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Contract #68-2004 <br />Personalized Patient Home Assistance, Inc. <br />ATTACHMENT B <br />SCOPE OF WORK <br />Orange County Department of Social Services <br />Federal Tax Id. or SSN ~ <br />Contract # 68-2004 <br />A. CONTRACTOR INFORMATION <br />1. Contractor Agency Name: Personalized Patient Home Assistance, Inc. <br />2. If different from Contract AAdministrator Information in General Contract: <br />Address /C'~ l ~~C~~~a ~~ ~ <br /> <br />Telephone Number: g/ `~-~~l-7~~ Fax Number: yl~-`~-~`~# <br />3. Name of Program (s): In-Home Services <br />4. Status: ( )Public ( )Private, Not for Profit (~ Private, For Profit <br />5. Contractor's Financial Reporting Year July 1, 2007 through June 30, 2008 <br />B. Explanation of Services to be provided and to whom (include SIS Service Code): <br />The Contractor will provide emplo ey es to perform in-home services for the <br />Department of Social Services' clients, at the level, amount and frequency specified by <br />the social worker in the In-Home Aide Services Plan. (SIS Code 0421 The Contractor <br />will provide Level II Home Management and Level III Personal Care. The Contractor is <br />required to meet all coals and outcomes listed in Attachment N. <br />C. Rate per unit of Service (define the unit): <br />1. If Standard Fixed Rate, Maximum Allowable, (See Rates for Services Chart) <br />$14.40/hour <br />2. Negotiated County Rate. <br />D. Number of units to be provided: <br />E. Details of Billing process and Time Frames; The County will reimburse the Contractor <br />for services described in this contract up to the budgetary limits of the contract allotment. <br />The County will reimburse the Contractor at a rate of $14.40/hour for approved services <br />provided. For reimbursement, the Contractor must submit an original and two copies of <br />an invoice by the fifth. of the month for the preceding month's expenditures to the <br />designated County Administrator. Expenditures for May and June must be estimated <br />based on average monthly expenditures year-to-date and reported by May 5, 2008. The <br />Contract-Scope of Work (06/04) Page 1 of 2 <br />