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(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 /Program Agreement Budget /Exhibit <br />B.Funding shall be distributed under State and Medicaid in the revenue section.The planned <br />expenditures for Consumer Support are based on authorized Clients,their acuity level and work <br />history for a given point in time.To determine the Additional Consumer Support amount,the <br />Consumer Support amount is multiplied by a percentage.The spending plan may only be <br />modified by mutual agreement of the parties in writing and shall not require a program <br />agreement amendment. <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 Ill services (Adult Day Health).Level II and Ill 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 Ill.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 />program agreement requirement. <br />8.Billing and Payment: <br />a.Program Agreement Budget:DSHS shall pay the County all allowable costs,which are defined by <br />DDA as cost incurred by the program for: <br />(1)Administration:Costs of the County Human Services Department or similar county office, <br />responsible for administration of the Developmental Disabilities Program.Allowable costs <br />include personnel and overhead costs directly related to the administration and coordination of <br />the program,including such activities as program planning,budgeting,contracting,monitoring, <br />and evaluation.Also included are departmental and county indirect and/or direct administrative <br />costs,to the extent that such costs are appropriately allocated to the program using an <br />established methodology consistent with grants management guidelines.For a County whose <br />DSHS Central Contract Services <br />1769CP Contract Amendrnent (12-10-21)Page 13