HomeMy WebLinkAboutThe Children's Adventure Centerit
'Idaho Falls
School District 91
I
A World Class Education
690 John Adams Parkway
Idaho Falls, Idaho 83401
Phone: (208) 525-7500 FAx: [208) 525-7596
Web Address: www.d91.k1Z.id.us
IDAHO FALLS SCHOOL DISTRICT 91
System of Care Protocol for Independent Contractors
Protocol for The Children's Adventure Center Providine
BEHAVIORAL INTERVENTION SPECIALIST (BI ), BEHAVORIAL
INTERVENTION PARAPROFESSIOANL (BI PARA)), BEHAVORIAL
TECHNICIAN (BI TECM. COMMUNITY BASED REHABILITATION SERVICES
(CBRS). INTERVENTION PROFESSIONAL , HABILITATIVE SKILLS (HS) AND
PERSO NAL CARE SERVICES (PC$:
The purpose ofthe 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 confiactors
in accordance an eligible student's Individualized Education Program (IEP) and developed
pursuant to Idaho Special Education Rules and Regulations, 2018; The Children's Mental Services
Act of 1998; and Medicaid billing policy for rehabilitative services in a school setting (IDAPA
16.03.09.245,IDAPA 16.03.10.124.05.c, IDAPA 16.03.10.653.05.e, and IDAPA 16.03.09.855.10
- Qualifications and Supervision).
The school will be the lead agency for any enrolled student while that student is in school. Before
the Independent Contractor may work with a student, a contmctual agreement must be completed
with the Independent Contractor and the Director of Student Services.
Independent Contractor Agency: The Children's Adventure Center
Supervisor: Heidi Abegglen
Business Address: 265 Gladstone, Idaho Falls, ID 83401
Telephone Numb er : 208-528-8639
E-Mail: tacheidia@hotmail.com
BI Rate: $34.34lhour
BI-Para Rate: $19.3 l/hour
BI Tech Rate: $30.03/hour
CBRS Rate: $36.26lhour
Intervention Professional $47.35/hour
HS Pro Rate: $30.03ihour
HS Para Rate 519.3l/hour
PCS Rate: $l 1.94lhour
lndependent
Students: As per addendum
Date:
Director of Student Services:
Contractor: The Children's Adventure Center
School Year 2022-2023
Date \oqlah
tlnl*
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'Idaho Falls
School District 91
A World Class Education
IDAHO FALLS SCHOOL DISTRICT 9T
System of Care Protocol for Independent Contractors
I. Protocol for Indenendent Con tractors P idine
BEHAVIO INTERVENTION SPECIAIIST (BN. B VORIAL
INTER ON PARAPROFESSIO NL (BI PARA). BI TECHNICIAN(BI
TECM.CO Y BASED ILITATION SER VICES (CBRS).
INTERVE ON PROFESSIONAL.AND HABILITATIVF],SKILLS (HS)
and PERS o NAL CARE SERVICES GCS):
The purpose ofthe 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 contractors in accordance an eligible student's Individualized Education
Program (IEP) and developed pursuant to Idaho Special Education Rules and Regulations,
2018; The Children's Mental Services Act of 1998; and Medicaid billing policy for
rehabilitative services in a school setting (IDAPA 16,03.09.245, IDAPA
16.03.10.124.05.c, IDAPA 16.03.10.653.05.e, and IDAPA 16.03.09.855.10
Qualifications and Supervision).
This protocol provides guidelines for Idaho Falls school District 91 and independent
contractors to implement Behavioral lntervention (BI) and Personal care services (pcS)
community Based Rehabilitation services (GBRS) that are delivered to Medicaid eligible
students with an IEP on file within the school district. In order to provide BI and GBRS
services in the school setting, the Independent contractor must be approved by the Director
of Student Services and provide the following documentation:
A copy of your current certificate of liability insurance with Idaho Fa[s
School District 9l named as an additional insured on the policy.
Proof of workers' compensation coverage for independent contractor
personnel.
A copy ofthe contractor personnel current criminal background check prior
to having contact with students pusuant to Idaho Code Section 33-130.
A copy of the contractor personnel credentials pertinent to the service being
provided prior to working with students.
A copy of all planned and subsequent completion of training taken towards
CBRS CPRP and,/or CFRP Certification in accordance with USPRA. IDAPA
I 6.03.09.855. 10.k.ii.
