HomeMy WebLinkAboutDSHS County Program AmendmentKittitas County
Review Form
'Grants & Contract Agreement
Contract/G ra nt lnformation
Recommendation for Board of Health Review on
Department Head Signature Director Date:€3
verification the contracting Agency is not suspended/Disbarred:
Today's Date
04/17 /2023 PA Camas Request #:\IUK
Fund/Depa rtment
116-Public Health Agenda Oate: ['[v Lv
Contract /Grant Agency: DSHS DDD Services Agreement Amendment 2
Period Begin Date: 01/0I/2023 Period End Date: 0G/30/2023
otaT G nra Co fant Act om n ct/nu t rease of 79 6.5Ss fo00 ar CWn m axt um ofm I 53 04 0005L,
Grant/Contract Number
This amendment is for a budget increase of $89,756.00 for a new maximum of $1,3s,|,040.00
Contract/G rant Summary:
Kittitas County Prosecutor, Auditor,and Board of Health Review and Comment:
APP ROVED AS TO RM
t 49 H.t 7r7
Signature of P ecutor's Office D
h
Signature of Auditor's Office Date
Agency is not suspended/disbarred I Not Checked (reason)
Grant/Contract Review
Page 1
Financial lnformation
B lnformation
Pass Through lnformation
Prosecutor Review
TotalAmount State Funds $Federal Funds $
Percentage Cou nty Funds Matching Funds $CFDA#
ln-Kind $
ls Equipment being purchased?Who owns equipment?
New Personnel bei hired?Contact HR hirin orting uirements-re
Future impacts or liability to Kittitas County
Bud Amendment Needed?
New Division Created?
Yes I attach budget form No El why not
Revenue Code 10s.568.334.04.68
Expense Code 105,568,541O1" / 54L22 DD Peoe qvc PAsi, ril f.u._
Agency to Pass Through
Amount to Pass Through Expense Code:
Sub-Contract Approved Date:
Has the Prosecutor reviewed this agreement?Yes No
Cou D rtments lmpacted
BOCC Approval Needed?
Ass ment of Tracki lnformation
Auditor Facilities Maintenance
lnformation Services Human Resource
Prosecutor Treasurer
Yes !Non
Staff Mem ber Presenting:
Auditor's Office
Human Resource
Prosecutor's Office { zr8r'}
Who Signed the grant application
Reviewer Date
Grant/Contract Review Page 2
Jlrr
frfir
if r..;,!r r 0 i o il 5 r.t,, t
Deparlment ol Sociai
& Health Services
Irarrrforning /fves
COI,JNTY PROG RAM AG REEMENT
AMENDMENT
DDD County Services
DSHS Agreement Number
2163-24876
Amendment No
02
This Program Agreement Amendment is by and between the state of washington
Department of Social and Health Serv ces (DSHS) and the County identified below
Administration or Division
Agreemenl Number
CIicl< here to enter text.
County Agreement Number
DSHS ADMINISTRATION
Developmental Disabilities
Admin
DSHS DIVISION
Division of Developmental
Disabilities
DSHS INDEX NUMBER
1225
CCS CONTMCT CODE
1225
DSHS CONTACT NAME AND TITLE
Seanna Woodard
DSHS CONTACT ADDRESS
1611-W lndiana Ave
Spokane, WA 99205
DSHS CONTACT TELEPHONE
(509)329-2952
DSHS CONTACT FAX
(509)568-3037
DSHS CONTACT E-MAII
woodas@dshs.wa.qov
COUNTY NAME
Kittitas County
Kittitas County DDA County Services
COUNTY ADDRESS
507 North Nanum Street Suite 102
EI , wA 98926-2886
COUNTY FEDERAL EMPLOYER IDENTIFICA-ION
NUMBER
COUNTY CONTACT NAME
Kasey Knutson
COUNTY CONTACT TELEPHONE
(509) 962-7090
COUNTY CONTACT FAX
(50s) 962-5883
COUNTY CONTACT E-I\4AIL
kasev. knutson @co kittitas.wa us
IS THE COUNTY A SUBRECIPIENT FOR PURPOSES OF THIS PROGRAM
AGREEMENT?
No
CFDA NUMBERS
AMENDMENT START DATE
01101t2023
PROGRAM AGREEMENT END DATE
06t30t2023
PRIOR MAXIMUM PROGMM AGREEMENT
AMOUNT
$1,261,284 00
AMOUNT OF INCREASE OR DECREASE
$89,756 00
TOTAL MAXIMUM PROGRAM AGREEMENT
AMOUNT
351 040.001
REASON FOR AMFNDMENT;
CHANGE OR CORRECT OTHER: SEE PAGE TWO
theEXHBITSWhen box low IS mar ke d wit a ch ec 4 or X,th follow no Exh ibits a re attached d arehhk()n na
in co to this rogra m Ag ree me nt Amend me by referporated
Exhibits
n P tn n
Exhibit B-1 reement BudP
This Program Agreement Amendmenl including all Exhi bits and other documents incorporated by reference, coniains all
of the terms and conditions agreed up:n by the parties as changes to the orrginal Program Agreemeni. No other
understandings or representations, oral or otheruvise, re garding the subject matter of this Program Agreement Amendment
shall be deemed to exist or bind the parties. All other te rms and conditions of the original Program Agreement remain in
fullforce and effect. The parties signing belowwarrant that they have read and understand this Program Agreement
Amendment and ave into this ram reement Amendment.
COUNTY PRTNTED NAME(S) AND IrLE(S)
Cot,y lDt ig ht
be@ CLL-k/.LAl-n--
DATE(S) SIGNED
o 5 l/uh3
DSHS SIGNATURE
7-annX-lqfrE
PRINIED NAME AND TITLE
Tammy Layton, Contract Manager
DATE SIGNED
6t7t2023
DSHS Central Contract Services
1769CP Contract Amendment (1 2-1 0-21 )
f;{EilHlV$:[;
f,'l/XY t .t ?01:i
[]il].A $fr{-}Ki\t{t*Page 1
1
This Program Agreement between the County and the State of Washington Department of Social and Health
Services (DSHS) is hereby amended as follows:
A. Exhibit B, Program Agreement Budget, is revised and replaced with Exhibit B-1, Program Agreement
Budget, which is attached hereto and incorporated herein.
