HomeMy WebLinkAboutSawtooth Rehab FY 21Idaho Falls
School District 9l +A World Class Educatiott
690 fohn Adams Parkway Idaho Falls, Idaho 83401
Phone: (208) 525-7 500 FAX: [208) 525-7596
Web Address: w,rvw.d91.kL 2.id.us
IDAHO FALLS SCHOoI- DISTRI(]T 9I
Sy stcm of Carc Protocol for Intlcpendcnt ('ontractors
The purpose of the System of Care is to establish a procedural protocol to assist the Idaho
Falls School District 91 in collaborating with Indcpendent Contractors lbr the delivery of
related scrvices provided by in accordance with the following:
1. Eligible students' Individual Education Plans (lEP) developed pursuant to ldaho
Special Education Manual 2016, and
2. The Medicaid Billing Policy lbr Physical Therapy and Evaluation in a school
setting IlDAPA 16.03.09).
This protocol provides guidelines for the ldaho Falls School District 9l and independent
contractors to implement Physical Therapy (PT) services that are delivcred to eligible
students with an lndividual I]ducational I'lan (IEP) on Iile in thc school district. ln order
1o providc PT services, the independenl contractor must be approved through the Director
of Student Services' office and provide the lollowing documentation:
Proof of workers' compensation coverage
Current Certificate of Liability Insurance
A currcnt Criminal Background Check
Ilvidence ofqualifications to perfbrm Physical Therapy Services
The school will be the lead agency lor any student enrolled while that student is in school.
Before thc Independent Contractor may work with the student. a Contractual Agrcement
must bc completed with the Contractor and Director of Student Services.
Idaho Falls School District must lollow the privacy provisions set lbrth by FERPA, IilPPA,
and Idaho Special liducation Manual 2016. The Idaho Falls School District will need
written authorization from the parent/guardian prior to sharing information with
lndependent Contractors.
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Contractor: Sa$'tooth Rchab/Eric Robcns
Student: Assigned PT Studcnts
Datc: June l. 2020
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I. Protocol for lndependent Contractors Providing
PHYSICAL THERAPIST:
II. Overvicrv for IndeDendent (lontracto rs Workins * ith Students
Independent Contractor means a person, group, agency, or organization that
meets the lollowing two conditions:
a. Is not an employee ol ldaho Falls School District9l orapublic agency with
legal jurisdiction over the circumstances rclated to their involvement with
the student, and
b. Is paid or reimbursed for services provided to the student through the
established billing policy
Independent Contractor may do the lollowing in ldaho Falls School District 9i:
lt Subrnit cvaluation rcpo rts to a school's I:valuation tcanrs lbr consiclcration
related to an evaluation being conducted.
b. Be invited to an evaluation team meeting by either the school or parent.
i. '['he determination ol' etigibility lbr special education and the
provision o1' a F.ree Appropriate Public Education (FAPE) are the
responsibility of the IEP teams and cannot be prescribed by any
other entity.
ii. AlI educational decisions regarding educational methodology,
materials. and personnel are the responsibility ol'the school district.
c. Provide services in the schools to students under the terms ofa contract with
the school dislrict. (Sce Independent Contractors Agreement)
i. Contracts are established when the school district is paying lbr the
services and describes tlre services, tl.re role and responsibilities ol
the Independent Contractor with the evaluation team and school
administration, and the frequency and duration of services; includes
documentation of licensure/certiflcation to perfbrm the prescribcd
services: addrcsses issues related to liability. terms ofpayment; and
states the provisions fbr changes or termination of the contract.
(Example: District contracts for physical therapy services)
ii. Contracted services to a student with a disability shall be included
on the students IEP.
d. Provide services to students on school grounds under lhc terms olSumrnary
of Scrvices with the school district. (See Summary of Services Form)
i. Summary o1'Services is establishcd to allow the services to take
place on school property to bencflt the student's progress in the
gcneral education curriculum. The Summary of Serviccs shall
describe the specilic services provided, the responsibilities ol thc
school and independcnt oontractor, procedures for background
checks ar.rd insurancc. and the provisions for space, time. equipmcnt,
and materials providcd by the school district. Tlre school clistricl
,nuy terminole the Suntmury o/ &rt,lces ol dny lime-
ii. Scrvices provided undcr a Summary ol Serviccs to a stuclcnt w-ith a
disability shall bc included on thc student's Individual Ilducation
I']lan (lt,P).
