HomeMy WebLinkAboutCelebration Speech of Idahoii.
'Idaho Falls
School District 9L
A World Class Education
69O fohnAdams Parkway
Idaho Falls, Idaho 83401
Phone: (2O8) 525-7500 FAX: (2OB) 525-7596
Web Address: www.d91.k12,id,us
I. Protocol for Indenendent Contractors Providins SPEECH LANGUAGE
PATHOLOGIST:
The purpose of the System ofCare is to establish a procedural protocol to assist Idaho Falls School
District 91 in collaborating for the delivery of related services provided by Independent
Contractorc in accordance with an eligible student's Individual Education Plan (IEP) developed
pwsuant to Idaho Special Education Manual 2016 and the Medicaid Billing Policy for
Speecl/Audiological Therapy and Evaluation in a school setting (IDAPA 16.03.09).
This protocol provides guitlelines for the Idaho Falls School District 91 and independent
contractors to implement Speech/Language Pathology (SLP) services that are delivered to eligible
students with an Individual Educational Plan (IEP) on frle 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:
A copy of your current certificate of liability insurance with Idaho Falls School
District 91 named as an additional irsured on the policy.
Proof of workers' compensation coverage for independent contractor personnel
A copy of the contractor persomel current crimirnl background check prior to
having contact with students pursuant to Idaho Code Section 33-130.
A copy of the contractor p€rsonnel credentials pertinent to the service being provided
prior to working with students.
A copy of the service/task plan the student is working on in non-school settings.
The school will be the lead agency for any student eruolled while that student is in school. Before
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 the privacy provisions set forth by FERPA, HIPAA, and
Idaho Special Education Manual 2016. The Idaho Falls School District will need written
ar.rthorization from the parenUguardian prior to sharing information with Independent Contractors.
Contrador: Celebration Speech of ldaho
School: Assigned Speech Sud€nts
1
2
J
4
5
Dde: August 2022
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IDAHO FALLS SCHOOL DISTRICT 91
System ofCare Protocol for Independent Contractors
I
II. Overview for Indene ndent Contractors Workins with Students
Independent Contractor means a person, group, agency, or organization that meets the
following two conditions :
a. Is not an employee of Idaho Falls School District 9l or a public agency with legal
jurisdiction over the cicumstances 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 evahration reports to a school's Evah:ation teams for qllg1atg4 related
to an evaluation being conducted.
b. Be invited to an evaluation team meeting by either the school or parent.
i The determination of eligfoility for special edrrcation 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 methodolory, materials,
and personnel are the responsibility of the school district.
c. Provide services in the schools to students under the terms of a contract with the
school district. (See Independent Contractors Agreement)
i. Conlracts are established when the school district is paymg for the services
and describes the services, the role and responsibilities of the Independent
Contractor with the evaluation team and school administration, and the
fiequency and duration of services; includes documentation of
licenswe/certifrcation to perform the prescnibed services; addresses issues
related to liability, terms of payment; and states the provisions for changes
or termination of the contract. (Example: District contracts for physic a I
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 growrds rurder the terms of Summary of
Services 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 benefit the student's progress in the general education
curriculum. The Summary of Services shall describe the specific services
provide{ the responsibilities of the school and independent contractor,
procedues for background checks and insurance, and the provisions for
space, time, equfiment, and materials provided by the school dist:rrcl. The
school district may terminate the Surnrnary ofServices at any time.
Contractor: Celetnat ion Speech ofldaho
School: Assigned Speech Students
1
2.
2Dde: August 2022
3
4.
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ii Services provided under a Summary of Services to a student with a
disability shall be included on the student's Indivilual Education Plan
(rEP).
The district has no obligation to enter into a contract with an independent contractor or
to allow an independent contractor access to school district property, space, materials,
or equipment.
School district records are only accessible to Independent Contractor under contract
with the school district and with written consent from the student's parent or guardian,
or the aduh student ( 18 years old or older). Request for records may be subject to a fee
to cover costs of copying 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 rehted to the amount of time students are removed from school for any purpose
fall rmder the terms of other school district policies.
Contractor: Celebration Speech of Idaho
&hool: Assigned Speech Srdents
3Dde: August 2022
Idaho Falls School District 91
Soe e ch./Lansuaee Patholo sv (SLP)Services
This Crntractual Agreenrntis entered into between ldaho Falls School Dis trict 9I (hereinafterreferred to as
"District") and Celebration Speech ofldaho (hereinafterreferred to as "Cont-actot").
