HomeMy WebLinkAboutFully Executed Agreement (2)DSHS Agreement Number
2663-71228
COUNTY
PROGRAM AGREEMENT
DDCS Gounty Services
sHs
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Dep6rtfrent of Soclal
and ffcdlth Sedkes
Administration or Division
Agreement Number
County Agreement Number
This Program Agreement is by and between the State of Washington Department of
Social and Health Services (DSHS) and the County identified below, and is issued in
conjunction with a County and DSHS Agreement On General Terms and Conditions,
which is incorporated by reference.
DSHS CONTRACT CODE
1769CS-63
DSHS ADMINISTRATION
Developmental Disabilities
Admin
Division of Developmental
Disabilities
DSHS DIVISION DSHS INDEX NUMBER
1225
DSHS CONTACT ADDRESS
1611 W lndiana Ave
Sookane. WA 93205
DSHS CONTACT NAME AND TITLE
Seanna Woodard
Operations Manager
DSHS CONTACT E-MAIL
woodas@dshs.wa.oov
DSHS CONTACT TELEPHONE
(509\329-2952
DSHS CONTACT FAX
(509)568-3037
507 North Nanum Street Suite 102
Ellensburq. WA 98926-2886
COUNTY ADDRESS
Kittitas County
Kittitas County DDA County Services
COUNTY NAME
COUNW CONTACT NAME
Kasey Knutson
COUNTY FEDERAL EMPLOYER IDENTIFICATION
NUMBER
COUNry CONTACT E-MAIL
kasev. knutson(Oco. kittitas.wa. us
COUNW CONTACT FAX
(509) 962-5883
COUNry CONTACT TELEPHONE
(509) 962-7090
ASSISTANCE LISTING NUMBERSIS THE COUNry A SUBRECIPIENT FOR PURPOSES OF THIS PROGRAM
AGREEMENT?
No
PROGMM AGREEMENT END DATE
06t30t2027
MAXIMUM PROGRAM AGREEMENT AMOUNT
$1.021,440.00
PROGRAM AGREEMENT START DATE
0710112026
Exhibits are aftached: Exhibit A - Data Security Requirements; Exhibit B - Budget and
and ofconditions this ndatermAgreementtheirbelowresthereetoCountyProgramagBysignatuparties
lhenderstandiUororotherwisentationsoraldocumentsreference.otherNo regardingngsrepreseincorporatedby
belowaThbeshalltodeemedorexistthebindsrgnrng certifysuattermthisofmentparliesAgreepartiesbjectProgram
that are
EXHIBITS. The
Plan
ent.
DATE(S) SIGNED
b)Llz1
PRINTED NAME(S) AND TITLE(S)
(r*rg \,^'Yr-tc'r q
()u,*rrt, bo<L
COUNry SIG
PRINTED NAME AND TITLE
Jessica Barbour, Contract Specialist
DATE SIGNED
08t05t2026Bazlou'
@6fIS SIGNATURE
DSHS Central Contract Services
1 769CS County Agreem enl (1 2-26-2025)
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Page 1
1
Special Terms and Conditions
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 DDCS
assessment.
b. "ALTSA Web Access (AWA)' means a web-based portalto the Developmental Disabilities
Community Services CARE system designed to support county services for DDCS clients.
c. "Additional Consumer Services" refers to indirect Client service types as follows:
(1) "Community lnformation and Education": Activities to inform and/or educate thc gcncral 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.
(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 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".
(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 employed 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 Community Services or is an
identified PASRR Client.
f. "Competitive lntegrated Employment" means work performed by a Client on a part-time or full-time
basis, within an integrated setting within the community that meets HCBS settings requirements.
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 performing
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 individuals without disabilities. The activities are based on Client interests
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1 769CS Gou nty Ag reement (12-26-2025)
Special Terms and Conditions
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
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 Employment or Group Supported Employment) for working age individuals
who have received nine months of employment support.
(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. Service may include assistive technology, audiology, family training/home
vioite, hcalth scrviceg, medicalservices, nursing services, nutritiott selviues, uuuupatiortal
therapy, physicaltherapy, psychological services, sign language, socialwork, special
instruction, speech-language pathology, vision, and transportation. 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 generalworkforce. These services may include intake, discovery, assessment, job
preparation, job marketing, job supports, record keeping and support to maintain a job.
(4) "lndividu alized Technical Assistance" or "lTA": services are a part of a Client's pathway to
individual employment 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 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 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 integrated employment in community settings.
h. "County" is the politicalsubdivision of the state of Washington and the county or counties entering
into this Program Agreement.
i. 'DDCS Case Resource Manager (CRM)" means a case manager for DDCS Clients.
j. "County Service Authorization (CSA)" means an authorization for county services.
k. "Developmentaldisabilities (DD)" means a disability attributable to intellectual disability, cerebral
palsy, epilepsy, autism, or another neurological or other condition of an individualfound 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
attains age eighteen, which has continued or can be expected to continue indefinitely, and which
constitutes a substantial limitation to the individual.
l. "Developmental Disabilities Community Services "DDCS' means a division within the Department of
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1 769CS Cou nty Ag reement (1 2-26-2025)
Special Terms and Conditions
Social and Health Services
m. "DDCS Regional office (DDCS Region)" means the regional DDCS office that supports DDCS
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 ten
hours of work per week an additional amount will be inoludc in thc payment.
p. "General Terms and Conditions" means the contractual provisions contained within that agreement,
which govern the contractual relationship between DSHS and the county.
q. "High Acuity Client" means a DDCS Client who requires significant and intensive support in the
community, often due to complex needs, as determined through the DDCS assessment.
r. "Medicaid Home and Community Based Services (HCBS)" means services that occur in a Client's
home or community rather than institutions or other isolated settings. These programs serve a
variety of targeted populations groups, such as people with intellectual or developmental
disabilities, physical disabilities, and/or mental illnesses
s. "Job Foundation Report" is a document derived from emplovment readiness activities performed by
students who are between ages 19 through 20 that identifies actionable next step for employment.