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(lolrtraclor: Silrvlooth Rehab/liric Roberts
Student: Assigncd PT Sludcnts
)I)atcr Junc l. 2020
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The district has no obligation to enler into a contract with an independent
contractor or to allow an independcnt contractor access to school district
propcrly. space. materials. or cqrripmcnl.
School district records are only accessible to lndependent Contractor under
contract with the school district and with wdtlen consent from the sludent's
parent or guardian, or the adult student ( l8 years old or older). Requesl for
records may be subject to a fee to cover costs ofcopying and mailing.
Nothing in this Syslcm olCarc protocol shall be construed to limit or impinge
in any way on services parents rnay acquirc lor thcir child that arc not provided
at the school. issues related to the amount of time students aro removed liom
school for any purpose lall under the terms ofother school district policies.
Contractor: Sart tooth Rehah/l.lric Roberts
Student: Assigncd P'l studcnts -)
l)alc: .lunc 1.2()10
Idaho Falls Scho0l District 91
I NI)EPENI)T]NT CONl'RACTOI{ CONTRACTAL A(iREEM ENI':
This Contractual Agreement is entered into between Idaho Falls School District 91 (hereinafter
referred to as "District'') and Sawtooth Rehab Physical Therapy (hereinafter referred 1o as
"Contractor").
Whereas, the District provides special educational and related services to assist studcnts aftending
school in the District in their educational development. as identified on the students' individualized
education program (tEP) plan; and
Whereas, the Contractol is duly licensed or qualified and able to providc [elated scrvices to thq
District's students:
It is hereby agrecd by both parties that
DURATION OF AGREEMENT:
The period ofthis Contractual Agreement will commence on August 26,2020 and rcmain in effect
until the last day ofschool June 3,2021. 'l'his Contractual ASrcement is contingent upon the
availability offunds ofthe District. 'l his Contractual Agreement shall not exceed twelve (12) calendar
months. At the discretion ofthe District. the Contractual Agrccment may be renewed annuallv.
RELATIONSHIP OF PARTIES:
In performing services under this Contractual Agrcement, Contractor is and sltall at all times be an
independent contractor ofthc District. Nothing herein is to be construed as establishing an employer-
employee relationship.
SERVICES TO BE RENDERED:
Provider shall render the professional services enumerated on Summary ol Services. attached hereto
and made a part ofthis Contractual Agreement as set forth fully herein.
RECORD KEEPING:
Contractor shall be responsible for maintaining complete and accurate records docunlenting the
professional services provided pursuanl to this Contractual Agreement and shall provide copies ol'the
records to the District within flve (5) working days ofthe date rcquested. Additionally, upon
reasonable notice, the District shall have the right to review such records at any time duling business
hours. Appropriate Mcdicaid billing sheets will be completed each month tbr the student(s) served.
CON FIDENT I A LITY:
Provider agrees thal all infbrmation regarding serviccs provided pursuant to this Contractual
Agreement, including. but not limited to. the studcnts' identity and the nature of scrviccs rendercd.
shall be confidential pursuant to thc !'arnily Educational Records and Privac)' Acl (l'llltl'A).
Contractor is prohibited tiom disclosing any inlbrmation obtained as a result ofrcndering services
pursuant to this Colltractual Agreement to any individual not authorized and directed b), the DistIict,
without parent/guardian co[sent or consent of the studcnt if I 8 years of agc or older'
REPORTING OF ABUSE, ABANDONMENT. OR NEGLECT:
Contractor acknowledges its obligation to comply with Idaho Code Section l6- 1601. c'l.teq. and repoft,
u,ithin 24 hours. anr- suspected abuse. abandonmcnt. or neglect ofa child to thc la$ cnfblcement
agcncy or ldaho Dcipartrrrcnt of Hcalth and Weifare. Contractor also agtccs to intbtnr the District.
rvithin 24 hours. of such sttspicion.
