
IT IS AGREED BETWEEN BOTH PARTIES AS NAMED HEREIN AS FOLLOWS:
1. The term of the above referenced agreement ends June 30, 2021.
2. Subcontractor will continue to provide for provision of Multi-Disciplinary Evaluation and
Assessment of children age birth to 2 years 8 months of age that are suspected of having
developmental delay or disability. The evaluation tools and procedures selected will
conform to WAC 275-27-026 requirements. Subcontractor will continue to provide
Individualized Family Service Plans (IFSP) that are developed in collaboration with the
family and other providers. Subcontractor and the family will write the IFSP jointly on
approved forms.
3. Subcontractor shall receive funding for: Specialized Services (developmental, corrective,
and other services) to assist infants and toddlers to achieve developmental goals as
specified in the IFSP, which may include, occupational therapy, physical therapy, speech-
language therapy, and specialized instruction/education.
4. One Unit of Early Intervention Services is $426.45. One Unit is defined as one Month of
direct service to one eligible child. A maximum of six (6) Units of Early Intervention
Services may be billed on a monthly basis.
5. Subcontractor will be entitled to an additional $80.10 in funding for services rendered
during the term of this contract amendment. Total compensation under this Agreement
shall not exceed $25,288.10 without express written amendment.
6. Specialized Services will be provided to the maximum extent appropriate in natural
environments, including the home and community settings in which children without
disabilities participate.
7. All other terms and conditions of the agreement will remain the same.
"7�3� ;Zf
Dated this L�� day of 4414j , 2021
(SIGNATURES FOLLOW ON THE NEXT PAGE)
ti
By:
Kate Dean, C irman
Jefferson Board of County Commissioners
By: "din/• C _
da Middleton
Executive Director, Concerned Citizens
ATTEST:
By: ( 4A lyn 6
Caro allaway, Clerk of tWe Board
APPROVED AS T FORM ONLY:
By: L . ( re(e/Philip H sucker, Chief Cputy Prosecuting Attorney
615 Sheridan Street
Port Townsend, WA 98368
09e!thson www.JeffersonCountyPublicHealth.org
Public Healt Consent Agenda
ejl
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 Coordinator
DATE:
SUBJECT: Agenda Item — Amendment #3 to the Professional Services Agreement —
Concerned Citizens for Early Intervention Services; September 13, 2019 —
June 30, 2021; Additional $80.10 for a total $25,288.10
STATEMENT OF ISSUE:
Jefferson County Public Health, Developmental Disabilities Division is requesting Board approval of Amendment
#3 to the Professional Services Agreement with Concerned Citizens, to provide Early Intervention Services;
September 13, 2019 —June 30, 2021; Additional $80.10 for a total of $25,288.10.
ANALYSIS/STRATEGIC GOALS/PRO'S and CON'S:
This amendment adds an additional $80.10, to continue providing therapeutic services for Jefferson County
children age birth to three years, with developmental disabilities.
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 Early Intervention Services or Child Development Services.
RECOMMENDATION:
JCPH management requests approval of the Amendment #3 to the Professional Services Agreement—
Concerned Citizens for Early Intervention Services; September 13, 2019 —June 30, 2021; Additional $80.10 for
a total of$25,288.10.