The employment service providers developing the Job Foundation report will be supporting
students with employment activities on average of 35 hours.
t. "Preadmission Screening and Resident Review (PASRR)' means individuals with intellectual
disabilities or related conditions (lD/RC) who have been referred for nursing facility (NF) care.
u. "Person Centered Service Plan or PCSP" means a document that authorizes and identifies the
DDCS paid services to meet a Client's assessed needs. Formerly referred to as the lndividual
Support Plan.
v. "Quality Assurance" means an adherence to all Program Agreement requirements, including DDCS
Policy 6.13, Provider Quatifications for Employment and Day Program Seruices, County Guidelines
and the Criteria for Evaluation, as well as a focus on reasonably expected levels of performance,
quality, and practice.
w. "Quality lmprovement" means a focus on activities to improve performance above minimum
standards and reasonably expected levels of performance, quality and practice.
x. "service Provider" is a qualified Client service vendor who is contracted to provide Employment and
Day Program services.
y. "subcontracto/' is the service provider contracted by the County to provide services.
2. Purpose: This Program Agreement is entered into between the Developmental Disabilities Community
Services and the County in accordance with chapter 71A.14 RCW. lts purpose is to advance the state
legislative policy to provide a coordinated and comprehensive state and local program of services for
persons with developmental disabilities.
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DSHS Central Contract Services
1 769CS Cou nty Ag reement (12-26-2025)
3.
4.
DSHS Central Contract Services
1 769CS County Ag reement (12-26-2025)
Special Terms and Conditions
Client Eligibility: Client eligibility and service referral are the responsibility of DDCS under chapter
388-823 WAC (Eligibility) and chapter 388-825 WAC (Service Rules). Only persons referred by DDCS
shall be eligible for direct Client services under this Program Agreement. lt is DDCS'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.
Gredentials 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 experience in the administration and/or thc dclivary of developmental disabilities
services to a community. For a county where the coordinator administers more than one program
area (e.g. Chemical Dependency, Mental Health, Developmental Disabilities), training and
experience in administration and/or a related Human or Social service may be considered.
c. 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 DDCS Regional Office (DDCS region) and contracted
providers.
d. 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.
e. Sufficient Policies and Procedures 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.
f. Background/Criminal History Check: A background/criminal history clearance is required every
three years for all employees (including DD program County staff), subcontractors, and/or
volunteers who may have unsupervised access to vulnerable DSHS Clients, in accordance with
RCW43.43.830-845, 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 DDCS shall deny payment for any subsequent services
rendered by the disqualified individual provider. The DSHS Background Check Central Unit (BCCU)
must be utilized to obtain background 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 with the County to provide such services.
Qualified Service Providers: The County assures that all service providers meet qualifications as
outlined in the DDCS Policy 6.13, Program Qualifications for Employment and Day Program
Providers.
i. Home and Community Based Waiver Services Assignment of Medicaid Billing Rights: The County
assures that each subcontractor has agreed to assign to DDCS its Medicaid billing rights for
g
h
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5.
Special Terms and Conditions
services to DDCS Clients eligible under Title XIX programs in this Program Agreement. Written
documentation shall be available to DSHS on request.
j. Reporting Abuse and Neglect: The County staff and its subcontractors who are mandated reporters-
under RCW 74.34.020(13) must comply with reporting requirements described in RCW 74.34.035,
.040 and chapter 26.44 RCW. 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 Child Development Services (birth to three early intervention services), must
provide those services under the regulations implementing the lndividuals with Disabilities
Education Aot (IDEA), Part G, and Washington Etate's Early $upport for lnfant and Toddler
Federally Approved Plan.
l. The County staff who perform evaluations of subcontractor work sites will promptly report to DSHS
per DDCS Policy 6-08, tncident Management and Reporting Requirements for County and County-
Contracted P rovide rs, it:
(1) They have reasonable cause to believe that abandonment, abuse, financialexploitation 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. Counties are specifically 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 by giving
precedence, in the following order, to:
(1) County Program Agreement; and
(2) Attached Exhibits.
Duty to Disclose: Under 42 CFR 5455.104, the Administration must obtain certain 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. the
person who authorizes expenditures. 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 whenever there is a
change in the staff holding these management positions [42 CFR 455.104 (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 collaboratively and
sharing information as needed for service coordination, the parties shall administer DD services within
the county as set forth below:
a. The DDCS region shall:
(1) Review subcontractors and shall immediately notify the County of any concerns with the
6
DSHS Central Contract Services
1 769CS Cou nty Ag reement (12-26-2025)
Page 6
Special Terms and Conditions
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;
(4) Work with the County when referring Client's for services and willwithdraw 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 service 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 DDCS Head 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 DDCS Region when Clients are referred for services, authorized services, and/or
for support modifi cations;
(2) Work with the DDCS Region to document planned services in the Client's Person Centered
Service Plan;
(3) Assist with informing the DDCS Region of any potential service level changes not documented
in the Client's DD Assessment prior to any changes;
(4) Work with the DDCS Region regarding service termination;
(5) Work with the DDCS Head Quarters on Spending Plan adjustments;
(6) lnform the DDCS Region of new providers to be included on the ALTSA Web Access (AWA)
system;
(7) Notify the DDCS Region of any intent to terminate a subcontractor who is serving a DDCS
referral;
(8) Provide a copy of each subcontractor's contract upon written request from DDCS; and
(9) Notify and work with the DDCS 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.
