HomeMy WebLinkAboutAgreements/Contracts - Renew_ r=
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ooHSCentral Contract Services
12163-24991
DSHS Agreement Number
..W.9,94017 or-off's tilt#
COUNTY PROG RAM AGREEMENT
V.Dcprtmant o.f 'soda'
70.0
AMENDMENT
DDD County Services
Amendment No.
02
Transform;ng fiVes
This Program Agreement Amendment is by and between the State of Washington
Administration or Division
Department of Social and Health Services (DSHS) and the County identified below.
Agreement Number
Click here to enter text.
County Agreement Number
DSHS ADMINISTRATION
DSHS DIVISION
DSHS INDEX NUMBER
CCS CONTRACT CODE
Developmental Disabilities
Division of Developmental
1221
1221
Admin
Disabilities
DSHS CONTACT NAME AND TITLE
DSHS CONTACT ADDRESS
Seanna Woodard
1611 W Indiana Ave
Spokane, WA 99205
DSHS CONTACT TELEPHONE
DSHS CONTACT FAX
DSHS CONTACT E-MAIL
509 329-2952
(509)568-3037 ---
woodas@dshs.wa.gov-
COUNTY NAME
COUNTY ADDRESS
Grant County
PO BOX 1057
Grant -Adams County DDA County Services
Moses Lake, WA 98837-0160
COUNTY FEDERAL EMPLOYER IDENTIFICATION
COUNTY CONTACT NAME
NUMBER
_I
Nicole Davidson
COUNTY CONTACT TELEPHONE
COUNTY CONTACT FAX
COUNTY CONTACT E-MAIL
(509).,764-6329
Click here to enter text.
Click here to enter text.
IS THE UNTY A SUBRECIPIENT FOR PURPOSES OF THIS PROGRAM
CFDA NUMBERS
No
AMENDMENT START DATE
PROGRAM AGREEMENT END DATE
01/01/2023
.06/30/2023
PRIOR MAXIMUM PROGRAM AGREEMENT.
'AMOUNT OF INCREASE OR DECREASE
TOTAL MAXIMUMPROGRAM AGREEMENT'
AMOUNT.
AMOUNT
$1,713,338.00
$48973.00
.00
REASON FOR AMENDMENT-,
CHANGE OR CORRECT -MAXIMUM CONTRACT AMOUNT
EXHIBITS. When the box below is marked with a check (4) or an X, the following Exhibits are attached and are
incorporated into this Program Agreement Amendment by reference:
Exhibits (specify): Exhibit B-1, Program Agreement Budget
This Program Agreement. Amendment,, including all Exhibits and other documents'incorporated by refe ontains all
rence, C.
Of the terms and condition' s agreed upon by the parties as changes to the original Prog*
ram Agreement. No other. -
understandings or representations, oral or otherwise, regarding the subject'matte . r of th . is P rogram Agreement. Amendment
shall be deemed to* exist or bind the parties. All oth ir te . ri
full force a hd 'effect.. The parties signing below warrant that the have * a ` ndersta'nd this'Program A
Amendment, and have authority to enter into thi's P gram Agreement Amend m*ent.
COUNTY SIGNATURE(S)
PRINTED NAME(S) AND TITLE(S)
DATE(S) SIGNED
.. 0
07
Rob Jones, Chair
3)�-, / � u >,3—
DSH IGNATURE
PRINTED NAME AND TITLE
DATE SIONED
Tammy Layton, Contract Manager
3-30-2023
ooHSCentral Contract Services
This Program Agreement between the County and the State of Washington Department of Social and Health
Services (DSHS) is hereby amended as follows:
A. Exhibit B, Program Agreement Budget, is revised and replaced with Exhibit B-1, Program Agreement
Budget, which is attached hereto and incorporated herein.
B. The Special Terms and Conditions are revised and replaced with the following (excluding Exhibit A --
Exhibit A remains the same):
�. Definitions Specific to Special Terms: The words and phrases listed below, as used in Contract,
shall each have the following definitions:
a. "Acuity Level" means the level of a Client's abilities and needs as determined through the DDA
assessment.
b. "ADSA Access (AWA)" means a web -based portal to the Developmental Disabilities Administration
CARE ,system designed to support county services for DDA clients.
C. "Additional Consumer Services" refers to indirect Client service types as follows:
(1) "Community Information and Education": Activities to inform and/or educate the general public
about developmental disabilities and related services. These may include information and
referral services; activities aimed at promoting public awareness and involvement; and
community consultation, capacity building and organization activities.
(2) "Training": To increase the job related skills and knowledge of staff, providers, volunteers, or
interning students in the provision of services to people with developmental disabilities. Also to
enhance program related skills of board or advisory board members.
(3) "Other Activities": reserved for special projects and demonstrations categorized into
the following types:
(a) Infrastructure projects: Projects in support of Clients (services not easily tracked back to a
specific working age Client) or that directly benefit a Client(s) but the Client is not of working
age. Examples include planning services like generic job development e.g. "Project
Search."
(b) Start-up projects: Projects that support an agency or directly benefit the agency. Examples
include equipment purchases and agency administrative support.
(c) Partnership Project: Collaborative partnerships with school districts,' employment providers,
DVR, families, employers and other community collaborators needed to provide the
employment supports and services young adults with developmental disabilities require to
become employed during the school year they turn twebty-one (21).
d. "Budget and Accounting Reporting System ,(BARS)" means a master classification of balance
sheet, revenue and expenditure/expense account reports.
e. "Client" means a person with a developmental disability as defined in chapter 388-823 WAC who is
currently eligible and active with the Developmental Disabilities Administration or is an identified
PASRR Client.