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Contractor: Children's Adventure Center
(BI, CBRS, INT PRO, HS, PCS)
Date: luly 25.2022
690 fohn Adams Parkway
Idaho Falls, Idaho 83401
Phone: [208J 525-7500 FAX: [208J 525-7596
Web Address: www.d91.k12.id.us
A copy ofthe service plan the student is working on in non-school settings.
Provide monthly documentation of one-to-one supervision by a qualified
agency representative with the CBRS provider(s) to review treatrnent
provided to the student in accordance with IDAPA 16.03.09.855.10. The
CBRS provider and agency are responsible to provide supervision with each
student the provider has worked with monthly. This includes if the provider
only worked with a student for one day and must be conducted within the
calendar month they are submitting billing.
The school will be the lead agency for any enrolled student while that student is in school.
Before the Independent Contractor may work with a student, a contractual agreement must
be completed with the Independent Contractor, the Building Principal, and the Director of
Student Services.
Idaho Falls School District 91 must follow the privacy provisions set forth by the Family
Educational fughts and Privacy Act (FERPA), Health Insurance Portability and
Accountability Act (HIPAA), and the Idaho Special Education Manual, 2018. Idaho Falls
School District 91 will need written authorization from the parenVguardian to share
information with private service providers.
II. Overview for Independent Contractors Working with Students
1. "Independent contractor" means a person, group, agency, or organization that
meets the following conditions:
a. Provides services to the District under the terms specified in the contractual
agreement;
b. Provides services to the District according to his or her own processes and
methods;
c. Is paid or reimbursed for services provided to a student through the
established billing policy.
2. "Conflict of interest" means any official action or any decision or
recommendation by a person who is employed by the school district, the effect
of which would be the private pecuniary benefit ofthe person or a member of
the person's household, or a business with which the person or a member of the
person's household is associated.
a. In the event that a school district employee has an interest in the independent
contract, or a conflict of interest, the employee must:
i. Prepare a written statement describing the matter required to be
acted upon and the nature ofthe potential conflict;
ii. Deliver the statement to the employee's direct supervisor.
3. The Independent Contractor may:
a. Submit assessment data and/or reports to a school's evaluation team for
consideration in the student evaluation process.
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b. Be invited to an evaluation team meeting by
parenVguardian.
the school and/or
Contactor: Children's Adventure Center
(BI, CBRS, INT PRO, HS, PCS)
Date: l\rly 25. 2022 2
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 education 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 ofthe contractual
agreement with the school district (see Independent Contractor Contractual
Agreement).
i. Contracts are established when the school district describes the
services to be provided, including the frequency and duration of
services; is paying for the services; and outlines the role,
responsibilities, and requirements of the Independent Contractor,
including documentation of licensureicertification to perform the
prescribed services, documentation of current background check(s),
documentation of liability insurance, terms of payment, and
provisions for changes or termination of the contract.
d. Provide services to students on school grounds under the terms of the
Summary of Services (see Summary of Services form).i. The Summary of Services is established to allow the services to take
place on school properfy to benefit the student's progress in the
general education curriculum. The Summary of Services shall
describe the specific services to be provided; the responsibilities of
the school and the Independent Contractor; and the 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 under the Summary 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 independent contractor who is
under contract with the school district and with the written consent of the
student's parenVguardian or the student, if 18 years old or older.
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 arnount of time students are removed from
school for any purpose fall under the terms ofother school district policies.
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3Contractor: Children's Adventure Centcr
(BI, CBRS, INT PRO, HS, PCS)
Date: l'uly 25- 2022
INDEPENDENT CONTRACTOR CONTRACTUA L AGREEM ENT
This Independent Contractor Contractual Agreement (hereinafter referred to as "Contractual
Agreement") is entered into between Idaho Falls School District 91 (hereinafter referred to as "the
District") and CHILDREN'S ADVENTURE CENTER (hereinafter referred to as "Contractor").
Whereas, the Distdct provides special educational and related services lo assist students attending
school in the District in their educational development, as identified on the student's Individualized
Education Program (lEP); and
Whereas, the Contractor is duly licensed and/or qualified and able to provide related services to the
Distdct's students;
It is hereby agreed by both parties that:
DURATION OF AGREEMENT
The period ofthis Contractual Agreement will commence on the 23th dav of Ausust 2022 and
remain ir effect until t e 26rh dav of Mav 2023 . This Contactual Agreement is contingent upon the
availability ofdistrict funding. This Contactual Agreement shall not exceed twelve (12) calendar
months. At the discretion ofthe District, the Contractual Agreement may be renewed annually.
