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Contract #68-2012 <br />Southern Home Care Services, Inc. <br />ATTACffi1~NT B <br />SCOPE OF WORK <br />Orange County Department of Social Services and Orange County Department on Aging <br />Federal Taz Id. or SSN <br />Contract # 68-2012 <br />A. CONTRACTOR INFORMATION <br />1. Contractor Agency Name: Southe o <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): In-Home Services <br />4. Status: ( )Public ( )Private, Not for Profit (X) Private, For Profit <br />5. Contractor's Financial Reporting Year July 1, 2008 through June 30, 2009 <br />B. Explanation of Services to be provided and to whom (include SIS Service Code): <br />The Contractor will provide employees t~erform in-home services for the <br />Department of Social Services' clients and the D~artment on Aging's clients, at the <br />level amount and frequency specified by the social worker in the In-Home Aide Services <br />Plan (SIS Code 0421 The Contractor will provide Level II Home Manacement and <br />Level III Personal Care The Contractor is required to meet all coals and outcomes listed <br />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 />X14 40/hour <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 <br />for services described in this contract up to the budgetary limits of the contract allotment. <br />The County will reimburse the Contractor at a rate of $14.40/hour for approved services <br />provided For reimbursement, the Contractor must submit an oricinal and two copies of <br />• <br />Contract-Scope of Work (06/04) Page lof 2 <br />