Contractor: Sawtooth llchabi l:ric I{oberts
Srudcnt: Assigned Pl Students
lI)ate: Junc l. l0l()
Physical Thcranr' (PT) Sen,ices
SERVICE DELIVERY: TIME AND PLACE:
Contractor shall perform scrvices set forth in Summary of Scrvices, unless the parties rDutually agree
to a modification ofthe tinre and place ofservice delivcry.
PRIOR APPROVAL OF SERVICES:
All services rendered by Contractor under the tenns of this Contractual Agreement shall rcquire prior
approval by the District in accordance with lederal and stalc laws and regulations, local policies and
procedures, and professional codes of conduct.
CONSENT/AUTHORIZATION TO ACCESS F,DUCATIONAL RECORD INFORMATION
OR PROTECTED HEALTH INFORMATION:
District and Contractor shall at all times require the written consent or authorization ol'the
parent/guardian/or adult studcnt, ifage of l8 years ofage or older, for the disclosure ofaccess to
educational information pursuant to FERPA or protected health information pursuant to the Health
Information Portability and n ccountability Act (HIPAA) regarding the student, and shall rnaintain the
confidentiality ofthat information consistent with tha state and federal law and regulations.
PROFESSIONAL SERVICES:
The services rendered pursuant to this Contractual Agreement will be provided by individuals who are
duly licensed 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 perfonned in accordance with the highest professional standards. Written
assurances will be provided to the District attesting thar all cnrployees who come into contact with
sludents shall have been subject to a criminal background chcck at least as stringent as that required by
Idaho Code 33 130 and policies ofthe District, and have been determined to not have a criminal
background inconsistent with working \yith children. The Disrict shall have the right to observe
services being provided to the clients.
INSURANCE AND LIABILITY:
Contractor shall be solely liable for any losses or damages resulting fiom Contractor's performance of
any ofthe services coyered by this Contractual Agreement. Contractor shall indemnily and hold
harmless the District from any liability, including, but not limited to, cost, expenses, and attomey fees,
resulting llom Contraclor's performance ofthe services provided under this Contractual Agreement.
Proof of insurance shall be submitted to the District within ten ( l0) days ofthe date ofthis Contractual
Agreement.
ASSIGNMENT:
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 person other than contractor, or contractor's employees, to
assume the duties subject to this contractual Agreement without the District's prior written ionsent.
AMENDMENT:
This contractual Agreement may be amended at any time with the prior written consent ofbothparties. Any and all amendments to this Contractual Agreement sh;ll be in writing.
Contactor: Sa\atooth Rehab/Eric Robens
Stud€nt: Assigned Pl'Srudents )I)a1e: Junc l. 2020
COORDINATION OF SERVICES:
To facilitate delivery of services, the District will provide: l) reasonable and prompt norification of
meetings and other appointments in which the Contractor is expected to participate;2) signed parental
consent forrns, as necessary;3) identifying information regarding the client and the parcnt/guardian;
and, 4) reasonable assistance in facilitaling communication between the Contractor and clients,
parents/guardian, and other providers and agencies.
TERMINATION;
This Contractual Agreement may be terminatcd without cause by either parly within thiny (30) days
after providing written notice ofthe intcnl to terminate to the other party.
Additionally, the District may immediatcly terminate this Contractual Agreement, upon written noticc,
in the event funding for the District's program is no longer available or the spccific services to this
Contractual Agreement are modified or temrinated for a student.
DEFAULT:
Upon default by either pady, the non-defaulting pafty may cancel this Contractual Agreement
immediately. upon notice and may pursue anl and all available legal, equitable, and other remedies.
The defaulting party shall be liable fbr any and all experscs that are incurred by the non-defaulting
party as a result thereol', including, but not lirllitcd to, proauring substitute pertbrmance, legal fees, and
other losses incurred due to the def'ault.
