HomeMy WebLinkAboutAccess Pointii
'Idaho Falls
School District 91
A World Class Education
690 fohn Adams Parkway
Idaho Falls, Idaho 83401
Phone: (2081 525-7500 FAX: (208)525-7596
Web Address: ifschools.org
IDAHO FALLS SCHOOL DISTRICTgI
Systcm ofCare Protocol for Indepcndenf Contractors
I. Protocol for Inde endent Contractors Providin {,n
BEHAVIORALINT ERVE,NTION SP ECIALIST (BI). BEHAVOI{IAI,
INTERVENTION P ARAPROF[,SSI OANL (BI PARA), BI TECHNIC IAN (BI
TECH).CO M MUNITY BASED REHABILITATI ON SERVICES (CBI{S)
The purpose ofthe system of care is to establish a procedural protocol to assist Idaho Falls
School Dist.ict 9l in collaborating for the delivery of related services pr.ovided by
independent conttactors in accordance an cligible student's indiviclualized Education
Program (IEP) and developed purs.ant to Idaho Special Education Rules and Reg,lations,
2018; T'he Cltildren's Mcntal Services Acr of 1998; and Medicaid billing policy for
rehabilitative services in a sclrool setting (lDApA t6.03.09.24i,
-
IDAPA
16.03.10.124.05.c, IDAPA 16.03.10.653.05.e, and IDAPA 16.03.09.855.10
Quali{ications and Supervision).
This protocol plovides guidelines for ldaho Falls Schoot District 9l and independent
contractors to implement Behaviolal Intervention (BI) conmlurity Based Rehabilitation
Services (cBRS) that are delivered to Medicaid eligible students with anlEponfile within
the school district. In order to provide BI and cBRS services in the sclrool setting, ths
Independent contractor must be approved by the Director of student Services arrd provide
the following docunentation:
AND HABILITATI}TE SKILL S (HS):
A copy of your cuucnt certifrcate of liability insurance wirh ldaho Falls
School District 91 named as an additional insured ou the policy.
Prool of rvorkers' corr.rpensation coverage for indepcndent contractor
personnel.
A copy of the contractor personnel cunent crirrrinal backgrorurd check prior
to having contact with students pusuant to Idaho Code Section 33-130.
A copy of the cor'itractol personnel credentials pertinent to the scruice being
provided prior to wor king with students.
A copy of all plaured and subsequent completion ollrair ng taken towards
CBRS CPRP and/or CFRP Certification in accordance with USPRA, IDAPA
1 6.03.09.8ss. 10.k. ii.
2.
J.
4.
J.
Contrador: Acccss Poio(
(Bl. cBrrs, l-tD
Datc: Jrl), 28,2022 1
6. A copy of the service plan.the student is workitg on in non_school settings.7. provide monthly docrurrentation^of olc_to_or. ,"rj..uision by a qualifredagency representarive with the GBRS pr.ovider(s) to review tieatmenlprovided to tlrc student in accordancc wittr tOepa 16.03.09. g55.10. TheCBRS provider and agency are responsible io p.oriae ,rp".ulrloii *i,fr.lu"f,student rhe provider has wortea with ,ontttu..firi, incUa"s iiiiie ;;il;;.only worked with a student fo, or. auy unJirst ile condu"ted within thecalendar month they are submitting biliing.
T.e schoor wi' be the lead aoengy for any e,rored student wh.ire trnt student is i, school.Before the Independenr cont[dor may work with u.,rJ*,'u
"ont.actuar agreement nlust
3il::lr!"J:iJ1h rhe rndependent contractor, 1," erilJi,;' irincipal u,a ii," oi,".to.li
Idaho Falls schoor District 9l must forow the privacy provisions set forth by the FanriryEducational Rights and privacy. Act (FERi'A), Hearth Insu.ance portabiritv andAccoLurtabiriry Act (HI.AA)' anairr" taurro sp"J"i'ai*",r* Manuar, 2018. Idaho FalrsSchool District 9l wi, need *.rtt"n urtt o.Ltronl;';ir" pare,t/guardian to shareinformation with private service providers
IL Ove rvie rv lbr Indc pe nd ent Cont ractors Wo rkins wit h Students
2.
