HomeMy WebLinkAboutCandice Perry FY 21'*.
'Idaho Falls
School District 91
A World Class Education
690 fohn Adams Parkway ldaho Falls, Idaho 83401
Phone: (208) 525-7 500 FAX: (208) 525-7 59 6
Web Address: i.vww.d9 1.k1 2.id.us
IDAHO FALLS SCHOOL DISTRICT 9I
System of Care Protocol for Independent Contractors
SPEECH LANGT]AGI' PATHOLOGIST:
The purpose of the System of Care is to establish a procedural protocol to assist the ldaho
Falls School District 9l in collaborating with Independent Contractors lor the delivery of
related services provided by in accordance with the following:
l. Eligible students' Individual Education Plans (lEP) developed pursuant to ldaho
Special Education Manual 2016, and
2. The Medicaid Billing Policy for Speech/Audiological Therapy and Evaluation in a
school setting flDAPA 16.03.09).
This protocol provides guidelines for the Idaho Falls School District 9l and independent
contractors to implement Speech,/Language Pathology (SLP) services that are delivered to
eligible students with an lndividual Educational Plan (lEI') on file in the school district. In
order to provide SLP services, the independent contractor must be approved through the
Director of Student Services' office and provide the following documentation:
Proof of workers' compensation coverage.
Current Cerlificate of Liability Insurance
A current Criminal Background Check
Evidence of qualilications to perform Speech/[,anguage Pathology Services
The school will be the lead agency for any student enrolled while that student is in school.
Belore the Independent Contractor may work with the student. a Contractual Agreement
must be completed with the Contractor, building principal and Director ol Student
Services.
Idaho Falls School District must follow the privacy provisions set forth by FERPA, HIPPA,
and ldaho Special Education Manual 2016. The ldaho Falls School District will need
written authorization lrom the parenVguardian prior to sharing information with
lndependent Contractors.
Contractor: Candice Perry (SLl,)
Student: Assigned SLP Students
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Datc: June 1.2020
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I. Protocol for Independcnt Contractors Providing
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II. Overview for lndependent Contractors Workinq wLth Students
Independent Contractor means a person, group, agency, or organization that
meets the lollowing two conditi,,rns:
a. Is not an employee of Idaho l"alls School District 9l or a public agency with
legal jurisdiction over the circumstanccs related to their involvement with
the student, and
b. Is paid or reimbursed lor services provided to the student through the
established billing policy.
Independent Contractor may do lhe lollowing in Idaho Falls School District 9l:
a. Submit evaluation repo rts to a school's Evaluation teams tirr consideration
related to an evaluation being conducted.
b. Be invited to an evaluation team meeting by either the school or parent.
i. The determinalion of eligibility lor special education and the
provision of a Free Appropriate Public Education (FAPE) are the
responsibility of thc tEP teams and cannot be prescribed by any
other entity.
ii. All educational decisions regarding educational methodology,
materials. and personnel are the responsibility ofthe school district.
c. Provide services in the schools to students under the terms ofa contract with
the school district. (See Independent Contractors Agreement)
i. Contracts are established when the school district is paying for the
services and describes the services, the role and responsibilities of
the Independent Contractor with the evaluation team and school
administration, and thc frequency and duration of services; includes
documentation of licensure/certification to perform the prescribed
services; addresses issues related to liability, terms ofpayment; and
states the provisions for changes or termination of the contract.
(Example: District contracts tbr physical therapy services)
ii. Contracted services to a studenl with a disability shall be included
on the students lEP.
d. Provide servicesto students on school grounds undertheterms ofSummary
of Services with the school district. (See Summary of Seruices Form)
i. Summary of Serviccs is established to allow the services to take
place on school property to benefit the student's progress in the
general education curriculum. The Summary of Services shall
describe the specific services provided. the responsibilities of the
school and indcpendent contractor, procedures tbr background
checks and insurancc. and the provisions for space. time- equipment,
and materials providcd by the school district. Ty'ie school di.strict
moy terminote the Summur.y of Services ol ony time.
ii. Services provided undet'a Summary of Services to a student with a
disability shall be includcd on the student's Individual Education
Plan (lEP).
