S Social Services - Home Health Solutions for In Home Aide to Eligible Adults

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Contract #68-2008 Home Health Solutions, Inc. ATTACHNIIrNT B SCOPE OF WORK Orange County Department of Social Services Federal Taz Id. or SSN ' Contract # 68-2008 A. CONTRACTOR INFORMATION 1. Contractor Agency Name: Home Health Solutions Inc. 2. If different from Contract Administrator Information in General Contract: Address la~i ~ ~s~s DR, ~w-~-~. 1~ ~ CJIr, ~ 11 r.T ~ a ~sl H Telephone Number: ~19-g2°t - l322 Fax Number: g- 3S Email: 3. Name of Program (s): In-Home Services 4. Status: ( )Public ( )Private, Not for Profit (X) Private, For Profit 5. Contractor's Financial Reporting Year July 1, 2007 through June 30, 2008 B. Explanation of Services to be provided and to whom (include SIS Service Code): The Contractor will provide employees to perform in-home services for the Department of Social Services' clients at the level amount and frequency specified by the social worker in the In Home Aide Services Plan (SIS Code 042) The Contractor willprovide Level II Home Management and Level III Personal Care. _The Contractor is required to meet all goals and outcomes listed in Attachment N. C. Rate per unit of Service (define the unit): 1. If Standard Fixed Rate, Maximum Allowable, (See Rates for Services Chart) $14.40/hour 2. Negotiated County Rate. D. Number of units to be provided: E. Details of Billing process and Time Frames; The County will reimburse the Contractor for services described in this contract up to the budge, tarn limits of the contract allotment. The County ~=rill reimburse the Contractor at a rate of $14 40/hour for approved services provided For reimbursement the Contractor must submit an original and two copies of an invoice by the fifth of the month for the preceding month's expenditures to the designated County Administrator Expenditures for Mav and June must be estimated • based on average monthly expenditures year-to-date and reported by Mav 5, 2008. The Contract-Scope of Work (06/04) Page lof 2