"lndependent contractor,, mea
meets the foltowing
"ona;tionrtlt
a person' Sroup' agency' or organization that
a' Provides services to the District under trre ternrs specifred in the contrachla lagleement;
b. Provides services to tlre District according to his or her own processes andmethods;
c. Is paid or rcirnbrrsed for services provided to a student tlrough theestablished biilirg poticy.'Conllict of interest., means any official action or arry decision olrecorn:endation by a person who is employed uy ttr" s"troot district, the effectof w^ich worrld be the orivate pecu.iary U"""n, "iii" l*.ron or. a nreurber ofrhe person,s household, o, u uuri,,"..'*ti., ;i;;i; il ;,.#"Ji a n,"n,b", of rh"person's household is associated.a. In the event that a school district employee has an interest in the htdependentcontract, or a conllict of irrterest, thi enrpioyee ,;;.,,---'-'i. Prepare a written statement descrti,rg ihe matter required to beacted upon and the nature of tn" pot.,Gf lo,rn[iiii. Deliver the statement to the emptyee,s air""t
-.up".uiro..
The Independent Contractor uray:a. Submit assessment data and/or. reports to a sclrool,s evaluation team for. gonsideration in the student eualuaiion proc;;. '*' " '*'
b. Be invited to an evaluation ,.r, " ,rr*i,U by the school and/orparent/guardian.
J
Conlrador: Access po inl
(ur, CBRS S)2
Datc: Jut), 28,2022
1.
4
i. The determination of eligibitity for special education aud the
provision of a Free Appropriate Public Education (FAPE) are the
responsibility of the IEP teams and cannot be prcscribed by any
other entity.
ii. All education decisions regarding educational rnethodology,
materials, alrd personneI are the responsibility of the sclrcol district.
c. Provide services in thc schools to students under the ter-ms of the corrtractual
agreement with the school district (see Independent Contractot Contractual
Agreement).
i. Contracts are established when tlre school district describes the
services to be provided, including the frequency and dulation of
serices; is paying for the services; and outlines the role,
responsibilities, and rcquirements of thc Independent Colttractor,
including docunentation of licensure/certiftcation to pelform the
prescribed services, documentation of current backg'ound check(s),
documentation of liability insurance, terms of payntent, and
provisions for changes or tern nation of the conhact.
d. Provide seryices to stxdents on school groturds under the ternrs of the
Sunrnrary of Services (see Sturuuary of Services folni).
i. The Sturmary of Services is established to allow the seryices to take
place on school property to benefit tlte student's progress in tlre
general education curriculum. The Sunlrrary of Services shall
describe the specilrc seruices to be provided; the lesponsibilities of
the school and the Independent Contractor; and tlre provisions for'
space, time, equipment, and materials provided by the school
district.
ii. The school district may terminate the Summary of Services at any
time.
iii. Services provided utder dre Sunmary of Services to a student with
a disability shall be included on the student's IEP.
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 an ildependent contractol who is
under contract with the school district and with the written consent of the
student's parenUguardian or tlte student, il l8 years old or older.
6.Nothing in this System of Care Protocol shall be constt'ued to limit or impinge
in any way on services pare ts may acquire for their child that are not provided
at the school. Issues related to the amourt of t r']e students are removed from
school fol any purpose fall tu.rder the ternN ofother school distt'ict policies'
Conlrador: Acccss Poid
(Br. CBRS HS)
Jl)alc: July 28,2022
5.