REV •
hilip orley, C n Administrator Date
Community Health Environmental Public Health
Developmental Disabilities 360 385 9444
360 385 9400 (f) 360-379-4487
360-385-9401 (f) Always working for a safer and healthier community
„ R
RECEIVED
Public t FEB 1 8 2021
CONTRACT REVIEW FORMJEFFERSON COUNTY
CONTRACT WITH: Concerned Citizens COMMISSIONERS
TRACKING NO.: DD-20-138 A3
(Contractor/Consultant)
CONTRACT FOR: Early Intervention Services Amendment 3 TERM: 9/13/19-6/30/21
COUNTY DEPARTMENT: Jefferson County Public Health
For More Information Contact: s°Anna McEnery
Contact Phone #: x410
RETURN TO: Karen Abbott RETURN BY: ASAP
(Person in Department) (Date)
AMOUNT: $80.10 PROCESS: • Exempt from Bid Process
❑ Consultant Selection Process
Revenue ❑ Cooperative Purchase
Expenditure $80.10 ❑ Competitive Sealed Bid
Matching funds Required ❑ Small Works Roster
Source(s) of Matching Funds ❑ Vendor List Bid
❑ RFP or RFQ
❑ Other-MOU
Step 1: REVIEW BY yip
Revie
4e Date Re, C l
"4.APPROVED FORM ❑ Return or revision(See Comments)
Comments 'k` Sec, 1,42 re-S tCo r- 4 t' ,
Step 2: REVIEW BY PROSEC TING ATTORNEY
Review by: - '• Philip C. Hunsucker
Date Reviewed: . ZuZ Chief Civil Deputy Prosecuting Attorney
APPROVED AS TO FORM ❑ Returned for revision(See Comments)
Comments "X (�krka,f1 —
Step 3: (If required)DEPARTMENT MAKES REVISIONS&RESUBMITS TO RISK MANAGEMENT AND
PROSECUTING ATTORNEY
Step 4: CONTRACTOR/CONSULTANT SIGNS APPROPRIATE NUMBER OF ORIGINALS
Step 5: SUBMIT TO BOCC FOR APPROVAL
Submit original Contract(s),Agenda Request,and Contract Review form. Also,please send 2 copies of just the Contract(s)
(with the originals)to the BOCC Office. Place"Sign Here”markers on all places the BOCC needs to sign. MUST be in
BOCC Office by 4:30 p.m.TUESDAY for the following Monday's agenda.
(This form to stay with contract throughout the contract review process.)
Philip Morley
From: Philip Morley
Sent: Friday, February 19, 2021 2:06 PM
To: Anna McEnery (AMcEnery@co.jefferson.wa.us)
Cc: Karen Abbott;Apple Martine (AMartine@co.jefferson.wa.us);Julie Shannon; Philip
Hunsucker (phunsucker@co jefferson.wa.us)
Subject: Contract Amendment guidance
Anna, I have approved for Risk and for BoCC Agenda Amendment#3 to the Concerned Citizens Early Intervention
Services agreement. However I would like to bring the following corrections to your attention for future amendments:
1. For amendments, please attach the original agreement and any prior amendments to the review packet for
reference (except for routine amendments to boilerplate state contracts, like the Health's consolidated
agreement)
2. Proof your work. In this case, the leading Whereas statement has typos/sentence fragments.
3. Properly identify the contract you are amending. In this case,you should have referenced the "Subcontract for
Professional Services Agreement Between Jefferson County Public Health and Concerned Citizens for
educational and therapeutic services for children age birth to three years and their families, executed on
February 24, 2020; as amended by Amendment No. 1, executed on June 8, 2020, and Amendment No 2,
executed on November 2, 2020"
4. Don't include extraneous provisions in the amendment. In this case, Sections 1,2,3,4 and 6 of Amendment#3
repeated existing provisions &did not amend anything, and should not have been included. Amendment#3
should only have included two sections:
• the text from #5 adding$$, and
• the text from #7 that all other terms remain the same.
I hope this is helpful information as you prepare amendments to other contracts in the future.
Philip
Philip Morley
Jefferson County Administrator
pmorlev@co.iefferson.wa.us
(360) 385-9100 x-383
This is a reminder that all email to or from this email address may be subject to the Public Records Act contained in RCW
42.56. Additionally, all email to and from the county is captured and archived by Information Services.
1
SUBCONTRACT FOR PROFESSIONAL SERVICES
Agreement Between
JEFFERSON COUNTY PUBLIC HEALTH
And tiv
CONCERNED CITIZENS G�"'
This agreement is made and entered into between Jefferson County Public Health(COUNTY)and Concerned Citizens
(SUBCONTRACTOR)for provision of educational and therapeutic services for Jefferson County children age birth
to three years and their families. The term of this agreement is September 13, 2019 through June 30, 2020. Either
party upon 60 days written notice may terminate this contract. Termination of this Contract shall not constitute a
breach.