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1769CP Contract Amendment (12-10-21) Page 2
f. "Competitive Integrated Employment" means work performed by a Client on a part-time or full-time
basis, within an integrated setting within the community that meets HCBS settings requirements.
The Client must be compensated at minimum wage or higher, using the higher of the Federal,
State, or local rate, and at a rate comparable to the wage paid to non -disabled workers performing
the same tasks, including receiving the same benefits and opportunities for advancement.
g. "Consumer Support" refers to direct Client service types as follows:
(1) "Community Inclusion" or "Cl": means individualized services provided in integrated community
settings with other individuals without disabilities. The activities are based on Client interests
and provide opportunities typically experienced by the general public of similar age in their local
community, accessible by public transit or a reasonable commute from their home. The goal of
the service is to support clients to participate, contribute, and develop relationships with
community members who are not paid staff. These services may be authorized for individuals
age 62 and older. These services may be authorized in addition to or instead of employment
support (individual Employment or Group Supported Employment) for working age individuals
who have received nine months of employment support.
(2) Child Development Services or "CDS": Birth to three services are designed to meet the
developmental needs of each eligible child and the needs of the family related to enhancing the
child's development. Services may include specialized instruction, speech-language pathology,
occupational therapy, physical therapy, assistive technology, and vision services. Services are
provided in natural environments to the maximum extent appropriate.
(3) "Individual Supported Employment" or "IE": services are a part of a Client'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.
(4) "Individualized Technical Assistance" or "ITA": services are a part of a Client's pathway to
individual employment or community inclusion. This service provides assessment and
consultation to the provider to identify and address existing barriers to employment or
community inclusion. This is in addition to supports received through supported employment or
community inclusion services for Clients who have not yet achieved their goal.
(5) "Group Supported Employment" or "GSE": services are a part of a Client's pathway to integrated
jobs in typical community employment. These services are intended to be short term and offer
ongoing supervised employment for groups of no more than eight (8) workers with disabilities in
the same setting. The service outcome is sustained paid employment leading to further career
development in integrated employment at or above minimum wage. Examples include
enclaves, mobile crews, and other business models employing small groups of workers with
disabilities in integrated employment in community settings.
h. "DDA Case Resource Manager (CRM)" means a case manager for DDA Clients.
L "County Service Authorization (CSA)" means an authorization for county services.
j. "Developmental disabilities (DD)" means a disability attributable to intellectual disability, cerebral
palsy, epilepsy, autism, or another neurological or other condition of an individual found by the
secretary to be closely related to an intellectual disability or to require treatment similar to that
required for individuals with intellectual disabilities, which disability originates before the individual
attains age eighteen, which has continued or can be expected to continue indefinitely, and which
DSHS Central Contract Services
1769CP Contract Amendment (12-10-21) Page *3
constitutes a substantial limitation to the individual.
k. "Developmental Disabilities Administration DDA" means a division within the Department of Social
and Health Services.
I. "DDA Regional office (DDA Region)" means the regional DDA office that supports DDA clients.
M. "Division of Vocational Rehabilitation (DVR)" means a division within the Department of Social and
Health Services.
n. "Employment Outcome Payment" means a payment to providers for transition students born
between specific dates; have high acuity; are authorized for Individual employment; and student
obtains a competitive integrated job within a specific timeframe. If the job is a minimum of ten hours
of work per week an additional amount will be include in the payment
o. "Medicaid Home and Community Based Services (HCBS)" means 'services that occur in a Client's
home or community rather than institutions or other isolated settings. These programs serve a
variety of targeted populations groups, such as people with intellectual or developmental
disabilities, physical disabilities, and/or mental illnesses. r
p. "Job Foundation Report" is a document derived from employee readiness activities performed by
students who are between ages 19 through 20 that identifies actionable next step for employment.
The employment service providers developing the Job Foundation report will be supporting
students with employment activities on average of 35 hours.
q. "Preadmission Screening and Resident Review (PASRR)" means individuals with intellectual
disabilities or related conditions (ID/RC) who have been referred for nursing facility (NF) care.
r. Person Centered Service Plan or PCSP" means a document that authorizes and identifies the DDA
paid services to meet a Client's assessed needs. Formerly referred to as the Individual Support
Plan.
S. "Quality Assurance" means an adherence to all Contract requirements, including DDA Policy 6.13,
Provider Qualifications for Employment and Day Program Services. County Guidelines and the
Criteria for Evaluation, as well as a focus on reasonably expected levels of performance, quality,
and practice.
t. "Quality Improvement" means a focus on activities to improve performance above minimum
standards and reasonably expected levels of performance, quality and practice.
U. "Service Provider" is a qualified Client service vendor who is contracted to provide Employment and
Day Program services.
V. "Subcontractor" is the service provider contracted by the Contractor to provide services.
2. Purpose: This Program Agreement is entered into between Developmental Disabilities Administration
(DDA) and the County in accordance with chapter 71A.14 RCW. Its purpose is to advance the state
legislative policy to provide a coordinated and comprehensive state and local program of services for
persons with developmental disabilities.
3. Client Eligibility: Client eligibility and service referral are the responsibility of DDA under 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
a current County Service Authorization are not reimbursable under this Contract.
