HomeMy WebLinkAboutGail Kisling FY 21.:t.' .
'Idaho Falls
School District 91
A World Class Education
690 fohn Adams Parkway ldaho Falls, Idaho 83401
Phone: (208) 525-7 500 FAX: (208) 525-7 596
Web Address: wu,rv-d91.k1 2.id.us
I. Protocol for Indeoendent Con tractors Providinp
SPEECH LANGUACE PATHOLOGIST:
The purpose of the System of Care is to establish a procedural protoool to assist the Idaho
Falls School District 9l in collaborating with lndependent Contractors fbr the delivcry of
related services provided by in accordance with the following:l. Eligible students' Individual Education Plans (lEP) developed pwsuant to Idaho
Special Education Manual 2016, and
2. The Medicaid Billing Policy for Speech/Audio logical Therapy and Evaluation in
a school setting (IDAPA 16.03.09).
This protocol provides guidelines for the ldaho Falls School District 9l and independent
contractors to implement Speech,{Language Pathology (SLP) services that are delivered to
eligible students with an Individual Educational Plan (IEP) 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 Certificate of Liability Insurance with School District 9l listed on thc
policy.
A current Criminal Background Check
Evidence of qualifi cations to perform Speech,/Language Pathology Services
The school will be the lead agency for any student enrolled while that student is in school.
Bcfore the Independent Contractor may work with the student, a Contractual Agreement
must be completed with the Contractor, building principal and Director of Student
Services.
Idaho Falls School District must follow thc privacy provisions sct lorth by FERPA, HIPPA,
and Idaho Special Education Manual 2016. The Idaho Falls School District will need
written authorization from the parenVguardian prior to sharing inlormation with
Independent Conff actors.
Contmctor: Gail Kisling (SLP)
Student: Assigned SLP Students
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Date: September 22, 2020
IDAHO FALLS SCHOOL DTSTRICT 9I
System of Care Protocol for Independent Contractors
I
II. Overview for Independent Contractors Workinq with Students
Independent Contractor means a person, group, agency, or organization that
meets the lollowing two conditions:
a. Is not an employee of ldaho Falls School District 91 or a public agency with
legal jurisdiction over the circumstanccs related 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 following in Idaho Falls School District 91:
a. Submit evaluation reports to a school's Evaluation teams for consideration
related to an evaluation being conducted.
b. Be invited to an evaluation team meeting by either the school or parent.
i. The determination of eligibility for special education and the
provision of a Free Appropriate Public Education (FAPE) are the
responsibility of the IEP teams and cannot be prescribed by any
other entity.ii. All educational decisions regarding educational methodology,
materials, and personnel are the responsibility of the school district.
c. Provide services in the schools to students under the terms ofa contract with
the school district. (See lndependent 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 lndependent Contractor with the evaluation team and school
administration, and the frequency and duration of services; includes
documentation of licensure/certification to perform the prescribed
services; addresses issues related to liability, terms of payment; and
states t}le provisions for 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 the terms of Summary
of Servioes with the school district. (See Summary of Services Form)i. Summary of Services is established to allow the services to take
place on school property to bcnefit the student's progress in the
general education curriculum. The Summary of Servioes shall
describe the specific services provided, the responsibilities of thc
school and independent contractor, procedures for background
checks and insurance, and the provisions for space, timc, equipment,
and materials provided by the school distict. The school district
may terminate the Summary of Services at any time.ii. Services provided under a Summary of Serviccs to a student with a
disability shall be included on the student's Individual Education
Plan (IEP).
Contractor: Gail Kisling (SLP)
Stude[t: Assigned SLP Studetrts
2Date: September 22, 2020
1.
2.
1
The district has no obligation to enter into a contract with an independent
contractor or 10 allow an independenl contractor access to school district
propefiy, space, materials, or equipment.
School district records are only accessible to lndependent Contractor under
contract with the school district and with written consbnt lrom the studcnt's
parent or guardian, or the adult student (18 years old or older). Request for
records may be subject to a lee to cover costs ofcopying and mailing.
Nothing in this System of Carc protocol shall be construcd 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 oltime studcnts are removed from
school for any purpose fall under the terms ofother school district policies.
Contractor Gail Kisljng (SLP)
Student: Assigned SLP Students JDate: September 22, 2020
).
5.
