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Special Terms and Conditions <br />DSHS Central Contract Services <br />1769CS County Agreement (05-06-2025) <br />Page 13 <br />(5)A new Community Inclusion referral is defined as a Client who has a new County Service <br />Authorization (CSA). Incentive/outcome payments to accept and support overall increased <br />CSAs billed over the year may be requested from DDA if funds are available. <br />(6)Community Inclusion case notes and 6-month progress report summary review that scores 16 <br />points or more with the "Community Inclusion Case Note Review Tool" when used in <br />conjunction with a Community Inclusion plan that has scored 20+ points with the Community <br />Inclusion plan Quality review tool, provider may receive an outcome payment. <br />(7)All outcome payments are described in the chart in the DDA Billing instructions. <br />7.Consideration: <br />a.Fees: <br />(1)Approval of fees is the responsibility of the DDA. The DDA HQ Employment and Day Unit <br />Manager reserves the right to approve fees/rates for the services being provided. The County <br />will submit a fee/rate schedule with the initial Program Agreement. The County will submit <br />updated fee/rate schedules to the HQ Employment and Day Unit Manager for approval as <br />changes occur. The rate schedule will include the following information: <br />(a)County(s) name; <br />(b)Time period for which the schedule is applicable; and <br />(c)Each contracted direct service (IE, GSE, CI, ITA, CDS) and its associated rate. <br />(2)Fee 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 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 parties in writing and shall not require a program <br />agreement amendment. <br />(a)Funds Designated for Additional Consumer Services: If a County provides Community <br />Information 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 available to Clients who were served between December 1996 and <br />December 2003 in Adult Day Health agencies and were subsequently determined ineligible