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1769CP Contract Amendment (12-10-21) Page 4
4. Credentials and Minimum Requirements:
a. Administration of the developmental disabilities Employment and Day program cannot be
subcontracted.
b. Qualified DD Program Coordinator: A qualified DD program coordinator has a minimum of five
years training and experience in the administration and/or the delivery of developmental disabilities
services to a community. For a county where the coordinator administers more than one program
area (e.g. Chemical Dependency, Mental Health, Developmental Disabilities), training and
experience in administration and/or a related Human or, Social service may be considered.
c. Administration Responsibility: The County must demonstrate the ability to administer the Contract
including contract oversight and monitoring, community outreach and education activities, and
regular communication with the DDA Regional office (DDA region) and contracted providers.
d. Fiscal Responsibility: The Contractor must demonstrate the ability to safeguard public funds
including maintaining books, records, documents and other materials relevant to the provision of
goods and services.
e. Sufficient Policies and Procedures for establishment and maintenance of adequate internal control
systems: The Contractor 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 absences occur. Policies shall be dated and include dates when updated.
f. Background/Criminal History Check: A background/criminal history clearance is required every
three years for all employees (including DD program Contractor stafl), subcontractors, and/or
volunteers who may have unsupervised access to vulnerable DSHS Clients, in accordance with
RCW 43.43.830-845, RCW 74.15.030, and Chapter 388 WAC. If the entity reviewing the application
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. The DSHS Background Check Central Unit (BCCU)
must be utilized to obtain background clearance.
g. Qualified Advisory Board Members: A Developmental Disabilities advisory board shall include
members knowledgeable about developmental disabilities. No board member shall have a contract
with the County or Contractor to provide Training, Community Information Activities, and Consumer
Support as defined in this Contract, and shall not be a board member, officer, or employee of an
agency subcontracting with the County or Contractor to provide such services.
h. Qualified Service Providers: The Contractor assures that all service providers meet qualifications
as outlined in the DDA Policy 6.13, Provider Qualifications for Employment and Day Program
Services.
L Home and Community Based Waiver Services Assignment of Medicaid Billing Rights: The
Contractor assures that each subcontractor has agreed to assign to DDA its Medicaid billing rights
for services to DDA Clients eligible under Title XIX programs in this Contract. Written
documentation shall be available to DSHS on request.
j. Reporting Abuse and Neglect: The Contractor staff and its subcontractors who are mandated
reporters under RCW 74.34.020(13) must comply with reporting requirements described in RCW
74.34.035, .040 and Chapter 26.44 RCW. If the Contractor 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 Contract.
DSHS Central Contract Services
1769CP Contract Amendment (12-10-21) Page 5
k. Contractor who provides Child Development Services (birth to three early intervention services),
must provide those services under the regulations implementing the Individuals with Disabilities
Education Act (IDEA), Part C, and Washington State's Early Support for Infant and Toddler
Federally Approved Plan.
1. The Contractor staff who perform evaluations of subcontractor work sites will promptly report to
DSHS per DDA Policy 6.08, Incident Management and Reporting Requirements for County
and County -Contracted Providers, if:
(1) They have reasonable cause to believe that abandonment, abuse, financial exploitation or
neglect (as defined in ROW 74.34.020) of a person who has a developmental disability (as
defined in RCW 71 A.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.
m. Contractors are specifically authorized to have data storage on portable devices or media in
accordance with the Data Security Requirements.
n. Order of Precedence: In the event of any inconsistency in this Contract and any attached exhibits,
unless otherwise provided herein, the inconsistency shall be resolved by giving precedence, in the
following order, to:
(1) Contract; and
(2) Attached Exhibits.
5. Dusty to Disclose: Pursuant to 42 CFR §455.104, the Administration must obtain certain disclosures
and complete required screenings to ensure the State does not pay federal funds to excluded person or
entities. The Contractor is required to provide disclosures from managing employees, specifically the
persons in the positions of Developmental Disabilities Director and Fiscal/Budget Director, i.e. the
person who authorizes expenditures. A completed Medicaid Provider Disclosure Statement, DSHS
Form 27-094, should be submitted to the Administration to complete the required screenings.
Disclosures must be provided at contract renewal and within thirty-five (35) days whenever there is a
change in the staff holding these management positions [42 CFR 455.104 (c)(1)].
6. Statement of Work: The Contractor shall provide the services and staff, and otherwise do all things
necessary for or incidental to the performance of work, as set forth below. Working collaboratively, the
parties shall administer DD services within the county as set forth below:
a. The DDA region shall:
(1) Review subcontractors and shall immediately notify the Contractor of any disapproval of the
subcontractors identified by the Contractor;
(2) Inform and include the Contractor in the discharge planning of Clients leaving institutions and
returning to the community who will need program funding;
(3) Inform the Contractor of Clients who have had their waiver status changed;
(4) Work with the Contractor when referring Clients for services and will withdraw referrals when
authorization is not issued;
(5) Authorize new service within 5 working days and will extend existing service authorization
before expiration date;
DSHS Central Contract Services
1769CP Contract Amendment (12-10-21) Page 6
(6) Inform Clients of service changes through Planned Action Notice(s);
(7) Work with the Contractor to document planned services in the Client's Person Centered Service
Plan including notification of assessment dates;
(8) Work with the Contractor when terminating services;
(9) Work with the DDA Head Quarters and Contractor on Spending Plan adjustments; and
(10) Work with the Contractor in participating in evaluation of direct service providers.
b. The Contractor shall:
(1) Work with the DDA Region to document planned services in the Client's Person Centered
Service Plan;
(2) Assist with informing the DDA Region of any potential service level changes not documented in
the Client's DD Assessment prior to any changes;
(3) Work with the DDA Region regarding service termination;
(4) Work with the DDA Head Quarters on Spending Plan adjustments;
(5) 1 nform the DDA Region of new providers to be included on the AWA system;
(6) Notify the DDA Region of any intent to terminate a subcontractor who is serving a DDA referral;
(7) Provide a copy of each subcontractor's contract upon written request from DDA; and
(8) Notify and work with the DDA Regional Employment Specialist when performing evaluations of
direct service providers.
c. Compliance with Budget and Accounting Reporting System Policies: The Contractor shall take any
necessary and reasonable steps to comply with BARS policy.
d. The Contractor shall comply with the following referenced documents found at DDA Internet site
https:/Iwww.dshs.wa.-gov/dda/Contractor-best-practices under "County Best Practices":
(1) DDA Policy 4.11, County Services for Working Age Adults;
(2) Chapter 388-850 WAC, chapter 388-828 WAC, and WAC 388-845-0001, 0030, 02107
02157 02201 0600-0610, 1030-1040, 2100, 2110;
(3) Criteria for Evaluation;
(4) DDA Guiding Values;
(5) County Guide to Achieve DDA's Guiding Values;
(6) DDA Guidelines for Community Assessments within Employment and Vocational
Programs; and
(7) Disability Riqhts Washington (formeriv Washington Protection and Advocacy Sys, tem)
Access Agreement.