DSHS Central Contract Services
1 769CS Cou nty Ag reement (12-26-2025)
Page 7
Special Terms and Conditions
d. The County shall comply with the following referenced documents:
(1) DDCS Policy 4.11, County Services for Working Age Adults;
(2) Chapter WAC 388-850, chapter 388-828 WAC, WAC 388-845-0001, 0030, 0210, 0215,0220,
0600-061 0, 1 030-1 040, 2100,2110i
(3) Criteria for Evaluation;
(4) DDA Guidinq Values:
(5) Countv Guide to Achieve DDA's Guidinq Values;
16; DDA Guidelines for Communitv Assessments within Emplovment and Vocational Pro0ramsl and
e
t
171 Disabilitv Riqhts Washinqton (formerlv Washinqton Protection and Advocacv Svstem) Access
Agreement.
The County shall develop and submit a comprehensive plan for the County DD Services as
required by WAC 388-850-020.
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 DDCS at lnternet site
https://wrannr.dshs.wa.oov/dda/countv-best-practices) to indicate the estimated number of people to
be served, 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
daysof execution of the Program Agreement. Once approved, the SIF outcomes may be modified
only by mutual agreement of the County and the DDCS Region.
Solicitation for Qualified Employment and Day Program Service Providers: Requests for
Applications (RFAs), Requests 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.
g.
h. Qualified Providers: A qualified provider must be a county or an individual or agency contracted
with a county or DDCS.
i. TechnicalAssistance: DDCS contracts with TechnicalAssistance providers that may be utilized by
Counties with prior written approval.
j. Subcontractors: The County will pass on all applicable contractual requirements that are between
DDCS and the County to the subcontractor. The County shall immediately notify the DDCS Region
of the County's intent to terminate a subcontractor who is serving a DDCS referral. lndividuals or
agencies contracted with a county or DDCS may not subcontract for Employment or Community
lnclusion services.
k. The County shall provide or contract with qualified Employment and Day Program Service
Providers for consumer support services that include the following program outcomes:
(1) Monthly Community lnclusion (Cl) service support hours will be based on the Client's Cl service
level per WAC 388-828-9310 for all Clients who began receiving Cl services July 1 ,2011 and
forward.
DSHS Central Contract Services
't 769CS County Ag reement (12-26-2025)
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Special Terms and Conditions
(a) To ensure health and safety, promote positive image and relationships in the community,
increase competence 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
should be supported to average twenty (20) hours of community work per week or eigh$-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 DDCS PCSP is the driver for service. The AWA County Service Authorization
(CSA) and updated Planned Rates information will not exceed the Client's DDCS PCSP.
Service changes will not occur until the Client has received proper notification from DDCS.
(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 Evatuation." A copy of the Client's individualized plan will be provided to the Client, their
DDCS 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-month period. The report will summarize activities and outcomes made towards
the Client's individualized 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 Supported Employment, have not obtained paid
employment at minimum 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 ClienVguardian; and
(c) Develop additional strategies with the ClienUguardian, 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. When requesting to participate in Cl, the Client shall
communicate directly with his or her DDCS Case Manager. The DDCS Case Manager is
responsible for authorizing Cl services.
DSHS Central Contract Services
1 769CS Cou nty Agreement (12-26-2025)
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Special Terms and Conditions
(9) For lndividual Employment 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
DDCS Client's date of hire. At the end of the six-month period, if the DDCS 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 DDCS issues prior written approval for the service
provider to continue to provide long-term supports if needed. lf the County or DDCS approves
the continuation of long-term supports where the service provider is also the Client's employer,
the County or DDCS will regularly monitor these positions to assure fading efforts occur when
appropriate and any potential conflict of interest is addressed.
(10) lndividual Employment staff hours must be attributed to the "lndividual Emplovment and Billable
Activitv 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. lf the direct service staff hours are
less than the collective amount, then the provider will be reimbursed only for the number of hours
staff actually Provided.
(a) The collective group'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 verify
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 less 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 supporting 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 identified in the Client plan to move a Client on their
pathway towards their employment goal(s).
(D 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) lndividualtime in the communi$ working towards the individualemployment 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) req uirements 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
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t.
Special Terms and Conditions
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 supports, and who provides
them.
Quality Assurance and Service Evaluation: The County shall develop and have available an
evaluation system to review services. The evaluation system must have both a Quality Assurance
and a Quality lmprovement component, and both must include objective measures. The objective
mea6ure6 af a minimum will inoludc pcrformancc indicators, by acuity, that include the number of
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 DDCS
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 excluding Child Development Services subcontractors. The County shall conduct at least
one visit to Child Development Services providers every three (3) 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 DDCS upon request.
The County shallwork 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 DDCS
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:
m
p
n
o
(1) Billing requests;
(2) Service provider address and phone number maintenance;
(3) Evaluation dates;
(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.
q. 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.
r. Review and respond the AWA "Work List" items within 5 working days including Referrals and
pending Authorization.
s. Review the AWA "Ticklers" Planned Rate tab and update the planned rate within 5 working days
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after the Planned Rate start date.
t. Partnership Project
(1) A Job Foundation document will be completed per guidelines for eligible students. Eligible
students are DDCS clients who were born between:
(a) For fiscal year 2026 911105 through 8/31/06
(b) For fiscal year 2027 911106 through 8131107
These stLrdents 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
tion 0407 20%20o/o28002o/o29. docx
(2) Qualified providers will 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 in the Partnership Project must have the ability to work collaboratively with
School Districts to identiff DDCS students in high school, collect and track information, be
proficient in electronic spreadsheets, and ability to evaluate if completed Job Foundation
document(s) meet quality standards.
u. Outcome Payment
Providers, with transition students born between
(a) For fiscal year 2026 911103 through Bl31l04
(b) For fiscal year 2027 9l1lo4 through 8/31/05
(2) High acuity transition students who are authorized for lndividual employment, the provider may
receive one outcome payment if transition student obtains a competitive integrated job approved
by the County within timeframes described in the chart in the Billinq lnstructions. lf the County
is also the service provider DDCS 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.
