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Special Terms and Conditions <br />(a) County(s) na-ne; <br />(b) Time period for whicl- the schedule is applicable; anc <br />(c) Each contracted direct service (IE, GSE, CI, ITA, CDS) and its associated rate. <br />(2) Pee Limitations: The DDA Billing Instructions found on the County Best Practices site provides <br />limitations on the Hourly Rate for each direct service. Hourly rates must be divisible by four. <br />b. Budget and Spending Plan, attached as Exhibit B: <br />(1) Budget amount li3ted in Exhibit B: The County may not exceed the state only revenue dollar <br />amount or the total revenge dollar amount indicated on the Prcgram Budget Agreement <br />Included in Exhilkit 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; FDA will provide the initial spending plan 1 Program Agreement Budget 1 Exhibit <br />B. Funding shall be distributec under State and Medicaid in the revenue section. The planned <br />expenditures for Consumer Support are t-ased on authorized Clients, their acuity level and work <br />history for a giver 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 part es in writing and shall not require a program <br />agreement amendment. <br />(a) Funds Designated for AddRional Consumer Services: If a County provides Community <br />Information and Education services under additional consumer services, then activities must <br />include outreach efforts to-ederally recognized local tribes. <br />(b) Funds Designated for Adul. Day Care Consumers: Funds cesignated for Adult Day Care <br />Consumers are available to Clients who were served between December 1996 and <br />December 2003 in Adult Day Health agencies and were subsequently determined ineligible <br />for Level II or 11 services (Adult Day Health). Level II and III services are licensed <br />rehabilitation znd 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, educa'ional, and recreational programs without the need for skilled nursing. These <br />Clients may to referred to services defined in the statement of work, or to an Adult Day Care <br />service other than Level II or III. If a C lent no longer needs and wants services, the funds <br />are available For other Clierts who are not part of the croup of original Clients Identified <br />between Dece-nber 1996 azd 2003. An Adult Day Care service shall only be provided by <br />Adult Day Ca•e agendas certified by the local Area Agency on Aging. Adult Day Care <br />service is not r waiver approved service <br />c. Program Agreement 4mendments: 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 amerdrnent for add it anal service hours Kthorized 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 DDAAssista-it Secretary may approve in writing an exemption to a specific <br />program agreement requirement. <br />DSHS Central Contract Services Page 13 <br />1769CS County Agreement 05-16-2023 <br />