HomeMy WebLinkAboutAmy Hopkins
Contractor: Amy Hopkins (SLP) Date: August 9, 2022
Student: Assigned SLP Students 1
690 John Adams Parkway Idaho Falls, Idaho 83401
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IDAHO FALLS SCHOOL DISTRICT 91
System of Care Protocol for Independent Contractors
I. Protocol for Independent Contractors Providing
SPEECH LANGUAGE PATHOLOGIST:
The purpose of the System of Care is to establish a procedural protocol to assist the Idaho
Falls School District 91 in collaborating with Independent Contractors for the delivery of
related services provided by in accordance with the following:
1. Eligible students ’ Individual Education Plans (IEP) developed pursuant to Idaho
Special Education Manual 2018, and
2. The Medicaid Billing Policy for Speech/Audiological Therapy and Evaluation in a
school setting (IDAPA 16.03.09).
This protocol provides guidelines 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 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:
1. Proof of workers’ compensation coverage.
2. Current Certificate of Liability Insurance
3. A current Criminal Background Check
4. Evidence of qualifications to perform Speech/Language Pathology Services
The school will be the lead agency for any student enrolled 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 D irector of Student
Services.
Idaho Falls School District must follow the privacy provisions set forth by FERPA, HIPPA,
and Idaho Special Education Manual 2018. The Idaho Falls School District will need
written authorization from the parent/guardian prior to sharing information with
Independent Contractors.
Contractor: Amy Hopkins (SLP) Date: August 9, 2022
Student: Assigned SLP Students 2
II. Overview for Independent Contractors Working with Students
1. 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 91 or a public agency with
legal jurisdiction over the circumstances related to their involvement with
the student, and
b. Is paid or reimbursed for services provided to the student through the
established billing policy.
2. 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 sc hool district.
c. Provide services in the schools to students under the terms of a contract with
the school district. (See Independent Contractors Agreement)
i. Contracts are established when the school district is paying for the
services and describes the services, the role and responsibilit ies of
the Independent Contractor with the evaluation team and school
administration, and the frequency and duration of services; inc ludes
documentation of licensure/certification to perform the prescribed
services; addresses issues related to liability, terms of payment; and
states the provisions for changes or termination of the contrac t.
(Example: District contracts for physical therapy services)
ii. Contracted services to a student with a disability shall be inc luded
on the students IEP.
d. Provide services to students on school grounds under 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 tak e
place on school property to benefit the student’s progress in the
general education curriculum. The Summary of Services shall
describe the specific services provided, the responsibilities of the
school and independent contractor, procedures for background
checks and insurance, and the provisions for space, time, equipment,
and materials provided by the school district. The school district
may terminate the Summary of Services at any time .
ii. Services provided under a Summary of Services to a student with a
disability shall be included on the student’s Individual Education
Plan (IEP).
Contractor: Amy Hopkins (SLP) Date: August 9, 2022
Student: Assigned SLP Students 3
3. 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.
4. 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 adult student (18 years old or older ). Request for
records may be subject to a fee to cover costs of copying and mailing.
5. Nothing in this System of Care protocol shall be construed to limit or impinge
in any way on services parents may acquire for their child that are not provided
at the school. Issues related to the amount of time students a re removed from
school for any purpose fall under the terms of other school dis trict policies.
Contractor: Amy Hopkins (SLP) Date: August 9, 2022
Student: Assigned SLP Students 4
Idaho Falls School District 91
INDEPENDENT CONTRACTOR CONTRACTAL AGREEMENT:
Speech/Language Pathology (SLP) Services
This Contractual Agreement is entered into between Idaho Falls School District 91 (hereinafter
referred to as “District”) and Amy Hopkins (hereinafter referred to as “Contractor”).