DSHS Central Contract Services
1769CP Contract Amendment (12-10-21) Page 7
e. The Contractor shall develop and submit a comprehensive plan for the Contractor DD Services as
required by WAC 388-850-020.
Conveyance of The Estimated Number of People to be Served and Targeted Outcomes: The
Contractor shall submit the Service Information Forms (SIF's) (provided by DDA at Internet site
https:l/www.dshs.wa.gov/dda/coun!y-best-practices to indicate the estimated number of people to
be served, targeted outcomes, and identified goal(s) that focus on quality improvement within the
categories of Training, Community information, Direct Client Services, and Other Activities within 30
days of execution of the Contract. Once approved, the SIF outcomes may be modified only by
mutual agreement of the Contractor and the DDA Region.
g. Solicitation for Qualified Employment and Day Program Service Providers: Requests for Information
(BFI's) and/or Requests for Proposals (RFPs), Requests for Qualifications (RFQ's) for direct
services, excluding Child Development, will be open continuous enrollment.
h. Qualified Providers: A qualified provider must be a Contractor or an individual or agency contracted
with Contractor named in this Personal Service Agreement or DDA.
Technical Assistance: DDA contracts with Technical Assistance providers that may be utilized by
Contractor with prior written approval.
Subcontractors: The County will pass on all applicable contractual requirements that are between
DDA and the County. to the subcontractor. The County shall immediately notify the DDA Region of
the County's intent to terminate a subcontractor who is serving a DDA referral. individuals or
agencies contracted with a county or DDA may not subcontract for Employment or Community
Inclusion services.
k. The Contractor shall provide or contract with qualified Employment and Day Program Service
Providers for consumer support services that include the following program outcomes:
(1) Monthly Community Inclusion (CI) service support hours will be based on the Client's CI service
level per WAC 388-828-9310 for all Clients who began receiving Cl services July 1, 2011 and
forward.
(a) To ensure health and safety, promote positive image and relationships in the community,
increase competence and individualized skill -building, and achieve other expected benefits
of CI, services will occur individually or in a group of.no.more than two (2) or three (3) clients
with similar interests and needs.
(b) Cl services will focus -on activities that are typically experienced -by the general public.
Support to participate in segregated activities and/or specialized activities will not be
reimbursed.
(2) Clients in an employment program will be supported to work towards a living wage. A living
wage is the amount needed to enable a client to meet or exceed living expenses. Clients
should be supported to average twenty (20) hours of community work per week or eighty-six
(86) hours per month; however, each person's preferred hours of employment should be taken
into consideration. The amount of service a Client receives will be based on demonstrated
need, acuity level and work history per WAC 388-828.
(3) The Client's DDA PCSP is the driver for service. The AWA County Service Authorization (CSA)
and updated Planned Rates information will not exceed the Client's DDA PCSP. Service
changes will not occur until the Client has received proper notification from DDA.
(4) All Clients will have an Individualized Employment and/or Community Inclusion plan to identify
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1769CP Contract Amendment (12-10-21) Page 8
Client's preferences. Minimum plan elements are outlined in the reference document "Criteria
for Evaluation." A copy of the Client's individualized plan will be provided to the Client, their
DDA Case Resource Manager (CRM), guardian and others as appropriate.
(5) Six-month progress reports describing the progress made towards achieving Client's goal will
be provided by the service provider to the CRM, Client, and/or guardian, if any, within 30 days
following the six-month period. The report will summarize activities and outcomes made towards
the Client's individualized goal(s).
(6) All Clients will be contacted by their service provider according to Client need and at least once
per month.
(7) If Clients in Individual Employment, Group Supported Employment have not obtained paid
employment at minimum; wage or higher within six (6) months, the Contractor will assure the
following steps are taken:
(a) Review the progress toward employment goals;
(b) Provide evidence of consultation with the family/Client; and
(c) Develop additional strategies with the family/Client, Contractor 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
Client's pursuit of employment. The additional strategies will be documented for each Client
and kept in the Client's file(s).
(8) If after twelve (12) months the Client remains unemployed, an additional review will be
conducted. The provider will address steps outlined in the previous six month progress report in
the next six month progress report.
(9) The Client may request Community Inclusion services in addition to or instead of employment
services after participation for nine months. When requesting to participate in Cl, the Client shall
communicate directly with his or her DDA Case Manager. The DDA Case Manager is
responsible for authorizing Cl services.
(10) For individual Employment where the service provider is also the Client's employer, long term
funding will remain available to the service provider employer for six months after the employee
DDA Client's date of hire. At the end of the six-month period, if the DDA Client continues to
need support on the job, another service provider who is not the employer of record must
provide the support unless the Contractor or DDA issues prior written approval for the service
provider to continue to provide long-term supports if needed. If the Contractor or DDA
approves the continuation of long-term supports where the service provider is also the Client's
employer, the Contractor or DDA will regularly monitor these positions to assure fading efforts
occur when appropriate and any potential conflict of interest is addressed.