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('ontractor: Cendice I'crr) (Sl.l')
Sludent: AssiSncd SLI' Sludcnts
1I)ete: .lunc 1.2020
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'fhe district has no obligation to enter into a contract with an independent
contractor or to allow an independent contractor access to school district
propefty, space, materials, or equipment.
School district records are only accessible to Independcnt Contractor under
contract with the school district and with written consent from the student's
parent or guardian, or the adult student (18 years old or older). Request for
records may be subject to a fee to cover costs olcopying and mailing.
Nothing in this System of Care protocol shall be construed to limit or impinge
in any way on services parents may acquire for their child that are not provided
at the school. Issues related to the amount of time studcnts are removed from
school fbr any purpose fall under the terms of other school district policies.
Contractor: Cxndice l,crry (51-p)
Student: Assigncd SLl, Studcnts -)
Datc: .lur)e l.l0l0
Idaho Falls School District 9l
INI)EPtNDEN'I' ('ONTR,\CTOR CONTR.\CTAI, .\GRI]T]}IE\'I':
Socech/Languae e Patholosv (SLl') Serviccs
This Contractual Agreement is entcrcd into between Idaho Falls School District 91 (hereinafter
referred to as "District") and Candice Perry (hereinafter referred to as "Contractor").
Whereas, the District providcs special educational and related services to assist students attending
school in the District in their educational developmeDt. as identified on the students' individualized
education program (lEP) plan: and
Whereas, the Contractor is duly licensed or qualified and able to provide related services to the
District's students;
It is herebl agreed b1 both panie: tlrat
DURATION OF AGREEMENI':
The period of this Contractual Agreement will comn'rence on the August 26,2020 and remain in effect
untilthelastdayofschool,June3.202l. This Contractual Agreement is contingent upon the
availability of fi.rnds ofthe District. This Contractual Agreement shall not exceed twelve (12) calendar
months. At the discretion ofthe Districr. the Contractual Agreement rnay be renewed annually.
RELATIONSHIP OF PARTIES:
ln performing services under this ('ontractual Agreenrent, Contractor is and shall at all times be an
independent contractor ofthe District. Nothing herein is to be construed as establishing an employer-
employee relationship.
RECORD KEEPING:
Contractor shall be responsible for rnaintaining complete and accurate records documenting the
professional serviccs provided pursuant to this Contractual Agreement and shall provide copies ofthe
reaords to the District within five (5) working days ofthe date requcsted. Additionally, upon
reasonable notice, lhe District shall have lhe right to review such records at any time during business
hours. Appropriate Medicaid billing sheets will be completed each month tbr the student(s) served.
CONFIDENTIALITY:
Provider agrees that all intbrmation regarding services provided pursttant to this Contractual
Agreement, including, but not limited to, the students' identity and the nature ofservices rendered,
shall be conftdentia! pursuant to the !amily Educational Records and Privacy Act (FERPA).
Contractor is prohibited liont disclosing any information obtained as a result ofrendering services
pursuant to this Contractuat Agrecment to any individual not authorized and directed by the District,
without parent/guardian consent or consent ofthe student if l8 years of age or older-
Conlractor: Candice Pcrq (SI P)
Student: Assigned SLP Sludenls
4I)irlc: Junc l. 2020
SERVICES TO BIi RENDERED:
Provider shall render the professional services enumerated on Sunlmary ofServices, attached hereto
and made a part ofthis Contractual Agreenrent as set forth fully herein.
REPORTING OF ABUSE, ABANDONMENT, OR Nf,GLECT:
Contractor acknowledges its obligation to comply with Idaho Code Section 16-1601, et seq. and rcport,
within 24 hours, any suspected abuse, abandonment, or neglect ofa child to the law enforcement
agency or ldaho Department ofHealth and Welfare. Contractor also agrees to inform the District,
within 24 hours, ofsuch suspicion.