Th is Independen t contmcto r cont"dual Agreenrent (lrere inafter refered to as ,,contractual
Agreement') is entered into between ldalro Falls School Dis trict 9 t lhereinafter referred to as ,.the
District")and ACC16S pOtNT (h erc irro n"r r.f"""Jr o n i: ti;;:i;;)
w hereas. the Dis trict provides s D€ciar ed ucationar and rerated s erv ices to assist s tudents attendingsclool irr the Districr in rheired ricationat a"uetoprr"rt, as raartin"a J-.' trrl,n,a"rt,s lndividuarizedEducation Prograrn(lEp); and
w hereas, the contracroris d ury ricensed and/orquarified and abre to pmvide rerated scv ices to theDistrict's students;
It is hereby agreed byboth parties that:
DURATION OF AGREET\4U{T
Idaho Falls Schoo I District 9l
D CO CT
The period ofthis Contmctual Agreen]ent ce c23 of us ;ln'l'his Conhachral Agreement is coutin genl upon the
greemen t s hall not exreed lwelve ( l2) calendarrnonths. At thediscre tion ofthe Dislrict. the Con lractualAgreement rray be rene wed annuallv
RELATIONS HTP OF PARTIES
In perfonning serv ices underthis contractuarAgreement, contractor is a.d s haU at afl tirnes be anindependentcontractoroftrre District Nothingiierern ii io be'""*i","ir. .rtrurishing an emproyer-elnployee relationsltip.
SERVICES TO BE RENDERED
contmctorsha'rr rendcr the orofcssionars ervices en urnerated on the Sunrnary olservices, attachedhereto and nude a pafi oftliis Contracluut egre.,r*ni rir"r fo"f,r frf fy iri*lr.
RECORD KEEPING
contracrorsha be rcs oonsibre for rrnintaining_comprete and accurate records docrment ing theprofes sionals ervices provided prrrsuantto rrriicort["t"J n gr".;,it o"ni sr.,orr p.ovia" copies oftherccods to the Disl rict wilhin five (5) working days ofthe darJr"q uo,J.' aaO,tionally. uponreasonable noticq rhe Districr s hau have the-rigrrr lo rev ierv s r.t
-l="orus
ut any r i,r* <iiri,ig uusiuesshours. Appropriate Medicaid biring sheetr *it'i b.
"o,rpLt"a """rr,*rirl rr.rrr" .,udenl(s) served.
CONFIDENTTALMY
contractor agrees thata, in fonr,t ion regarcringseruices provided puBuantto th is con tmctrrarAgreernenr, incrudins, bur not rirnited rolr r,," , tia.irt;. iaJnriiy.ra','r,,ir.i*",rrervices rendered,shallbeconfidentialpursuantto the Far;ily eaucatio,rofn co,rjs urj i,,iru.y nolfeneelcontractor is prohibited frorn discrosing any inronnat ion outoi*ir.
" "t rr,
"r*ndering serv icespurs uant {o r h is corrrractuar A o reernenito arry ind ivid uarnoiliiirr-*i*a ."a a i,".ted by l he Dis trict orwittrout the consenr ofrhe p a re"n t/grrard ia, ""ri".iru"*, iij S i"#irrg" ororo"r.
REPORTING OFABUSE ABANDONME{T, OR NECI,ECT
Co ntrac tor ackn owledqes its obliparionto cornp Iy wit h ldaho Code Sect ion l6_ 1601. er .rcr7. and repo4with in 24 hours, anv s rapected ab-Lrse. obararr',rirr. ,r,r+i".i "i" .r,i,il" ,*"r rrrcerncnr or rrreIdaho Deparrrnenl ofHeirrh and w"trar.. conr.acro;il;".;;';;il; rhe Disrricr, wirhi. 24lrours, ofsuch suspicion.
Conlrador: Acccss point
(Br, CBRS, HS)4
Dalc: July 28,2022
SERVICE DELIVERY TIME AND PLACE
contracto's ha, perronn s erv ices s et fortt, in ttr" su,r,*,y otservices, un ress the pa rl ies lrutuaryagrse to a mod ification ofthe t irne and p lace ofscrv ice d eliv",y, --
COORDINATION OF SERVICES'fo faciritate deriverv ofservices- the Districr wi, provide: ( I) reasonabre and prcmpt notification ofrneerings and orrrcrappoinlrnents in wrr icr, ,i;. c;;i;r;;; il ;;Jir"eiil panicipate:12) s igned parenrarconscnr fonns. as nccessarv: (3) idenrift.ing infon,orioiireiu,.iirg,1i"",,"r, ,"0 ,he pa.en/grnrdian:a.d (4) reasonabre assistance'i; facirirar ing cornurunicarion-b"i*&li,r," .ont r",orand the crien(,paren t/guadian, and other pr oviders and algencie s.