(3) High acuity Clients who are authorized for lndividual employment, provider may receive one
outcome payment if client obtains a new competitive integrated job at a minimum of ten hours of
work per week for a minimum of 4 out of each 6 months during the fiscal year.
(4) Client who are authorized for Community lnclusion who have an acuity of F which equals 18
support hours per month or G which equals 20 support hours per month as based on the
Support lntensity Scale (SlS), provider may receive on outcome payment per month if provider
delivers a minimum of 80o/o of the authorized hours.
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Special Terms and Conditions
(5) A new Community lnclusion referral is defined as a Client who has a new County Service
Authorization (CSA). lncentive/outcome payments to accept and support overall increased
CSAs billed over the year may be requested from DDCS if funds are available.
(6) Community lnclusion case notes and 6-month progress report summary review that scores 16
points or more with the "Community lnclusion Case Note Review Tool" when used in
conjunction with a Community lnclusion plan that has scored 26+ points with the Community
lnclusion plan Quality review tool, provider may receive an outcome payment.
(7) All outcome payments are described in the chart in the Billinq lnstructions.
7. Consideration:
a. Fees
(1) Approval of fees is the responsibility of the DDCS. The DDCS HQ Employment and Day Unit
Ir4anager 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 HQ Employment and Day Unit Manager for approval as
changes occur. The rate schedule will include the following information:
(a) County(s) name;
(b) Time period for which the schedule is applicable; and
(c) Each contracted direct service (lE, GSE, Cl, lTA, CDS) and its associated rate.
(2) Fee Limitations: The Billinq lnstructions found on the County Best Practices site provides
limitations on the Hourly Rate for each direct service. Hourly rates must be divisible by four
b. Budget and Spending Plan, attached as Exhibit B:
(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: DDCS 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 parties 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 localtribes.
(b) Funds Designated for Adult Day Care Consumers: Funds designated for Adult Day Care
Consumers are available to Clients who were served between December 1996 and
December 2003 in Adult Day Health agencies and were subsequently determined ineligible
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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 referred 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 part 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 localArea Agency on Aging. Adult Day Care
service is not a waiver approved service.
c. Program Agrocmcnt Amcndmcnts: 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 DDCS Assistant Secretary may approve in writing an exemption to a specific
program agreement requirement.
8.Billing and Payment:
a. Program Agreement Budget: DSHS shall pay the County all allowable costs, which are defined by
DDCS 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 overhead 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 extent that such costs are appropriately allocated to the program using an
established methodology consistent with grants management guidelines. For a County whose
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:
i. 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, providers, volunteers, or interning students in the provision of developmental
d isabilities services.
ii. Board Training: 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
developmentaldisabilities and related services. These may include information and referral
services; activities aimed at promoting public awareness and involvement; and community
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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 support an agency or directly benefit the agency.
Examples include equipment purchases and agency administrative support.
iii. Partnership project: 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
schoolyear they turn twenty-one (21). Supports provided should complement and not
replace what the student(s) receive through the lndividualized Education Program (lEP).
(3) Consumer Support.
(a) Adult Day Care services are available to Clients who were served between December 1996
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.
(b) Community lnclusion Services are individualized and provided in integrated community
settings with other individuals 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 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 Employment or Group Supported Employment)
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. Service may
include: assistive technology, audiology, family training/home visits, health services,
medical services, nursing services, nutrition services, occupationaltherapy, physical
therapy, psychological services, sign language, socialwork, special instruction, speech-
language pathology, vision, and transportation. 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 to individual needs, interests, and abilities to 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
generalworKorce. These services may include intake, discovery, assessment, job
preparation, job marketing, job supports, record keeping and support to maintain a job (per
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the lndividual Emplovment Phases & Billable Activities)
(e) lndividualized Technical Assistance services are a part of a Client's pathway to employment
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 individuals who have not yet achieved their goal.
(f) Group Supported Employment services are a part 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
dieabilitics in thc samc setting. The service outcomc is sustained paid entployntettt leadirrg
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 integrated employment community settings.
b. Reimbursement for the state Fiscal Year shall not exceed the total amount listed in Exhibit B to this
Program Agreement. However, with a Program Agreement amendment, the parties may increase
or decrease the Program Agreement amount. Counties willwork with DDCS HQ on amendments to
the Program Agreement.
c. Monthly lnvoice with Signed Documentation: All requests for reimbursement amounts must be
entered and posted into the AWA system. The County may post a combined claim of all
programs/services covered by this Program Agreement. DSHS shall make all payments due to the
County for all invoices submitted pursuant to this section within forty five (45) days following posting
of required information.
d. Clients will be assisted in accessing DVR services per the DDCS/DVR MOU. Client services shall
not be reimbursed under this Program Agreement when the same services are paid for under the
Rehabilitation Act ot 1973 by DVR, Public Law 94-142 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 "Hou/' is at least fifty (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
Day Care reimbursement.
(3) A "Month" represents a minimum of at least fifty (50) minutes of direct service for CDS
reimbursement.
f. 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 under Administration or
for the actual costs incurred in the given month but the totalAdministration billed will be the lesser
of the two. Administration cost reimbursement will not exceed 10% unless the Assistant Secretary
of DDCS approves a request for an exception under chapter 388-850 WAC.
g. The lndividual Employment Phases & Billable Activities document defines the individual Client
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services that DDCS reimburses. That document is located on the DSHS DDCS County Best
Practices Web site at https://www.dshs.wa.qov/dda/countv-best-practices.
h. The Community lnclusion Billable Activities document defines the individual Client services
DDCS reimburses. That document is located on the DSHS DDCS County Best Practices Web site
at https://www. dshs.wa. qov/dda/countv-best-practices.
i. Timeliness of and Modification to Billings: All initial invoices with signed documentation must be
received by the DDCS 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 thc associatecl fiscal year uttless arr exleltsiutt is apploved by the DDCS
Regional Administrator or designee. Payment will not be made on any invoice submitted past sixty
(60) calendar days after the Program Agreement fiscal year.
