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Special Terms and Conditions the continuation of long-lerm supports where the service provider is also the Client's employer,the county or DDA will regularly monitor these positions to issure fading efforts oicur whenappropriate and any potential conflict of interesi is addressed (10) lndividual Employment staff hours must be attributed to the "lndividual Emplovment and qjllable Aetivitv Phase(s)". (11) For Group Supported Employment (GSE), clients must have paid work. The total number ofdirect service staff hours provided to the gjioup srroud oe equal to or greatei in"n irr" group,scollective amount of. individual support monthly base hours. lf the direct service staff hours areless than the collec-tive amount, thi;n the provider will be reimbursed only for the-number of hoursstaff actually provided. (a) The collective group's individual hours should be the minimum staff hours delivered tosupport the group. (b) A GsE Client must be on-site/at work at least their base individual hours as a minimum permonth' lf a client is not on-site/at work for all of their base hours, tne countvihould veriflithat the provider delivered the collective group's individual hours to ilre gioip iwf, at was thenumber of staff hours provided to the group during the month? lf it wastiss irrbn tnecollective group's total the provider cah oity oitt f6r the staff hours tnii iiie-piovided,l. (c) A GSE agency may not bill for a GSE client who does not receive services during an entireservice rnonth. (d) A GSE agency must have a record of which staff is supporting which Clients on any givenday. (e) A GSE agency m99t harle supportive.d-ocumentatiorr that provides clear evidence of supporthelping with specific activities as identified in the Client fiin to move a Client on theirpathway 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 withcsE). (g) lndividual time in the community working towards rhe individual employment goal, separate !9.m lhe group time, must include phasd information (refer to empnymeni.p6"ases anoBillable Activities - see phases 1 - 4 for element / activity oescripiionl. (12) Employment and day seruices must adhere to the Home and Community Based settings(HCBS) requirements of 42 c.F.R. section 441.g01(ci)(41 inctuoing tnat: ' (a) The setting is integrated in the greater community and supports Client's lo have full accessto the greater community; (b) Ensures the Client receives services_in the community to the same degree of access asindividuals not receiving Medicaid HCBS; (c) The. setting provides opportunities to seek employment and work in competitive integratedsettings; and (d) The setting facilitates individual choice regarding services and supports, and who provides DSHS Central Contract Services 1 769CS County Agreement 05,1 6-2023 Page 10