RELATIONSHIP OF PARTIES
In performing services under this Contractual Agreement, Contactor is and shall at all times be an
independent contractor ofthe District. Nothing herein is to be construed as establishing an employer-
employee relationship.
SERVICES TO BE RENDERED
Contractor shall render the professional services enumerated on the Summary ofServices, attached
hereto and made a part ofthis Contactual 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 ofthe
records to the District within five (5) working days ofthe date requested. Additionally, upon
reasonable notice, the District shall have the dght 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
Contmctor agrees that all information regarding services provided pursuant to this Contractual
Agreement, inctuding, but not limited to, the student's identity and the natwe ofservices rendered,
shall be confidential pusuant 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 aulhorized and directed by the District or
without the consent ofthe parenvguardian or the student, if l8 years of age or older.
REPORTING OF ABUSE, ABANDONMENT, OR NEGLECT
Contractor acknowledges its obligation to comply with ldaho Code Section 16-160t, et seq. and report,
within 24 hours, any suspected abuse, abandonment, or neglect ofa child to law enforcement or the
Idaho Department of Health and Welfare. Contractor also agrees to inform the District, within 24
hours, of such suspicion.
Contractor: Children's Adventure Center
(BI, CBRS, tNT PRO, HS, PCS)
4Date: lrly 25,2022
Idaho Falls School District 91
SERVICE DELIVERV: TIME AND PLACE
Confactor shall perform services set forth in the Summary of Services, unless the parties mutually
agree to a modification ofthe time and place ofservice delivery.
COORDINATION OF SERVICES
To facilitate delivery ofservices, the District will provide: (1) reasonable and prompt notification of
meetings and other appointments in which the Contractor is expected to participate; (2) signed parental
consent forms, as necessary; (3) identi8/ing information regarding the client and the parent/guardian;
and (4) reasonable assistance in facilitating communication between the Contractor and the client,
parenVguardian, and other providers and agencies.
PRIOR APPROVAL OF SERVICES
All services rendered by Contractor under the terms ofthis Contractual Agreem€nt shall require prior
approval by the Disrict in accordance with federal and state laws and regulations, local policies and
procedures, and professional codes of conduct.
CONSENT/AUTHORIZATION TO ACCESS EDUCATIONAL RECOR-DS OR PROTECTED
HEALTTI INFORMATION
The District and Contractor shall at all times require tie written consent or authorization ofthe
parenrguardian or student, if l8 years ofage or older, for the disclosure or access to educational
information pursuant to FERPA or protected health information pursuart to the Health Information
Portability and Accountability Act (HIPAA) regarding the student, and shall maintain the
confidentiality ofthat information consistent with the state and federal law and regulations.
PROFESSIONAL SERVICES
The services rendered pursuant to this Contractual Agreement will be provided by individuals who are
duly licensed to perform the services or supervised by a licensed/certified provider in accordance with
applicable professional standards. Contractor agrees that all work pursuant to this Contractual
Agreement will be performed in accordance with the highest professional standards. Written
documentation will be provided to the District attesting that all employees who come into contact wilh
students shall have been subject to a criminal background check at least as stringent as that required by
Idaho Code Section 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 services being provided to the clients.
INSURANCE AND LIABILITY
Contractor shall be solely liable for any losses or damages resulting fiom Contractor's performance of
any ofthe services covered by this Contractual Agreement. Contractor shall indemni$ and hold
harmless the District from any liability, including, but not limited to, cost, expenses, and attorney fees,
resulting from Contractor's performance ofthe services provided under this Contractual Agreement.
Proof of insurance shall be submitted to the District within ten (10) days ofthe date ofthis Contractual
Agreement.
COMPENSATION/BILLING
The District shall compensate Contractor for the direct services identified on the attached Idaho School
Based Medicaid Program Service Detail and Activity Record. Reimbursement for approved hours will
be at the allowable billing rate (per unit) for Behavioral Intervention (BI) and Personal Care Services
(PCS) less state funding rate (30%) and billing services ( l0%) rates, in an amount not to exceed the
District's rate forthe term ofthe Conractual Ageement. Additional hours will be compensated at the
same rate, provided that the additional hours have been pre-approyed, in wdting, by the Distdct's
designee.