B. The Special Terms and Con,Jitions are revised and replaced with the following (excluding Exhibit A -
Exhibit A remains the same).
Definitions Specific to Program Agreement: The words and phrases listed below, as used in this
Program Agreement, shall each have the following definitions:
a. "Acuity Level" means the level of a Client's abilities and needs as determined through the DDA
assessment.
b. "ADSA Web Access (A!\A)' means a web-based portal to the Developmental Disabilities
Administration CARE system designed to support county services for DDA clients.
c. "Additional Consumer Se rvices" refers to indirect Client service types as follows:
(1) "Community lnformat on and Education": Activities to inform and/or educate the general public
about developmental disabilities and related services. These may include information and
referral services; activities aimed at promoting public awareness and involvement; and
community consultati'tn, capacity building and organization activities.
(2) "Training": To increase the job related skills and knowledge of staff, providers, volunteers, or
interning students in the provision of services to people with developmental disabilities. Also to
enhance program related skills of board or advisory board members.
(3) "Other Activities" reserved for special projects and demonstrations categorized into the following
types.
(a) lnfrastructure projects: Projects in supporl of Clients (services not easily tracked back to a
specific working age Client) or that directly benefit a Client(s) but the Client is not of working
age. Examples include planning services like generic job development e.g. "Project
Search".
(b) Start-up projects: Projects that support an agency or directly benefit the agency. Examples
include equipment purchases and agency administrative support.
(c) Partnership Project: Collaborative partnerships with school districts, employment providers,
DVR, families, employers and other community collaborators needed to provide the
employment supports and services young adults with developmental disabilities require to
become employec during the school year they turn twenty-one (21).
d. "Budget and Accounting Reporting System (BARS)' means a master classification of balance
sheet, revenue and expenditure/expense accounts.
e. "Client" means a person with a developmental disability as defined in chapter 388-823 WAC who is
currently eligible and active with the Developmental Disabilities Administration or is an identified
PASRR Client.
f. "Competitive lntegrated Errployment" means work performed by a Client on a part-time or full{ime
basis, within an integratec setting within the community that meets HCBS settings requirements.
DSHS Central Contract Services
1769CP ContractAmendment (12-10-21) page 2
The Client must be compensated at minimum wage or higher, using the higher of the Federal,
State, or local rate, and at a rate comparable to the wage paid to non-disabled workers per-forming
the same tasks, including receiving the same benefits and opportunities for advancement.
g. "Consumer Support" refers to direct Client service types as follows:
(1) "Community lnclusion" or "Cl": means individualized services provided in integrated community
settings with other in,liyl6rr'r without disabilities. The activities are based on Client interests
and provide opportunities typically experienced by the general public of similar age in their local
community, accessible by public transit or a reasonable commute from their home. The goal of
the service is to supp,orl clients to participate, contribute, and develop relationships with
community members who are not paid staff. These services may be authorized for individuals
age 62 and older. These services may be authorized in addition to or instead of employment
support (lndividual Enployment or Group Supported Employment) for working age individuals
who have received nine months of employment supporl.
(2) "Child Development Services" or "CDS": Birth to three services are designed to meet the
developmental needs of each eligible child and the needs of the family related to enhancing the
child's development. Services may include specialized instruction, speech-language pathology,
occupational therapy, physical therapy, assistive technology, and vision services. Services are
provided in natural environments to the maximum extent appropriate.
(3) "lndividual Supported Employment" or "lE": services are a part of a Client's pathway to
employment and are tailored to individual needs, interests, and abilities, and promote career
development. These are individualized services necessary to help persons with developmental
disabilities obtain and continue integrated employment at or above the state's minimum wage in
the general workforce. These services may include intake, discovery, assessment, job
preparation, job marketing, job supports, record keeping and support to maintain a job.
(4) "lndividualized Technical Assistance" or "lTA": services are a part of a Client's pathway to
individual employmert or community inclusion. This service provides assessment and
consultation to the provider to identify and address existing barriers to employment or
community inclusion. This is in addition to supports received through supported employment or
community inclusion services for Clients who have not yet achieved their goal.
(5) "Group Supported Employment" or "GSE": services are a part of a Client's pathway to integratedjobs in typical commr;nity employment. These services are intended to be short term and offer
ongoing supervised employment for groups of no more than eight (8) workers with disabilities in
the same setting. The service outcome is sustained paid employment leading to further career
development in integrated employment at or above minimum wage. Examples include
enclaves, mobile crews, and other business models employing small groups of workers with
disabilities in integra.ed employment in community settings.
h. "County" is the political subdivision of the state of Washington and the county or counties entering
into this Program Agreement.
i. "DDA Case Resource Manager (CRM)" means a case manager for DDA Clients.
j. "County Service Authorization (CSA)" means an authorization for county services.
k. "Developmental disabilit es (DD)" means a disability attributable to intellectual disability, cerebral
palsy, epilepsy, autism, or another neurological or other condition of an individual found by the
secretary to be closely related to an intellectual disability or to require treatment similar to that
required for individuals with intellectual disabilities, which disability originates before the individual
DSHS Central Contract Services
1769CP Contract Amendment (12-10-21) page 3
2.
attains age eighteen, wl'rich has continued or can be expected to continue inde1nitely, and which
constitutes a substantial limitation to the individual.
l. "Developmental Disabilities Administration DDA" means a division within the Department of Social
and Health Services.
m. "DDA Regional office (DDA Region)" means the regional DDA office that supporls DDA clients.
n. "Division of Vocational Rehabilitation (DVR)" means a division within the Department of Social and
Health Services
o. "Employment Outcome Payment" means a payment to providers for transition students born
between specific dates; have high acuity; are authorized for lndividual employment; and student
obtains a competitive integrated job within a specific timeframes. lf the job is a minimum of tenhours of work per week an additional amount will be include in the payment.
p. "General Terms and Corditions" means the contractual provisions contained within that agreement,which govern the contractual relationship between DSHS and the county.
q. "Medicaid Home and Cornmunity Based Services (HCBS)" means services that occur in a Client,shome or community rather than institutions or other isolated settings. These programs serve avariety of targeted populations groups, such as people with intelleitual or develJpmental
disabilities, physical disabilities, and/or mental ilinesses
r. "Job Foundation Reporl" is a document derived from emplovment readiness activities performed bystudentswhoarebetweenages19through20thatidmployment.
