S Social Services - Arcadia Health Care for In Home Elegible Adults

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Contract #68-2005 Arcadia Health Services, Inc. ATTACIIIVIVIENT B SCOPE OF WORK Orange County Department of Social Services Federal Taz Id. or 5SN ~~ Contract # 68-2005 A. CONTRACTOR INFORMATION 1. Contractor Agency Name: Arcadia Health Services. Inc. 2. If different from Contract Administrator Information in General Contract: Address Sheena Dickey 101 North Third Street, Mebane NC 27302 Telephone Number: (919) 304-2004 Fax Number: Email: 3. Name of Program (s): In-Home Services 4. Status: ( )Public ( )Private, Not for Profit (~ 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 emnloyees to perform in-home services for the Department of Social Services' clients at the level amount and freauency syecified by the social worker in the In-Home Aide Services Plan. (SIS Code 042) The Contractor will~rovide Level II Home Manayement and Level III Personal Care. The Contractor is required to meet all Qoals 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 u~ to the budgetary limits of the contract allotment. The County will reimburse the Contractor at a rate of $14.40/hour for apuroved services provided For reimbursement the Contractor must submit an original and two conies 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