TIME OF PERFORMANCE:
Time is ofthe essence in this Contractual Agreement, therefore, all titnes for perlormance ofthe
obligations, as stated herein, shall be strictly cornplied with by the parties.
NON.WAVIER BREACH:
The failure of Contractor or the District to insist upon strict perfonnance of any of the terms ofthis
Contractual Agreement, or to exercise any option herein conferred in any or all instances, shall not
constitute a waiver or relinquishment ofan) such term, but the same shall be and remain in full force
and effect, unless such waiver is evidcnce b)' the prior written consent ofContractor or the District.
NON-DISCR I M INATION:
The parties hereby agree that no pcrsql shall. ort the grounds ofracc. color. creed. national origin, sex.
age, or disability, be excluded from or dcnied participation in, or othcrwise subiccted to, discrimination
under any activity performed pursuant to this Clonfactual Agreement.
GOVERNANCE:
This Contractual Agreement shall bc governed by the laws ofthe State of [daho. Contractor shall, at all
times, comply with and observe all fcderal, state, and local laws, regulations, and ordinances which are
in effect and applicable during the pcriod of this Contractual Agreement.
ATTORNEY FEES:
Ifeither pafty defaults in any manncr or lails to lulfill any and/or all provisions ofthis Contractual
Agreement, and ifthe non-delaulting part-'- hircs an atlorney to exercise its rights upon such default or
failure, or iithe parties arc involvcd in an) litigation (including any proceedings in bankruptcy), the
prevailing party shall bc entitled to rccover rcasonable attonrey fees and costs tiom the other pal1y.
This paragraph shall be errforceablc by the parties notwithstanding any rescission, forfeiture, or other
termination of this Contractual Agrcemcnt.
DISPUTE RESOLUTION:
All participating agencies agree to resolve systemic disputes that arise in the provision of special
eduiation and independent contractol services in a non-adversarial tnanner and to ensure that using the
following process to rcsolve intelagency disputes does not disrupt services to students and t'amilies:
l. An individual or agency with a concem witl first use the agency's internal procedures to address
the concem.
2. lfresolution is not achieved at thc previous level. thc issuc and all relevant information will now
be forwarded to the l)irector ofstudent Services ofthe Idaho Falls school District 9l and
contractor's administrator.
3. Ifconsensus is not rcached at the previous level, the Dircctol oiStudent Services will forward the
issue and all relevant infornration to thc superintendent of ldaho I alls school District 9 | .
Contractor: Sat\kxnh Rehab/l'lric Robcrls
Student: AssiSned I'T Studcnts
Datc: .lunc I- 2020 6
4. Ifa concern is identified that is related to the quality ofservice or health and safety issues, schools
should refer concems about a contractor, their services, or quality ofservices to the Director of
Studcnt Services and contractor's administrator to address these conccrns.
5. Ifthcse concems are not resolved in the dialogue with school admirlistrator (Director ofStudent
Services and/or superintendent) and the contractor's administrator, the I)HW regional licensing
entity may be contacted to investigate the situation.
COMPENSATION/BILLING :
The District shall compensale Confactor for the direct services identificd 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 ol'Student Services, by the end of each month, an lnvoice
(statement of services rendered) for that month and the completed district's Meclicaid reponing forrns
for each student served whether Medicaid eligible or not. These conrpleted fornrs must be accurate
and ready to submit to the district's billing servicc. Cenerally, the district will issue checks biweekly if
statement and paperwork is completed and in the District Office by the end ofthe previous month. All
forms must be completed fully, signed and be the original. Each monthly staten'rcnt must include the
following information for each student receiving services: a) student's name; b) description or services
provided; c) total number of hours spent in providing professional services; ancl d) cost of services
provided. Additional documentation may be required by the District and must be provided within five
(5) working days ofthe date the wdtten request for the documentation is made.
