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5 Special Terms and Conditions is cited or on the registry for a substantiated linding, then that associated staff will be prohibitedfrom providing services under this program Agreeirent. k' Counties who provide child Development services (birth to three early intervention services), mustprovide those servrcgsyndel the regulations implementinjtne lndividuals with DisabititiesEducation Act (IDEA), Part c, and Washington btate's i.ity srpport for tnrant "no roootu1Federally Approved plan. l' The County staff who per-form evaluations of subcontractor work sites will prompily report to DSHSper DDA Policy 6-a8, hcident Management and Reporring Requirementsior coiitty and County-Contracted Provicters, if: (1) They have reasonable cause to believe that abandonment, abuse, financial exploitation orneglect (as defined in RCW 74.34.020) of a person who has a developmental disability (asdefined in RCW 71A.10.020) has occurred, and, (2) lf they have reason to suspect that sexual or physical assault of such a person has occurred,they shail also immediately report to the appropiiut. ta* enforcement ;g;;t: m' Counties are specifically authorized to have data storage on portable devices or media inaccordance with the Data Security Requirements. n' order of Precedence: ln the event of any inconsistency in this program Agreement and anyattached exhibits, unless.othenruise provided herein, th; in;;nsistency snJtt be resttved by givingprecedence, in the following order, to: (1) County Program Agreement; and (2) Attached Exhibits. Duty to Disclose: Under 42 CFR $455.104, the Administration must obtain certain disctosures andcomplete required screenings to eniure the,.state ooes- noi fay federal funds to "i"ruolo person orentities' The county is required to provide disclosures rrom mlnaging employees, specifically thepersons in the positions of Developmental Disabilities Director and Fiscal/Budget Director, i.e. theperson who authorizes expenditures. A completed Medicaid proviOer Disclosuie Statement, DSHSForm 27-094, should be submitted to the Administratio; t; ;o'"dete the required screenings.Disclosures must be provided at contract renewal ano wtnin nihy-riu" (3s) A;ys;h"nlu", there is achange in the staff hording these management positions t+i Cin'+ss.10a (c)(1)1. Statement of Work: The County shall provide the services and staff, and otherwise do all thingsnecessary for or incidental to the peformance of work, as set tonn nerow. w"r[ing Llliboratively andsharing information as needed foi service coordination, ttre parties shall administer DD services withinthe county as set forlh below: a. The DDA region shall: (1) Review subcontractors and shall immediately notify the County of any concerns with thesubcontractors identified by the County; (2) lnform and include the county in the discharge planning of client's leaving institutions andreturning to the community who will need pro-gram funding; (3) lnform the county of client's who have had their waiver status changed; 6 DSHS Central Contract Services 1 769CS County Agreement 05-1 6-2023 Page 6