The employment service providers developing the Job Foundation report will be supporting'
students with employmen: activities on average of 35 hours.
s. "Preadmission Screening and Resident Review (PASRR)' means individuals with intellectual
disabilities or related concitions (lD/RC) who have been referred for nursing facility (NF) care.
t. "Person Centered Service Plan or PCSP" means a document that authorizes and identifies the DDApaid services to meet a Client's assessed needs. Formerly referred to as the lndividual SupportPlan.
u' "Quality Assurance" means an adherence to all Program Agreement requirements, including DDAPolicy 6.13, Provider QLtstillsations fot Employmen{and Diy Program Services, County cui"oetinesand the Criteria for Evaluation, as well as a focus on reasonably 6xpected levels of periormance,quality, and practrce. -' r-'
v' "Quality lmprovement" means a focus on activities to improve performance above minimumstandards and reasonably expected levels of performance, quality and practice.
w' "Service Provider" is a qualified Client service vendor who is contracted to provide Employment andDay Program services.
x. "subcontractor" is the service provider contracted by the County to provide services.
Purpose: This Program Agreement is entered into between the Developmental DisabilitiesAdministration and the County in accordance with chapter 71A]4 RCW. lts purpose is to advance thestate legislative policy to provide a coordinated and comprehensive state and local program of servicesfor persons with developmental disabilities.
3' Client Eligibility: Client eligibility and service referral are the responsibility of DDA under chapter 3gg-DSHS Central Contract Services
1769CP Contract Amendment (12-10-2j) page 4
4.
823 WAC (Eligibility) and chapter 388-825 WAC (Service Rules). Only persons referred by DDA shall
be eligible for direct Client services under this Program Agreement. lt is DDA's responsibility to
determine and authorize the appropriate direct service(s) type. Direct Client services provided without
a current County Service Authorization are not reimbursable under this Program Agreement.
Credentials and Minimum Requirements:
a. Administration of the developmental disabilities County program cannot be subcontracted.
b Qualified DD Program Coordinator: A qualified DD program coordinator has a minimum of five
years training and experence in the administration and/or the delivery of developmental disabilities
services to a community For a county where the coordinator administers more than one program
area (e.9. Chemical Dependency, Mental Health, Developmental Disabilities), training and
experience in administration and/or a related Human or Social service may be considered.
Administration Responsibility: The County must demonstrate the ability to administer the program
agreement including contract oversight and monitoring, community outreach and education
activities, and regular communication with the DDA Regional Office (DDA region) and contracted
providers.
Fiscal Responsibility: The County must demonstrate the ability to safeguard public funds including
maintaining books, records, documents and other materials relevant to the provision of goods and
services.
Sufficient Policies and Pr:cedures for establishment and maintenance of adequate internal control
systems: The County will maintain written policy procedural manuals for information systems,
personnel, and accounting/finance in sufficient detail such that operations can continue should
staffing change or absences occur. Policies shall be dated and include dates when updated.
Background/Criminal History Check: A background/criminal history clearance is required every
three years for all employ=es (including DD program County staff), subcontractors, and/or
volunteers who may have unsupervised access to vulnerable DSHS Clients, in accordance with
RCW 43.43.830-845, RCW 74.15.030, and chapter 388 WAC. lf the entity reviewing the application
elects to hire or retain an individual after receiving notice that the applicant has a conviction for an
offense that would disqualify the applicant from having unsupervised access to vulnerable adults as
defined in chapter 74.34 RCW, then DDA shall deny payment for any subsequent services
rendered by the disqualified individual provider. The DSHS Background Check Centrat Unit (BCCU)
must be utilized to obtain rackground clearance.
Qualified Advisory Board Members: A Developmental Disabilities advisory board shall include
members knowledgeable about developmental disabilities. No board member shall have a contract
with the County to provide Training, Community lnformation Activities, and Consumer Support as
defined in this Program Agreement, and shall not be a board member, officer, or employee of an
agency subcontracting witr the County to provide such services.
Qualified Service Providers: The County assures that all service providers meet qualifications as
outlined in the DDA Policy 6.13, Program Qualifications for Emptoyment and bay program
Providers.
Home and Community Based Waiver Services Assignment of Medicaid Billing Rights: The County
assures that each subcontractor has agreed to assign to DDA its Medicaid billing rights for servicbs
to DDA Clients eligible under Title XIX programs in this Program Agreement. Written documentation
shall be available to DSHS on request.
c
d
e
f
g.
h
L
j. Repofting Abuse and Negl:ct: The County staff and its subcontractors who are mandated repoders
DSHS Central Contract Services
1769CP Contract Amendmeni (12-10-21)Page 5
6.
5.
DSHS Central Contract Services
1769CP Contract Amendment (12-10-21)
under RCW 74.34.020(13) must comply with reporting requirements described in RCW 74.34.035,
.040 and chapter 26.44 fCW. lf the County is notified by DSHS that a subcontractor staff member
is cited or on the registry for a substantiated finding, then that associated staff will be prohibited
from providing services under this Program Agreement.
k. Counties who provide Cnild Development Services (birth to three early intervention services), must
provide those services under the regulations implementing the lndividuals with Disabilities
Education Act (IDEA), Part C, and Washington State's Early Support for lnfant and Toddler
Federally Approved Plar.
l. The County staff who perlorm evaluations of subcontractor work sites will promptly report to DSHS
per DDA Policy 6-08, lnc'ident Management and Reporiing Requirements for County and County-
Contracted P rovi de rs, il'.