It is Agreed Between Both Parties as Named
Herein as Follows:
A. PROFESSIONAL SERVICES
Upon written request by COUNTY Developmental Disabilities Coordinator or a COUNTY authorized Family
Resource Coordinator(FRC),professional services to be provided by SUBCONTRACTOR shall include:
1) Multi-disciplinary Evaluation and Assessment of children age birth to 2 years 8 months of age that are
suspected of having developmental delay or disability.
2) Individualized Family Service Plans(IFSP)developed in collaboration with the family and other providers.
SUBCONTRACTOR and the family will write the 1FSP jointly on approved forms.
3) Evaluation and documentation of funding sources available for intervention services, both educational and
therapeutic services will be specified in the IFSP. Potential funding sources to be evaluated include private
insurance,military health benefits,Medicaid/Apple Health,OSPI,and other public or private sources.
4) IFSP will contain parent planning priorities/outcomes and child outcomes.
5) Specialized Services(developmental,corrective,and other services)to assist infants and toddlers to achieve
developmental goals as specified in the IFSP, which may include, occupational therapy, physical therapy,
speech-language therapy,and specialized instruction/education.
6) Specialized Services will be provided to the maximum extent appropriate in natural environments, including
the home and community settings in which children without disabilities participate.
7) Program management.
CONCERNED CITIZENS Contract 2019-2020
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
71A.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.
3) If SUBCONTRACTOR reviews the application and elects to hire or retain an individual after receiving
notice that the applicant has a conviction for an offense that would disqualify the applicant from having
unsupervised access to vulnerable adults as defined in Chapter 74.34 RCW,then DDA shall deny payment
for any subsequent services rendered by the disqualified individual provider.
4) SUBCONTRACTOR is required pursuant to RCW 74.15.030, that if any prospective employee who has not
resided in Washington State during the last three years, and who will or may have unsupervised access to a
vulnerable person with a developmental disability in the course of his or her employment,or involvement with
the business or organization,must have an F.B.I.Fingerprint Check before they have unsupervised access and
before prospective employer begins working. The DSHS Background Check Central Unit (BCCU) or DEL
background check must be utilized to obtain background clearance.
5) SUBCONTRACTOR is required to repeat the background/criminal history clearance for all employees or
volunteers who will or may have unsupervised access to a vulnerable person with a developmental disability in
the course of his or her employment,or involvement with the business or organization,every three years. The
DSHS Background Check Central Unit (BCCU) must be utilized to obtain background clearance in
accordance with RCW 43.43.830-845,RCW 74.15.030 and Chapter 388-06 WAC.
6) SUBCONTRACTOR shall comply,as mandated reporters under RCW 74.34.020(11),with all state and federal
requirements under RCW 74.34.035, .040 Abuse and neglect of Vulnerable Adults; RCW 26.44, Abuse of
Children;the WACs:275-26 Division of Developmental Disabilities Services Rules;296-24 General Safety
& Health; 296-62 General Occupational Health Standards; WACs: 388-828 Developmental Disabilities
Administration, (DDA) Assessment; 388-845 Home and Community Based Waivers; Definitions 0001;
Criteria for HCBS Services 0030; Basic Waiver Services 0200; Basic Plus Waiver Services 0210; Core
Waiver Services 0215.
7) SUBCONTRACTOR shall comply with the following Developmental Disabilities Administration, (DDA)
Policies that apply: 3.01 Client Service Plans; 5.01 Criminal History Background Checks and Safeguarding
Personal Information; 5.02 Necessary Supplemental Accommodation (NSA); 5.03 Client Complaints; 5.05
Limited English Proficiency(LEP)Clients; 5.06 Client Rights; 5.13 Protections From Abuse; 5.14 Positive
Behavior Support; 5.15 Use of Restrictive Procedures; 6.08 Mandatory Reporting Requirements for
Employment and Day Program Services Providers;6.13 Employment/Day Program Provider Qualifications;
9.07 Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome(AIDS); 12.01
Incident Management; 13.04 DRW Access Agreement,and the 1992 County Guidelines.