(11) Individual Employment staff hours must be attributed'to the "Individual Employment and
Billable Activity Phases)".
(12) For Group Supported Employment (GSE), Clients must have paid work. The total number of
direct service staff hours provided to the group should be equal to or greater than the group's
collective amount of individual support monthly base hours. If the direct service staff hours are
less than the collective amount, then the provider will be reimbursed only for the number of
hours staff actually provided.
(a) The collective group's individual hours should be the minimum staff hours delivered to
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1769CP Contract Amendment (12-10-21) Page 9
support the group.
(b) A GSE Client must be on-site/at work at least their base individual hours as a minimum per
month. If a Client is not on-site/at work for all of their base hours, the county should verify
that the provider delivered the collective group's individual hours to the group (what was the
number of staff hours provided to the group during the month? If it was less than the
collective group's total the provider can only bill for the staff hours that were provided).
(c) A GSE agency may not bill for a GSE Client who does not receive services during an entire
service month.
(d) A GSE agency must have a record of which staff is supporting which Clients on any given
day.
(e) A GSE agency must have supportive documentation that provides clear evidence of support
helping with specific activities as identified in the Client plan to move a Client on their
pathway towards their employment goal(s).
(f) Running a GSE service is a part of the business operation and not billable to Clients
(contract procurement, contract maintenance, or administration functions associated with
GSE).
(g) Individual time in the community working towards the individual employment goal, separate
from the group time, must include phase information (refer.to Employment Phases and
Billable Activities - see Phases 1 — 4 for element / activity description).
(13) Employment and day services must adhere to the Home and Community Based settings
(HCBS) requirements of 42 C.F.R. Section 441.301(c)(4), including that:
(a) The setting is integrated in the greater community and supports Client's to have full access
to the greater community;
(b) Ensures the Client receives services in the community to the same degree of access as
individuals not receiving Medicaid HCBS;
(c) The setting provides opportunities to seek employment and work in competitive integrated
settings; and
(d) The setting facilitates individual choice regarding services and supports, and who provides
them
Quality Assurance and Service Evaluation: The Contractor 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 indicators, by acuity, that include the number of
new jobs; job loss and reasons for job loss; the percentage employed earning minimum wage or
better; and the average number of hours worked. The Contractor's service evaluation system shall
serve as the method by which current providers demonstrate that they continue to be qualified
providers. A copy or description of such evaluation system shall be provided upon request to DDA
for review.
m. Evaluation: The Contractor shall evaluate and review services delivered to reasonably assure
compliance and quality. The Contractor shall conduct at least one visit to each subcontractor every
two (2) years. The Contractor shall maintain written documentation of all evaluations,
recommendations and corrective action plans for each subcontractor. Copies of such
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1769CP Contract Amendment (1.2-10-21) Page 10
documentation will be provided to the DDA upon request.
n. The Contractor shall work with local developmental disability advisory groups to plan for and
coordinate services.
o. The Contractor shall participate in regularly scheduled meetings between Contractor DD staff and
DDA staff to remain updated and current including ACRS and Regional Meetings.
p. AWA Data System: In compliance with the AWA Training Manual, the County shall use the AWA
data system for all:
(1) Billing requests;
(2) Service provider address and phone number maintenance;
(3) Evaluation dates;
(4) Employment outcome information; and
(5) Monthly provide all data described in the Billing Instructions and in the Employment Outcomes
Instructions, which is hereby incorporated by reference.
q. Assure the integrity of data submitted to the State. When data is submitted and rejected due to
errors or an error is later identified, the County will correct and resubmit the data within thirty (30)
days.
r. Review and respond the AWA "Work List" items within 5 working days including Referrals and
pending Authorization.
s. Review the AWA "Ticklers" Planned Rate tab and update the planned rate within 5 working days
after the Planned Rate start date.
t. Partnership Project.
(1) A Job Foundation document will be completed per guidelines for eligible students. Eligible
students are DDA clients who were born between:
(a) For fiscal year 2021 9/1/00 through 8/31/01
(b) For fiscal year 2022 9/1/01 through 8/31/02
.11 (c) For fiscal year 2023 9/1/02 through 8/31/03
(d) For fiscal year 2024 9/1/03 through 8/31/04
These students currently attending school and have completed an application to participate in
this Value Based Payment (VPB) project. The VBP project application will include the following
minimum criteria identified in the sample application found at:
https://www.dshs.wa.gov/sites/default/files/DDA/dda/documents/Job%2OFoundation%2OApplica
tion 040720%20%250021/o29.docx
(2) Qualified providers will collaborate with School District staff to complete the Job Foundation
document and then provide a copy to the County. To be a qualified provider for the Partnership
Project the Counties must require the provider to have a current contract with the Division of
Vocational Rehabilitation;, a contract in good standing with the County and cannot be in
DSHS Central Contract Services
1769CP Contract Amendment (12-10-21) Page 11
provisional status; a minimum of two years' experience providing Individual Employment with
demonstrated job placement skills. The Job Foundation recommendation will only have
actionable next steps towards integrated competitive employment.
(3) County participating in the Partnership Project must have the ability to work collaboratively with
School Districts to identify DDA students in high school, collect and track information, be
proficient in electronic spreadsheets, and ability to evaluate if completed Job Foundation
document(s) meet quality standards.
u. Employment Outcome Payment. — Providers, with transition students born between:
For fiscal year 2023 9/1/00 through 8/31/01
• For fiscal year 2024 9/1/01 through 8/31/02
• For fiscal year 2025 9/1/02 through 8/31/03
• For fiscal year 2026 9/1/03 through 8/31/04
High acuity Clients who are authorized for Individual employment, may receive one outcome
payment if student obtains a competitive integrated job approved by the County within timeframes
described in the chart in the DDA Billing Instructions. If the County is also the service provider DDA
will provide the job approval. If the job is at a minimum of ten hours of work per week an additional
amount will be include in the payment.