W h ereas, the Dis trict provid es s pecial ed ucd ional and re lated s €rvices to as sist s t udents attending s chool in
the District in theireducalionaldevelopnFn! as identified on the surd€nls' individualized edrcaion program
(EF) plan; and
Whereas, the Co n tracto r is duly licensed orqualified and able to provide related services to the District's
stud€nE;
It is hereby agreed byboth partiesthd:
DIJRATION OF AGR"EDVIE{ T:
The period ofthis C-ontractual AgreenEnt will commence on the 23'h dav ofAuqust2022 and remain in
effect until the 26ti dav of lVlav 2023, This Contmctual AgreerrEnt is contingent upon theavailability offunds
ofthe District. This ConfactualAgreementshall not e)aeed twelve(12) calendar rnntlE. At the discretion of
the District, the Crntractual Agreernent may be renewed annually.
RU,ATIONS HIP OF PARTIES:
In performing services underthis ContachnlAgreerrn! Contractoris andshallat all times be an independent
contractorofthe District. Nothing hoein is to be construedas establishing an erployer-employeerelationship.
SERVTCES TO BE R"U\DR"U):
Provid er s hall rcnd er th e pro fessional s ervices enurnerated on Sunnnary ofServ ices, atached hereto and ma de a
part ofth is Contractual A greerrrcnt as s et forth fu lly here in.
R,rcORD KEING:
C.ontractor shallbe res ponsible for nnintaining conplete and accurate records d ocunrnt in g the pro fessio nal
sewices provided pursuant to this ConfactualAgrcenrentand shallprovidecopies ofthe records to the Disticl
within five (5) working days ofthe date requested. Additionally, upon reasonable notice,the District shallhave
therightto review such records at any tinrc during business hours. Appropriate Medicaid billing sheebwillbe
corpleted each nnnth forthe studen(s ) s€rved.
CONflDE{TI,ALITY:
Prov id er agrees tha all in fonrnt ion regard ing s erv ices pro vided pusualt to this Crnt-actual A g reenEnt,
including, but not limited to, the s tudents' identity andthe nature ofs ervices rendercd, shallbe confidertial
pursuantto the Family Educational Records and Privacy Act (I'ERPA). Contractor is prohibited liom
disclos ing any infornation obhinedas a res ult o frend ering s erv ices pursuanl tothis Contractual A greement to
any individual not authorized and directed bythe Distict, without parent/g uard ian consent o r consentofthe
studentifl8 years ofage or older.
R"UORTING OFABUSE AB ANDONMEYT, OR NEGLECT:
Contractoracknowledges itsobligationto conply with ldaho Code Section 1Gl@L el seq. andreport, within
24 hours, any s uspected abtue, abandonnEnt, or neglect ofa child to the law enforcenrcnt agmcy or ldaho
Department ofHeahh and Welfare. Contractcnalso agrees to informthe District, within 24hours, of such
suspicion.
1Contractor: Celebration Speech of Idaho
School: Assigned Speech $u&nts
Dde: August 2022
F]tE{l
Sf,RVrcE DU,MY: TIME AI\[D PLACE
Contractor s hall perform services sd fofih in SunnEry ofservices, unless the parties mutually agrceto a
nndification ofthe tinr and place ofservice delivery.
COORDINATION OF SRVICES :
To facilitate delivery ofservices, the District will provide: l)reasonable and prornpt notification ofnretings
and otherappointnrents in which the Crntractor is eryectedto participate;2) signed parental consent forms, as
necessa-y;3) identifying infonrntion regard ing theclient andthe parent/guard ian; and,4) reasonable assisbnce
in facilitating connnunication betrveen the Contractorand clients, parorts/guardiaq and otherproviders and
agencies.
PRJOR APPROVAL OF SRWCES:
A ll services rendered by Cont"ctor underthe terns ofthis ContrachmlAgreenEnt shallrequire prio r approval
by the District in accordance with federdl and state laws andregulations, local policies and procedures, and
profes siornl codes ofcondug.
