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(2) Fee Limitations: The DDA will set limitations on the Hourly Rate for each direct service. Hourly <br />rates must be divisible by four. The current rates are as follows: <br />(a) Employment services. <br />Individual Employment services will not exceed $75.00/hour. <br />ii. Group Supported Employment services will not exceed $65.00/hour. <br />(b) Community Inclusion services will not exceed an hourly rate of $35.00. <br />(c) Child Development services will not exceed a monthly rate of $500.00. <br />b. Budget and Spending Plan, attached as Exhibit B: <br />(1) Budget amount listed in Exhibit B: The County may not exceed the state only revenue dollar <br />amount or the total revenue dollar amount indicated on the Program Budget Agreement <br />included in Exhibit B. The waiver revenue dollar amount may be exceeded to accommodate <br />Clients moving from state -only employment and day services to waiver employment and day <br />services. <br />(2) Spending Plan: DDA will provide the initial Spending Plan. Funding shall be distributed under <br />planned expenditures as well as allocated under State and Medicaid shall function as a line item <br />budget for expenditures under this agreement. The planned expenditures for Consumer <br />Support are based on Client numbers as well as planned additional consumer services <br />expenditures. The spending plan may only be modified by mutual agreement of the parties in <br />writing and shall not require a program agreement. <br />(a) Funds Designated for Additional Consumer Services: If a County provides Community <br />Information and Education services under additional consumer services, then activities must <br />include outreach efforts to federally recognized local tribes. <br />(b) Funds Designated for Adult Day Care Consumers: Funds designated for Adult Day Care <br />Consumers are available to Clients who were served between December 1996 and <br />December 2003 in Adult Day Health agencies and were subsequently determined ineligible <br />for Level II or III services (Adult Day Health). Level II and III services are licensed <br />rehabilitation and skilled nursing services along with socialization. Level I services (Adult <br />Day Care) are supervised day programs where frail and disabled adults can participate in <br />social, educational, and recreational programs without the need for skilled nursing. These <br />Clients may be referred to services defined in the statement of work, or to an Adult Day Care <br />service other than Level II or III. If a Client no longer needs and wants services, the funds <br />are available for other Clients who are not part of the group of original Clients identified <br />between December 1996 and 2003. An Adult Day Care service shall only be provided by <br />Adult Day Care agencies certified by the local Area Agency on Aging. Adult Day Care <br />service is not a waiver approved service. <br />c. Program Agreement Amendments: A County can request an amendment at any time. An <br />amendment for additional client(s) may be supported when clients exceed the number used to <br />develop the contract. An amendment for additional service hours authorized may be supported <br />when county provides evidence. An amendment request for expenditures exceeding contract total <br />due to hourly rates paid to service provider may not be supported as the county is responsible to <br />manage contract and rates paid to their providers. <br />d. Exemptions: The DDA Assistant Secretary may approve in writing an exemption to a specific <br />DSHS Central Contract Services Page 11 <br />1769CS County Agreement 5-1-2019 <br />