CONCERNED CITIZENS Contract 2019-2020
2
8) 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:
(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.
9) SUBCONTRACTOR shall comply with the following referenced documents found at DDA Internet site
https://www.dshs.wa.govidda/county-best:practices under"Counties":
(1) WAC 388-850, WAC 388-828, WAC 388-845-0001,0030,0205,0210,0215,0220,0600-0610,
1200-1210, 1400-14I0,2100,2110;
(2) Criteria for Evaluation;
10) 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:
• DDA Policy 6.13,Employment/Day Program Provider Qualifications,
http :11www_c shs;w ,}Gov.'ctdalppli ies-arid-ntieslpnliry_-ttianual;
• County Guide to Achieve Developmental Disability Administration's Guiding Values
11) 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.
12) SUBCONTRACTOR shall have written policies regarding; sexual harassment and non-discrimination(said
policies must guarantee human/civil rights), a person's right to privacy, safeguarding personal information
abuse of participants, agency medication procedure, respectful staff-to-participant interactions, (i.e.:
including a person's right to be treated with dignity and respect and free of abuse).
13) 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.
14) 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.
CONCERNED CITIZENS Contract 2019-2020
3
15) 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 on not less than an annual basis.
16) SUBCONTRACTOR will encourage participant involvement in policy development.
17) Has assurance that 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 which employs, or is about to employ, any of the above, has financial or other interest in the
client(s).
18) SUBCONTRACTOR shall have adequate staffing ratios and patterns to maintain quality and safety.
19) 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.
20) SUBCONTRACTOR shall track and analyze incident reports for potential trends and patterns.
21) Current emergency contact and medical information(medications,diet,allergies,etc.)needed during the
hours of service is readily available for each participant.
22) 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.
23) If SUBCONTRACTOR is found to have a substantiated finding of abuse,neglect,abandonment or financial
exploitation they shall comply with the following CPS guidelines:
• Upon receiving documentation of a substantiated finding of abuse,neglect,exploitation or abandonment
from CPS,the Regional DDA office will send a copy of the CPS substantiation report to the COUNTY
within one working day.
• Upon receiving documentation of a substantiated finding of abuse,the COUNTY will send a letter to the
SUBCONTRACTOR within one working day.
1. The-contracted provider is required to:
a. Document the steps the agency has taken to protect the vulnerable
person(s)immediately;and
b. Submit a corrective action plan, if needed,to the COUNTY within 10
working days.
CONCERNED CITIZENS Contract 2019-2020
4
2. The COUNTY will respond to the steps taken and the sufficiency of the proposed corrective action plan
within 10 working days. If the corrective action is not accepted the plan will be returned to the provider
for correction and an amended plan will be required within 5 working days.
3. Once accepted, the COUNTY will send the corrective action plan to DDA for final approval. DDA
Regional staff will respond as to plan sufficiency and whether any additional information is needed
within 10 working days. The Region will send a copy to Central Office.
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) Qualified Staff': Adequate, qualified staff with certification, skills and experience in evaluation,teaching,
therapeutic services and support of infants and toddlers with developmental disabilities.
SUBCONTRACTOR will provide COUNTY with information regarding staff qualifications upon request.
(b) Performance.Plan: SUBCONTRACTOR has a written performance plan which describes its mission,
program objectives, expected outcomes, how and when objectives will be accomplished; and that the
plan is evaluated at least biennially and revised based on actual performance.
(c) Participants: SUBCONTRACTOR has a commitment to support integration of infants and toddlers with
developmental disabilities with others who do not have a disability and has involved family members of
infants and toddlers with developmental disabilities in policy development.