PRIOR APPIIOVAL OF SERVICES
All services renderedby contractorunderthe tennsofthis conhactuarAgreementsharrrequire priorapprovarby the District in accorda*e witrr ferier,arand s rare ru*, u,ra r"grrr,io*, rocalporicies andprocedures, and professiona I codes ofconduct
fiflri!#1,$.tsf3l+ftrroN ro AccESS EDUCATToNAL RECoRDS oR pRorFcrDD
The District and con tractor s har at a, t imes req uirc the written consent or.aurl0rization oftheparcnt_/guardian o's .,rdenL if t8 ,"u^ orrg"riola";, f";al;;ffifi[
"racc."s to educarionalin fonnal ion pursuant to FERpA orprotectJo heatttr inronrnr ion p-r rsranr to tr," Hearth In ronnrtionportability and A ccou nra bititv Acr iHtpAai;.gr;Jr"gii,",i.j#i o,ii'jrorr,*in,ui,, ,t,.confidenriatiry ofthar infonnation ionsi,t",n,riiitri"!irt.r,,,i[i""il]* *o *gutariom.
PROFESSIONAL S ERVTCES
The services rendered pursuant lo this connactuarA grecrnent wi, be provide, by individuars who ared triy licensed to perfonr tr)e serv ices or sup"r"ir.a ui,
-rr""*.ii"ri,'i.'o
,-",0o in accordance wirhapp ticable pro fessionar s r a,da.ds. c"rt.Jora,*iir,ri;ii;;;;il[i*," rhis contrachrarAgreernenr wi, be perfonned in accordarrc. ;,t",, ,t,,;i il;;,;;;iJrlii,i'rr.tunaurar. writt"ndocurnentation wi' be provided ro rhe Dir r.i.'o,,ot ing?i,riri1"rpo]""r r,,o
"orr. inro conrarl $ithstudcnrs sha lthave bce, s ubiecr r() a crirni,,"l U""lgii,iJ"i *t ",tlllrril, ,,r,ng.nt as thar rcq uired byldaho Code Secrion 33- 130 and noticies oir f,r. pi.iri.t,."Ji,r"l"Je"ei"dirennined to not hau",
il'ltrJlfrLffi:fl[;il;f;trlJt:J;',*j;s"ilr'';ilrr;;;]ii'Ii'l'j'll"'o''"'"""'ri"'i!i'tio
INS UITANCB AND LIABILITY
contraclor s ha' be sorery iiabre forany rosses ordarrnges res urti,g fromContractor,s perfonnance o fany ofthe s ervices covcred bv rhisConrr..n q1aer*,ri"",. c""t.i"oiri,,.rrina",nn iry and hordhanntess rhe Dis*ict frornanv Iiabiritv, i""rrJi"gluriir"tli,r",'t"";i;,;;;J,
"*p."r*, and atroncy fees,res ulting frornContracror''s oe rfonna n ce o fthe s"ervices proriiia ,,i*i,. c.,rhactuarAgreernent.proo fo firs u mnces har bc sirbrnitrea ioir,; Diri;;i ;r, r,"; l;" iioj ilrJ'" nu" o"re o frh is con rracruarAgreerlent.
