Loading...
HomeMy WebLinkAboutHuman Dynamics & Diagnosticsii'Idaho Falls School District 91 A World Class Education 690 fohnAdams Parkway Idaho Falls, Idaho 83401 Phone: [208) 525-7500 FAx: (208)SZ5-7596 Web Address: www.d9 1.k1 2,id.us IDAHO FALLS SCHOOL DISTRICT 91 System of Carr Protocol for Independent Contractors BEHA!'IORAL INTER}'ENTION SPECIALIST (B I), BEHAVORIAL INTERVENTION PARAPROFESSIOANL (BI PARA), BI TECHNICIAN (BI TECH), COMMUNITY BASED REHAB ILITATION SERVICES (CB RS), INTER}'ENTION PROFESSIONAL, AND HABILITATIVE SKILLS (HS) and PERSONAL CARE SERVICES (PCS): The purpose of the System ofCare is to establish a procedural protocol to assist Idaho Falls School District 9l in collaborating for the delivery of related services provided by independent contractors in accordance an eligible student's Individualized Education Program (lEP) and developed pwsuant to Idaho Special Education Rules and Regulations, 2018; The Children's Mental Services Act of 1998: ard 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 Intervention (BI) and Personal Care Services (PCS) Community Based Rehabilitation Services (CBRS) that are delivered to Medicaid eligible students with an IEP on file within the school district. In order to provide BI and CBRS 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 certifrcate of liability insurance with Idaho Falls School District 91 named as an additional insured on the policy Proof of workers' compensation coverage for independent contractor personneL A copy of the contractor personnel current criminal backgror,md check prior to having contact with students pusuant to Idaho Code Section 33-130. A copy of the conkactor 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 16.03.09.855. 10.k. ii. 1 2. J. 4. 5. Contrador: Hunan D),namics & Diagnostics (BI, CBRS, INT PRO, HS, PCS)IDate:8/16/2A2 t -l q I I. Protocol for Independent Contractors Providing A copy of the service plan the student is working on in non-school settings. Provide monthb documentation of one-to'one supervision by a qualiFred agency representative with the CBRS provider(s) to review treatrnent provided to the sflrdent 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 whih that sttrdent 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 Disfbt 91 must follow the privacy provisions set forth by the Family Educational Rights and Privacy Act (FER?A), Health Insurance Portability and Accountability Act (HIPAA), and the Idaho Special Education Manual, 2018. Idaho Falls School District 9l will need written authorization from the parent/guardian to share information with private service providers. II. Overview for Indeoe nde nt Contracton Workins with Stude nts l. 'llndependent contractor" means a person, group, agency, or organization that meets the following conditions: a. Provides services to the District under the terms specifred in the contractual agreement; b. Provides services to the District according to his or her own processes and methodsl c. Is paid or reimbursed for services provided to a student through the established billing policy. 2. 'ConIlict of interest" means any offrcial 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 benefrt of the person or a member of the person's household, or a business with which tlre 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 independe nt contract, or a conllict of interest, the employee must: i. Prepare a written statement describing the rnatter required to be acted upon and the nature of the 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. b. Be invited to an parenVguardian. evahntion team meeting by the school and,/or Contractor: Httrnan Dynamics & Diagnostics (BI, CBRS, INT PRO, HS PCS) 6 7 2Date:8ll6DO22 4 5 6 i The determination of efuibility for special education and the provision of a Free Appropriate Public Education (FAPE) are the resporsibility of the IEP teams and carurot be prescnbed 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 of the contractual agreement with the school district (see Independent Contractor Contractual Agreement). i. Contracts are established when the school district descnlbes the services to be provide{ inchding the frequency and duration of services; is paying for the services; and outlines the role, responsibilities, and requirements of the Independent Contractor, inchding documentation of licensure/certifrcation 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 grormds 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 property to benefit the student's progess in the general education cuniculum. The Summary of Services shall descnibe 