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DocuSign Envelope ID:412EAE5F-3824-43FA-AC95-54AOC4DF83A2 <br /> ATTACFIAWNT B <br /> SCOPE OF WORK <br /> Orange County Department of Social Services and Orange County Department on Aging <br /> Federal Tax Id.or SSN 56-1629016 <br /> Contract# 68-2045 <br /> A. CONTRACTOR INFORMATION <br /> 1. Contractor Agency Name: Personalized Patient Home Assistance, Inc. <br /> 2. If d ierent from Contract Administrator Information in General Contract: <br /> Address <br /> Telephone Number: Fax Number: Email: <br /> 3. Name of Program(s): In-Home Services <br /> 4. Status: ( )Public ( )Private,Not for Profit (X)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 employees to perform in-home services for the Department of Social <br /> Services' clients and the Department on Aging's clients,at the level,amount and frequency <br /> specified by the social worker in the In-Home Aide Services Plan (SIS Code 042). The <br /> Contractor will provide Level II Home Management and Level II Personal Care. The Contractor <br /> is required to meet all goals and outcomes listed in Attachment O.The Contractor may be asked <br /> to provide employees to perform personal care services during an emergency shelteringevent. <br /> vent. <br /> C. Rate per unit of Service(define the unit): <br /> 1. If Standard Fixed Rate,Maximum Allowable,(See Rates for Services Chart) <br /> A maximum allowable rate of$23.881hour,of which the Contractor must pay the In <br /> Home Aide at least the County's Living Wage_(currently 14.95 perlhr).The County has <br /> increased the standard fixed rate to compensate Contractor for any amount above Federal <br /> Minimum Wage. <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$23.881hour 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. All <br /> invoices for the provision of services to the Department of Social Services shall be submitted to <br /> Contract-Scope of Work(06/04) Page lof 2 <br />