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DocuSign Envelope ID:AA69FB9A-1A2E-426C-AC90-FAA292CFBF41 <br /> ATTACHMENT B <br /> SCOPE OF WORK <br /> Orange County Department of Social Services <br /> Federal Tax id.or'SSN 56-2460614 <br /> Contract# 68-2041 <br /> A. CONTRACTOR INFORMATION <br /> 1, Contractor Agency Name: Senior Care of Orange County,Inc. <br /> 2. If derent 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 1,2018 through .Tune 30 2019 <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 034 and 155)to clients of the <br /> Orange ComM Department of Social Services. These services will include assistance with <br /> Activities of Daily Living health monitoring by an RN and therapeutic recreational programs. <br /> These services will be provided in accordance with provisions set forth in Volume IV of the <br /> Adult and Family Services Manual Chapter II-Adult DU Care Services. The Contractor is <br /> required to meet all goals and outcomes listed in Attachment O. <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: $38.92Jdaâ–ºyper 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$38.921day for approved services_provided. For <br /> reimbursement. the Contractor must submit an original and two copies of an invoice by fifth <br /> of the month for the preceding.month's expenditures to the designated County Administrator.. <br /> The Coupty will reimburse the Contractor monthly upon receipt of a complete and correctly filed <br /> report. <br /> Contract-Scope of Work(06/04) Page ]of 2 <br />