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 wrder 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 distric t property, space, materials, or equfment. School district records are only accessible to an independent contractor who is under contlact with the school district and with the written consent of the student's parent/guardian 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 rnay acquire for their child that are not provided at the school. Issues related to the amount of time students are removed from school for any purpose fall under the terms of other school district policies. Contrador: Hurnan Dynamics & Diagnostics (BI, CBRS INT PRO. HS PCS)JDate:8/16l2U2 INDPETDENT CONTRACTOR CONTR{CTUAL AGRMTU\T This Independant Co ntracto r Co n tractual AgreenEnt (hercinafterrcfered to as "Contactual AgreenEnt') is entered into between Idaho Falls School District 9l (hereinafter refened to as "the District") and Human Dlnamics & Diagnmtics (hereinafterreferred to as "Contrador"). Whereas, the District provides specialeducdional and related services to as sist s tudenb atterding school in the District in theireducationaldevelopnent, as identified onthe stLdent's Ind ivid ua lized Education Program (lEP); and Whereas, theContractor is duly licensed an d/o r qrmlified and able to provide related s ervices to the District's students; It is hereby agreed by both partiesthd: DIJRATION OF AGR.EEVTU\ T The period ofthis Contr&tual AgrearEnt will commence on the 23'i day ofAusust 2022 and This ContractualAgreernent is contingent upon the availability ofdistrict funding. This Contractual A greenrcnt s hall not e)ceed twelve(12) calendar nnnths. At thedisoetion ofthe Disrict, the Cont'actualAgreerEnt rnay be renewed annually. R"U.ATIONS HIP OF PARTIES In performing s ervices underthis Crnt"actual Agreernent, Contractor is and shall at all tirnes be an independantcontractorofthe District Nothingherein is to be comtruedas establishing an employer- ernployee relat ionship. SM,\rcES TO BE RU\DER"ED Contractor shall render the professional s ewices enr.rrBrated onthe Sunnnary ofSewices, attached hereto and rnade a part ofthis ContractualAgreernent as s et forth fully herein. RECORD K@ING Con-tractorshallbe respomible fornrainlaining corplete and accurate records d ocurnent ing t he profes sional services prov ided pursr.rantto this c,ntractualAgreenrntand s hall provide copies ofthe records 10 the District wirhin five (5)worldng days ofthe date requested. A dd itionally, u pon reas onable notice, the District shallhave theright to review such records at any tinre during business hours. Appropriale Medicaid billing shee6 willbe corpleted each rmnthiorthe studen(i) served. CONFIDP{TIALITY c, ntractor ag rees t lrat all in fo rnnt io n regard ing s ervices provided puNuant to th is con tractu al Agreenrent, including, but not limited to, the student's identit) andthe nature ofservices renderd shallbe confidentialpuntmnt to the Family EducationalRecords and privacy Act (FERPA ).crnt ractor is p roh ibited fro m d is c losing any in fo rnnt ion obtained as a res uh ofrend ering s erv ices p u rs uant 1o th is Crnt retual A g re€rnent to any ind iv id ual not authorized and d irected by ih e Ds trict or without the cons€nt ofthe parent/guardian orthe student, if lg years ofage orolder. RPORTING OFABUSE ABANDONMEYT, OR NreLrcT contractoracknowledges its obligationto corply with Idaho code Section l6-1601, erseq. and repor!within 24 hours, any suspected abuse, abandonnrnt, orneglect ofa child to lawenforcenrent orthi Idaho DepartnEnt ofHealth and welfare. c-ontractoralso-agrees to informthe District, within 24 hours, ofsuch suspicion. Contractor: Human Dyramics & Diagnoslics (BI, CBRS INT PRO. HS! PCS)4Date:8/1612022 Idaho Falls School District 91 remain in effectuntil the 26thdav of ll,lav 2023. SERVICE DE-M.Y: TIME AND PI,ACE C.o ntractor s hall performservices set forth in the Sunnrnry ofServices, unless theparties mutually agree to a rnodification ofthe tinre and place ofservice delivery. COORDINATION OF S m,YICES To facilitate delivery ofservices. the Dstrict will provide: (l) reasonable and pronpt notification of rneetings and other appo int rEnts in which the Contrador is eryectedto participate; (2) signed paranta.l consent forms, as necessary;(3) identi!ing infonnation regarding the client and the parent/guardian; and (4) reasonable as sistance in facilitating conrnunication bdweenthe Contractorandthe client, parenVgu,ardiaq and other p ro v iders and agencies. PRIOR APPROVAL OF SM,VICES A ll s erv ices rendered by C-o nb:actor under the tefirs o fth is Contractua I A gre€nEnt s hall