SERVICE DEI,IVERY: TIME AND PLACE:
Contraclor shall perform services set forth in Summary ofServices, unless the parties mutually agree
to a modification ofthe time and place ofservice delivery.
COORDINATION OF SERVICES:
To facilitate delivery ofservices, the District will provide: 1) reasonable and prompt notification of
meetings and other appointments in which the Contractor is expected to participatei 2) signed parental
consent forms, as necessary;3) identifying information regarding the client and the parenl/guardian;
and, 4) reasonable assistance in facilitaling communication between the Contractor and clients,
parents/guardian, and other providers and agencies.
PRIOR APPROVAL OF SERVICES:
All services rendered by Contractor under the terms ofthis Contractual Agreement shall require prior
approval by the District in accordance with federal and state laws and regulations. local policies and
procedures, and professional codes of conduct.
CONSEN'I/AUTHORIZATION TO ACCESS EDUCATIONAL RECORD INFORMATION
OR PROTECTED HEALTH TNFORMATION:
District and Contractor shall at all times require the written consent or authorization ofthe
parenVguardian/or adult student, ifage of l8 yean of age or older, for the disclosure ofaccess to
educational information pursuant to FERPA or protaated health information pursuant to the Health
Information Podability and Accountability Act (HIPAA) regarding the sludent. and shall maintain the
confidentiality ofthat information consistent with the state and federal law and regulations.
PROFESSIONAL SERVICES:
The services rendered pursuant to this Contractual Agreement will be provided by individuals who are
duly liccnsed to perform the services or supervised by a licensed/certified provider in accordance with
applicable professional standards. Contractor agrees that all work pursuant to this Contractual
Agreement will be performed in accordance with the highest professional standards. Written
assurances will be provided to the District attesting thal all employees who come into contact with
students shall have been subject to a criminal background check at least as stringent as that requir€d by
Idaho Code -li - 130 and policies ofthe District, and have been determined to rrot have a criminal
background inconsistent with working with children. The Districl shall have the right to observe
services being provided to lhe clients.
INSURANCE AND LIABILITY:
Contractor shall be solely liable for any losses or damages resulting fiom Contractor's performance of
any ofthe serviccs covered by this Contractual Agreemcnt. Contractor shall indemnifu and hold
harnrless the District from any liability, including, but not limited to, cost, expenses, and atlorney fees,
resultinS from Contractor's performance ofthe services provided under this Contractual Agreement.
Proof of insurance shall be submitted to the District within ten (10) days ofthe date ofthis Contractual
Agreemenl.
ASSIGNMEN'I':
This contractual Agreement shall not be subject to assignment, in whole or in part, by contractor or by
operation of law, so as to authorize any persotr other than Contractor, or Contr;ctor's employees, to
assume thc duties subject to this contractual Agreement without the District's prior *rittin ionsent.
Contractor: Candice l,crry (SLP)
Studenl: Assigncd SLP Students 5
f)ate: iune 1,2020
AMENDMENT:
This Contractual Agreement may be anrended at any lime with the prior written consent ofboth
parties. Any and all amendments to this Conlractual Agreement shall be in writing.
TERM INATION:
This Contractual Agreement may be terminated without cause hy either party within thirty (30) days
after providing written notice ofthe intent to terminate to the other party.
Additionally, the District may immediately terminate this Contractual Agreement, upon writlen notice,
in the event funding for the District's program is no longer available or the specific services to this
Contractual Agreemenl are modified or terminated for a student.
DEFAULT:
Upon default by either party, the non-defaulting party tnay canccl this Contractual Agreement
immediately, upon notice and may pursue any and all available legal, equitable, and other remedies.
The defaulting party shall be liable for any and all expenses that are incurred by the non-defaulting
parry as a result thereof, including, but not limited to, procuring substitute performance, legal fees, and
other losses incurred due to the default.