COMPEI\SATION/B ILLING
The District s lraltcompensate contractorforthe d irect services identificd on tl)e altached Idaho SchoolBased Medicaid prosranService Detailand-activiry Reco,.U. ii"i,r[r,*,*r, forapproved hoLrrswilibe ar r'e a,owabre biilins rare (per unirj fb;rr;r,;;;;ffi;"rir"riti,"li"r, ,,.,. rirnding rate (30%)and billi,g services ( r0%) rates, in an arnount not to e),iceed the District t rzte for the ten,oftheconlraclualAgrcement. A dditiorarhours wir be cornpersarJ
"ili. r^,r" r*. p.videa lrrar rheadd itionallrours have been pre-approved, i, *riting. fri iii"'bii;;;:r";;;;"*
Contractorwill s ubrnit a n.ronthlv invoice (s talcrrrcnt ofservices rendered ) and tl.recompleted districtMedicaid repodirrgronns ro the Dirc;i;.;isi;ils;;iliui',r,i
"]ii'lir"*'' nronth. .r.hee
comp letcd foms rnust be ac".rmte and ready ros ubnrit lo rhe oirtri"it uitirng ,"*ice. ccnerairy, theDist.ict will issuecrreck" rnonrhrv ifthe invoice ani;"p".*;rk;;;;;ilbtec an<r i, the Disrrict offceby the end ofthe previous month. Agency providers are responsible forgettangtheapprop ate
Conlrador: Acccss Poinl
(Bl. cuRS, IIS)5
Datc: July 28.2022
supervis ion completed by tlrc ap propriate supewisordependingon savice beingprovided. A-llfonrs
rnist be completLd fully, sigrred ind be the original. Each montlrly invoice must include tlrefollowing
infonnation foreach student receiving servic€s:(l) student's narne, (2) description ofservices
provided, (3) total nuutberofhours spent in providing services, and (4) cost ofservices PIovid€d.
AdditionaidocLrnrentalion may be req uired by the District and mlst be provided within five (5)
working days ofthe date tlr€ written req trc:it forthe documenlalion is rnade.
Thc Districtagrees to [ny Contractorat a ratc of S19.31 perhourfor Bchavioral
Intcwe n tion Paranrofess io nal (BI PARA) Se rv ices ' $34.34 p r hourfor Behavioral
Intc lle ntion S nc cialis t (llI Sc rvice S30.03 rre r hour for Bc havioral Intc rve ntion
Te chnician.$36.26 pcr hour for Communi tv Based Rehabilitation Serv iccs (CB RS)
Scrv ices. $30.03 p:rhourf<rr l{abilitative Skills Pro (HS l'RO)' and $19.31 perhorrr
for Habilitative Sl<ills Para (H S PARA) for the duration of thc contract
NON.DISCRIMINATION
Ttre parties hereby agreethatno person shallbe excluded frorq denied participation in, orothetrvise
s ubjLcted to d is crirn'r-n at io n on the grounG ofrace, color, creed, nalionalodgin, seX age, ordisability
irr perfonnance ofthis Conhactual Agreement.
COVERNANCE
Th is Co ntractualAgreernent s hall be govemed by tlrc laws ofthe State ofldaho. Contmctorshall, at all
tirnes, cornp ly with and observeallfedeml, state, and local laws, regulations, atrd odinances which arc
in effectand applicable during thepeliod ofthis Cont-actualAgreement
ASSIGNMENT
This ContractualAgreementshallnot be s ubject lo assignment, in whole or in part, by Contractoror by
operation of law, so as to authorize any person otherthan Colltraclor, or Con[actor's emPloyees, to
ais unre the d Lrties s ubject to tlris Contracttral Agreernent without the Dis trict's prior written consent.
S TJCCESSORS AND ASS IGNS
Tlris ContractualAgreernent is binding upon, and inuresto tlte benefit of, s uccessols and pennitted
ass igr)s to theContractual Agreement.
AMENDMENT
This ContractualAgrcenrentrnay be amended at any time with the PrioI written consent ofboth
parties. Any and allarnendrnents to this ContractualAgrcement shallbe in writing.
TERMINATION
This Co ntractual Agreernent rnay be terminated withot[ cause by eitherparty within thirty (30) days
after providing written notice oftlre intentto tenninate to the other party.