req u ire prior approva.lby the District in accordance with federal and state laws andregulatiors,localpolicies and pmcedures, and prcfessional cod€s of conduct CONS E\TT/AUTHORIZATION TO ACCESS DTJCATIONAL R.rcORDS OR PROTECTED HEALTH IIIFORMATION The District and Contractor shallat alltinrs require the writlen consentorauthorizationofthe parent/guardian or student, if l8 years ofage or older, for the disclosure or access to edrrcationa.l infornration pun r.rant to FERPA orprotected health infornntionpursumtto the Health Infornation Portability and Accounbbility Acr (HIPAA) regardingthe strderf, and shallrBinrain the confidentiality o fthat in format io n comistent with thestate and federal lawand regulations. PROFESSIONAL SRVICES The services rendered punuant to this Contractual Agreernent will be provided by individuals who are duly licensedto perform the s ervices or s upervis ed by a licensed/certified provider in accordance with applicable professional standards. Contractor agrees that all wo* purs uant to this Contractual Agreenrcnt will be performed in accordance with thehighest professional standards. Written docunEntationwill be provided to the Dis trict att6t ing that allenployees who conE into contact with studsrts s hall have been subjec to a criminal background check at least as stringenl as that req uired by ldaho Code Section 33-130 and policies ofthe District, andhave been determined to not have a criminal backgrormd inconsistent with working with children. The District shall have theright to observe s ervices being pro vid ed to the clients. INSURANCE AIID LIABILITY Co ntractor s hall be solely liable forany losses or darrages resulting fromConlractor's performance of any ofthe services covered by this ContactualAgreernent. ContracOr shallindenmi! andhold hannles s the Dislrict ftomany liability, including, br:t not limited to, cost, erpenses, and attomey fees, resulting fromC-ontractor's perfonnanceofthe services providedunderthis ConfadualAgreernent. Proofofinsurance shallbe s u bmitted tothe Dis trict wit h in ten (10) days ofthe date ofthis Contractual Agreement. COMPE\IS ATION/BILLING The Dis trict s hall cofipemate Co ntractor fo r the d irect s ewices ident ified on the attac]red Id ah o Sc hool Based_Medicaid Prograrn Service Detail and Activity Record. Reimbunenrntfor approved hours will be at the allowable billing rate (perunit) for Behavioral Intervention (BI) and pen onal care services (PCS) Iess stde funding rate (30plo) and billing services (l0olo) rates, in an annunt not to e)@eed the District's rate forthe termofthe contractua.l Agreernent. Additionalhoun will be conpensated at the sarne rate, providedthatthe add itional horns havebeen pre-approved, in witing, by th; District,s des ignee. Co ntractor will submit a monthly invoice (statenEnt ofservices rendered) and theconpleted districr Medicaid re-porting fonrs tothe D ectorofstudent services by the endofeach month. These conpleted forns must be accurate and ready to submit to the Dstricf s billing service. cEnerally, the District will issue checks rnonthly ifihe invoice and papawork are conp leted and in the Districi ofice Contrador: Hurnan D).namics & Diagnosjics (BI, CBRS! INT PRO, HS, PCS)5Date:8/)6/2022 by the end ofthe previous rnonth. Agency providers are responsible forgetting theapgopriate s up ervis ion conp leted by the ap propriate s upervis or d ependin g on s erv ice being p rovided. A ll fo nrs must be conpleted fully, s igned and be the original. Each monthly invoice nustinclude thefollowing infonnation for each s tudent receiving services:(l ) student's nanrc, (2) description ofservices provided, (3) totalnumberofhours s pent in providing services, and (4) cost ofservices provided. Additional d oc unrentat ion rnay be required by the District andmust be provided within five (5) wo rking day s o fth e d ate the written req uest for th e doc urnentation is made. The District agrees to pay Contractor at a rate as follo\m: $19.31 pe rhourfor Behavioral Intervention Paranrofe s s ional (BI PARA) $34.34 pe r hour for B e havioral Inte rre ntion SDecitlist (BI) Se rvices $30.03 rre r hour for B e havio ral Inte rve ntion Technician $36.26 per hour for Community Based Rehabilitation Services (CBR$ Services $47.35 pe r hour for Intervention Professional 11.94 r hour for Personal Care Services s 30.03 r hour for Habilitative Skills Pro S PRO NON-DISCRIMINATION The parties hereby agreethatno pe6on shallbe e>aluded florq denied pafticipation in, or otherwis e subjectedto d is crimin ation onthe grounds ofrace, color, creed, nationalorigin, sex, age, or d is ability in perfonnance