The district agrecs to pay the Contractor at n rate of $!!QQ p er hour for l'hvsical Therafiy
Serviccs (individual physical therapy provided by professional) anrl a ratc of $20.00 per hour
for IEP meetings for the duration ofthe contract. In any case, total compsnsation for services
shall not orceed $75,000 total for thc term of service.
COMPLETE STATEMENT OF TERMS:
This Contractual Agreement constitutes the entire agreement between the pafiies hereto, and shall
supersedc 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 cxcept by an instrument in writing signed by the duly authorized representatives ofthe
parties.
Contractor: Sawtooth Rchab/Eric Roberts
Studcnt: Assigrod P'l Students 7Date: Junc l, 2020
SUMMAITY oI'SERVICES
I ndependent Contraclor'/ldnho l'alls School District 9l Protocol
This Summary of Services is to be used txly after the District and Contractor has signed the
contract, Independenl Contractor Contractual ASreement.
lndependent Contraclor Agency: SaMooth Rehab, Pt,l-C
Administrator: Eric Roberts
Business Addrcss: 185 Pevero Dr.. ldaho Falls. ldaho 83401
Telephone Nurnber: (208) 522-5600
Supervisor: Independent
Direct Service Provider: Eric Deloy Roberts
Idaho Liccnsure Number: PT-2268
Telephone Nurnber: (208) 360-3900
lrxpiration Date: I I I 17 12020
t',-Mail: juiceww@yahoo.com
Direct Servicc Provider: Qualified indivrdual tnutually agreed upon
Review of Service: lndicate when each revie\\' will be done and who will do the review:
Review: November 1 6, 2020
Review: January 18,2021
Review: March 29, 2021
Other: Upon the request ofeither party
Service(s) to be provided: Physical Therapy Seruices
When will service(s) be provided:
Time: Not to exceed 8 hours per day
Location: All District 91 schools
8I)atc: Junc 1.2020Contractor: Sawtooth Rehab/Eric Robcrts
Student: Assigncd P l' Students
Contractor will comply with the district/school operational proccdures and rvill fulfill the
following rcsponsibilities:
o Sign in and out ofschool office each visit - provide proper identitication.
. Must wear a picture identification and/or obtain a visitor's identillcation badgc from the
school at lhc tirne ofeach visit.
. Must wear appropriate clothing for a school setting.
. Adhere to set schedule - arrive and leave on time.
o Notil)' building adrninistrator ifyou will be absent (one day notice ifpossible).
. Student must be picked up fronr and returned to an appropriate school stalTperson each visit
if applicable.
. Rcmain in assigned location.
o Be knowledgeable about emergency procedures ofthe school.
. Do not violate the right of privacy ofany student by using any infbrmation 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 f'he special education teacher and/or general education teacher is the instructional leader in
the classroom. At no time should a service provider assume that theirjudgment tbr
instructional implementation or superuision ofan individual/class can supersede the teacher
or school staff merlber.
o Notify the district/school ofany stalfing changes within the agency that relates to the services
indicated on this agreement.
. Be cooperative when resolving conflicts with school/district stafl.
School/District responsibilities include:
o Respcct lhe rights ofcontractor.
o Provided information regarding the procedurals and schedule oftlre school.
o Provide information on emergency procedures.
. When appropriate. invite service provider to specific student's MDT and/or IEP team
meelings, with parental approval.
. Accommodate, within reason, Contractor's needs to fulfill the service review plan.
o Provide a positive clirnate and building environment to facilitate mutual assistance.
. Be cooperative when resolving conflicts between contractor and school stafi
-lhe above itenrs are not to be conscribed as all inclusive. Any concerns will bc adcl.cssed
according to the Dispute Resolution item in the Contractual Agreemcnt.
IN WITNIISS WHEREOF, the parties have executed this Contraclual Agreemenr
,/1(r-
S ractor's Repr(Jsentat lVC l)atc
lp?.O
Signat urc o t'Super'dcnt/Dcsignee
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('ontrack)r: :il\\'tooth Rchab/l.lric Robel1s
slud.rt: Assisrcd Pl Sludcl]ls
l)|Lu: .lurt. l. 2020
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