j. Recovery of Fees: lf the County bills and is paid fees for services that DSHS later finds were (a) not
delivered or (b) not delivered in accordance with Program Agreement standards, DSHS shall
recover the fees for those services and the County shall fully cooperate during the recovery.
k. Preadmission Screening and Resident Review (PASRR) Administration: The County may billfor
administration costs as identified in Exhibit B. Monthly claims for administration cost will be based
on the actual PASRR expenditures multiplied by 10%.
l. Reimbursement for Partnership project: A claim of $3,000 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.
m. Job Foundation report line item 95 as identified in the ADSA Web Access (AWA) billing system. A
copy of the completed Job Foundation document will be sent electronically to the shared mailbox
located at: DDAJobFoundationReports@dshs.wa.gov
n. 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.
o. Job Foundation Administration: The County may billfor administration costs as identified in Exhibit
B. Monthly claims for administration cost will be based on the actual expenditures multiplied by
10%. Participating counties will use line item 13.
g. lntermediate Care Facilities for lntellectual Disabilities (lCF/lD) Agreement. lf applicable per 42
CFR 483.410, the County shall assure that all county-operated or subcontracted programs serving
persons living in ICF/ID facilities develop a plan and coordinate their services with the facility on behalf
of the ICF/ID resident.
10. Single State Medicaid Agency-Health Care Authority (HCA): HCA, as the single state Medicaid
Agency, has administrative authority for Title XIX coverage per 42 CFR 431.10. DSHS is the operating
agency for the Home and Community Based Waivers for services for people with developmental
disabilities. The County only has responsibility for services covered in this agreement.
11. DSHS/DRW Access Agreement: The DRW February 27,2001 Access Agreement with DDCS is
incorporated by reference. The County assures that it and its subcontractors have reviewed the
Access Agreement. The agreement covers DRWs access to individuals with developmental
DSHS central contract services
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Special Terms and Conditions
disabilities, Clients, programs and records, outreach activities, authority to investigate allegations of
abuse and neglect, and other miscellaneous matters and is binding for all providers of DDCS
contracted services.
12. Confidential lnformation. All Counties and their subcontractors must:
13.
a. Ensure the security of Confidential lnformation, and
b. When transporting client records containing Confidential lnformation outside a Secure Area, one or
more of the following as appropriate:
(1) llsing a Trusted Network; or
(2) Encrypting the Confidential lnformation, including:
(a) Email and/or email attachments
(b) Confidential lnformation when it is stored on portable devices or media including but not
limited to laptop computers and flash memory devices.
Data Security Requirements. Exhibit A shall only apply to the County if the County possesses 150 or
more DSHS records across all programs or services throughout their organization, or transmits more
than 5 records at one time.
14.Supersession of Prior Data Security Agreement. lf the Parties hereto have previously entered into a
Standalone Data Security Requirements Agreement, both Parties hereby agree that upon mutual
execution said Agreement shalltake precedence as the sole Data security Agreement between the
Parties.
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Special Terms and Conditions
Exhibit A - Data Security Requirements
1 Definitions. The words and phrases listed below, as used in this Exhibit, shall each have the following
definitions:
a. 'AES" means the Advanced Encryption Standard, a specification of Federal lnformation Processing
Standards Publications for the encryption of electronic data issued by the National lnstitute of
Standards and Technology (https://nvlpubs.nist.gov/nistpubs/FIPS/NlST.FlPS.197-upd1.pdf).
b. "Authorized Users(s)" means an individual or individuals with a business need to access DSHS
Confidential lnformation, and who has or have been authorized to do so.
c. "Category 4 Data" is data that is confidential and requires special handling due to statutes or
regulations that require especially strict protection of the data and from which especially serious
consequences may arise in the event of any compromise of such data. For purposes of this
contract, data classified as Category 4 refers to data protected by: the Health lnsurance Portability
and Accountability Act (HIPAA).
d. "Cloud" means data storage on servers hosted by an entity other than the Contractor and on a
network outside the control of the Contractor. Physical storage of data in the cloud typically spans
multiple servers and often multiple locations. Cloud storage can be divided between consumer
grade storage for personal files and enterprise grade for companies and governmental entities.
Examples of consumer grade storage would include iCloud, Dropbox, Box.com, and many other
entities. Enterprise cloud vendors include Microsoft Azure, Amazon Web Services, 0365, and
Rackspace.
e. "Encrypt" means to encode Confidential lnformation into a format that can only be read by those
possessing a "key"; a password, digital certificate or other mechanism available only to authorized
users. Encryption must use a key length of at least 128 bits (256 preferred) for symmetric keys, or
2048 bits for asymmetric keys. When a symmetric key is used, the Advanced Encryption Standard
(AES) must be used if available.
f. "Hardened Password" means a string of at least eight characters containing at least three of the
following four character classes: Uppercase alphabetic, lowercase alphabetic, numeral, and special
characters such as an asterisk, ampersand, or exclamation point.
"Mobile Device" means a computing device, typically smaller than a notebook, which runs a mobile
operating system, such as iOS, Android, or Windows Phone. Mobile Devices include smart phones,
most tablets, and other form factors.
h. "Multi-factor Authentication" means controlling access to computers and other lT resources by
requiring two or more pieces of evidence that the user is who they claim to be. These pieces of
evidence consist of something the user knows, such as a password or PIN; something the user has
such as a key card, smart card, or physicaltoken; and something the user is, a biometric identifier
such as a fingerprint, facial scan, or retinal scan. "PlN" means a personal identification number, a
series of numbers which act as a password for a device. Since PlNs are typically only four to six
characters, PlNs are usually used in conjunction with anotherfactor of authentication, such as a
fingerprint.
i. "Portable Device" means any computing device with a small form factor, designed to be transported
from place to place. Portable devices are primarily battery powered devices with base computing
resources in the form of a processor, memory, storage, and network access. Examples include, but
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g
k.
