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Special Terms and Conditions <br />and December 2003 in Adult Day Health agencies and were subsequently determined <br />ineligible 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. <br />(b) Community Inclusion Services are individualized and provided in integrated community <br />settings with other individuals without disabilities. The activities are based on Client <br />interests and provide opportunities typically experienced by the general public of similar age <br />in their local community, accessible by public transit or a reasonable commute from their <br />home. The goal of the service is to support Clients to participate, contribute, and develop <br />relationships with community members who are not paid staff. These services may be <br />authorized for individuals age 62 and older. These services may be authorized in addition to <br />or instead of employment support (Individual Employment or Group Supported Employment) <br />for working age individuals who have received nine months of employment support. <br />(c) Child Development Services are designed to meet the developmental needs of each eligible <br />child and the needs of the family related to enhancing the child's development. Services <br />may include specialized instruction, speech -language pathology, occupational therapy, <br />physical therapy, assistive technology, and vision services. Services are provided in natural <br />environments to the maximum extent appropriate. <br />(d) Individual Supported Employment services are a part of a Client's pathway to employment <br />and are tailored to individual needs, interests, and abilities to promote career development. <br />These are individualized services necessary to help persons with developmental disabilities <br />obtain and continue integrated employment at or above the state's minimum wage in the <br />general workforce. These services may include intake, discovery, assessment, job <br />preparation, job marketing, job supports, record keeping and support to maintain a job (per <br />the Individual Em lovment Phases & Billable Activities) <br />(e) Individualized Technical Assistance services are a part of a Client's pathway to employment <br />or community inclusion. This service provides assessment and consultation to the provider <br />to identify and address existing barriers to employment or community inclusion. This is in <br />addition to supports received through supported employment or community inclusion <br />services for individuals who have not yet achieved their goal. <br />(f) Group Supported Employment services are a part of a Client's pathway to integrated jobs in <br />typical community employment. These services are intended to be short term and offer <br />ongoing supervised employment for groups of no more than eight (8) workers with <br />disabilities in the same setting. The service outcome is sustained paid employment leading <br />to further career development in integrated employment at or above minimum wage. <br />Examples include enclaves, mobile crews, and other business models employing small <br />groups of workers with disabilities in integrated employment community settings. <br />b. Reimbursement for the state Fiscal Year shall not exceed the total amount listed in Exhibit B to this <br />Program Agreement. However, with a Program Agreement amendment, the parties may increase <br />or decrease the Program Agreement amount. Counties will work with DDA HQ on amendments to <br />the Program Agreement. <br />c. Monthly Invoice with Signed Documentation: All requests for reimbursement amounts must be <br />entered and posted into the AWA system. The County may post a combined claim of all <br />programs/services covered by this Program Agreement. DSHS shall make all payments due to the <br />DSHS Central Contract Services Page 15 <br />1769CS County Agreement 05-16-2023 <br />