Idaho Falls School District 9l
INDI]PI]NDT]N'I' CO\'TRACTOR CON'f RACTAI ACREEMENT:
Spccch/Lansuase Patholosv (SLP) Services
Whereas. the District provides special educational and related services to assist students attending
school in the District in their educational development, as identified on the students' individualized
education program (IEP) plan; and
Whcreas, the Contractor is duly licensed or qualified and able to provide rclated selviccs to the
District's students;
It is hereby agreed by both parties that
DURATION OI' ACREUMENT:
The period ofthis Contractual Agreement will commence on the August 26, 2020 and remain in effbct
until the last day ofschool, June 3,2021. This Contractual Ageement is contingent upon the
availability of I'unds ofthe District. This Contractual Agreement shall not exceed twelve (12) calendar
months. At the discretion ofthe District, the Contractual Agreement may be renewed annually.
RELATIONSIIIP OF PARTIES:
ln performing services under this Contractual Agreement, Contractor is and shall at all times be arr
independent contractor ofthc District. Nothing herein is to be constued as establishing an employer-
employcc rclationship.
SERVICl]S 'tO BE RENDERIiD:
Provider shall render thc profcssional services enumerated on Summary ofServices. attached hcreto
and made a pan ofthis Contractual Agreement as set forth fully herein.
RECORD KEEPING:
Contractor shall be responsible for maintaining complete and accurate records documetrting the
professional services provided pursuant to this Contractual Agrcement and shall provide copies ofthe
records to the District within five (5) working days ofthe date requested. Additionally, upon
reasonable notice, the District shall havc the right to review such records at any time during business
hours. Appropriate Medicaid billing sheets will be completed each month for the studeot(s) served.
CONFIDENTIAT,ITY:
Provider agrees that all information regarding services provided pursuant to this Contractual
Agreement, including, but not limited to, the sludents' identity and the nature ofservices rendercd,
shall be confidential purcuanl to the F'amily Educational Records and Privacy Act (FERPA).
Contractor is prohibited from disclosing any information obtained as a result ofrendering services
pursuant to this Contractual Agreement to any indiyidual not authorized and directed by the District
without parent/guardian consent or consent ofthe student if l8 years ofage or older.
Contractor: Cail Kisling (Sl,P)
Student: Assigned SLP Studenrs 4Datc: Septembcr 22, 2020
This Contractual Agreement is entered into b€lween ldaho Falls School District 9l (hereinafter
referred to as "District") and Gail Kisling (hereinafter referr€d to as "Contractor").
REPORTTNG OF ABUSA, ABANDONMENT, OR NEGLECT:
Contractor acknowledges its obligation to comply with ldaho Code Section 16-1601, et seq. and repon,
within 24 hours, any suspected abuse, abandonment, or neglect ofa child to the law enforcement
agency or Idaho Department ofHealth and Welfare. Contractor also agrees to inform the Districl,
within 24 hours, of such suspicion.
SERVICE DELI!'ERY: TIME AflD PLACE:
Contractor shall perfom services set forth in Summary ofServiccs, unless the panies mutually agree
to a modification ofthe time and place ofservice delivery.
COORDINATION OF SERVICES:
To facilitate delivery ofservices, the f)istrict will provide: l) reasonable and prompt notification of
meetings and other appoiotments in which the Contractor is expccted to participate; 2) signed pareutal
consent forms, as necessary;3) identifying inlormation regarding the client aDd the parent/guardian:
and, 4) reasonable assistance in facilitating communication between the Contmctor and clients.
parentVguardian, and other providers and agencies.
PRIOR APPROVAL OF SERVICES:
All services rendered by Contractor under the terms ofthis Contractual Agreement shall rcquire prior
approval by the District in accordance with federdl and statc laws and rcgulations, local policics and
procedures, and professional codes of conducl.
CONSENT/AUTHORIZATION TO ACCESS EDUCATIONAT- RECORD INFORMATION
OR PROTtrCTED HEALTH INFOR.IVIATION:
District and Contractor shall at all times require the writlen consent or authorization ofthe
parent/guardian/or adult student, ifage of l8 years ofagc or older. for the disclosure ofacoess to
educational information pursuant to FERPA or protected health information pusuant to the Health
Information Portability and Accountability Act (HIPAA) regarding the student, and shall maintain the
confidcrtiality ofthat information consistent with the state and federal law and regularions.
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
applicablc professional standards. Conractor agrees that all work pursuant to this Contractual
Agreement uill be performed in accordance with the highest profbssional standards. Written
assurances will be provided to the District attesting that all employees who come into contact with
students shall have been subject to a criminal background check 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 with children. The District shall have the right to observe
sen'ices being provided to the clients.