TIME OF PERFORMANCE:
Time is ofthe essence in this Contractual Agreement; therefore. alt times for performance ofthe
obligations, as stated herein. shall be strictly complied with by the parties.
NON-WAVIER BREACH:
The failure ofContraclor or the District to insist upon strict performance ofany ofthe terms ofthis
Contractual Agreement, or to exercise any option herein cqnferred in any or all instances, shall not
constitute a waiver or relinquishment ofany such term. but the same shall be and renrain in lull force
and effect, unless such waiver is evidence by the prior written consent ofContractor or the District.
NON.DISCRIMINA'I'ION:
The parties hereby agrce that no person shall, on the grounds ofrace. color, creed, national origin, sex,
age, or disability, bc excluded from or denied participation in. or otherwise subjected to. discrimination
under any activity perlbrmed pursuanl to this Contractual Agrecment.
GOVERNANCEI
This Contractual Agreement shall be govemed by the laws ofthe State ofldaho. Contractor shall, at all
times, comply with and observe all federal, state, and local laws, regulations, and ordinances which are
in effect and applicable during the period ofthis Contractual Agreement.
ATTORNEY FEES:
Ifeither party defaults in any manner or fails to fulfill any and/or all provisions ofthis Contractual
Agreement, and ifthe non-defaulting pany hires an afiomey to exercise its rights upon such default or
failure, or ifthc parties are involved in any Iitigation (including any proceedings in bankruptcy), the
prevailing pany shall be entitled to recover reasonable attomey lees and costs from the other party.
This paragraph shall be enforceable by the parties notwithstanding any rescission, forfeiture, or other
termination of this Contractual Agreement.
DISPUTE RESOLUl'ION:
All participating agencies agree to resolve systemic disputes that arise in the provision of special
education and independent contractor services in a non-adversarial manner and to ensure that using the
following process to resolve interagency disputes does not disrupt services to students and families:
l. An individual or agency with a concern will first use the agency's internal procedures to address
the concern.
Contractor: Candice Pcrry (Sl.P)
Student: Assigned Sl,l' Studcnts
6Datcr June l. l(120
2. lfresolution is not achieved at the previous level, the issue and all relevant information will now
be forwarded to the Director ofStudent Services ofthe Idaho Falls School District 9l and
contractor's administrator.
3. lfconsensus is not reached at the previous level, the Director ofStudent Services will forward thc
issue and all relevant information to the superintendent of Idaho F'alls School District 9l .4. lfa concern is identified that is related to the quality ofservice or health and safety issues, schools
should refer concerns about a contractor, their services. or quality ofservices to the Director of
Snrdent Services and contractor's administrator to address these concems.5. Ifth€se concems are not resolved in the dialogue with school administrator (Director ofstudent
Services and/or superintendent) and the contractor's administrator, the DHW regional Iicensing
entity may be contacted to investigate the situation.
COMPENSATION/BILLING :
The District shall compensate Contractor for the direct services identified below. Additional hours
will be compensated at the same rate, provided that the additional hours have been pre-approved, in
writing, by the District's designee.
Contractor will submit to the Director ofStudent Senr'ices, by the end ofeach month, an Invoice
(statement ofservices rendered) for that month and the completed district's Medicaid reporting forms
for each student served whether Medicaid eligible or not. These conrpleted forms must be accurate
and ready to submit to the district's billing service. Generally, the district will issue checks on the
second Tuesday ofeach month. after Board approval ifstatemcnt and paperwork is completed and in
the District Office by the end of each month. Each monthly statenlent must include the following
information for each studenl receiving services: a) student's name; b) description or services provided;
c) total number ofhours spent in providing professional services; and d) cost of services provided.
Additional documentation may be required by the District and must be provided wirhin five (5)
working days ofthe date the u,riten request for the documentarion is made.
The district agrees to pay the (lontractor at a ratc of $!aqq per hour for $g!!4ggggp
PathologyServicesforthe(lurationoftheco[tract.'lhiscontractisnottoexceed$31,8S0
based on the number of days worked (approximately 175 days at 2 days per weck when school is
in scssion) x 7 hours per day x $65.00 per hour, unless agreed to by both parties.