CONSEYT/AUTIIORZATION TO ACCESS E)I.]CATIONAL RECORD INFORIT{ATION OR
PROTrcTE) HEALTH INFORIVIATON:
Dstrict and Contractorshallat all tirEs require the wfitten consenl or authorization ofthe parent/guadian/or
adult student, ifage ofl8 years ofage orolder, forthe d isclosure ofaccess to educdional infonnation punuant
to FERPA orprotectedhealth infonnation pusuant to theHealth [nforrnation Portability and Accomtability
Act (HIPAA) regarding thestudent, and shallnnintain the confrdurtiality o fth at in fonnatio n c omistent with
the stateand federal law and regulations.
PROFTSSIONAL SMYICES:
The services rendercd pusuant to this Crnt'actualAgreernent will be pmvided by individuals who are duly
licensed to performthe services or s upewised by a licensed/certified provider in accondancewith applicable
professional standards. Contractoragre6 thatallwork pursuant to this CrntrachElAgreenrent willbe
perfonrrd in accordancewith the highest professionalslandtrds. Written as surances willbe providedto the
Dis trict attestingthat allenployees who corne into conad with studen6 shallhave beensubjed to a criminal
background check at least as string€nt as that required by Idaho Code 33 - 130 and policies ofthe District, and
have beendetermined to not havea criminal background incorsistent with working with children. The District
shallhave the fight to obssveservices being provided to the cliens.
INS IJRANCE AND LIABILITY:
C, ntractor s hall be liab le for any los ses o r darnages res ulting liom C, ntractor's perfo nrnnce o fany s e rvice s
covered bythis AgreenEnl Contractor shallobtain liability insurance and submit proofofsuch insuranceto the
District within ten (10) days ofthe date ofthis Agreonent Contractor shallindermifl and hold harnrlessthe
District from any liability, including but not limited to, costs, e&enses andattomeyfees resuhingfrom
Crntractols p€rforrfiance ofsewices provided underthis Agreenrcnt. District sha.llindenmif andhold
hannless Contradorfromany liability, including butnotlimited to, costs, eryenses and attomey fees resulling
liom Dis trict's reckle s s or willfu I mis con d uct re lated to this A greernent
ASSIGNMF]\IT:
This ContractualAgreanrnt shallnot be s ubjed to assignnrent, in who le orin part, by Contractororby
operationoflaw, so as to authorizf any pason otherthanContrador, orContractor's emp loyees, to assume the
duties subject tothis Crntra(,ual Agreernent without the Dis trict's prior written consent
AME{DMETIT:
This ContractualAgreenEntrnay be anpnded at any time with the prior wfitten consent ofboth parties. Any
and all amendnrentsto this ContractualAgreementshall be in writing.
)Contrador: Celetration Spe€ch of Idaho
School: Assigned Speech Sudents
Dde: Augusl 2022
TBJVTINATION:
This Contractual A greeirEnt may be terminated without caue byeitherparty within thirty(30)days after
providing written notice ofthe intertto terminate tothe otherparty.
Additionally, the District rlay irmEdiately terminate this Contractual AgreenEn!upon \aritten notice, in the
event funding forthe District's program is no longer available orthe s pecific services to this Contractual
AgreefiEnt are rnodified orterminaledfor a student.
DEAULT:
Upon default by eitherparty, thenondefaultingpafty ray cancelthis ContractualAgreenEnt ifirrEd iate ly.
upon notice and nny punue anyandallavailable legal, equitable, and otherrenEdies. The defaulting party
shallbe liable for any and alleryenses that are incurred by the non-d efaulting p arty as a result thereoi
including, but not limited to, procuring substitute perfonnancg legal fees, and other losses incurred due to t he
default.
TIME OF PMJORMANCE
Time is ofthe essencein this Contractual Agreenrnq Iherefore, alltimes for perfornance ofthe obligations, as
stated herein, shall be strictly corplied with by the parties.
NON.WAVIN, BR"EACII
The failure ofC.ontractororthe District to insist upon strict p€rfomrane ofany ofthe tenrs ofthis Crntractual
AgreenEnt, orto e>ercise anyoptionherein confened in any or all instances, shall not corstitute a waiveror
re linq u is h nrnt o fany sudl tenr! but the same shallbe and renain in full force and effect, unless srch waiver is
evidence by the prior written consent ofcrntretororthe Districl
NON-DISCRIMINATION:
The parties hereby agreethatno person shall, on the grounds ofrace, color, c reed, national origin, sex, age, or
d isability, be excluded fromordenied participation in, orotherwise subjectedto, discrimination underany
activity perfonned pursuant to this Contr-actual Agreerr)ent.
