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DocuSign Envelope lD: 7FBBA023-2C51 -4D27 -A692-C4E00648D734 staff), subcontractors, and/or volunteers who may have unsupervised access to vulnerable DSHS clients, in accordance with Rcw 43.43.g30-94s, Rcw 74.15.030, and Chapter 388 WAC. lf 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. Qualified Service Providers: The Contractor assures that all service providers meet qualifications as outlined in the DDA policy 6.13, program provider Qualifications. Home and Community Based Waiver Services Assignment of Medicaid Billing Rights: The Contractor agrees to assign to the County its Medicaid billing rignts for services to DDA clients eligible under Tifle XIX programs in this erogram ProvisionalAgreement. Written documentation shall be available to DSHS on request. Reporting Abuse and Neglect: contractor's staff, who are mandated reporters under RCW 74.34.020 (13), must comply with reporting requirements described in RCW 74.34.035 and 040 Rcw and 26.44 Rcw. tf the county is notified by DSHS that a subcontractor staff member is cited or on the registry for a substantiated finding, then that associated staff will be prohibited from providing services under this Program Provisional Agreement. g Contractor recognizes that the County staff must perform on-site evaluations of Contractor work sites and promptly report findings from such evaluations to DSHS under the attached Program Provisional Agreement. The evaluation will have a Quality Assurance and a Quality lmprovement component and will include objective measures to comply with DDA Criteria and Service Provisional Agreement. Contractor shall provide full assistance with any such inspection and does hereby waive any cause of action against the County, its officers or staff for any action associated with such evaluations or reporting. 4. Statement of Work a. Address provisional contract required items including the submission of missing information from the 2021 on-site evaluation (deadline within 1 month of provisional contract execution), notifu all Kittitas county clients of the provisional contract status (deadline within 1 week of provisional contract execution), comply with an additional on-site evaluation in December of 2021; Professional Services Provisional Agreement Page 20 d