Special Terms and Gonditions
are not limited to, mobile phones, tablets, and laptops. Mobile Device is a subset of Portable
Device.
"Portable Media" means any machine readable media that may routinely be stored or moved
independently of computing devices. Examples include magnetic tapes, optical discs (CDs or
DVDs), flash memory (thumb drive) devices, external hard drives, and internal hard drives that have
been removed from a computing device.
"secure Area" means an area to which only authorized representatives of the entity possessing the
Confidential lnformation have access, and access is controlled through use of a key, card key,
combination lock, or comparable mechanism. Secure Areas may include buildings, rooms or
locked storage containere (ouoh ae a filing oabinct or dcsk drawer) within a room, as long as access
to the Confidential lnformation is not available to unauthorized personnel. ln otherwise Secure
Areas, such as an office with restricted access, the Data must be secured in such a way as to
prevent access by non-authorized staff such as janitorial or facility security staff, when authorized
Contractor staff are not present to ensure that non-authorized staff cannot access it.
"Trusted Network" means a network operated and maintained by the Contractor, which includes
security controls sufficient to protect DSHS Data on that network. Controls would include a firewall
between any other networks, access control lists on networking devices such as routers and
switches, and other such mechanisms which protect the confidentiality, integrity, and availability of
the Data.
m. "Unique User lD" means a string of characters that identifies a specific user and which, in
conjunction with a password, passphrase or other mechanism, authenticates a user to an
information system.
Authority. The security requirements described in this document reflect the applicable requirements of
policies and standards of the Washington Technology Services Agency
(https://watech.wa.qov/policies?combine=&field cateqories tarqet id=8O&field tvpe tarqet id=All),
and oi the DSHS lnformation Security Policy and Standards Manual. Reference material related to
these requirements can be found here: https://www.dshs.wa.qov/ffalkeepinq-dshs-client-information-
private-and-secure, which is a site developed by the DSHS lnformation Security Office and hosted by
DSHS Central Contracts and Legal Services.
Administrative Controls. The Contractor must have the following controls in place:
a. A documented security policy governing the secure use of its computer network and systems, and
which defines sanctions that may be applied to Contractor staff for violating that policy.
b. lf the Data shared under this agreement is classified as Category 4 data, the Contractor must be
aware of and compliant with the applicable legal or regulatory requirements for that Category 4
Data.
c. lf Confidential lnformation shared under this agreement is classified as Category 4 data, the
Contractor must have a documented risk assessment for the system(s) housing the Category 4
Data.
Authorization, Authentication, and Access. ln order to ensure that access to the Data is limited to
authorized staff, the Contractor must:
2
3
4.
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Special Terms and Conditions
a. Have documented policies and procedures governing access to systems with the shared Data
b. Restrict access through administrative, physical, and technical controls to authorized staff.
c. Ensure that user accounts are unique and that any given user account logon lD and password
combination is known only to the one employee to whom that account is assigned. For purposes of
non-repudiation, it must always be possible to determine which employee performed a given action
on a system housing the Data based solely on the logon lD used to perform the action
d. Ensure that only authorized users are capable of accessing the Data.
e Fnsrrre that an employee's access to the Data is removed immediately:
(1) Upon suspected compromise of the user credentials.
(2) When their employment, or the contract under which the Data is made available to them, is
terminated.
(3) When they no longer need access to the Data to fulfill the requirements of the contract.
f. Have a process to periodically review and verify that only authorized users have access to systems
containing DSHS Confidential lnformation
g. When accessing the Data from within the Contractor's network (the Data stays within the
Contractor's neiwork at alltimes), enforce password and logon requirements for users within the
Contractor's network, including:
(1) A minimum length of 8 characters, and containing at least three of the following character
classes: uppercase letters, lowercase letters, numerals, and special characters such as an
asterisk, ampersand, or exclamation point.
(2) That a password does not contain a user's name, logon lD, or any form of theirfull name.
(3) That a password does not consist of a single dictionary word. A password may be formed as a
passphrase which consists of multiple dictionary words'
(4) That passwords are significantly different from the previous four passwords. Passwords that
increment by simply adding a number are not considered significantly different.
h. When accessing Confidential lnformation from an external location (the Data will traverse the
lnternet or otherwise travel outside the Contractor's network), mitigate risk and enforce password
and logon requirements for users by employing measures including:
(1) Ensuring mitigations applied to the system don't allow end-user modification.
(2) Not allowing the use of dial-up connections.
(3) Using industry standard protocols and solutions for remote access. Examples would include
RADIUS and Citrix.
(4) Encrypting all remote access traffic from the externalworkstation to Trusted Network or to a
component within the Trusted Network. The traffic must be encrypted at all times while
traversing any network, including the Internet, which is not a Trusted Network.
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Special Terms and Conditions
(5) Ensuring that the remote access system prompts for re-authentication or performs automated
session termination after no more than 30 minutes of inactivity.
(6) Ensuring use of Multi-factor Authentication to connect from the external end point to the internal
end point.
Passwords or PIN codes may meet a lesser standard if used in conjunction with another
authentication mechanism, such as a biometric (fingerprint, face recognition, iris scan) or token
(software, hardware, smart card, etc.) in that case:
(1) The PIN or password must be at least 5 letters or numbers when used in conjunction with at
least one other authentication factor
(2) Must not be comprised of all the same letter or number (11111,22222, aaaaa, would not be
acceptable)
(3) Must not contain a "run" of three or more consecutive numbers (12398, 98743 would not be
acceptable)
lf the contract specifically allows for the storage of Confidential lnformation on a Mobile Device,
passcodes used on the device must:
(1) Be a minimum of six alphanumeric characters.
(2) Contain at least three unique character classes (upper case, lower case, letter, number)
(3) Not contain more than a three consecutive character run. Passcodes consisting of 12345, or
abcd12 would not be acceptable.
k. Render the device unusable after a maximum of 10 failed logon attempts.