Whereas, the District provides special educational and related services to assist students attending
school in the District in their educational development, as ide ntified on the students’ individualized
education program (IEP) plan; and
Whereas, the Contractor is duly licensed or qualified and able to provide related services to the
District’s students;
It is hereby agreed by both parties that:
DURATION OF AGREEMENT:
The period of this Contractual Agreement will commence on the August 23, 2022 and remain in effect
until the last day of school, May 26, 2023. This Contractual Agreement is contingent upon the
availability of funds of the District. This Contractual Agreement shall not exceed twelve (12) calendar
months. At the discretion of the District, the Contractual Agreement may be renewed annually.
RELATIONSHIP OF PARTIES:
In performing services under this Contractual Agreement, Contractor is and shall at all times be an
independent contractor of the 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 of Services, attached hereto
and made a part of this Contractual Agreement as set forth fully herein.
RECORD KEEPING:
Contractor shall be responsible for maintaining complete and accurate records documenting the
professional services provided pursuant to this Contractual Agreement and shall provide copies of the
records to the District within five (5) working days of the date requested. Additionally, upon
reasonable notice, the District shall have the right to review such records at any time during business
hours. Appropriate Medicaid billing sheets will be completed each month for the student(s) served.
CONFIDENTIALITY:
Provider agrees that all information regarding services provided pursuant to this Contractual
Agreement, including, but not limited to, the students’ identity and the nature of services rendered,
shall be confidential pursuant to the Family Educational Records and Privacy Act (FERPA).
Contractor is prohibited from disclosing any information obtained as a result of rendering services
pursuant to this Contractual Agreement to any individual not authorized and directed by the District,
without parent/guardian consent or consent of the student if 18 years of age or older.
Contractor: Amy Hopkins (SLP) Date: August 9, 2022
Student: Assigned SLP Students 5
REPORTING OF ABUSE, ABANDONMENT, OR NEGLECT:
Contractor acknowledges its obligation to comply with Idaho Code Section 16-1601, et seq. and report,
within 24 hours, any suspected abuse, abandonment, or neglect of a child to the law enforcement
agency or Idaho Department of Health and Welfare. Contractor a lso agrees to inform the District,
within 24 hours, of such suspicion.
SERVICE DELIVERY: TIME AND PLACE:
Contractor shall perform services set forth in Summary of Services, unless the parties mutually agree
to a modification of the time and place of service delivery.
COORDINATION OF SERVICES:
To facilitate delivery of services, the District will provide: 1) reasonable and prompt notification of
meetings and other appointments in which the Contractor is expe cted to participate; 2) signed parental
consent forms, as necessary; 3) identifying information regarding the client and the parent/guardian;
and, 4) reasonable assistance in facilitating communication bet ween the Contractor and clients,
parents/guardian, and other providers and agencies.
PRIOR APPROVAL OF SERVICES:
All services rendered by Contractor under the terms of this Contractual Agreement shall require prior
approval by the District in accordance with federal and state laws and regulations, local policies and
procedures, and professional codes of conduct.
CONSENT/AUTHORIZATION TO ACCESS EDUCATIONAL RECORD INFORMATION
OR PROTECTED HEALTH INFORMATION:
District and Contractor shall at all times require the written consent or authorization of the
parent/guardian/or adult student, if age of 18 years of age or older, for the disclosure of access to
educational information pursuant to FERPA or protected health information pursuant to the Health
Information Portability and Accountability Act (HIPAA) regardin g the student, and shall maintain the
confidentiality of that information consistent with the state a nd 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 performed in accordance with the highest professional 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 of the District, and have been determined to not have a criminal
background inconsistent with working with children. The Distric t 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 from Contractor’s performance of
any of the services covered by this Contractual Agreement. Contractor shall indemnify and hold
harmless the District from any liability, including, but not limited to, cost, expenses, and attorney fees,
resulting from Contractor’s performance of the services provided under this Contractual Agreement.
Proof of insurance shall be submitted to the District within te n (10) days of the date of this 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 consent.
Contractor: Amy Hopkins (SLP) Date: August 9, 2022
Student: Assigned SLP Students 6
AMENDMENT:
This Contractual Agreement may be amended at any time with the prior written consent of both
parties. Any and all amendments to this Contractual Agreement shall be in writing.