ofthis Contradual Agreement. GOVMNANCE This Contractual Agreanrcntshallbe govemed bythe laws ofthe Stal€ ofldaho. Contractor s hall, at all tinEs, conply with and obs erve all federal, state, and locallaws, regulatiors, and ordinances which arc in effect and applicable during theperiod ofthis ContractualAgreenEnt ASSIGNMBIT This Crntractua.l Agreefirntsha]l not be s ubjed to assignrnent, in whole or in part, by Contractor or by operation oflaw, so as to authorize any person otherthan Contrador, orC-ontractor's ernp loyees, to assurne theduties s ubjecl to this Cont'ac'tualA greernent withoutthe District's prior written coment. STrcCESSORS ANDASSIGNS This ContractualAgre€rnentis binding upon, and inures to the benefrt of, successon and permitted as s igrs to the Contractual Agree[rEnl AME\DME\TT This C-ontractual A gre€nEnt nBy be afiEnded at any tinr with the p rior *ritten consat ofbodr parties. Anyand allanpndnpna to this Crntractual AgreerEnt shallbe in writing. TMMINATION This Contractual Agreenrcntrnay beterminated without cause byeitherparty with in thirty (30) days afterproviding written notice ofthe intentto terminate tothe otherparty. Additionally, the District rnay inrrrcdiately terminate this Contrdctua.l Agreernent, upon written notice, in the eventfundingforthe District's program is no longe r av ailab le orthe s pecific serv ices to this Contractual AgreenEnt are nndified orterminated fora stud€nl DE'AIJLT Upon default by either party, th e non-default ing p arty may, upon written notice, carrelthis Crntractual Agreement irmEdiately and nny pursue any andall available legaland equitable Contrador: Human Dlnamics & Diagnostics (Bl, CBRE rNT PRO, HS, PCS)6Datet 8/1612022 Services $19.31 perhourfor Habilitative Skills Para (HS PARA) for the duration ofthe contract remedies. The defaulting party shallbe liable for any and allepenses that arc incunedby the non- defau hing party as a res ult thereof in c lu d ing, b ut not limited to, procuring s ubstit ute perfonrancg legal fees, and otherlosses incurred due to the default. TIME OF PERK'RMANCE Tinre is ofthe essence in this Contractual A greenen( therefore, all tinres for perfornnnce ofthe obligations, as stated herein, s hall be strictly cornplied with by the paties. NON.WAVIIR BREACH The failure ofContractororthe District to insist upon strict p€rfonnance ofany ofthe terrs ofthis Contractual AgreerEnt, orto e)ercise any opt ion herein confened in any orallinstances, shall not constitute a waiver or re linq u is hrnent o fany s uch tenrl but the same s hall be and rennin in full force and effect, unless s rrch waiv er is ev idenced bythe prior written consent ofcontractororthe Dis trict ATTORNEY FMS If either party defaul6 in any rnanner or fails to fulfill any and/orallprovisiors ofthis Contractua.l Agreenrcnt, and ifthe non-defaufting party h ires an attorney to e)€rcis e its righ8 upon such default or failure, or if the parties are involved in any litigation (includingany proceedings in bankuptcy),the prevailing party shallbe enthled to recover reasonable attomey fees andcosts fromthe other party. This pamg raph s hall be enforceable by the panies notwithstanding any rescissior! forfeiture, orother termination ofthis Contractual AgreerrEnt DISPUTE RESOLUTION All participatingagencies agree to resolve systemic dis putes that aris e in the provision ofspecial education and in depend€nt contraclor s ewices in a non-adversarial nnnnerand to ensure that usingthe fo llo wing pro cess to res olve interagency d isputes does not d is rupt s erv ices to s tudent an d families : l. An individual oragerrywith aconcem willfint use the agancy's internalprccedues to address the concem.2. lfresolution is notachieved at theprevior.rs level, the issueand allrelevant infornation will now be forwarded to the Director ofstudent Sewices forldaho Falls SchoolDistrict 9l and Contractor's administrdor. 3. Ifconsensus is not reached at theprevious level the Directorofstud€nt Service willforward the issue and all relevant infonrntion to the Superintendentofldaho Falls School District 91.4. Ifa concem is relatedto the quality ofservice orhealth and safety issues, schools should refer such corrcerrs about Contractor an d/or t he sewices being provided to the Drectorofstud€nt Services and C.ontractor's ad min is trator to be addrcssed.5. If these corrcerns are notresolved in a dialoguewith the schmladministrator(the Dircctorof Student Services and/orthe Superintend€nt) andthe Contaclor's administ:ator, the Department of Heahh and W elfare regional licensingenlity may be conhctedto investigde the s ituation. SRVMABILITY A ny term