Protection of Data. The Contractor agrees to store Data on one or more of the following media and
protect the Data as described:
a. Hard disk drives. For Data stored on localworkstation hard disks, access to the Data will be
restricted to Authorized User(s) by requiring logon to the localworkstation using a Unique User lD
and Hardened Password or other authentication mechanisms, which provide equal or greater
security, such as biometrics or smart cards.
b. Network server disks. For Data stored on hard disks mounted on network servers and made
available through shared folders, access to the Data will be restricted to Authorized Users through
the use of access control lists which will grant access only after the Authorized User has
authenticated to the network using a Unique User lD and Hardened Password or other
authentication mechanisms which provide equal or greater security, such as biometrics or smart
cards. Data on disks mounted to such servers must be located in an area, which is accessible only
to authorized personnel, with access controlled through use of a key, card key, combination lock, or
comparable mechanism.
For DSHS Confidential lnformation stored on these disks, deleting unneeded Data is sufficient as
long as the disks remain in a Secure Area and otherwise meet the requirements listed in the above
paragraph. Destruction of the Data, as outlined below in Section 8 Data Disposition, may be
deferred untilthe disks are retired, replaced, or otherwise taken out of the Secure Area.
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d
c.
e.
Special Terms and Conditions
Optical discs (CDs or DVDs) in localworkstation optical disc drives. Data provided by DSHS
on optical discs which will be used in localworkstation optical disc drives and which will not be
transported out of a Secure Area. When not in use for the contracted purpose, such discs must be
Stored in a Secure Area. Workstations which access DSHS Data on optical discs must be located
in an area which is accessible only to authorized personnel, with access controlled through use of a
key, card key, combination lock, or comparable mechanism
Optical discs (CDs or DVDs) in drives or jukeboxes attached to servers. Data provided by
DSHS on optical discs which will be attached to network servers and which will not be transported
out of a Secure Area. Access to Data on these discs will be restricted to Authorized Users through
the use of access control lists which will grant access only after the Authorized User has
authentioatcd to tho nctwork using a Uniquc Uscr lD and Hardened Pasgword or other
authentication mechanisms which provide equal or greater security, such as biometrics or smart
cards. Data on discs attached to such servers must be located in an area, which is accessible only
to authorized personnel, with access controlled through use of a key, card key, combination lock, or
comparable mechanism.
Paper documents. Any paper records must be protected by storing the records in a Secure Area,
which is only accessible to authorized personnel. When not in use, such records must be stored in
a Secure Area..
f. Remote Access. Access to and use of the Data over the State Governmental Network (SGN) or
Secure Access Washington (SAW will be controlled by DSHS staff who will issue authentication
credentials (e.g. a Unique User lD and Hardened Password) to Authorized Users on Contractor's
staff. Contractbr will notify DSHS staff immediately whenever an Authorized User in possession of
such credentials is terminated or otherwise leaves the employ of the Contractor, and whenever an
Authorized User's duties change such that the Authorized User no longer requires access to
perform work for this Contract.
g. Data storage on portable devices or media.
(1) Except where otherwise specified herein, DSHS Data shall not be stored by the Contractor on
portable devices or media unless specifically authorized within the terms and conditions of the
Contract. lf so authorized, the Data shall be given the following protections::
(a) Encrypt the Data.
(b) Control access to devices with a Unique User lD and Hardened Password or stronger
authentication method such as a physicaltoken or biometrics.
(c) Manually lock devices whenever they are left unattended and set devices to lock
automatically after a period of inactivity, if this feature is available. Maximum period of
inactivity is 20 minutes.
(d) Apply administrative and physical security controls to Portable Devices and Portable Media
by:
i. Keeping them in a Secure Area when not in use,
ii. Using check-in/check-out procedures when they are shared, and
iii. Taking frequent inventories.
DSHS Central Contract Services
1 769CS Cou nty Ag reement (1 2-26-2025)
Page 23
Special Terms and Gonditions
(2) When being transported outside of a Secure Area, Portable Devices and Portable Media with
DSHS Confidential lnformation must be under the physical control of Contractor staff with
authorization to access the Data, even if the Data is encrypted.
h. Data stored for backup purposes.
(1) DSHS Confidential lnformation may be stored on Portable Media as part of a Contractor's
existing, documented backup process for business continuity or disaster recovery purposes.
Such storage is authorized until such time as that media would be reused during the course of
normal backup operations. lf backup media is retired while DSHS Confidential lnformation still
exists upon it, such media will be destroyed at that time in accordance with the disposition
requirements below in Section 8 Data Disposition.
(2) Data may be stored on non-portable media (e.9. Storage Area Network drives, virtual media,
etc.) as part of a Contractor's existing, documented backup process for business continuity or
disaster recovery purposes. lf so, such media will be protected as otherwise described in this
exhibit. lf this media is retired while DSHS Confidential lnformation stillexists upon it, the data
will be destroyed at that time in accordance with the disposition requirements below in Section 8
Data Disposition
i. Cloud storage. DSHS Confidential lnformation requires protections equalto or greater than those
specified elsewhere within this exhibit. Cloud storage of Data is problematic as neither DSHS nor
the Contractor has control of the environment in which the Data is stored. For this reason:
(1) DSHS Data will not be stored in any consumer grade Cloud solution, unless all of the following
conditions are met:
(a) Contractor has written procedures in place governing use of the Cloud storage and
Contractor attest to the contact listed in the contract and keep a copy of that attestation for
your records in writing that all such procedures will be uniformly followed.
(b)The Data will be Encrypted while within the Contractor network.
(c) The Data will remain Encrypted during transmission to the Cloud.
(d) The Data will remain Encrypted at all times while residing within the Cloud storage solution
(e) The Contractor will possess a decryption key for the Data, and the decryption key will be
possessed only by the Contractor.