TERMINATION:
This Contractual Agreement may be terminated without cause by either party within thirty (30) days
after providing written notice of the intent to terminate to the other party.
Additionally, 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 student.
DEFAULT:
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 not limited to, procuring substitute performance, legal fees, and
other losses incurred due to the default.
TIME OF PERFORMANCE:
Time is of the essence in this Contractual Agreement; therefore, all times for performance of the
obligations, as stated herein, shall be strictly complied with by the parties.
NON-WAVIER BREACH:
The failure of Contractor or the District to insist upon strict performance of any of the terms of this
Contractual Agreement, or to exercise any option herein conferred in any or all instances, shall not
constitute a waiver or relinquishment of any such term, but the same shall be and remain in full force
and effect, unless such waiver is evidence by the prior written consent of Contractor or the District.
NON-DISCRIMINATION:
The parties hereby agree that no person shall, on the grounds o f race, color, creed, national origin, sex,
age, or disability, be excluded from or denied participation in , or otherwise subjected to, discrimination
under any activity performed pursuant to this Contractual Agreement.
GOVERNANCE:
This Contractual Agreement shall be governed by the laws of the State of Idaho. 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 of this Contractual Agreement.
ATTORNEY FEES:
If either party defaults in any manner or fails to fulfill any and/or all provisions of this Contractual
Agreement, and if the non-defaulting party hires an attorney to exercise its rights upon such default or
failure, or if the parties are involved in any litigation (including any proceedings in bankruptcy), the
prevailing party shall be entitled to recover reasonable attorney fees and costs from the other party.
This paragraph shall be enforceable by the parties notwithstanding any rescission, forfeiture, or other
termination of this Contractual Agreement.
DISPUTE RESOLUTION:
All participating agencies agree to resolve systemic disputes that arise in the provision of special
education and independent contractor services in a non-adversarial manner and to ensure that using the
following process to resolve interagency disputes does not disrupt services to students and families:
1. An individual or agency with a concern will first use the agency’s internal procedures to address
the concern.
Contractor: Amy Hopkins (SLP) Date: August 9, 2022
Student: Assigned SLP Students 7
2. If resolution is not achieved at the previous level, the issue and all relevant information will now
be forwarded to the Director of Student Services of the Idaho Falls School District 91 and
contractor’s administrator.
3. If consensus is not reached at the previous level, the Director of Student Services will forward the
issue and all relevant information to the superintendent of Idaho Falls School District 91.
4. If a concern is identified that is related to the quality of service or health and safety issues, schools
should refer concerns about a contractor, their services, or quality of services to the Director of
Student Services and contractor’s administrator to address these concerns.
5. If these concerns are not resolved in the dialogue with school administrator (Director of Student
Services and/or superintendent) and the contractor’s administrator, the DHW regional licensing
entity may be contacted to investigate the situation.
COMPENSATION/BILLING:
The District shall compensate Contractor for the direct services identified below. Additional hours will
be compensated at the same rate, provided that the additional h ours have been pre-approved, in
writing, by the District’s designee.
Contractor will submit to the Director of Student Services, by the end of each month, an invoice
(statement of services rendered) for that month and the completed district’s Medicaid reporting forms
for each student served whether Medicaid eligible or not. These completed forms must be accurate
and ready to submit to the district’s billing service. Generally, the district will issue checks once each
month, after Board approval if statement and paperwork is completed and in the District Office by the
end of each month. Each monthly statement 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; and d) cost of services provided. Additional documentation
may be required by the District and must be provided within five (5) working days of the date the
written request for the documentation is made.
The district agrees to pay the Contractor at a rate of $75.00 per hour for Speech/Language
Pathology Services for the duration of the contract.
COMPLETE STATEMENT OF TERMS:
This Contractual Agreement constitutes the entire agreement between the parties hereto, and shall
supersede all previous oral or written proposals, negotiations, commitments, and all other
communications between the parties. This Contractual Agreement may not be released, discharged, or
modified except by an instrument in writing signed by the duly authorized representatives of the
parties.