INSURANCE AND LIABILITY:
Confactor shall be solely liable lbr any losses or damages resulting from Contractor's performance ol'
any ofthe serviccs covered by this Conractual Agreement. Confactor shall indemnify and hold
harmless the District from any liability, including, but not limited to, cost, expenses, and attorney ibes,
resulting from Contractor's performance ofthe services provided under this Contractual Agre€ment.
Proofof insurance shali be submitted to the District within ten ( l0) days ofthe date of this Contractual
AEireement.
ASSIGNMENT:
This Contractual Agreemcnt shall not be subject to assignment, in whole or in part, by Contractor or by
operation of law, so as to authodze any person other than Contractor, or Contractor's cmployees, to
assume the duties subject to this conhactual Ag'e€ment without the Distict's prior written corrsent.
Contmctor: Gail Kisling (SI-P)
Student Assigned SLP Students -5
Date: September 22, 2020
TERMINATION:
This ContractMt Agreement may be tenninated without cause by either party within thirty (30) days
after providhg written notice ofthe intont to terminate to the other pany,
Additiomlly, the District may immediately terminate this Contractual Agreement, upon written notice.
in the event funding for the District's program is no longer available or the specific services to this
Contractual Agreement are modified or terminated for a studenl.
DEIAULT:
Upon default by either party, the non-defaulting party may cancel 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
party as a result thereof, including, but nol limited to, prccuring substitute performance, Iegal fees. and
other losscs incured due to the default.
TIME OF PERFORMAITICf,,:
Time is ofthe essence in this Contractual Agreemenr; therefore, all times for performance ofthe
obligations, as stated herein, shall be stricrly complied with by the panies.
NON.WAVIER BRf,ACH:
The failure of Contactor or the District to insist upon stricl performance of any ofthe terms ofthis
Contractual Agreement, or to exercise any option herein conferred in any or all instanccs. shall not
constitute a waiver or relinquishment ofany such lenrl but the same shall be and remain in full force
and effect, uoless such waiver is evidence by the prior written oonsent ofContractor or the District.
NON-DISCRIMINATION:
The parties hereby agree that no person shall, on the grounds of race, color. creed, national origin, sex.
age, or disability, be excluded from or denied participation in, or otherwise subjected to. discrimination
under any activity perlbrmed pursuant to this Contrzctual Aefeement.
GOVERNANCE:
This Conractual Agreement shall be govemed by the laws ofthe State of ldaho. 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.
DISPUTE RESOLUTION:
AII participating agencies agree to resolve systemic disputes that arise in the provision ofspecial
education and independent contractor services in a non-adversarial manncr and to ensure that using the
following process to resolve interagency disputes does not disrupt services to students and families:
1. An individual or agency with a concem will first use the agency's internal procedures to address
the concern.
ContEctor: Gail Kisling (SLP)
Studenl: Assigned SLP Students 6Date: September 22, 2020
AMI]NDMENT:
'l'his Contractual Agreement may be amended at any time with the prior written consent ofboth
parties. Aly and all amendments to this Contractual Agrcement shall bc in writing.
ATTOR\EY FEES:
Ifeither party defaults in any manner or fails to fulfill any anrVor all provisions ofthis Contractual
Agreement, and ifthe nondefaulting party hires an attomey to exercise its rights upon such default or
failure, or ifthe parties are involved in any litigation (including any proceedings in bankruptcy), thc
prevailing party shall be entitled to recover reasonable attomey fees and costs fiom the othcr pany.
This paragraph shall be enforceable by the panies notwithstanding any rescission, forfeiture, or other
termination of this Contractual Agreement.
2. lfresolution is not achieved at the previous level, the issue and all relevant information will now
be forwarded to the Director ofStudent Services of the ldaho Falls School Disrrict 9l aDd
contractor's administrator.
3. Ifconsensus is not reached at the previous level, the Director of Student Scrviccs will lbrward thc
issue and all releyant information to the superintendent ofldaho Falls School Disrict 9l.
4. lfa concem is identified that is related to the quality of service or health and safety iszues, schools
should retbr concems about a contractor, their services, or quality olservices to the Director of
Student Services and contractor's administrator to address these conc€r[s.
5. lftlese concems are not resolved in the dialogue with school administrator (Director ofStudent
Sewices and/or superintendent) and the contactor's administralor, the DHW regiolal licensing
entity may be contacted to investigale the situation.
