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Special Terms and Conditions the continuatior of long-L-rm supports where the service provider is also the Client's employer, the County or DQA will regularly monitor these positions to assure fading efforts occur when appropriate and any potential conflict of interest is addressee. (10) Individual Employment staff hours must be attributed to the "individual Employment and Billable Activity Phase[s'�' ' (11) 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 collective amount of individual support monthly base hours. If the direct service staff hours are less than the collective anourg, then the provider will be reimbursed only for the number of hours staff actually provided. (a) The collective group's indvidual hours should be the min mum staff hours delivered to support the group. (b) A GSE Client mull be tin-silelat work. at least their base individual hours as a minimum per month. If a C ient is not or-sitelat work for all of their base hours, the county should verify that the provider deliverec the collective group's individual hours to the group (what was the number of staff Fours provided to the grorip during the month? If it was less than the collective 9MP's rota! the provider can only bill for the staff hours that were provided). (c) A GSE agency may rot brit for a GSE Client who does nct receive services during an entire service month. (d) A GSE agency must have a record o-which staff is s,apporting which Clients on any given day. (e) A GSE agency must have supportive documentation that provides clear evidence of support helping with specific activities as idertified in the Client plat to move a Client on their pathway towards the!- 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 with GSE). (g) Individual tima in the community working towards the individual employment goal, separate from the gro jp time, must include phase information frefer to Employment Phases and Billable Activities - see Phases 1 — 4 =or element / activity description). (12) Employment and day services must adhere to the Home and 3ommunity Based settings (HCBS) requirements of 42 C.F,R. Section 441.301(c)(4), indt.ding that: (a) The setting is integrated it the greater community and supports Client's to have full access to the greater community; (b) Ensures the Client receives services n the community to the same degree of access as individuals not receiving Medicaid HCBS; (c) The setting provides oppo-tunities to seek employment and work in competitive integrated settings; anc (d) The setting facilitates individual choice regarding services and supports, and who provides DSHS Central Contract Services Page 10 1769CS County Agreement 05-16-2023