(1) They have reasonable cause to believe that abandonment, abuse, financial exploitation or
neglect (as defined in RCW 74.34.020) of a person who has a developmental disability (as
defined in RCW 71A.10.020) has occurred, and,
(2) lf they have reason to suspect that sexual or physical assault of such a person has occurred,
they shall also immediately report to the appropriate law enforcement agency.
m. Contractors are specifica'ly authorized to have data storage on portable devices or media in
accordance with the Data Security Requirements.
n. Order of Precedence: ln the event of any inconsistency in this Program Agreement and any
attached exhibits, unless otherwise provided herein, the inconsistency shall be resolved bygiving
precedence, in the following order, to:
(1) County Program Agreement; and
(2) Attached Exhibits.
Duty to Disclose: Under 42CFR 5455.104, the Administration must obtain cedain disclosures and
complete required screenings to ensure the State does not pay federal funds to excluded person or
entities. The County is required to provide disclosures from managing employees, specifically the
persons in the positions of Developmental Disabilities Director and Fiscal/Budget Director, i.e. tne
person who authorizes expenJitures. A completed Medicaid Provider Disclosure Statement, DSHS
Form 27-094, should be submitted to the Administration to complete the required screenings.
Disclosures must be provided at contract renewal and within thirty-five (35) days wheneveithere is a
change in the staff holding these management positions [42 cFR 4ssla4 (cX1)]
Statement of Work: The County shall provide the services and staff, and otherwise do all things
necessary for or incidental to the performance of work, as set forth below. Working collaborativety anO
sharing information as needec for service coordination, the parties shall administer DD services within
the county as set forth below:
a. The DDA region shall:
(1) Review subcontractors and shall immediately notify the County of any concerns with the
subcontractors identified by the County;
(2) lnform and include the County in the discharge planning of Client's leaving institutions and
returning to the community who will need program funding;
(3) lnform the County of Client's who have had their waiver status changed;
Page 6
(4) Work with the County when referring Client's for services and will withdraw referrals when
authorization is not issued;
(5) Authorize new service within 5 working days and will extend existing service authorization
before expiration date;
(6) lnform clients of sen'ice changes through planned Action Notice(s);
(7) Work with the County to document planned services in the Client's Person Centered Service
Plan including notification of assessment dates;
(8) Work with the County when terminating services;
(9) Work with DDA Heao Quarters and the County on Spending Plan adjustments; and
(10) Work with the County in participating in evaluation of direct service providers.
b. The County shall:
(1) Work with the DDA Region when Clients are referred for services, authorized services, and/or
for support modifications;
(2) Work with the DDA Ragion to document planned services in the Client's Person Centered
Service Plan;
(3) Assist with informing the DDA Region of any potential service level changes not documented in
the Client's DD Assessment prior to any changes;
(4) Work with the DDA Region regarding service termination;
(5) work with the DDA Head Quarters on spending plan adjustments;
(6) lnform the DDA Region of new providers to be included on the ALTSA Web Access (AWA)
system;
(7) Notify the DDA Region of any intent to terminate a subcontractor who is serving a DDA referral;
(8) Provide a copy of each subcontractor's contract upon written request from DDA; and
(9) Notify and work with tl-e DDA Regional Employment Specialist when performing evaluations of
direct service providers.
c. Compliance with Budget and Accounting Reporting System Policies: The County shall take any
necessary and reasonable steps to comply with BARS policies,
d. The County shall comply with the following referenced documents found at DDA lnternet site
https://www,dshs.wa.qov/cda/countv-best-practices under "County Best Practices":
(1) DDA Policy 4.11, County Services for Working Age Adutts;
(2) Chapter WAC 388-850, chapter 3BB-828 WAC, WAC 388-845-OOO1, 0030, OZ1O, OZ1S, O2ZA,
0600-0610, 1030-1 040, 2100, 21 10;
(3) Criteria for Evaluation;
DSHS Central Contract Services
1 769CP Contract Amendment (12-1 0-21 )Page 7
6
(4) DDA Guiding Values:
(5) County Guide to Acl'ieve DDA's Guiding Values;
(6) DDA Guidqlineg for Communitv Assessments within Emplovment and Vocational Prosrams: and
(7) Disabilitv Rights Washington (formerlv Washington Protection and Advocacy Svstem) Access
Aqreement.
The County shall develop and submit a comprehensive plan for the County DD Services as
required by WAC 388-850-020.
f. Conveyance of The Estimated Number of People to be Served and Targeted Outcomes: The
County shall submit the Service lnformation Forms (SlF's) (provided by DDA at lnternet site
https://www.dshs.wa.qov/dda/county-best-practices) to indicate the estimated number of people to
be seryed, targeted outcomes, and identified goal(s) that focus on quality improvement within the
categories of Training, Community lnformation, Direct Client Services, and Other Activities within 30
days of execution of the Program Agreement. Once approved, the SIF outcomes may be modified
only by mutual agreemerrt of the County and the DDA Region.
g. Solicitation for Qualified Employment and Day Program Service Providers: Requests for
Applications (RFAs), Recuests for lnformation (RFl's) and/or Requests for Proposals (RFPs),
Requests for Qualifications (RFQ's) for direct services, excluding Child Development, will be open
continuous enrollment.
h. Qualified Providers: A qualified provider must be a county or an individual or agency contracted
with a county or DDA.
i. Technical Assistance: DDA contracts with TechnrcalAssistance providers that may be utilized by
Counties with prior written approval.