COMPENSATION/BILLIN G:
The Districl shall compensate Contractor for the direct services identified below. Additional hours
will be compensated at the same mte, provided that the additional hours have been pre-approved, in
writing, by the District's designee.
Contractor will submit to the Director ofStudent Services, by the end ofeach month, an Invoice
(stntcmeut of services rendered) for that month and tie completed district's Medicaid reporting forms
for each student served whether Medicaid eligible ornot- These completcd fornls mustb€ aqcurate
and ready to submit to the district's billing service. Generally, the district will issue checks biweekly,
after Board approval ifstatemeni and paperwork is completed and in the District Oflice by the end of
each month. All forms must be completed fully, signed and be the original. Each monthly statement
must include the following information for each student receiving services: a) description or services
provided: b) totat number ofhours spent in providing professional services: and c) cost ofservices
provided. Additional documentation may be required by the District and must be provided r.r,.ithin hve
(5) working days ofthe date thc written request for the documentation is made.
The district agrees to pay the Contractor at a rate of @QQ p€r hour I'or SDeech/Lanquaqe
Patho Services for the duration ofthe contracl This contract is not to exceed $18,375
based on the number of days worked (approximately 175 days at I day per week when school is
in session) x 7 hours per day x $75.00 per hour, unless agreed to by both parties.
COMPLETE STATEMENT OF TERMS:
This Contractual Agreement constitutes the entire agreement bctween 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
rnodified except by an instrument in writing signed by the duly authorized representatives ofthe
parties.
Contractor: Gail Kisling (SLP)
Studert: Assigned SLP Studenrs 7Date: Ssptember 22, 2020
SUMMARY OF SERVICES
Independent Contractor/ldaho l-alls School District 9l Protocol
This Summary of Services is to be used only after the District and Contractor has signed the
conffact, lndependent Conhactor Contractual Agreement.
lndependent Contractor Agency: Gail Kisling
Direct Service Provider: Gail Kisling
Business Address: 3378 Leroy Dr, Ammon, ID 83406
TelephoneNumber:208-7052424 E-Mail:kislgail@d9l.kl2.id.us
Bueau of Occupational License:
Idaho Licensure: SLP-1254
ASHA Association: 01077252
Expiration Date: 1,0 /21 2020
Expiration Date: 12 I 3 | /2020
Review of Service: 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, 2021
Other: Upon tle request ofeither party
Service(s) to be provided: SpeecVlanguage Services
When will service(s) be provided:
Day(s): As agreed upon (when school is in session)
Time: I day a week (7 hour days)
Location (i.e. classroorn, playground, etc...): Assigned SLP Students, Monthty SLP
Departrnent meetings and District IEP team meetings as needed.
Duration of services (each day): As required by the assiped students' IEPs.
C:ontmctor: Gail Kisling (SLP)
Sludenl: Assigned SLP Studetrts 8Date: September 22, 2020
Contractor will comply with the districUschool operational procedures and will fulfill the
followin g responsibilities:
o Sign in and out ofschool office each visit provide proper identification.. Must wear a picture identification and/or obtain a visitor's identification badge from the
school at the time of each visit.. Must wear appropriate clothing for a school setting.o Adhere to set schedule arrive and leave on time.. Notify building adminishator ifyou will be absent (one day notice ifpossible).o Student must be picked up from and retumed to an appropriate school staffperson each visit
if applicable.
o Remain in assigned location.o Be knowledgeable about emergency procedures of the school.o Do not violate the right ofprivacy of any 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 teacher and/or general education teacher is the instructional leader in
the classroom. At no time should a service provider assume that theirjudgnent for
instructional implementation or supervision ofan individual/class can supersede ttre teacher
or school staff member.
o Notify the district/school ofany stalfing changes within the agency that relates to the services
indicated on this agreement.o Be cooperative when resolving conflicts with schooVdistrict staff.
SchooUDistrict responsibilities include:. Respect the rights of contractor.o Provided information regarding the procedurals and schedule ofthe school.r Provide information on emergency procedures.
o 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.o Be cooperative when resolving conflicts between contractor and school staff.
The above items are not to be conscribed as all inclusive. Any concerns will be addressed
according to the Dispute Resolution item in the Contractual Agreement.
IN WITNESS WHEREOF, the parties have executed this Contractual Agreement.
>o
Signature ol Contractor tativc,s te
Signature o p crintend Dec
9Date: Septembcr 22, 2020
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(:ontractor: Cail Kisling (SLP)
Student: Assigred SLP Students