COMPLETE STATEMENI' OF TERMS;
This Contractual Agreement constitutes the entire agreement between the parties hereto, and shall
supersede all previous oral or written proposals, negotiations, commitments, and all other
communications between the parties. This Contractual Agreement may not be released, discharged, or
modified except by an instrument in writing signed by the duly authorized representatives ofthe
parties.
(bntraclor: Candice Perry (SLl,)
Student: Assigned SLP Studenls 7
Date: June 1.2020
SUMMARY OF SERVICES
Independent Contractor/Idaho Falls School District 9l Protocol
This Summary of Services is to be used only after the District and Contractor has signed the
conlract, lndependent Contractor Contractual Agreement.
lndependent Contractor Agency: TCand K Services, [,LC, Candice Perry
Direct Service Provider: Candice Perry
Business Address: 577 Pheasant Run Circle, Rigby, ldaho 8i442
Telephone Number: 208-604-6569 E-Mail: candiccforbush@hotmail.corn
Bureau of Occupational License:
ldaho Education Credenlial Expiration Dale:. I l07l?020
Review ofService: Indicate when each review will be done and who will do the review
First Review: September 28,2020
Second Review: November 16,2020
Third Review: February 15,2021
Fourth Review: April 26, 2O2l
Other: Upon the request of either party
Service(s) to be provided: Speech/Language Services
When will service(s) be provided:
Day(s): Monday - Friday (when school is in session)
Time: 3 days a week (7 hours a day)
Location (i.e. classroom, playground, etc...): Assigned SLP Students, Monthly SLP
Department meetings and District IEP team meetings as needed.
Duration ofservices (each day): As required by the assigned students' IEPS.
Conlractor: Candicc Perr)_ (SLP)
Srudent: Assigned SLP Sludcnts
Itl)ate: .lunc 1.2020
Contractor will comply \vith the district/school operational proccdures and will fulfill the
following responsibilities:
. Sign in and out of school office each visit - provide proper identification.. Must wear a picture identification and/or obtain a visilor's identification badge from the
school at the time ofeach visit.
o Must wear appropriate clothing for a school setting.. Adhere to set schedule - arrive and leave on time.
. Notify building administrator ifyou will be absent (one day notice ifpossible).. Student must be picked up from and returned to an appropriate school staffperson each visil
if applicable.
. Remain in assigned location.
. Be knowledgeable about emergency procedures ofthe school.
. Do not violate the right ofprivacy ofany student by using any information randomly
obtained by observing other students as service reference to make contact with parents to sell
or contract them to services from your agency.
o The special education leacher and/or general education teacher is the instructional leader in
the classroom. At no time should a service provider assume that theirjudgment for
instructional implementation or supervision of an individual/class can supersede Ihe teacher
or school staff member.
. Notify the district/school ofany staffing changes within the agency that relates to the services
indicated on this agreement.
. Be cooperative when resolving conflicts with school/district staff.
School/District responsibilities include:
o Respect the rights ofcontractor.o Provided information regarding the procedurals and schedule olthe school.. Provide information on emergency procedures.
. When appropriate, invite service provider to specific student's MDT and/or IEP team
meetings, with parental approval.
o Accommodate, within reason. Contractor's needs to fulfill the service review plan.
o Provide a positive climate and building environment to facilitate mutual assistance.. Be cooperative when resolving conflicts between conlractor and school staff.
The above items are not to be conscribed as all inclusive. Any concems will be addressed
according to the Dispute Resolution item in the Contractual Agreement.
lN WITNESS WHEREOF, the pa(ies have executed this Contractual Agreement.
06t11t2020
Signa ture of Contractor's Re presentative Date
2a2O
Signatu ntcn dent/Designeeo
Lbnlrlck)r: Cao(lice I,crn (SI-P)
StLdont: Assigncd SLI, Sludcnts 9Dale: .lune 1.202t)
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