Contractor will submit a monthly invoice (statement ofservices rendered) and the completed district
Medicaid reporting forms to the Director ofStudent Services by the end ofeach month. These
completed forms must be accurate and ready to submit to the District's billing service. Generally, the
District will issue checks monthly ifthe invoice and paperwork are completed and in the District offrce
Contractor: Children s Adventure Center
(BI, CBRS, INT PRO, HS, PCS)
5Date: July 25.2022
Intervention Paraprofessional (BI PARA) Services. $34.34 per hour for
Behavioral Intervention Specialist (BI) Services, $30.03 per hour for Behavioral
Intervention Technician.$36.26 pe r hour for Communitv Based Rehabilitation
Seryiccq (LBRS) Serviqes, ) Intqrvention Prafesslonal $4735 per trsur,$11,94
per hour for Personal Care Services (PC S). $30.03 oer hour for Habilitative
Skills Pro (HS PRO), and $19.31 pe r hour for Habilitative Skills Para (HS
!\\1\) for the duration of the contract.
NON.DISCRIMINATION
The parties hereby agree that no person shall be excluded from, denied participation in, or otherwise
subjected to discrimination on the grounds ofrace, color, creed, national origin, sex, age, or disability
in performance ofthis Contractual Agreement.
GOVERNANCE
This Contactual Agreement shall be govemed by the laws ofthe State ofldaho. Confactor 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.
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 Contactor's employees, to
assume the duties subject to this Contractual Agreement without the District's prior wiften consent.
SUCCESSORS AND ASSIGNS
This Contractual Agreement is binding upon, and inures to the benefit of, successors and permitted
assigns to the Contractual Agreement.
AMENDMENT
This Contactual Agreement may be amended at any time with the prior written consent ofboth
parties. Any and all amendments to this Contractual Ageement shall be in wliting.
TERMINATION
This Contractual Agreement may be terminated without cause by either party within thirty (30) days
after providing uritten notice ofthe intent to terminate to the other party.
Additionally, the District may immediately terminate this Contactual Agreement, upon written notice,
in the event funding for the District's program is no longer available or the specific services to this
Contractual Ageement are modified or terminated for a student.
DEFAULT
Upon default by either party, the non-defaulting party may, upon wdtten notice, cancel this
Conhactual Agreement immediately and may pursue any and all available legal and equitable
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.
Contractor: Children's Adventure Center
(BI, CBRS, INT PRO, HS, PCS)
6Date. July 25,2022
by the end ofthe previous month. Agency providers are responsible for getting the appropriate
supervision completed by the appropriate supewisor depending on service being provided. All forms
must be completed fully, signed and be the original. Each monthly invoice must include the following
information for each student receiving services: (l) student's name, (2) description ofservices
provided, (3) total number ofhours spent in providing services, and (4) cost ofservices provided.
Additional documentation may be required by the District and must be proyided within five (5)
working days ofthe date the writlen request for the documentation is made.
TheDislrictagreestopaycontractoratarateof@
TIME OF PERFORMANCE
Time is ofthe essence in this Contractual Agreement; therefore, all times for performance ofthe
obligations, as stated herein, shall be strictly complied with by the parties.
NON-WAVIER BREACH
The failure ofContractor or the District to insist upon strict performance ofany ofthe terms ofthis
Contractual Agreement, or to exercise any option herein conferred in any or all instances, shall not
constitute a waiver or relinquisbment ofany such term, but the same shall be and remain in full force
and effect, unless such waiver is evidenced by the prior written consent of Contractor or the District.
ATTORNEY FEES
Ifeither party defaults in any manner or fails to fulfill any and,/or all provisions ofthis Contractual
Agreement, and ifthe non-defaulting parfy 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), the
preyailing party shall be entitled to recover reasonable aftomey fees and costs fiom the other party.
This paragraph shall be enforceable by the panies 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 ofspecial
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:
l. Al individual or agency with a concern will first use the agency's intemal procedures to address
the concern.
2. Ifresolution is not achieved at the previous level, the issue and all relevant information will now
be forwarded to the Director ofStudent Services for Idaho Falls School District 9l and
Contractor's administator.
3. Ifconsensus is not reached at the previous level, the Director ofStudent Services will forward the
issue and all relevant information to the Superintendent ofldaho Falls School District 9l.4. Ifa concem is related to the quality ofservice or health and safety issues, schools should refer
such concems about Contractor and/or the services being provided to the Director ofStudent
Services and Contractor's administrator to be addressed.