Subcontractors: The County will pass on all applicable contractual requirements that are between
DDA and the County to the subcontractor. The County shall immediately notify the DDA Region of
the County's intent to terminate a subcontractor who is serving a DDA referral. lndividuals or
agencies contracted with a county or DDA may not subcontract for Employment or Community
lnclusion services.
k. The County shall provide'rr contract with qualified Employment and Day Program Service
Providers for consumer support services that include the following program outcomes:
(1) Monthly Community lrclusion (Cl) service support hours will be based on the Client's Cl service
level per WAC 388-823-9310 for all Clients who began receiving Cl services July 1 ,2011 and
forward.
(a) To ensure health and safety, promote positive image and relationships in the community,
increase competer,ce and individualized skill-building, and achieve other expected benefits
of Cl, services will occur individually or in a group of no more than two (2) or three (3)
Client's with similar interests and needs.
(b) Cl services will focus on activities that are typically experienced by the general public
Support to participate in segregated activities and/or specialized activities will not be
reimbursed.
(2) Clients in an employment program will be supported to work towards a living wage. A living
wage is the amount needed to enable a Client to meet or exceed living expenses. Clients
DSHS Ceniral Contract Services
1769CP Contract Amendment (12-10-21) page B
should be supported to average twenty (20) hours of community work per week or eighty-six
(86) hours per month; however, each person's preferred hours of employment should be taken
into consideration. The amount of service a Client receives will be based on his/her
demonstrated need, acuity level and work history per WAC 388-828.
(3) The Client's DDA P C S P is the driver for service. The AWA County Service Authorization
(CSA) and updated Planned Rates information will not exceed the Client's DDA PCSP. Service
changes will not occur until the Client has received proper notification from DDA.
(4) All Clients will have an lndividualized Employment and/or Community lnclusion plan to identify
Client's preferences. Minimum plan elements are outlined in the reference document "Criteria
for an Evaluation." A copy of the Client's individualized plan will be provided to the Client, their
DDA Case Resource Manager (CRM), guardian and others as appropriate.
(5) Six-month progress reports describing the progress made towards achieving Client's goalwill
be provided by the service provider to the CRM, Client, and/or guardian, if any, within 30 days
following the six-mon:h period. The report will summarize activities and outcomes made towards
the Client's individual;zed goal(s).All Clients will be contacted by their service provider according
to Client need and at least once per month.
(6) All Clients will be contacted by their service provider according to Client need and at least once
per month.
(7) lf Clients in lndividual Employment or Group Supporled Employment, have not obtained paid
employment at mihim rm wage or higher within six (6) months, the County will assure the
following steps are taken:
(a) Review the progress toward employment goals;
(b) Provide evidence of consultation with the Client/guardian; and
(c) Develop additional strategies with the Client/guardian, county staff, employment support
staff, case manager, and others identified by the Client. Strategies may include providing
technical assistance, changing to a new provider, and/or providing additional resources as
needed to support the Client's pursuit of employment. The additional strategies will be
documented for each Client and kept in the Client's file(s).
(8) lf after twelve (12) months the Client remains unemployed, an additional review will be
conducted. The provider will address steps outlined in the previous six month progress report in
the next six month progress report. \lVhen requesting to participate in Cl, the Client shall
communicate directly with his or her DDA Case Manager. The DDA Case Manager is
responsible for authorizing Cl services.
(9) For lndividual Employnent where the service provider is also the Client's employer, long term
funding will remain available to the service provider employer for six months after the employee
DDA Client's date of hire. At the end of the six-month period, if the DDA Client continues to
need support on the job, another service provider who is not the employer of record must
provide the support unless the County or DDA issues prior written approval for the service
provider to continue to provide long-term supports if needed. lf the County or DDA approves
the continuation of longterm supports where the service provider is also the Client's employer,
the County or DDA will regularly monitor these positions to assure fading efforls occur when
appropriate and any potential conflict of interest is addressed.
DSHS Central Contract Services
1 769CP Contract Amendment (1 2-1 0-21 )Page 9
(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
m
DSHS Central Contract Services
1769CP Contract Amendment (12-1O-21)
n
o
p
new jobs; job loss and reasons for job loss; the percentage employed earning minimum wage or
better; and the average number of hours worked. The County's service evaluation system shall
serve as the method by which current providers demonstrate that they continue to be qualified
providers. A copy of description of such evaluation system shall be provided upon request to DDA
for review.
Evaluation: The County shall evaluate and review services delivered to reasonably assure
compliance and quality. The County shall conduct at least one visit to each subcontractor every two
(2) years. The County shall maintain written documentation of all evaluations, recommendations
and corrective action plans for each subcontractor. Copies of such documentation will be provided
to the DDA upon reques:.
The County shall work with local developmental disability advisory groups to plan for and coordinate
services.
The County shall participate in regularly scheduled meetings between County DD staff and DDA
staff to remain updated and current including ACHS and Regional Meetings.
AWA Data System: ln compliance with the AWA Traininq Manual, the County shall use the AWA
data system for all:
(1) Billing requests;
(2) Service provider address and phone number maintenance;
(3) Evaluation dates; r
(4) Employment outcome information; and
(5) Monthly provide all data described in the Billing lnstructions and in the Employment Outcomes
lnstructions, which is hereby incorporated by reference.
Assure the integrity of data submitted to the State. When data is submitted and rejected due to
errors or an error is later identified, the County will correct and resubmit the data within thirty (30)
days.
Review and respond the AWA "Work List" items within 5 working days including Referrals and
pending Authorization.
Review the AWA "Ticklers' Planned Rate tab and update the planned rate within 5 working days
after the Planned Rate start date.
Partnership Project.
(1) A Job Foundation document will be completed per guidelines for eligible students. Eligible
students are DDA clierrts who were born between:
(a) Forfiscal year 2021 9t1t00 through B/31t01
(b) Forfiscal year 202291110'1 through BtgltO2
(c) For fiscal year 2023 911102 through 8/31/03
(d) For fiscal year 202L 911103 through Bt31t04
q
r
S
t.