(d) Partnershjps: SUBCONTRACTOR has a history of working cooperatively with community-based
organizations including other Agencies,Early Support for Infants and Toddlers(ESIT),the Lead Agency
for ESIT, the County DD Program, the Developmental Disabilities Administration and other School
Districts.
(e) Financial and Program Management: 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.
25) All services for infants and toddlers 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. Staffing ratios and patterns are adequate to maintain quality and safety.
26) 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 by:
(1) Data Transport: When transporting DSHS Confidential Information electronically,including via
email,the Data will be protected by:
(a) Transporting the Data within the(State Governmental Network)SGN or Contractor's internal
network,or;
(b) Encrypting any Data that will be in transit outside the SGN or Contractor's internal network.
This includes transit over the public Internet.
(2) 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:
CONCERNED CITIZENS Contract 2019-2020
5
(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 k.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.
(g) Remote Access: Access to and use ofthe l.)at< over the State Governmental Network(SOON)or
Secure Access Washington(SAWZwill be controlled OSI-lS stall'who will issue authentication
credentials_{e,gia Unique I.1ser H,)and Hardened Password)to Authorized Users on Contractor
staff. Contractor will notifxDSHS staff immediately whenever an Authorized User in possession
of such credentials is terminated or otherwise leaves the employ of the Contractor,and whenever
an Authorized user's duties change such that.the Authorized User no longer requires access to
perform work for this Contract
(h) Data storage on portable devices or media:
(I) 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.
CONCERNED CITIZENS Contract 2019-2020
6
•
Physically Secure the portable device(s)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 k. 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 k.Data Disposition.
(j) Data Segregation:
(I) 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,
(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.
(k) Data Disposition:
When the contracted work has been completed or when no longer needed,except as noted in
Section 2.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:
CONCERNED CITIZENS Contract 2019-2020
7
Data stored on: Will be destroyed by:
Server or workstation hard disks,or Using a"wipe"utility which will overwrite the Data at
least three(3)times using either random or single
Removable media(e.g. floppies, USB flash drives, character data,or
portable hard disks)excluding optical discs Degaussing sufficiently to ensure that the Data cannot
be reconstructed,or
Physically_destro in_the disk
Paper documents with sensitive or Confidential Recycling through a contracted firm provided the
Information contract with the recycler assures that the
confidentiality of Data will be protected.
Paper documents containing Confidential Information On-site shredding,pulping,or incineration
requiring special handling(e.g. protected health
information)
Optical discs(e.g. CDs or DVDs) Incineration,shredding,or completely defacing the
readable surface with a coarse abrasive
Ma_netic tape Degaussing, incinerating or crosscut shredding
(I) 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 laws.
27) SUBCONTRACTOR will provide Child Development Services(Birth to Three)Services:
a) To the child and family in a timely manner.(Services are considered timely if they begin within 30
days of the start date on the signed IFSP unless the IFSP documents that the parent requested a delay in
the start of the services).
b) In compliance with the natural environments criteria for IDEA,Part C and Washington State's
federally approved Early Intervention Plan.
c) That meet the highest entry level requirements in Washington State for Early Intervention
professionals,(training,experience and expertise of staff)and relate to the needs of the participants.
d) That conducts the evaluation(eligibility),assessment(child and family need)and the Individualized
Family Service Plan(IFSP)within 45 days of receipt of referral.(Referral is defined as the date the
family resources coordinator or lead agency received referral).
e) That assist the family to ensure the child obtained an evaluation by a multidisciplinary team.
f) That receives from the parent, a written consent for all activities related to the provision of Early
Intervention Services in the family's native language or other mode of communication.
g) That assure the IFSP was reviewed every six months with a new plan written annually.
h) That assures that progress toward the child and family outcomes within the IFSP are assessed on an
ongoing basis and documented at least annually.
