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DocuSign Envelope ID: FBF0391 D-70C4-4BC1-A063-A23742F80EC1 <br /> ATTACHMENT B <br /> SCOPE OF WORK <br /> Orange County Department of Social Services <br /> Federal Tax Id. or SSN <br /> Contract# 68-2014 <br /> A. CONTRACTOR INFORMATION <br /> 1. Contractor Agency Name: Senior Care of Orange County,Inc. <br /> 2. If different from Contract Administrator Information in General Contract: <br /> Address <br /> Telephone Number: _ Fax Number: Email: <br /> 3. Name of Program(s): Adult Day Health Service <br /> 4. Status: ( )Public (X)Private,Not for Profit ( )Private,For Profit <br /> 5. Contractor's Financial Reporting Year July 1, 2017 through June 30,2018 <br /> B. Explanation of Services to be provided and to whom (include SIS Service Code): The <br /> Contractor will provide Adult Day Health Services(SIS Code 091)to clients of the Orange <br /> County Department of Social Services. These services will include assistance with Activities of 11 <br /> Daily Living,health monitoring by an RN, and therapeutic recreational programs. The <br /> Contractor is required to meet all 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: $3892/damper client {, <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 for <br /> services described in this contract up to the budgetary limits of the contract allotment. The <br /> County will reimburse the Contractor at a rate of$38.92/day for approved services provided. For <br /> reimbursement,the Contractor must submit an original and two copies of an invoice by the fifth <br /> of the month for the preceding month's expenditures 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 lof 2 <br />