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DocuSign Envelope ID:4n0Ce831-88Eu-408B-8r1n~^r1C30u3n3*4 <br /> ATTACHMENT B <br /> SCOPE OF WORK <br /> Orange County Department of Social Services <br /> Federal Tax Id. or SSN <br /> Contract# _68'2814 <br /> A. CONTRACTOR INFORMATION <br /> I. Contractor Agency Name: Senior Care of Orange County, Inc. <br /> 2. If clUfereni from Contract Administrator Information in General Contract: <br /> Address <br /> Telephone Number: _ Fax Number: ______£nnoil:_ <br /> 3. Name of Program (s): Adult Day Health Service <br /> 4. Status: ( ) Public ( ){ ) Private, Not for Profit ( ) Private, For Profit <br /> 5. Contractor's Financial Reporting Year July ], 2Ol6 through June 30, 2017 <br /> B. Explanation of Services to be provided and to whom (include SIS Service Code): _The <br /> Contractor wilLprovide Adult Day Health Servic (SIS Code 091)to clients of the Orange <br /> County Department of Social Services. These services will include assistance with Activities of <br /> Daily Living, health monitoring by an Ky4- and therapeutic recreational programs. The <br /> Contractor is required to meet ajj goals 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 /> Minimum daily rate: $38.42/duy per client_ <br /> 2. Negotiated County Rate. <br /> D. Number of units to be provided: <br /> E. I)etails of Billing process and Time Frames; The County will reimburse the Contractor for <br /> services described in this contract up to the budgetary limits of the contract allotment. The <br /> County will reimburse the Controrat a rate of$38.92/daylor approved services provided. For <br /> reimbursement,the Contractor niust submit an original and two copies of an invoice by the fifth <br /> of the month for the preceding month's expenditEes to the designated County Administrator. <br /> The County will reimburse the Contractor monthly upon receipt of a complete and correctly filed <br /> report. <br /> The service(s) under contract with the Contractor are services for which a client may voluntarily <br /> contribute to the cost. Policies regarding the solicitation and acceptance of voluntary <br /> contributions are contained in Family Services Manual, Volume VI, Chapter III. If a client <br /> Contract-Scope of Work(06/04) Page |of| <br />