CONCERNED CITIZENS Contract 2019-2020
8
•
i) That provides child and family outcomes within the IFSP that are functional and based on the
individualized needs of the infant or toddler and the concerns and the priorities of the family. Child
specific outcomes reflect the child's participation in everyday routines and activities.Family specific
outcomes address the capacity of the family to enhance their child's development.
j) To the maximum extent appropriate for the individual child, in naturally occurring environments and
occurs in a setting other than a natural environment only when early intervention cannot be achieved
satisfactorily for an infant or toddler in a natural environment.
k) That provide a Transition Plan for each child participating in the early intervention program was
developed at least 90 days prior to the child's third birthday.
28) SUBCONTRACTOR shall report any injury or accident, which requires more than simple first aid, and any
extraordinary incident that requires intervention, first 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.
1. The initial report may be done through documented telephone calls to the County Coordinator.
2. 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) 385-9401 or by mail to Jefferson County Public Health, 615 Sheridan Street Port Townsend,
WA 98368.
3. Serious and emergent incidents shall be handled in accordance with DSHS/DDA Policy 12.01 Incident
Management.
29) When requested, SUBCONTRACTOR will provide 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.
30) For five 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 biannual summary progress toward meeting client goals.
31) 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.
32) The COUNTY shall monitor services delivered and conduct at least one on-site visit with
SUBCONTRACTOR during the biennium to assure compliance with the DDA State Work Order.
33) 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.
34) If the Developmental Disabilities Program Coordinator finds indications of potential non-compliance
during the contract monitoring process or learns that the SUBCONTRACTOR is out of compliance with
any of the terms or conditions of this contract,the following process will be pursued:
CONCERNED CITIZENS Contract 2019-2020
9
(a) Informal Notification:Informal process wherein the County Coordinator alerts the
SUBCONTRACTOR in writing of the potential non-compliance and an agreeable solution is reached
within five(5)days.
(b) Official Notification: If the informal notification does not result in resolution,the official notification
of possible non-compliance to establish a date,within five(5)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.
(c) Written Summary: Within five(5)working days of such official notification the County will provide
the SUBCONTRACTOR a written summary of the areas of non-compliance by certified mail. Notice
shall be sent to the address identified in the Agreement.
(d) Discussion: Within twenty(20)days of the date of the written summary,a discussion between County
and SUBCONTRACTOR shall be conducted to resolve areas of non-compliance or potential non-
compliance.
(e) Should the above procedures fail to resolve the compliance issue,the parties will obtain the services of
the Peninsula Dispute Resolution Center, or another agreed upon resource,and shall share equally in
any retainer fees or other costs of services. If no agreement is reached,the mediator's decision in the
matter will be binding on all parties,except that in no event will the County honor a financial
determination that is greater than the funds allowed the scope of this Agreement.
C. REIMBURSEMENTS
For said services rendered under this agreement,COUNTY shall reimburse SUBCONTRACTOR on a unit rate
basis,as follows:
1) Early Intervention Services SUBCONTRACTOR will be paid per MONTHLY Unit assigned Service
Responsibility of regular Program Service provided to eligible clients on a fee-for-service basis according to
Attachment 1,Fee Schedule. Reimbursement to SUBCONTRACTOR by COUNTY will be the net amount
of the applicable fee per Attachment 1, less any amounts received from other funding sources for the service
provided.
2) All referrals or requests for services under this agreement will be in writing using a County Service
Authorization form,(CSA)agreed to and signed by the parties. A copy of the signed CSA must be in the
client's file.
3) SUBCONTRACTOR will bill COUNTY on a monthly basis, on or before the 5th day of the month,for units
of service provided under this agreement during the preceding month. SUBCONTRACTOR will submit a
Monthly DDA Services Report(ADSA)form for its billings.
4) COUNTY may,at its option,withhold reimbursement for any invoices older than 60 calendar days,(following
the last day of the month for which the services were provided).
5) 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.
6) COUNTY may withhold reimbursement for any service for which documentation that shows the COUNTY
as the second payer of last resort has not been provided.The IFSP must clearly document funding source per
service for each service reimbursement requested.