Page 1 1
U
These students currently attending school and have completed an application to participate in
this Value Based Payment (VPB) project. The VBP project application will include the following
minimum criteria identified in the sample application found at:
https://www.dshs.wa.qov/sites/defaulUfiles/DDA/dda/documents/Job%20Foundation%20Applica
tio n O 407 20o/o20o/o28QO2o/o29 . do cx
(2) Qualified providers vrill collaborate with School District staff to complete the Job Foundation
document and then provide a copy to the County. To be a qualified provider for the Partnership
Project the Counties must require the provider to have a current contract with the Division of
Vocational Rehabilitation; a contract in good standing with the County and cannot be in
provisional status; a minimum of two years' experience providing lndividual Employment with
demonstrated job placement skills. The Job Foundation recommendation will only have
actionable next steps towards integrated competitive employment.
(3) County participating n the Partnership Project must have the ability to work collaboratively with
School Districts to identify DDA students in high school, collect and track information, be
proficient in electroni: spreadsheets, and ability to evaluate if completed Job Foundation
document(s) meet quality standards.
Employment Outcome Payment. - Providers, with transition students born between:
(1) For fiscal year 2023 911100 through 8131101
(2) For fiscal year 2024 g/1101 through.8131l02
(3) For fiscal year 2025 9l1lO2 through 8131103
(4) For fiscal year 2026 gl1103 through 8131104
High acuity Clients who are authorized for lndividual employment, may receive one outcome
payment if student obtains a competitive integrated job approved by the County within timeframes
described in the chart in tre DDA Billing lnstructions. lf the County is also the service provider DDA
will provide the job approval. lf the job is at a minimum of ten hours of work per week an additional
amount will be include in the payment.
7. Consideration:
a. Fees
(1) Approval of fees is the responsibility of the DDA. The DDA Region reserves the right to approve
fees/rates for the services being provided. The County will submit a fee/rate schedule with the
initial Program Agreement. The County will submit updated fee/rate schedules to the DDA
Regional Employment Specialist for approval as changes occur. The rate schedule will include
the following information:
(a) County(s) name;
(b) Time period for wh ch the schedule is applicable; and
(c) Each contracted direct service (lE, GSE, Cl, lTA, CDS) and its associated rate
(2) Fee Limitations: The DDA Billinq lnstructions found on the County Best Practices site provides
limitations on the Hourty Rate for each direct service. Hourly rates must be divisible by four.
b. Budget and Spending Plan, attached as Exhibit B:
DSHS Central Contract Services
1769CP Contract Amendment (12-10-21) page 12
I
(1) Budget amount listed in Exhibit B: The County may not exceed the state only revenue dollar
amount or the total revenue dollar amount indicated on the Program Budget Agreement
included in Exhibit B. The waiver revenue dollar amount may be exceeded to accommodate
Clients moving from state-only employment and day services to waiver employment and day
services.
(2) Spending Plan: DDA will provide the initial spending plan / Program Agreement Budget / Exhibit
B. Funding shall be distributed under State and Medicaid in the revenue section. The planned
expenditures for Consumer Support are based on authorized Clients, their acuity level and work
history for a given point in time. To determine the Additional Consumer Support amount, the
Consumer Support amount is multiplied by a percentage. The spending plan may only be
modified by mutual agreement of the parlies in writing and shall not require a program
agreement amendment.
(a) Funds Designated for Additional Consumer Services: lf a County provides Community
lnformation and Education services under additional consumer services, then activities must
include outreach efforts to federally recognized local tribes.
(b) Funds Designated for Adult Day Care Consumers: Funds designated for Adult Day Care
Consumers are a'railable to Clients who were served between December 1g96 and
December 2003 in Adult Day Health agencies and were subsequently determined ineligible
for Level ll or lll services (Adult Day Health). Level ll and lll services are licensed
rehabilitation and skilled nursing services along with socialization. Level I services (Adult
Day Care) are supervised day programs where frail and disabled adults can participate in
social, educational, and recreational programs without the need for skilled nursing. These
Clients may be relerred to services defined in the statement of work, or to an Adult Day Care
service other than Level ll or lll. lf a Client no longer needs and wants services, the funds
are available for other Clients who are not parl of the group of original Clients identified
between December 1996 and 2003. An Adult Day Care service shall only be provided by
Adult Day Care agencies certified by the local Area Agency on Aging. Adult Day Care
service is not a waiver approved service.
c. Program Agreement Amerdments: A County can request an amendment at any time. An
amendment for additional Client(s) may be supported when clients exceed the number used to
develop the contract. An amendment for additional service hours authorized may be supported
when county provides evidence. An amendment request for expenditures exceeding contract total
due to hourly rates paid to service provider may not be supported as the county is responsible to
manage contract and rates paid to their providers.
d. Exemptions: The DDA Assistant Secretary may approve in writing an exemption to a specific
program agreement requirement.
Billing and Payment:
a. Program Agreement Budget: DSHS shall pay the County all allowable costs, which are defined by
DDA as cost incurred by the program for:
(1) Administration: Costs of the County Human Services Department or similar county office,
responsible for administration of the Developmental Disabilities Program. Allowable costs
include personnel and cverhead costs directly related to the administration and coordination of
the program, including such activities as program planning, budgeting, contracting, monitoring,
and evaluation. Also included are departmental and county indirect and/or direct administrative
costs, to the extenttha.such costs are appropriately allocated tothe program using an
established methodology consistent with grants management guidelines. For a County whose
DSHS Central Contract Services
'1 769CP Contract Amendment (12-10-21)Page 1 3
designated coordinator manages multiple programs, the County must be able to provide
evidence of the time the coordinator spent working on the Developmental Disabilities program
(2) Additional Consumer Services:
(a) Training
Staff Training: Costs incurred by the program for planned, structured activities for the
purpose of providing, or improving, or enhancing job-related knowledge and skills of
staff, provide's, volunteers, or interning students in the provision of developmental
disabilities se rvices.
ii. Board Trainirg: Costs incurred by the program for planned, structured activities
designed to provide, improve, or enhance program-related skills of board and advisory
committee members.
