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I <br />(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 parlies in writing and shall not require a program <br />agreement amendment. <br />(a) Funds Designated for Additional Consumer Services: lf a County provides Community <br />lnformation 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 a'railable to Clients who were served between December 1g96 and <br />December 2003 in Adult Day Health agencies and were subsequently determined ineligible <br />for Level ll or lll services (Adult Day Health). Level ll and lll 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 relerred to services defined in the statement of work, or to an Adult Day Care <br />service other than Level ll or lll. lf a Client no longer needs and wants services, the funds <br />are available for other Clients who are not parl 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 Amerdments: 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 />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 cverhead 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 extenttha.such costs are appropriately allocated tothe program using an <br />established methodology consistent with grants management guidelines. For a County whose <br />DSHS Central Contract Services <br />'1 769CP Contract Amendment (12-10-21)Page 1 3