7. Consideration:
a. Fees:
(1) Approval of fees is the responsibility of the DDA. The DDA Region reserves the right to approve
fees/rates for the services being provided. The Contractor will submit a fee/rate schedule with
the initial Contract. The Contractor will submit updated fee/rate schedules to the DDA Region
for approval as changes occur. The rate schedule will include the following information:
(a) Contractor(s) name;
(b) Time period for which the schedule is applicable; and
(c) Each contracted direct service (IE, GSE, Cl, ITA, CDS) and its associated rate.
(2) Fee Limitations: The DDA Billinq Instructions found on the County Best Practices site provides
limitations on the Hourly Rate for each direct service. Hourly rates must be divisible by four.
b. Budget and Spending Plan, attached as Exhibit B:
(1) Budget amount listed in Exhibit B: The Contractor may not exceed the state only revenue dollar
amount or the total revenue dollar amount indicated on the Program Budget Agreement
included in Exhibit B. The waiver revenue dollar amount may be exceeded to accommodate
Clients moving from state -only employment and day services to waiver employment and day
services.
(2) Spending Plan: DDA will provide the'initial spending plan/Program Agreement Budget / Exhibit
B. Funding shall be distributed under State and Medicaid in the revenue section. The planned
expenditures for Consumer Support are based on authorized Clients, their acuity level and work
'history for a given point in time. To determine the Additional Consumer Support amount, the
DSHS Central Contract Services
1769CP Contract Amendment (12-10-21) Page 12
Consumer Support amount is multiplied by a percentage. The spending plan may only be
modified by mutual agreement of the parties in writing and shall not require a program
agreement amendment.
(a) Funds Designated for Additional Consumer Services: If a Contractor provides Community
Information and Education services under additional consumer services, then activities must
include outreach efforts to federally recognized local tribes.
(b) Funds Designated for Adult Day Care Consumers: Funds designated for Adult Day Care
Consumers are available to Clients who were served between December 1996 and
December 2003 in Adult Day Health agencies and were subsequently determined ineligible
for Level II or III services (Adult Day Health). Level II and III services are licensed
rehabilitation and skilled nursing services along with socialization. Level I services (Adult
Day Care) are supervised day programs where frail and disabled adults can participate in
social, educational, and recreational programs without the need for skilled nursing. These
Clients may be referred to services defined in the statement of work, or to an Adult Day Care
service other than Level Il or III. If a Client no longer needs and wants services, the funds
are available for other Clients who are not part of.the group of original Clients identified
between December 1996 and 2003. An Adult Day Care service shall only be provided by
Adult Day Care agencies certified by the local Area Agency on Aging. Adult Day Care
service is not a waiver approved service.
c. Contract A Contractor can request an amendment at any time. An amendment for additional
Client(s) may be supported when clients exceed the number used to develop the contract. An
amendment for additional service hours authorized may be supported when county provides
evidence. An amendment request for expenditures exceeding contract total due to hourly rates
paid to service provider may not be supported as the county is responsible to manage contract and
rates paid to their providers.
d. Exemptions: The DDA Assistant Secretary may approve in writing an exemption to a specific
Contract requirement.
8. Billing and Payment:
a. Contract Budget: DSHS shall pay the Contractor all allowable costs, which are defined by DDA as
cost incurred by the program for:
(1) Administration: Costs of the County Human Services Department or similar county office,
responsible for administration of the Developmental Disabilities Program. Allowable costs
include personnel and overhead costs directly related to the administration and coordination of
the program, including such activities as program planning, budgeting, contracting, monitoring,
and evaluation. Also included are departmental and county indirect and/or direct administrative
costs, to the extent that such costs are appropriately allocated to the program using an
established methodology consistent with grants management guidelines. For a Contractor
whose designated coordinator manages multiple programs, the Contractor must be able to
provide.
(2) Additional Consumer Services:
(a) Training:
i. Staff Training: Costs incurred by the program for planned, structured activities for the
purpose of providing, or improving, or enhancing job-related knowledge and skills of
staff, providers, volunteers, or interning students in the provision of developmental
DSHS Centra( Contract Services
1769CP Contract Amendment (12-10-21) Page 13
disabilities services.
ii. Board Training: Costs incurred by the program for planned, structured activities
designed to provide, improve, or enhance program -related skills of board and advisory
committee members.
(b) Community Information and Education: to inform and/or educate the general public about
developmental disabilities and related services. These may include information and referral
services; activities aimed at promoting public awareness and involvement; and community
consultation, capacity building and organization activities.
(c) Other Activities.
i. Infrastructure projects: Projects in support of Clients (services not easily tracked back to
a specific working age Client) or that directly benefit a Client(s) but the Client is not of
working age. Examples include planning services like generic job. development e.g.
"Project Search."
ii. Start-up projects: Projects that support an agency or directly benefit the agency.
Examples include equipment purchases and agency administrative support.
iii. Partnership project: Collaborative partnerships with school districts, employment
providers, Division of Vocational Rehabilitation (DVR), families, employers and other
community collaborators needed to provide the employment supports and services
young adults with developmental disabilities require to become employed during the
school year they turn twenty-one (21). Supports provided should complement and not
replace what the student(s) receive through the Individualized Education Program (IEP).
(3) Consumer Support.
(a) Adult Day Care services are available to Clients who were served between December 1996
and December 2003 in Adult Day Health agencies and were subsequently determined
ineligible for Level 11 or III services (Adult Day Health). Level II and III services are licensed
rehabilitation and skilled nursing services along with socialization. Level I services (Adult
Day Care) are supervised day programs where frail and disabled adults can participate in
social, educational, and recreational programs without the need for skilled nursing.