(b) Community lnformation and Education: to inform and/or educate the general public about
developmental disabilities and related services. These may include information and referral
services; activities aimed at promoting public awareness and involvement; and community
consultation, capacity building and organization activities.
(c) Other Activities.
i. lnfrastructure projects: Projects in support of Clients (services not easily tracked back to
a specific working age Client) or that directly benefit a Client(s) but the Client is not of
working age. Examples include planning services like generic job development e.g.
"Project Search."
ii. Start-up projects: Projects that suppoft an agency or directly benefit the agency.
Examples include equipment purchases and agency administrative support.
iii. Partnership prrject: Collaborative partnerships with school districts, employment
providers, Division of Vocational Rehabilitation (DVR), families, employers and other
community collaborators needed to provide the employment supports and services
young adults with developmental disabilities require to become employed during the
school year they turn twenty-one (21). Supporls provided should complement and not
replace what the student(s) receive through the lndividu alized Education Program (lEp).
(3) Consumer Support.
(a) Adult Day Care services are available to Clients who were served between December 1gg6
and December 2003 in Adult Day Health agencies and were subsequently determined
ineligible for Level ll or lllservices (Adult Day Health). Level ll and lll services are licensed
rehabilitation and skilled nursing services along with socialization. Level I services (Adult
Day Care) are supervised day programs where frail and disabled adults can parlicipate in
social, educational and recreational programs without the need for skilled nursing.
(b) Community lnclusion Services are individualized and provided in integrated community
settings with other ndividuals without disabilities. The activities are based on Client
interests and provide opportunities typically experienced by the general public of similar age
in their local community, accessible by public transit or a reasonable commute from their
home. The goal of the service is to support Clients to participate, contribute, and develop
relationships with ccmmunity members who are not paid staff. These services may be
authorized for indiv duals age 62 and older. These services may be authorized in addition to
or instead of employment support (lndividual Employment or Group Supported Employment)
DSHS Central Contract Services
1769CP Contract Amendment (12-10-21) page 14
for working age individuals who have received nine months of employment support.
(c) Child Development Services are designed to meet the developmental needs of each eligible
child and the needs of the family related to enhancing the child's development. Services
may include spe'lialized instruction, speech-language pathology, occupational therapy,
physical therapy assistive technology, and vision services, Services are provided in natural
environments to the maximum extent appropriate.
(d) lndividual Supported Employment services are a part of a Client's pathway to employment
and are tailored lo individual needs, interests, and abilities to promote career development.
These are individualized services necessary to help persons with developmental disabilities
obtain and contirrue integrated employment at or above the state's minimum wage in the
general workforce. These services may include intake, discovery, assessment, job
preparation, job marketing, job supports, record keeping and support to maintain a job (per
the lndividual Erployment Phases & Billable Activities)
(e) lndividualized Technical Assistance services are a parl of a Client's pathway to employment
or community indusion. This service provides assessment and consultation to the provider
to identify and address existing barriers to employment or community inclusion. This is in
addition to supporls received through supported employment or community inclusion
services for individuals who have not yet achieved their goal.
(f) Group Supported Employment services are a pad of a Client's pathway to integrated jobs in
typical community employment. These services are intended to be short term and offer
ongoing supervised employment for groups of no more than eight (8) workers with
disabilities in the 3ame setting. The service outcome is sustained paid employment leading
to furlher career development in integrated employment at or above minimum wage.
Examples include enclaves, mobile crews, and other business models employing small
groups of workers with disabilities in integrated employment community settings.
b. Reimbursement for the s.ate Fiscal Year shall not exceed the total amount listed in Exhibit B to this
Program Agreement. Hourever, with a Program Agreement amendment, the parties may increase
or decrease the Program Agreement amount. Counties willwork with DDA HQ on amendments to
the Program Agreement.
Monthly lnvoice with Sigred Documentation: All requests for reimbursement amounts must be
entered and posted into tre AWA system. The Contractor may post a combined claim of all
programs/services covered by this Program Agreement DSHS shall make all payments due to the
Contractor for all invoices submitted pursuant to this section within forty-five (45) days following
posting of required infornation.
d. Clients will be assisted in accessing DVR services per the DDA/DVR MOU. Client services shall not
be reimbursed under this Program Agreement when the same services are paid for under the
Rehabilitation Act o'f 1973 by DVR, Public Law g4-142 or any other source of public or private
funding.
e. Reimbursement of Client Services. A claim for each Client is made on the AWA system by
indicating the number of service units delivered to each Client listed and the fee per unit. Units are
defined as:
(1) An "Hour" is at least fily (50) minutes of direct service. Partial hour to the quarter may be
recorded.
(2) A "Day" is at least four (4) hours of direct service and will only be used in connection with Adult
DSHS Central Contract Services
1 769CP Contract Amendment (1 2-l 0-21 )Page 15
t.
f
g
h
m
n
Day Care reim burses"nent.
(3) A "Month" represents a minimum of at least fifty (50) minutes of direct service for CDS
reimbursement.
Program Administration: The County will provide program administration and coordination including
such activities as planning, budgeting, contracting, monitoring, and evaluation. Monthly claims for
administration can be 1112 of the maximum amount identified in Exhibit B underAdministration or
for the actual costs incurred in the given month but the total Administration billed will be the lesser
of the two. Administration cost reimbursement will not exceed 7% unless the Assistant Secretary of
DDA approves a request for an exception under chapter 388-BS0 WAC.
The lndividual Employment Phases & Billable Activities document defines the individual Client
services that DDA reimburses That document is located on the DSHS DDA County Best Practices
Web site at https ://www. dshs, wa. qov/dda/countv-best-practices.
The Community lnclusion Billable Activities document defines the individual Client services
DDA reimburses. That document is located on the DSHS DDA County Best Practices Web site at
https://www. dshs.wa. oov./dda/county-best-practices.