C,OVMNANCE
This ContractualAgreementshall be govemed by the laws ofthe State ofldaho. Cont?ctor s ha.ll, at all tirEs,
conrp ly with and obs erve all fedeml, state, and local laws, regulations, and ordinances which are in effect and
applicable duringthe period ofthis Contractual Agreernent.
ATTORNEY FES:
Ifeither party defaults in any rnanner or fails to fulfill any and/orall provis ions ofthis Contrac{ual Agreernent,
and if the nondefaulting party hires an attomey to e)€rcise its rights upon srch default or failure, or if the
parties are involved in any litigation (including any proceedings in bankuptcy),the prevailing party shallbe
entitled to recover reasonable altomey fees and costs liom the otherparty. This paragraph shall be enforceable
by th e part ies n ot\yithshnding any res cis sion, fo rfe it ure, or oth er terminat ion o fth is Contzctual A gre€rnen t
DISPUTE RDSOLUTION:
A ll p art ic ipating ag errcies agee to resolve systemic d is putes that aris e in the provision ofspecialedtrdion and
in d ependant co ntractor s erv ices in a non-adversarialnnnner and toensure thd usingthe following process lo
res olve interag€ncy disputes does not disrupt s erv ices to student and families:
l. An individualor agencywith a concem will fint use the agancy's internal procedures to address the
concem.
2. Ifresolution is notachieved at theprevious level, the iss ueand allrelevant infonrntion will now be
forwarded to the Director ofstudent Services ofthe IdahoFalls SchoolDistrict 91 and contractor's
ad min is t rator.
3. lfconsersus is not reached at theprevious level, the Directorofstudent Services will forward the issueand
all relevant infonnationto thesuperintendent ofldaho Falls School District 91.
Contrador: Celekation Speech of Idaho
School: Assigned Speech Sudents
6Dde: Aueust 2022
4. Ifa concem is identified that is related to the quality ofservice or healthand safdy issues. schools should
refer concems about a cont-actor, th e ir s erv ices, orquality ofservices tothe Director ofstudent Services
and contractor's ad min is t"ator to address these concerns.
5. lfthese corrcems arc notresolved in the dialogue with schooladminist-ator (Director ofstudent Services
and/or s uperintendent ) andthe contrador's administrator, the DHW regional licensingentity may be
contactedto investigate the situation.
COMPE\IS ATION/BILLING:
The Dstrict s hall co rpemate Crnfactorforthe direct services identified onthe attadled Idaho School Based
Medicaid Service Detailand Activity Record Reimbursernent forapprovedhours will be atthe rate ofthe
allowable arnount perhour for Speeclrtanguage Pathology serv ices (SLP) less state funding rate (3fflo) and
billing services ( l0lo) rates, in an arnount not to e)ceed the District's rate forthe termofthe Contractual
Agreenrcnt. Additional hours will be conpensated at the sarE rate, providedthar theadditional hous have
been pre-approvd in writing, by the District's designee.
Contractor will submit to the Directorofstudent Services, by the end ofeach monttl an tnvoice (statementof
sewices rendued) forthat month andthe conpleted district's Medicaid reporting forns. Theseconpleted
forrB rnust be accurateand ready to s ubmit to the district's billing service. Cenerally, the district will issue
checks by the semnd Friday ofthe nnntlr ifstatarrnt and paperwork is conpletedand in the District Office by
the end ofthe previous nnnth. Each rmnthly statement mustincludethe following infornntion for each stdent
receiving sewices:a) student's narne; b)description orservices provided; c)totalnumberofhours s pent in
providing professional services; andd)cost ofservices provided. Additionaldocunrntation nny be required by
the District and must be provided within five (5) wofting days ofthe date the \4ritten req uest for the
docurEnation is made.
The districtagrees to Fy the Contractor at a rate of$75.00 pe r hour for Spe e ch,/Languaqe
Patholosy Se wices.
COMPI,ETE STATUUE\IT OF TB}IS:
Th is Contractual A greernent const it utes the entire agreefrEnt between the p arties herdo, and shallsupersede all
previous oral orwritten propo6als, negotiatiors, conrnitnents, and all otherconrnunicatiom between the
parties. This ConfactualAgreernentrmy not be released, disdnrged, ormodifred ercept by an instrunrcnt in
writing signed by the duly authorized represantatives ofthe parties.