Contractor: Amy Hopkins (SLP) Date: August 9, 2022
Student: Assigned SLP Students 8
SUMMARY OF SERVICES
Independent Contractor/Idaho Falls School District 91 Protocol
This Summary of Services is to be used only after the District and Contractor has signed the
contract, Independent Contractor Contractual Agreement.
Independent Contractor: Amy Hopkins
Business Address: 1931 Sandpiper Way Idaho Falls, Id 83404
Telephone Number: 208-709-2815 E-Mail: amy.hopkins504@gmail.com
`
Bureau of Occupational License:
Idaho Education Credential Expiration Date:
ASHA Expiration Date: 6/11/2023
Review of Service: Indicate when each review will be done and who w ill do the review:
First Review: September 26, 2022
Second Review: November 14, 2022
Third Review: February 13, 2023
Fourth Review: April 24, 2023
Other: Upon the request of either party
Service(s) to be provided: Speech/Language Services
When will service(s) be provided:
Day(s): Monday – Friday (when school is in session)
Time: 1 to up to 2 days a week as need (8 hours a day)
Location (i.e. classroom, playground, etc…): Assigned SLP Students, Monthly SLP
Department meetings and District IEP team meetings as needed.
Duration of services (each day): As required by the assigned students’ IEP s.
conlrrctor rrlll comply rrlth the distrlcttchool op€rsrlonrt procedurrs rrd lrllr furfi[ thefollonlng respon:lbilltlcs :
r Srgn in and out ofschool offrce each visit - provile proper identificatbn.r Must wcar apicturc ilcntilrcation and/or obtain a visitor's idcntification badge from thc
schoolat thc limc ofc.ch visit.. Must wear spproprbte clothing for a school senhg.. Adherc to set schcdule - arivc and lcave on time.. Notify buiHing administraror ifyou will bc abscnt (onc day noricc ifpossiblc).. S-tudcnt must bc pickcd up frorn and rctumcd to an sppropriato school staffperion cach vbit
if applicable.o Rcmain io assigncd location.o Bc knowledgeablc about c.rnergc.ncy proccdurcs ofthe school. Do not violatc thc right ofprivacy ofany studcnt by using any informatbn randomly
obtahed by observing other students as service refercnca to make contact wi& parerts to sen
or contract them to scrvices frcrn your agency.. The spcrhl cducation teacher ond/or ge-ncral educalion teacher b thc instructional leader in
thc cl&ssroom. At no timc should a scrvicc proviicr assumc that thcir judgncnt for
instructional implementation or supcrvbiori ofan indiviluaVclass can su*rscde the tcacher
or schoolstaffmemb€r.. Notify thc dbhicUschool ofany staffmg chatEcs wirhin the agency that rehtcs to the scrvicG
hdbded on this agleement.. Be cooperative whcn rcsohing confltts with schooydisfbt staff.. Provile technology devbes (hptop, iPad, headphoues) for pcrsonal llsc 8trd to work with
sndeflts.
SchooUDlstrlct re spor sibillties Include:
o Rcspcct the rights ofcontractor.. Provided information regarding the procedurals and schedule ofthe schooLo Provilc information on ancrgeocy procedurcs-. trvhen apFopriatc, invitc serviceprovirer to specffic studcnt's MDT and/or IEp team
meetings, with parental approvalr Accommodate, within reason, Contractor's needs to fuErll the scrvice review phn-r Provide a positive climate and buildiog environment to facilitste mutualsssistance.. Bc cooper8tive when rcsoking conflicts between contaclrr atrd school staff
The above iterns are not to bc conscribcd as all hchrsivc. Any concerns witl be ad&esscd
according to the Dispute Resolution item in the Conractual Agreement.
IN WTTNESS WHEREOF, thcpaiies h aw occuted this Contractual AgrccnErt.
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Signa 's Reprcsentative
Siguture of Suprintendent/Designee
q\ralooTh
Contridor: Anry lrop*ins (SLP)
Su&nt: Assigncd 9,P 9ul'nts
Ilalc: AuB6l ,,2m2
Date
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