(b) Community Inclusion services are individualized and provided in integrated community
settings with other individuals without disabilities. The activities are based on Client interests
and provide opportunities typically experienced by the general public of similar age in their
local community, accessible by public transit or a reasonable commute from their home. The
goal of the service is to support Clients to participate, contribute, and develop relationships
with community members who are not paid staff. These services may be authorized for
individuals age 62 and older. These services may be authorized in addition to or instead of
employment support (individual Employment or Group Supported Employment) for working
age individuals who have received nine months of employment support.
(c) Child Development Services are designed to meet the developmental needs of each eligible
child and the needs of the family related to enhancing the child's development. Services
may include specialized instruction, speech-language pathology, occupational therapy,
physical therapy, assistive technology, and vision services. Services are provided in natural
environments to the maximum extent appropriate.
(d) Individual Supported Employment services are a part of a Client's pathway to employment
and are tailored to individual needs, interests, and abilities to promote career development.
DSHS Central Contract Services
1769CP Contract Amendment (12-10-21) Page 14
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 (per
the Individual Employment Phases & Billable Activities).
(e) Individualized Technical Assistance services are a part of a Client's pathway to employment
or community inclusion. This service provides assessment and consultation to the provider
to identify and address existing barriers to employment or community inclusion. This is in
addition to supports received through supported employment or community inclusion
services for Clients who have not yet achieved their goal.
(f) Group Supported Employment services are a part of a Client's pathway to integrated jobs in
typical community employment. These services are intended to be short term and offer
ongoing supervised employment for groups of no more than eight (8) workers with
disabilities in the same setting. The service outcome is sustained paid employment leading
to further career development in integrated employment at or above minimum wage.
Examples include enclaves, mobile crews, and other business models employing small
groups of workers with disabilities in integrated employment community settings.
b: Reimbursement for the Fiscal Year shall not exceed the total amount listed in Exhibit B to this
Contract. However, with a Contract amendment, the parties may increase or decrease the Contract
amount. The Contractor will work with DDA HQ on amendments to the Contract.
c. Monthly Invoice with Signed Documentation: All requests for reimbursement amounts must be
entered and posted into the AWA system. The Contractor may post a combined claim of all
programs/services covered by this Contract. DSHS shall make all payments due to the Contractor
for all invoices submitted pursuant to this section within sixty (60) days following posting of required
information.
d. Clients will be assisted in accessing DVR services per the DDA/DVR MOU. Client services shall not
be reimbursed under this Contract when the same services are paid for under the Rehabilitation Act
of 1973 by DVR, Public Law 94-142 or any other source of public or private funding.
e. Reimbursement of Client Services: A claim for each Client is made on the CMIS system by
indicating the number of service units delivered to each Client listed and the fee per unit. Units are
defined as:
(1) An "Hour" is at least fifty (50) minutes of direct service. Partial hour to the quarter may be
recorded.
(2) A "Day" is at least four (4) hours of direct service and will only be used in connection with Adult
Day Care reimbursement.
(3) A "Month" represents a minimum of one service visit which is at least fifty (50) minutes of direct
service for CDS reimbursement.
Program Administration: The Contractor will provide program administration and coordination
including such activities as planning, budgeting, contracting, monitoring, and evaluation. Monthly
claims for administration can be 1/12 of the maximum amount identified in Exhibit B under
Administration or for the actual costs incurred in the given month but the total Administration billed
will be the lesser of the two. Administration cost reimbursement will not exceed 7% unless the
Assistant Secretary of DDA approves a request for an exception under chapter 388-850 WAC.
g. The Employment Phases & Billable Activities document defines the individual Client services that
DSHS Central Contract Services
1769CP Contract Amendment (12-10-21) Page 15
DDA reimburses. That document is located on the DSHS DDA County Best Practices Web site at
,hftps://www.dshs.wa.gov/dda/Contractor-best-r)ractices.
h. The Community Access Billable Activities document defines the individual Client services DDA
reimburses. That document is located on the DSHS DDA County Best Practices Web site at
https://www.dshs.wa.gov/dda/Contractor-best-practices.
i. Timeliness of and Modification to Billings: All initial invoices with signed documentation must be
received by the DDA Region within forty-five (45) calendar days following the last day of the month
in which the service is provided. Corrected invoices and documentation including re -posted billing
information will be accepted throughout the fiscal year as long as they are received within sixty (60)
calendar days of the associated fiscal year unless an extension is approved by the DDA Regional
Administrator or designee. Payment will not be made on any invoice submitted past sixty (60)
calendar days after the Contract fiscal year.
j. Recovery of Fees: If the Contractor bills and is paid fees for services that DSHS later finds were (a)
not delivered or (b) not delivered in accordance with Contract standards, DSHS shall recover the
fees for those services and the Contractor shall fully cooperate during the recovery.
k. Preadmission Screening and Resident Review (PASRR): The Contractor may bill for administration
costs as identified in Exhibit B. Monthly claims for administration cost will be based on the actual
PASRR expenditures multiplied by 7%.
I. Reimbursement for Partnership project: a claim of $2,400 per student for each completed Job
Foundation document that is at a satisfactory or above rating will be requested through the AWA
system as other monthly cost
m. Job Foundation report line item 95 and 96 as identified in the ADSA Web Access (AWA) billing
system. King, Snohomish and Pierce Counties will use line item 95, all other participating Counties
will use line item 96 (OSPI). A copy of the completed Job Foundation document will be sent
electronically to the shared mailbox located at: DDAJobFoundationReports@dshs.wa.gov
n. Job placement verification for transition students: The AWA Employment Output for Individual
Employment will be completed and submitted with payment request to verify employer, job start
date, job type, etc.
o. Job Foundation Administration: The County may bill for administration costs as identified in Exhibit
B. Monthly claims for administration cost will be based on the actual expenditures multiplied by 7%.
King, Snohomish and Pierce Counties will use line item 13, all other participating Counties will use
line item 14 (OSPI).