Add itionally, the Districttnay irnnrcdiately terminate th is ContractualAgreenEnt' upon written notice,
in the event fundingforthe District's pmgram is no longer available orthe s pecific services to this
ConftactualAgr€ement are modified or tenninated for a student.
DEFAULT
Upon default byeither party, thenon-delaulting party Inay, upon written notice, cancelthis
Contractual A greernent inunediately and tnay pursue any and allavailable legal and eqrritable
renedies. The dsfaulting party shallbe liable for any and allexpenses that are incuned by the non-
defaulting party as a result thereof, including, but not limited lo, procuringsubstituteperfonnance,
legalfees, and otha losses incurred due to the default.
TIMO OF PERFORMANCE
Tirne is ofthe essence in this ContractualAgreerrlent; thereforc, alltimes for perfonrrance ofthe
obligations, as statei herein, shallbe strictly conrplied with by tlre parties.
6Contrador: Acccss I'oint
(Br, CBRS, r.rs)
Dale: July 28.2022
NON-WAVIE8. BREACTI
The failure ofcontmctororthe Dislrict to insist upor) stricr pcrfonnance ofany oftrre ternrs ofrh iscontractua I A greernent' orto e)€rcise any optron ir",ei,, co,irenIJ iiany orrrt i,.,.tnnces, sha, notconstitLrte a lvaivcr or rerirro uis hrnen t o fa-ny'. r"r.,tl.ifuri t'r* riir,".j.,orru" uro ,"main in fuI fo rceand effecr' un ress s uch waiver is cvidencjbyrh" prio;;;,;fi;
"on..n, orconouoor orthe District.A'l-roRNEY Flt'rs
Ifeither party defau Its in anv nun ner or fairs to fu rfilr any and/or a, prov is ions oftrr is co ntmctuarAgreement, and ifthe non-d'efaurting pany hi.es an atioiney ro
"orcrisl it. .rgr,s upon such defaurr orfaiture, or if rhe parties are invorvedrn any ,i'grti"<ir.l"ir,u uiy fii.."ai"g. i,,' uankr.uptcy), theprcvailing party shal be e. t it red to recover reasonab re al rom.i r"", l,,i "o.s ,iom the ol her Daft v.'rhis paragraphshatrbe enforceabte by tnrpJl", "-",*iii,'i_i;ffi;}"-*;;;:,{b,[;i;;:#Xil",lennination ofth is Contractual A grecrnent.
DISPUTE RESOLUTION
A ll participating agencies a.ree to resorve s )sternic d isputes that arise in th€ provision ofspecialeducation and independenr c-onrra,orscrrr"o in o no,i.l"Jr.,irrl"ir,rr.* r, a," cnsurc lrrat using thefollowirrg process to resolve inlemgenq. di.p"i", J*, ,rrt ol*,pi r.ijilo ,o.,ro"nls and farnilies:
,
f,: llJ:*:,"r agency with a concem rvi firsr use rhe agency,s in tenrat p rocedures ro addrcss
2 lf res o lution is not achieved at theprcvious level, the iss ue and all re levant in fonrntion will nowbe forwarded to the Direcrorofstidmts.;i"";'f";l;;;F;irs'sciiooiDis trict 9r andContmctor's administrator.J lfco nsensus is not reached at the p rcvious level, th e Director.ofstudent services will foruard theiss ue and alrrcrevant hrfonrntion to t'e Srp"rir,"no* oiiiui,olaiis sc'oor oisrrict 9 t.4. lf a conccrn is related to thc or ratity ofr"*i"" o, h"ulit, nnU ,li*yi..r"r. ,.,r*ls s^ould re lers uc' concems aboutcontraoorand/or rr,."."i"t.r i" iri'pr", iii'a ilo ,r,. oir"",oro rstrdent_ S-ervices and Co nl ractor's ad tnin is t-ator to be addresscdl5 rfthesc concerns are not res olved i, a o ia rogue *ittr trr" s choorad nrin istrator (the Directo r o fstuderrr services and/or rhe Su oerin rend",ui"ra,ii" dl,,,*.i",.lliininirrutor, tt," Dcpanrnenr ofHealttrandWelfareregionallicensingerrtityrryO._,.t.tJiJiir"stigatetlresitt,ation,
S ERVERAB ILITY
AnytcnrrorprovisionorlhisconrractuarAgreernentthatisirrvaridorunen[orceabreinanysituatioo
in anviuris.dicr ion wiI be deerned rnodifi"Ji;;,[;i;il;il ;ri"'iirl rri"r. a"*nnined bv rcrercnceto the invalid or unenforceable tenn(rhevaridityorenforc",rir,,y"r,r,.'Jffili"l,llllilT"1jLl,i,!$iil%1,i;xil;lix;:1H:1T*i
the validitv orenforceabirirv oftrrc otrcndi;;t;;;;l;;#'in'i,r"r ll'l'"rr,,*,'on orjurisd icr ion.