Timeliness of and Modification to Billings: All initial invoices with signed documentation must be
received by the DDA Region within forty-five (45) calendar days following the last day of the month
in which the service is provided. Corrected invoices and documentation including re-posted billing
information will be accepted throughout the fiscal year as long as they are received within sixty (60)
calendar days of the asscciated fiscal year unless an extension is approved by the DDA Regional
Administrator or designee. Payment will not be made on any invoice submitted past sixty (60)
calendar days after the Program Agreement fiscal year.
Recovery of Fees: lf the County bills and is paid fees for services that DSHS later finds were (a) not
delivered or (b) not deliveied in accordance with Program Agreement standards, DSHS shall
recover the fees for those services and the County shall fully cooperate during the recovery.
Preadmission Screening and Resident Review (PASRR) Administration: The County may bill for
administration costs as identified in Exhibit B. Monthly claims for administration cost will be based
on the actual PASRR expenditures multiplie d by 7%.
Reimbursement for Parlnership project: A claim of $2,400 per student for each completed Job
Foundation document that is at a satisfactory or above rating will be requested through the AWA
system as other monthly cost.
Job Foundation report line item g5 and gO as identified in the ADSA Web Access (AWA) billing
system. King, Snohomish and Pierce Counties will use line item 95, all other participating Counties
will use line item 96 (OSPII. A copy of the completed Job Foundation document will be sent
electronically to the sharec mailbox located at: DDAJobFoundationReports@dshs.wa.qov
Job placement verification for transition students: The AWA Employment Output for lndividual
Employment will be completed and submitted with payment request to verify employer, job start
date, job type, etc,
Job Foundation Administration: The County may bill for administration costs as identified in ExhibitB. Monthly claims for admrnistration cost will be based on the actual expenditures multiplie d by 7o/o.
King, Snohomish and Pierce Countieswill use line item 13, all otherparticipating Countieswill use
line item 14 (OSPI).
k
o
DSHS Central Contract Services
1 769CP Contract Amendment (12-10-21)Page 16
#dfti*i'{,H,4##,,'?ffi **** ** g***i;***1*, *,of the lCfltOie.
program.
Single State lVledicaid Agency_HrAgency, has adn
ff g1*i*ffill$**$i"**ff l-tli?*,**pi[fl Hr,:r;r##n'l,incorporatel ;y";:.:: 1
greeme nt: The DRw F ebruarv 27
--t:.?:: nn';#;;l"T;:";r4",""???y::.r:. il;;'t;fu?:tJ,fff;:i3i:?Tent with DDA isotsabilities, crients, p;;;r#'"":ffI^._*,"" DRw's ,."".. 1i;:i,;::,tji.t*: traue reui*wel ini
33#jil'n"u'lif li,,g:*::ilin:,:"Xffi,nllffi ;g:3l;,Sffi i.o:*,"0,;nir,.,.s b i n dins i";;i; il":::?l:l g!Xj.l,li#..
confidentiar rnformation. All counties and their subcontractors must:a. Ensure the security of Confidential lnformation, andb.
3l_"^" tra.nsporting ctient -ecords comore of the followlng * rpp;";;;;?n'"'ng confidentiat tnformation outside a secure Area, one or(1) Using a Trusted Network; or
(2) Encrypting the confidentiar rnformation, incruding:
(a) Emait and/oremail attachments
(b) Confidr
,,,,,"o ?i'ijl[i"g;l"J#:: ] j: srored on p<, and flash r.rory ;5,:':J""ices or media inctudins but not3:l: :"^:ylity Requirements. Exhibmore DSHS recorc
than 5,".oii,-li''rs ac-ios's';i
';;l'il'*;::'i"'g:?f,iJX#ifff::,lrljl",-,.^"-,,.'" possesses 150 oruon, or transmits more
3,:3::ffi:';:,:'.:T_r D{, se : u rity
;:i.,J$;J'"tH'"?:y,T;#,;"r-**[",'"J:*,#[fifr &i:i;,:iir,#i{;1%{dfj?ii,.,
All other terms and conditions of this program Agreement rr:main in fullforce and effect.
9
10.
11.
12.
13
14.
'!3,"3:ll?l#ffi1ff ],lifi 2 _ 1 0.2 1 )
Page 17
l- tscal
Year
r Fund S ource
2022 lstRe visionState o nl 2nd Revision
ion2rdRevisMedicaid
313,916
Total Rev
$630
Exhibit B1
Program Agreement Budget
Originat Budget
REVENUES X Budget Revision
FY22
toco LIVING
I Fiscal-_
Year
I Fund Source
2023 lstRevis ionState o lon2ndRevis316,726 3rd R evisionMedicaid
Total Rev
$
Job Fo unoation
Funds PASRR
Funds State Funds
Medicaid
Funds
S/A
AD MI NI STRA TION
cMl WA BARS 1 1
22494 18405
CONS UM ER
PSU PORTS
IS/ACM WA Code J 13214929394
21 023 1720a
co NSU MER
LYSTATE.ON
SUPPORT
chitd nt
c LIENTS
48A0
5,472
[3 f ilfi?l.?il,iiJ,i.Tffi fi 2. 1 o.2 1 )
Page 1g
Job F oundation
Funds PASRR
Funds Staie Funds
Medicaid
Funds TOTAL
MIS/AWA BARS 1 1
ADMINISTRATION
336
25724 21A47 47,1Q7
OTH ER c ONS EUM R
SU P P o RTS
s/AcMt WA 3Code
32 z
I4 92 93 94 336
2515A 20577 46,063
CONS UMER
SUPPO RT
STAT E.ONLY
chitd nt
ME DICAID CL E NTS 4800
214Start - U 281214 56 7,229
60000
60,000
R OADS to
LIVINGCOMMUNITY
TOTAL
392,0gg 322 838 720,398
FY23
5,472
i*!: f ilT?i:il,tritff y!?i,., 0.,,,
Page 19