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(10) lndividual Employm Activitv Phase(s)". ent staff hours must be attributed to the "lndividu al Emolovment Billable (1 1) For Group Supported Employment (GSE), Clients must have paid work. The total number of direct service staff hours provided to the group should be equal to or greater than the group's collectiveamountof individual supportmonthlybasehours. lf thedirebtservicestaff hours'are less than the collective amount, then the provider will be reimbursed only for the number of hours staff actual ly provided. (a) The collective grc'up's individual hours should be the minimum staff hours delivered to support the group. (b) A GSE Client must be on-site/at work at least their base individual hours as a minimum per month. lf a Client is not on-site/at work for all of their base hours, the county should veriiy that the provider delivered the collective group's individual hours to the group (what was the number of staff hours provided to the group during the month? lf it was Tess than the collective group's total the provider can only bill for the staff hours that were provided). (c) A GSE agency may not bill for a GSE Client who does not receive services during an entire service month. (d) A GSE agency must have a record of which staff is supportin g which Clients on any given day (e) A GSE agency must have supportive documentation that provides clear evidence of supporl helping with specific activities as identified in the Client plan to move a Client on their pathway towards their employment goal(s). (0 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 the individual employment goal, separate from the group time, must include phase information (refer to Employment phases and Billable Activities - see Phases 1 - 4 for element / activity description). (12) Employment and day services must adhere to the Home and Community Based settings (HCBS) requirements of 42 c.F.R. section 441,301(cX4), including that: (a) The setting is integrated in the greater community and supports Client's to have full access to the greater community; (b) Ensures the Client receives services in the community to the same degree of access as individuals not receiving Medicaid HCBS; (c) The setting provides opportunities to seek employment and work in competitive integrated settings; and (d) The setting facilitates individual choice regarding services and supporls, and who provides them Quality Assurance and Service Evaluation: The County shall develop and have available an evaluation system to revievr services. The evaluation system must lrave both a Quality Assurance and a Quality lmprovement component, and both must include objective measures. T[re objective measures at a minimum wi,l include performance indicators, by acuity, that include the number of DSHS Central Contract Services 17 69CP Contract Amendment (1 Z-l 0-21)Page 10