9. Intermediate Care Intermediate Care Facilities for Intellectual Disabilities (1CF1lD) Agreement. If
applicable per 42 CFR 483.410, the Contractor shall assure that all Contractor -operated or
subcontracted programs serving persons living in ICF/ID facilities develop a plan and coordinate their
services with the facility on behalf of the ICF/ID resident. DDA will supply to the Contractor a list of
ICF/ID residents who attend a day program.
10. Single State Medicaid Agency—Health Care Authority (HCA): HCA, as the single state Medicaid
Agency, has administrative authority for Title XIX coverage per 42 CFR 431.10. DSHS is the operating
agency for the Home and Community Based Waivers for services for people with developmental
disabilities. The Contractor only has responsibility for services covered in this agreement.
11. DSHS/DRW Access Agreement: The DRW February 27, 2001 Access Agreement with DDA is
incorporated by reference. The Contractor assures that it and its subcontractors have reviewed the
Access Agreement. The agreement covers DRVVs access to individuals with developmental
DSHS Central Contract Services
1769CP Contract Amendment (12-10-21) Page 16
disabilities, Clients, programs and records, outreach activities, authority to investigate allegations of
abuse and neglect, and other miscellaneous matters and is binding for all providers of DDA contracted
services.
12. Confidential Information. All Counties and their(subcontractors must:
a. Ensure the security of Confidential Information, and
b. When transporting client records containing Confidential Information outside a Secure Area, one or
more of the following as appropriate:
(1) Using a Trusted Network; or
(2) Encrypting the Confidential Information, including:
(a) Email and/or email attachments
(b) Confidential Information when it is stored on portable devices or media including but not
limited to laptop computers and flash memory devices.
13. Data Security Requirements. Exhibit A shall only apply to the County if the County possesses 154 or
more DSHS records across all programs or services throughout their organization or transmits more
than 5 records at one time.
DSHS Central Contract Services
1769CP Contract Amendment (12-10-21) Page 17
Exhibit 131
Program Agreement Budget
Original Budget X Budget Revision
REVENUES
Fiscal
Year
Fund Source
Original 1St Revision 2nd Revision 3rd Revision
2022
State only
434,835
Medicaid
Medicaid
421,834
1
Fun
Fund's
Total Rev.
Total Rev.
$8561669 $ $ $
..
Fiscal
Year Fund Source
Original
1 st Revision 2nd Revision 3rd Revision
2023 State only
434,835
4767632
Medicaid
421,834
429,010
1
Fun
Fund's
Total Rev.
$8561669
$905,642 $ $
..
FY22
DSHS Central Contract Services
1769CP Contract Amendment (12-10-21) Page 18
Job Foundation
Funds P�OSRR
State
, ! �S x)r Ylsj ✓ S ` Ya
:ri; y Medicaid °�
1
Fun
Fund's
Funds
. /�` � " •s �. 2✓r'>c ;»rdtirl�tkr yit�
� •
TOTAL .
..
��r�1
N f l h /✓ s( t h LY%t
;ADMINISTRATLON
•
grdJ � x R��p�. � ��
" l /� ! � Iib 11As.,�. ���ya w�./i Y; iyt.
•
(C M I S/AWA BARS 11)
30E2.4
56, 044----,
�' - ),R
-
t%. �. •s:iti r L- bjl e
is Ir
-
HER CONSUMER
,r dFly � t ✓ ��4) i)�il L% /1'j itf
SUPPORTS
. t�...
g i-
d
(CMIS/AWA Code 31,
l
LL
.32 ,141 92 9 3 -94)
..
28807
bj� ),� _ ✓'� ;23570
52 377
CONSUMER SUPPORT
:...STATE -ON -LY''..
ChlldDevelopment .
21160
.21160
373044
�^ 373044,; .
.746,088
MEDICAI.D.CLIENT.S
ROADS to COMMUNITY
LIVING
434,835
4211834
8561669
TOTAL
DSHS Central Contract Services
1769CP Contract Amendment (12-10-21) Page 18
FY2 3
All other terms and conditions of this Program Agreement remain in full force and effect.
DSHS Central Contract Services
1769CP Contract Amendment (12-10-21) Page 19
Job Foundation
Funds
PASRR
a ~Iedica�dr
Funds State Funds,
Finds
TOTAL
ADMINISTRATION
(CMTS/AWA BARS
_
32586.:J.:_s
26662.
591248'
OTHER CONSUMER.
r
SUPPORTS
CM IS/AWA Code
�'>
Ry4 �'x,�-: .y�t
sy'�'
! �92.931. 317:32 417 f
xs<-t
arX L�n� r ^'�{rr.yiC
*•.ly i r,MtYz n
t;
.
94)
30454
s; x917
55,371
.CONSUMER
,SUPPORT
TAT-OIV:l,
Child, D0el:apment,
2160
Start-up
34000
373044r,�
' :a
37304 <°
' 4' r`� `.34
746,088 ,
IEDLIENTS
C
Medicaid Proviso4388
F •J.. :[" m'.lluhtn_i1
, �., •5 %..t.n.. Y 4
ROADS to
nix..
COMMUNITY
ING
476,632
429,010
1905,642
TOTAL
All other terms and conditions of this Program Agreement remain in full force and effect.
DSHS Central Contract Services
1769CP Contract Amendment (12-10-21) Page 19