COMPLE'TE STATEMUVT OF TEI{MS
Th is contmctuarA grcanent constit ules the ent ire agreernent bcrween th e part ies h ereto. and s harlsu persedeall previous ora lor wrirren proposats, neiotiations, .",,r;ii;;;;i;:;;; ;ii;;l;;"" '"""
cornrnu n ica I ions between r^e parties. This Con;?c"tuaiAgr;i*ri ,*v ""t u",.en ,dis.hrrg.ct,n,,rnrcd ified except by an insl ru,renr in wriring. s;gn"o ut rriEd;ty;,1ii,;;1;; ,"p*."nranves o frheparties.
Contraclor: Acccss point
(BI, CBRS, H$1Dnlc: .,uly 28.2022
SUMMARYOFSERVICES
Indelrndent Contractor and Itlaho Falls School District 9l
This Su,rrnary ofServices is to be used onry after the District and contractor have s igned thelndependent Contractor Contractual Agreernent.
Department of Health & Welfare
Contact: School Based Medicaid
Address: 3232 Elder Street, Boise, ID 83705
Telephone Number 208-364- 1903
Independent Contractor Agency: Access point
Administrator: Pete Molino
Business Address: ZZ2ZTeton plaza, Suite 2, Idaho Falls, lD g3404
Telephone Nurnber: 208- 522-4026
E-Mail: Tarnmera@AccesspointKids.com
Supervisor: Tamrnera Smith
Certificate/LicensureNumber: 7ACCPrFAM0TT ExpirationDate: 3/3u2075
Direct Service Provider: Qualified individual as rnutually agreed upon
Review of Service:
First Review: November 14, 2022
Second Review: Febn:ary 13,2023
Third Review: April 24, 2023
At the student's annuallEp Team meeting
SIRVICE PLAN(S) MUST BE ATTACHED (For Information Onty)
Service(s) to be provide: Behaviorar Intervention (BI) , community Ehsed Rehabilitation
Services (CBRS), and Habilirative Skills (lJS)
When service(s) willbe provided:
Day(s):. Monday - Friday rvhen school is in session and student is attendingTirne: the school day when student is attending
Location (i.e., classroom, playground, etc...): all locations
Duration ofservices (each day): As required by the assigned students, IEps.
Contraclor: Access poinl
(BI, CBRS t.ts)8
Dalc: July 28.2022
contractor will comply with the District an orschool opcrational procedures and rvill fulfithe following r.esponsibilities:. Sign in and out ofthe schooloffice each visjt \vith proper identification.r wear picture identification and/or obtain a visitor's identification badge frorr theschoolfor each visit.o Wear appropriate clothing for the schoolsetting.o Adhere to set schedule _ arrive and leave on time.o Notify the buirding adrninistrator ifyou wi, be absent (one day notice, ifpossibre).. P ick up and retu rn the s tudent to an appropriate schooi staff person fo, *" f,'
"
t;i, iiapplicablc.
o Rernain in assigned location.. Be knowledgeable about schoolernergency proccdures.
