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SUBCONTRACT FOR PROFESSIONAL SERVICES �qyl <br />Agreement Between 6' <br />JEFFERSON COUNTY PUBLIC HEALTH e®J9 <br />And <br />CONCERNED CITIZENS <br />This agreement is made and entered into between Jefferson County Public Health (COUNTY) and Concerned <br />Citizens (SUBCONTRACTOR) for provision of Early Intervention Services for Jefferson County infants and <br />toddlers age birth to three years and their families. The term of this agreement is September 15, 2018 through June <br />30, 2019. Either party upon 60 days written notice may terminate this contract. Termination of this Contract shall <br />not constitute a breach. <br />It is Agreed Between Both Parties as Named <br />Herein as Follows: <br />A. PROFESSIONAL SERVICES <br />Upon written request by COUNTY Developmental Disabilities Coordinator or a COUNTY authorized Family <br />Resource Coordinator (FRC), Early Intervention Services to be provided by SUBCONTRACTOR shall include: <br />1) Multi -disciplinary Evaluation and Assessment of children age birth to 2 years 8 months of age that are <br />suspected of having developmental delay or disability. The evaluation tools and procedures selected will <br />conform to WAC 275-27-026 requirements. <br />2) Individualized Family Service Plans (IFSP) developed in collaboration with the family and other providers. <br />SUBCONTRACTOR and the family will write the IFSP jointly on approved forms. <br />3) Evaluation and documentation of funding sources available for intervention services, both educational and <br />therapeutic services will be specified in the IFSP. Potential funding sources to be evaluated include private <br />insurance, military health benefits, Medicaid/Apple Health, OSPI, and other public or private sources. <br />4) IFSP will contain parent planning priorities/outcomes and child outcomes. <br />5) Specialized Services (developmental, corrective, and other services) to assist infants and toddlers to achieve <br />developmental goals as specified in the IFSP, which may include, occupational therapy, physical therapy, <br />speech-language therapy, and specialized instruction/education. <br />6) Specialized Services will be provided to the maximum extent appropriate in natural environments, <br />including the home and community settings in which children without disabilities participate. <br />7) Program management. <br />B. OBLIGATIONS <br />SUBCONTRACTOR shall fulfill the following obligations: <br />1) SUBCONTRACTOR shall comply with all state and federal requirements regarding the confidentiality of <br />Client records. Client information is not disclosable to the public. Information acquired pursuant to RCW <br />7IA. 14.070 requires a signed Release of Information or a signed Oath of Confidentiality Form. <br />2) SUBCONTRACTOR is required to provide background checks, pursuant to RCW 43.43.830-845, RCW <br />74.15.030, and Chapter 388-06 WAC, which state that any prospective employee or volunteer who will or <br />may have unsupervised access to a vulnerable person with a developmental disability in the course of his or <br />her employment, or involvement with the business or organization, must have a background/criminal history <br />CONCERNED CITIZENS Contract 2018-2019 <br />