5. [fthese concerns are not resolved in a dialogue with the school adminisfiator (the Director of
Student Services and/or the Superintendent) and the Contractor's administrator, the Departrnent of
Health and Welfare regional licensing entity may be contacted to investigate the situation.
SERVERABILITY
Any term or provision ofthis Contractual Ageement that is invalid or unenforceable in any situation
in anyjurisdiction will be deemed modified to reflect the intent ofthe parties, determined by reference
to the invalid or unenforceable term or provision, to the greatest permissible extent, and will not affect
the yalidity or enforceability ofthe remaining terms and provisions ofthe Contractual Agreement or
the validity or enforceabitity ofthe offending term or provision in any other situation orjurisdiction.
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 instrum€nt in writing, signed by the duly authorized representatives ofthe
parties.
Contractor: Children's Adventure Center
(Br, CBRS. INT PRO, HS, PCS)
7Date: luly 25,2022
SUMMARY OF SERVICES
Independent Contractor and Idaho Falls School District 9l
This Summary of Services is to be used only after the District and Contractor have signed the
Independent Contractor Contractual Agreement.
Department of Health & Welfare
Contact: School Based Medicaid
Address: 3232 Elder Street, Boise, ID 83705
Telephone Number: 208-3 64- 1903
Independent Contractor Agency: Children's Adventure Center
Administrator: Heidi Abegglen
Business Address: 265 Gladstone, Idaho Falls, ID 83401
Telephone Number: 208-528-8639
E-Mail: TACHeidiA@hotmail.com
Certificate/LicensureNumber: TADVENTCTRI03 Expiration Date: 513112025
Direct Service Provider: Qualified individual as mutually agreed upon
Review of Service:
First Review: November 14, 2021
Second Review: February 13,2022
Third Review: April 24, 2022
At the student's annual IEP Team meeting
SERVICE PLAN(S) MUST BE ATTACHED (For Information Only)
Service(s) to be provide: Behavioral Intervention (BI), Community Based Rehabilitation
Services (CBRS), Personal Care Services (PCS) and Habilitative Skills (HS)
When service(s) will be provided:
Day(s): Monday - Friday when school is in session and student is attending
Time: the school day when student is attending
Location (i.e., classroom, playground, etc...): all locations
Duration of services (each day): As required by the assigned students' IEPs.
Contractor: Children's Adventure Center
(BI, CBRS, INT PRO, HS, PCS)8Date: July 25, 2022
Contractor will comply with the District and/or school operational procedures and witl fulfill
the following responsibilities:
. Sign in and out ofthe school offrce each visit with proper identification.r Wear picture identification and/or obtain a visitor's identification badge from the
school for each visit.
r Wear appropriate clothing for the school setting.
o Adhere to set schedule - arrive and leave on time.
. Notiry the building administrator ifyou will be absent (one day notice, ifpossible).. Pick up and return the student to an appropriate school staff person for each visit, if
applicable.
. Remain in assigned location.
o Be knowledgeable about school emergency procedures.
. Not use any information obtained by observing other students to make contact with
parents for solicitation purposes.
. Not attempt to supersede a teacher or school staffmember in the instructional
implementation or supervision ofan individual or class. The special education
teacher and./or general education teacher is the instructional leader in the classroom.o Notifu the District and./or school of any staffing changes within the agency that relate
to the services indicated on this agreement.
o Be cooperative when resolving conflicts with district and/or school staff.
District/school responsibilities include:. Respect the rights of Contractor.o Provide information regarding the procedures and schedule ofthe school.o Provide information on emergency procedures.
. When appropriate, invite Contractor to specific student's Multi-Disciplinary Team
(MDT) meetings and,/or Individualized Education Program (lEP) team meetings.. Accommodate, within reason, Contractor's needs to fulfill the service plan.o Provide a positive climate and building environment to facilitate mutual assistancer Be cooperative when resolving conflicts between Contractor and school staff.
The above items are not to be considered all inclusive. Any concerns will be addressed according
to the Dispute Resolution section in the Contractual Agreement.
IN WITNESS WHEREOF, the parties have executed this Contractual Agreement.
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of Contraclor slgnee D ate
1 0,\?h
Signature of Di strlct 9l Supe t or Designee
9Contractor: Children's Adv€nture Center
(BI, CBRS, INT PRO, HS, PCS)
Date: Jdy 25.2022
Date