or p rov is ion o fth is Crntractual A grcerEnt that is inv alid or u nenforceable in any s it uatio n in any juris d ict io n will be deenpd nndified to reflect the intent ofthe paties, determined by reference to the invalid or unenforceable termor provis ior\ to the greaest permis sible e*ent, and willnot affect the valid ity orenforceability ofthe rennining tenrs and provisions ofthe ContractualAgreenrcnt or the valid ity orenforceability ofthe o ffending term or p rov is ion in any other s ituation orjurisdiction COMPLETE STATEI{E\T OF TMT$ This C-ontractual A greerEnt const it utes theentire agrcernentbetweentheparties hereto, and shall supersede allprevious oralorwritten proposals, negotiations, conrnitnrcnts, and all other connnunications between the parties. This Conhaclral AgreenEnt nny not be released, d ischarged, or nndified e:cept by an instrument in writing, s igned by the duly authorized representatives oftha parties. Contrador: Human Dlnamics & Diagnostics (BI, CBRS INT PRO. HS! PCS)7Date: 8/16/2n2 SUMMARYOFSERVICES 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 Heahh & Welfare Contact: School Based Medicaid Address: 3232EHer Street, Eloise, ID83705 Telephone Number: 208-364- I903 Independent Contractor Agency: Human Dynamics & Diagnostics Administrator: Dr. Phil Girling Supervisor: Tasha Riedehach Ei.rsiness Address:2267 TetonPlazz, Idaho Falls, Idaho 83404 Telephone Number: 208-534-8303 E-MaiL tashar@humandynamicsid.com Certifrcate/LicensureNumber:DDA-3559 ExpirationDate: 1113012024 Direct Service Provider: Qualif,rcd indivilual as mutually agreed upon Review of Service: Fhst Review: November 14, 2022 Second Review: February 13,2023 Third Review : Aprl 24, 2023 At the student's annual IEP Team meeting SR.VICE PLAN(S) MUST BE ATTACIIED (For Information Only) Service(s) to be provide: Behavioral Intervention (BI), Community Based Rehabilitation Services (CBRS), Personal Care Services (PCS) and tlabilitative Skilb (HS) When service(s) willbe provided: Day(s): Monday - Friday when school is in session and student is attending Time: the schoolday when student is attending I-ocation (i.e., classroom, playground, etc...): all locations Duration of services (each day): As required by the assigned students' IEPs. Contrador: Hr[nafl Dyramics & Diagnosics (BI, CBRS INT PRO. HS PCS) 8Date. 8/1612m). Contrxclorwlll com ply with the Districl rndor sclmol operrtionol pttcedur€s rnd will fulf{ the followlng rcspnsllililles: o Sign in and out of the schrnloffice cach vbit with proper identification. . Wear picture identif-rcation and/or ohtain a vbitor's identificatbn badge from the school for each vbit. . Wear sppropriate c lothhg for the school setlinS. . Adhere to set schedule - arrive and leave on time. . Notify the building administrator if you will be absent (one day notice. if possible)' . Pic k up and return the student to an appropriatc sc hoo I staff person for eac h vis it. if applicablc. o Remain in assigned location. o Be know ledgeable about sc hool emergcnc.y- prcredurcs. . Not use any information obtained by observing other students to make contacl w ith parents for solic itathn purposes. . Not attempt to supcrsede a teacher or sc krol staff member in lhe instructional implementathn or supcrvision of an indivilual or chss. 'l'he specbleducathn tcacher and/or glcneral educ at ion teacher is the instructirnal leader in the chssroom. o Notify the Dbtrict and/or schoolof any staffing c hanges u'ithin thc agency that rehte to the serviccs indicatcd on this agrecmcnt. . Be coop€rative when resolving conflicts with dhtrict and/or schoolslaff. Diit rict/school rtrponsitilitie include: . Respect the rights of('ontractor. . Provile information regarding the proccdures and schedule ofthe school. . Provide information on emergency procedun:s. . When appropriate. invite Contractor t() specifr studcnt's Muhi-Disciplhary 'l'eam (MDT) meetinSs and/or lndivilualized Iducatirn Program (lF-P) tcam meelings. o Accommodale. within reason. Contraclor's needs lo lult'illthc scrvice phn. o Provide a positive climate and building envitonment to f-ac ililBte mutual assistance . & cooperative when resolving conflicts bctwccn Conlact)r and schoolstaffl The above items are nol to be considered all inclusive. Any concerns willbe addressed accoding to the Dbpute Resolution section in the Contractual Agrccment. lN WITNBSS WHERIOF. thc panics have cxecuted this Conlractual Agrcement. z Signature of Contractor or l)csijmcc ate Sigruture of Dblricl 9l SuJrrintc or Dcsilnee I)atc 9(ilnlrador: llurnan l))namie s & l)i gno{ic} (Dt.('nRs tNt PR(). Its P(\t l)ilc: lt ll, ll)ll ?\W