' Not use any information obtairred by obseivilg other students to make contact w ithparents for solic itation purposes.. Not.attempt to supersede a teacher or sc lroolstafl member in the irrstructionalimplementation or supervision of an individual or class. The specialeducation
teacher and/or generar education teacher is the insrructionar leader rn tre
"tassioorn.' Notify the Dhhict and/or schoorofany staffing chanies rvithin tt.'" og"n"y tt uir"toi"to the services indicated on this agreernent.r Be cooperative when resorving conflicts with district and/or schoorstarf.
District/school res po nsi bi I i ties incluttc:. Respect the rights ofContractor.. Provide inforrnation regarding the procedures and schedule ofthe school.. Provide information on emergency procedurcs.o When appropriate, invite-Contractor to specific stude,rt,s Multi-Disc iplinary Teanr(MDT) meetings and/or Individuarized Edrcation prograrn (lEp) rearn mcetincs.. Accommodate, within reason, Contractor,s needs to finf r ,r," *."i""pirr. """"
' Providc a Positive climate and building environrnent to facilitate rnutual assistance.o Be cooperati'e rvhen resolving conflicts between Contractor and schoorstafi
The above items are not to be considered afl incrusive. Any concerns wifl be addressed accordingto the Dispute Resolution section in the Contractual Agreement.
IN WII'NESS WHEREOF, thc parties have executed Contractual Agreement.
ontr a cslgnee
o
Datc
Sigrutule of Distict 9l Superiutende or Desigrec
\nlar
Datc
9Contractor: Acccss Point
(Br. CDRS, H$
Dnlc: JUly 28.2022
'+.
'Idaho Falls
School District 91
A Worlcl Class Eclucatiort
690 fohn Adams parkway
Idaho Falls, Idaho 83401
Phone: (2081 525-7500 FAx: (2081 SZS-7596
Web Address: idschools.org
IDAHO FALLS SCHOOL DISTRICT 9I
System of Care Protocol for Indepcndent Contrnctors
I. Protocol for Access Point Fam ilv Servic cs Providin l!
BEHAVIORAL I NTERVENTION SPEC IALIST (BI),BEHAVORIAL
IN TERVENTION PAIT,AP ROFESS IOANL (BI PARA).I]EHAVORIAL
TECHNI CIAN (BI TECH).MMIINITY I}ASDD RI'IIABILIT TION SERV ICES(CBRS) AND H AB ILITATIVE SKI (HS):
The purpose ofthe System ofCare is to establisl: a procedural protocol to assist Idaho Falls SchoolDistrict 91 in collaborating for the delivery ofrelated services frovided by independelit contractorsin accordance an eligible student's Idividualized Educatio, program ltin) a,d developedpursuantto Idaho Special Education Rules and Regulations, 20l g; The Children;s Mental serviccsAct of 1998; and Medicaid billing policy for rehabilitative seruices in a school setting (lDApA
16.03.09.245,IDAPA 16.03.10.124.05.c,tDAPA 16.03.10.653.05.e, and rDApA 16.03.09.855.10
- Qualifications and Supenrision).
The school will be the lead agency for any enrolled student while tlrat student is in school- Before
the_lndependent contractor may work with a student, a contractual agreement must be completed
with the Independent Contractor and the Director of Student Services.
Independent Contt'actor Agency: Access point Family Services
Supervisor: Tanrnrera Srn ith
Administrator: Pete Molino
Business Address: 2722 Teton plaza, Suite 2, Idaho Falls, ID g3404
Telephone Nurnber : 208-522-4026
E-Mail; .l anltreritri,tAccqssl\)intli ids.conr
BI Rate: $34.34lhour'
Bl-Para Rate: $l9.3lihour
BI Tech Rate: $30.03/hour
CBRS Rate: $36.26lhour
HS Pro Rate: $30.03/hour
HS Para Rate $19.31/hour
I ndepcndent Contractor:
Director of Student Serviccs:
Students: As per addendurn
Date:
Dato:
1 Lal 202'z-
1
Contrac(or: Acccss Point Family Services
School Ycar 2022-2023
n )a