Contrador: Celebration Speech of Idaho
School: Assigned Speech Sudents
7Dde: Awust 2022
Certific atell-ic ens ure Number: 09126842
B:reau of Occupational Licenses: SLP-1412
SUMMARYOF SERI'ICES
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 contact,
Independent Contractor Contractual Agreement.
Department of Heahh & Welfare Contact: SchoolEhsed Medicaid
Address: 3232 EHer Street Ebise, ID 83705
Telephone Number: 208-364- 1903
Independent Contractor Agency: Celebration Speech of Idaho
Administrator: Kim Stowell
Brsiness Address: 1979 Eagb Pointe Ct, Ammon, ID 83406
Telephone Number: 208-589-838 I
Supervisor: Kim Stowell E-Mail: kdstowell(rigmail.com
Direct Service Provider: Dawn Taylor
Telephone Number: 208-52 1 -3880
Certific atellic en s ure Number: 0l I 19251
Bureau of Occupational Licenses: SLP- 1494
Celebrationspeec hidaho@ gmail.com
Expiration Date: 08 I 23 I 2023
DMait dawn.taylor. SlP@celebrationspeech.com
Expiration Date: 03 I 24 /2023
Review of Service: Indicate when each review will be done and who will do the review
First Review: September 26, 2022
Second Review: November 14, 2022
Third Review: February 13, 2023
Other: at each student's annualIEP team meeting
Service(s) to be provide: Speech/Language Services
When service(s) will be provided:
Day(s): As mutually agreed upon
Incation: As assigned on the Ancillary Schedule for 2022-2023
Duration ofservices (each day): As required by the assigned students'IEP
Contractor: Celetration Speech of ldaho
School: Assigned Speech sudents
{lDde: August 2022
cortrrctor will comply witt tlc drstricrhchoor oFnarDrrr pmc.dlrca ,rd ;ilr fEt r[ rbc fotlowrtrgr6pooribiliriB:
. Sign in and our of schol o{fice each visit _ provide proper idenrification.
' t'lust wear a picturc idcntificarion and/or obrain a visitor's identification badge frcm the
school st tlre time ofthe each Yisit.. Must wear apFopriste clothing for a school setting.. Adhere to 3et schedule - arrive and leave on time.o Norify building adminisraror ifyou lvill be abs€nr (one d6y notice ifpossible).
' srudent must be picked up from and retumed ro an appropriate schooi staffpenon each visil
ifapplicable.
. Remain in assigned location.. Be knowledgeable about e ergency procedures ofthe school.. Do nol violare the right of privacy of any student by using an) information randomly
obtained by observing oth€r stud€nts as service refirence to make conlact with parents to seltor contmct them to services from your agency.
' The sP€cial educalion teacher and/or general educadon teacher is the insaucdonal leader in
the classroom. At no time should a service provider assume that theirjudgment forinstructional imPlemcntsion or supcrvision ol'an irdividual/class can sulnede rhe teacher
or schml staff member.o Notify the districtzschoor ofany starling changes within rhe agency thar rera1gs to the sen ices
indicated on rhis agreement.. Be cooperative when resolving conflicts with school/district staf!:
ScloouDbarht rG poliibilid!3 hchde:. Respect the riglrts ofcontractor.o Provided infomation regarding the procedurals and sche{ule ofthe school.r Provide information on emergency procedures_. Whes appropriate. iovite service providsr to specific stud€nr,s MDT and/or tEp tcammeetings. with parcnEl spproval.r Accommodate, wilhin reason, Contractor.s needs to fulfilt the service rwiew pla[,r Provide a positive climaJe and buirding environment to faciritate muuar assislance.o Be cmpemtive when resolving conflicts between conrractor and school sraff
Th€ above items ar€ nor to be conscribed as aI incrusive. Any concerns wi be addressed according tothe Dispute Resolution item in the Contracrual Agreemenr.
IN WITNESS WHEREOF, the parties have executed this Contractual Agreemenl
ature of C
z_
Date
o\ ar \raSignaturc ol'District Supcri
Contracror: Cekb.stion SFaoch of tdsho
school: Asigncd SF.ch Stud.n6
nec
Ddei
^ugrN1202!
Datc