Orange County NC Website
Browse       Search
DocuSign Envelope ID: FBA030F0-9120-42B9-A272-5932D959B8F6 <br /> ATTACHMENT B <br /> SCOPE OF WORK <br /> Orange County Department of Social Services <br /> Federal Tax Id.or SSN 58-1582881 <br /> Contract# 68-2042 <br /> A. CONTRACTOR INFORMATION <br /> 1. Contractor Agency Name: Charles House Association <br /> 2. If dierent from Contract Administrator Information in General Contract: <br /> Address <br /> Telephone Number: Fax Number: Email: <br /> 3. Name of Program(s): Adult Dgy Care <br /> 4. Status: ( )Public (X)Private,Not for Profit { }Private, For Profit <br /> 5. Contractor's Financial Reporting Year July 1 2019 through June 30,2020 <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 030 and 155 to clients of the <br /> Orange County Department of Social Services. These services will include assistance with <br /> Activities of Daily Livin& health monitoring by an RN and therapeutic recreational progams. <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 QLay 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: $33.071dgy per client <br /> 2.Negotiated County Rate. <br /> D.Number of units to be provided: <br /> E.Details of Billing process and Time Frames;The Coup will reimburse the Contractor for <br /> services described in this contract up to the budget limits of the contract allotment. The <br /> County will reimburse the Contractor at a rate of$33.07/day for approved services provided. For <br /> reimbursement the Contractor must submit an on final and two copies of an invoice by the fifth <br /> of the month for the preceding month's expenditures to the designated Coup Administrator. <br /> The Couajy will reimburse the Contractor monthly upon receipt of a com lete and correctly filed <br /> report. <br /> Contract-Scope of Work(06/04) Page Iof 2 <br />