CONCERNED CITIZENS Contract 2019-2020
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7) SUBCONTRACTOR will provide documentation of County service reimbursements along with all other
funding sources pursued by SUBCONTRACTOR at the end of the service period /annually or during site
monitoring. Documentation will identify the funding source(s), client name, service provided, date of
service,amount(s)paid and amount(s)denied.
8) Total reimbursements for the fiscal year of 2019-2020 to SUBCONTRACTOR by COUNTY under this
contract shall not exceed$12,400.00 in completion of these services without express written amendment signed
by both parties to this Agreement. Work performed between September 13, 2019 and the execution of this
Agreement that is consistent with the provisions of this Agreement is hereby ratified.
MISCELLANEOUS
1) Pursuant to WAC 275,DSHS Division of Developmental Disabilities(DDA)shall determine individual
eligibility of persons for services delivered under this agreement. DDA shall notify COUNTY of persons
authorized for services reimbursed under this agreement. Only persons referred to COUNTY by DDA shall
be eligible for services reimbursed under this agreement.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.
2) The SUBCONTRACTOR'S relation to the COUNTY shall be at all times as an independent
SUBCONTRACTOR and any of all employees of the SUBCONTRACTOR or other persons engaged in
the performance of any work or service required of the SUBCONTRACTOR under this AGREEMENT
shall be considered employees of the SUBCONTRACTOR only and any claims that may arise on behalf of
or against said employees shall be the sole obligation and responsibility of the SUBCONTRACTOR.
3) The SUBCONTRACTOR shall not sublet or assign any of the services covered by this AGREEMENT
without the express written consent of the COUNTY.Assignment does not include printing or other
customary reimbursable expenses that may be provided in an AGREEMENT.
4) The SUBCONTRACTOR shall obtain and keep in force during the terms of the AGREEMENT, or as
otherwise required, the following insurance with companies or through sources approved by the State
Insurance Commissioner pursuant to RCW 48:05:
(a) Worker's compensation and employer's liability insurance as required by the State of Washington.
(b) Commercial Automobile Liability or Business Use Insurance providing bodily injury and property
damage liability coverage for all owned and non-owned vehicles assigned to or used in the
performance of the work for a combined single limit of not less than$1,000,000 each occurrence
with the COUNTY named as an additional insured in connection with the SUBCONTRACTOR'S
performance of the contract.
(c) General Commercial Liability Insurance in an amount not less than a single limit of one million
dollars($1,000,000.00)per occurrence and aggregate of not less than two(2)times the occurrence
amount(S2,000,000.00 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:
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(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.
5) 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
in the amount of not less than one$1,000,000 each claim and$2,000,000 aggregate. In no case shall such
professional liability to third parties be limited in any way. professional liability insurance policy should be
on an"occurrence"form. If the professional liability policy is"claims made,"then an extended reporting
periods coverage(tail coverage)shall be purchased for three(3)years after the end of this Agreement,at
the SUBCONTRACTOR's sole expense. The SUBCONTRACTOR agrees the SUBCONTRACTOR's
insurance obligation to provide professional liability insurance shall survive the completion or termination
of this Agreement for a minimum period of three(3)years.
6) Proof of SUBCONTRACTOR's membership in a self-insured risk pool for school districts pursuant to
chapter 48.62 RCW shall suffice if the applicable liability limits of said liability policy exceed those listed
here.
7) 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.
8) 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,off set against funds due
the SUBCONTRACTOR from the COUNTY.
9) All cost for insurance shall be considered incidental to and included in the unit contract prices and no
additional payment will be made.
10) 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.
11) 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.
12) The COUNTY will pay no progress payments until the SUBCONTRACTOR has fully complied with all
insurance requirements listed herein. 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. The
COUNTY may, upon the SUBCONTRACTOR'S failure to comply with all provisions of this contract
relating to insurance, withhold payment or compensation that would otherwise be due to the
SUBCONTRACTOR.
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