(f) The Data will not be downloaded to non-authorized systems, meaning systems that are not
on the contractor network
(g) The Data will not be decrypted until downloaded onto a computer within the control of an
Authorized User and within either the DSHS or Contractor's network.
(2) Data will not be stored on an Enterprise Cloud storage solution unless either:
(a) The Cloud storage provider is treated as any other Sub-Contractor, and agrees in writing to
all of the requirements within this exhibit; or,
(b) The Cloud storage solution used is HIPAA compliant.
DSHS Central Contract Services
1 769CS Cou nty Ag reement (12-26-2025)
Page 24
7
6.
DSHS Central Contract Services
1 769CS Cou nty Ag reement (1 2-26-2025)
Special Terms and Conditions
(3) lf the Data includes protected health information covered by the Health lnsurance Portability and
Accountability Act (HIPAA), the Cloud provider must sign a Business Associate Agreement prior
to Data being stored in their Cloud solution.
System Protection. To prevent compromise of systems which contain DSHS Data or through which
that Data passes:
a. Systems containing DSHS Data must have all security patches or hotfixes applied within 3 months
of being made available.
b. The Contractor will have a method of ensuring that the requisite patches and hotfixes have been
applied within the required timeframes,
c. Systems containing DSHS Data shall have an Anti-Malware application, if available, installed.
d. Anti-Malware software shall be kept up to date. The product, its anti-virus engine, and any malware
database the system uses, will be no more than one update behind current.
Data Segregation.
a. DSHS category 4 data must be segregated or otherwise distinguishable from non-DSHS data. This
is to ensurethat when no longer needed by the Contractor, all DSHS Data cari be identified for
return or destruction. lt also aids in determining whether DSHS Data has or may have been
compromised in the event of a security breach. As such, one or more of the following methods will
be used for data segregation
(1) DSHS Data will be kept on media (e.9. hard disk, optical disc, tape, etc.) which will contain no
non-DSHS Data.
(2) DSHS Data will be stored in a logical container on electronic media, such as a partition or folder
dedicated to DSHS Data
(3) DSHS Data will be stored in a database which will contain no non-DSHS data. And/or,
(4) DSHS Data will be stored within a database and will be distinguishable from non-DSHS data by
the value of a specific field or fields within database records.
(5) When stored as physical paper documents, DSHS Data will be physically segregated from non-
DSHS data in a drawer, folder, or other container.
b. When it is not feasible or practical to segregate DSHS Data from non-DSHS data, then both the
DSHS Data and the non-DSHS data with which it is commingled must be protected as described in
this exhibit.
Data Disposition. When the contracted work has been completed or when the Data is no longer
needed, except as noted above in Section 5.b, Data shall be returned to DSHS or destroyed. Media on
which Data may be stored and associated acceptable methods of destruction are as follows:
8
Data stored on:Will be destroyed by:
Server or workstation hard disks, or Using a "wipe" utility which will overwrite the Data at
least three (3) times using either random or single
character d or
Page25
9.
Special Terms and Conditions
Notification of Compromise or Potential Compromise. The compromise or potential compromise of
DSHS shared Data must be reported to the DSHS Contact designated in the Contract within one (1)
business day of discovery. lf no DSHS Contact is designated in the Contract, then the notification must
be reported to the DSHS Privacy Officer at dshsprivacyofficer@dshs.wa.gov. Contractor must also
take actions to mitigate the risk of loss and comply with any notification or other requirements imposed
by law or DSHS.
Data shared with Subcontractors. lf DSHS Data provided under this Contract is to be shared with a
subcontractor, the Contract with the subcontractor must include all of the data security provisions within
this Contract and within any amendments, attachments, or exhibits within this Contract. lf the
Contractor cannot protect the Data as articulated within this Contract, then the contract with the sub-
Contractor must be submitted to the DSHS Contact specified for this contract for review and approval.
10.
DSHS Central Contract Services
1 769CS Cou nty Ag reement (12-26-2025)
Removable media (e.9. floppies, USB flash drives,
portable hard disks) excluding optical discs Degaussing sufficiently to ensure that the Data
cannot be reconstructed, or
Phvsically destroying the disk
Paper documents with sensitive or Confidential
lnformation
Recycling through a contracted firm, provided the
contract with the recycler assures that the
confidentiality of Data will be protected.
Paper documents containing Confidential lnformation
requlrlng speclal handllng (e.9. protected health
information)
On-site shredding, pulping, or incineration
Optical discs (e.9. CDs or DVDs)lncineration, shredding, or completely defacing the
readable surface with a coarse abrasive
Maqnetic tape Deqaussinq, incinerating or crosscut shredding
Page 26
Exhibit B
Program Agreement Budget
X Original Budget Budget Revision
REVENUES
FiscalYear Fund Source Oriqinal 1st Revision 2no Revision 3rd Revision
2026 State onlv 567,912 576.712
Medicaid 555.171 562,371
$Total Rev $1,123,083 s1.139.083 $
FiscalYear Fund Source Orioinal 1st Revision 2nd Revision 3rd Revision
2027 State onlv
Medicaid
Total Rev $$$$
Job
Foundation
Funds
PASRR Funds
State Funds
Medicaid
Funds TOTAL
ADMTNTSTRATION (11,
12. 13. 14\51072 41786 92,858
OTHER CONSUMER
SUPPORTS
(31, 32, 41, 92,93, 94,
97)33411 27337 60.748
CONSUMER
SUPPORT
STATE-ONLY
G2.64,65, 67, 69)
Child Development (61)
MEDICAID CLIENTS
rc2.64.67. 69. 95. 96)433917 433917 867.834
ROADS to
COMMUNITY LIVING
i62.64.65, 67, 69)
TOTAL
518,400 503,040 1,021,440
DSHS Central Contract Services
1 769CS Cou nty Ag reement (12-26-2025)
Page27