ATTACHMENT AA SCOPE OF WORK Vendors providing services under this contract agree to provide employment supports to an applicant or eligible client of the Vocational Rehabilitation Division (Division). Services may include, but are not limited to: Job Development; Job Coaching; Resume Development; Jobsite Analysis; Educational assessments and Transferable Skills Analysis/Assessment; The purpose of the service is to facilitate program participation and education for eligible clients to achieve employment. Referrals Accepted or rejected referrals for service will result in an appointment no more than (10) business days from date of referral. Any extenuating circumstances preventing the referred service by the vendor will be documented in writing, or email, and communicated by telephone to the referring counselor/agency within five (5) business days. Invoicing - All services must be pre-authorized by the Division according to the established fee schedule. Invoices must include the following; authorization number, the client s name, a description of the services provided, service start and end dates, and the appropriate service fee. Providers will not bill the Division or the participant when no service has been provided. Invoices must be submitted with a report that documents the efforts made by the vendor on behalf of the participant. If the referral is rejected by the vendor the report must document the details regarding the reasons the vendor believes the participant is not ready to be placed in employment. Invoices and reports must be submitted within fifteen (15) business days of the provided service. Services provided without prior authorization will not be paid by the Division. Payment may be delayed or denied if the invoice is not submitted correctly, and/or the required reports are not submitted; vendors will not receive payment for claims submitted after 90 days from the date of the service. Providers serving underserved rural areas may be reimbursed mileage at the current General Services Administration (GSA) rate as identified on www.gsa.gov. Mileage must be preapproved by the Division and will only be authorized if the provider is travelling more than 50 miles in excess of his/her normal commute, a provider s normal commute is considered the round trip mileage between the provider s residence and official duty station. Provider s shall complete and submit the Mileage Log and Reimbursement Form and a State of Nevada Travel Expense Reimbursement Claim form, provided by the Division, with the invoice for services. Page 1 of 3 Revised: 02/05/14
ATTACHMENT AA SCOPE OF WORK Licensure and Credentials - Vendors must provide evidence of a Nevada State Business License in good standing with the State of Nevada Secretary of State s office. The individual/provider providing the employment supports and signing the report of services must be qualified in their discipline per their accreditation board, meet State of Nevada requirements for professional standards and certification and maintain educational requirements of your emphasis. All vendors must adhere to the Rehabilitation Division: BVR/BSBVI Participant Services Policy and Procedures Manual, Section 12.1, Job Development and Placement, and Section 12.2, Job Coaching and Advocacy Services. All vendors are required to complete fingerprints and background checks, at the cost of the vendor. (Attachment EE) Out of state vendors must provide evidence of a Nevada State Business License in good standing with the State of Nevada Secretary of State s office, and must be licensed and qualified in their discipline per their accreditation and licensure in the state that the service is provided. The State of Nevada will not utilize the services of any non-licensed vendor. Vendors will not be added to the approved vendor list without complete and approved receipt of all required documentation. The following outlines the expectations and fee schedules for non-supported employment, supported employment, and job coach services. Job Developers (Non-Supported Employment) All Job Development vendors will be provided the Rehabilitation Division: BVR/BSBVI Participant Services Policy and Procedures Manual, Section 12.1, Job Development and Placement, and Section 12.2, Job Coaching and Advocacy Services All job development vendors are expected to utilize the examples, and guidelines in this overview as well as the training below: Certificate required documenting training from the following: Employment Services Certificate from San Diego State University Nevada E-Rehab Job Developer Series-all 4 modules Ethics Training provided annually by Rehab Division or approved provider Per the fee schedule, service providers are expected to meet the potential client and counselor in person prior to accepting the referral. It is expected that clients representing the complete spectrum of perceived difficulty will be accepted. No one population may be routinely excluded. The only exception to this policy will be for individuals assisting those clients identified as Most Severely Disabled (MSD)/Supported Employment (SE) clients. It is recognized that these clients, identified as meeting specific programmatic criteria, require customized support and job carving services which are more time consuming and require greater expertise. Page 2 of 3 Revised: 02/05/14
ATTACHMENT AA SCOPE OF WORK If a Community Based Assessment becomes a job placement: Placement must be appropriate, consistent with IPE and agreed to by the counselor and participant Follow along needs will be determined on an individual basis Job Developers (Supported Employment) Only the Vocational Rehabilitation Counselor can make the determination of whether a client is approved for Supported Employment (SE, MSD) services. All Job Development vendors will be provided the Nevada Rehabilitation Division Overview of Job Development and Job Coaching Policies. All job development vendors are expected to utilize the examples, and guidelines in this overview. Certificate required documenting training from the following: Employment Services Certificate from San Diego State University Nevada E-Rehab Job Developer Series-all 4 modules Ethics Training provided annually by Rehab Division or approved provider Job Coaching Job Coaching is intended for supported employment clients. Job coaching is not standard for non-supported Employment clients. No job coaching hours will be available for non- Supported Employment clients without significant justification by the employment specialist and pre-approval by the Vocational Rehabilitation Counselor. All Job Coaching vendors will be provided the Nevada Rehabilitation Division Overview of Job Development and Job Coaching Policies. All job coaching vendors are expected to utilize the examples, and guidelines in this overview. Certificate required documenting training from the following: Nevada E-Rehab Job Coach Series- 2 modules Ethics Training provided annually by Rehab Division or approved provider Job Coaching hours will be available for Supported Employment clients based on identified need and justification of the employment specialist and approved in advance by the Vocational Rehabilitation Counselor. Page 3 of 3 Revised: 02/05/14
ATTACHMENT BB INSURANCE SCHEDULE INDEMNIFICATION CLAUSE: Contractor shall indemnify, hold harmless and, not excluding the State's right to participate, defend the State, its officers, officials, agents, and employees (hereinafter referred to as Indemnitee ) from and against all liabilities, claims, actions, damages, losses, and expenses including without limitation reasonable attorneys fees and costs, (hereinafter referred to collectively as claims ) for bodily injury or personal injury including death, or loss or damage to tangible or intangible property caused, or alleged to be caused, in whole or in part, by the negligent or willful acts or omissions of Contractor or any of its owners, officers, directors, agents, employees or subcontractors. This indemnity includes any claim or amount arising out of or recovered under the Workers Compensation Law or arising out of the failure of such contractor to conform to any federal, state or local law, statute, ordinance, rule, regulation or court decree. It is the specific intention of the parties that the Indemnitee shall, in all instances, except for claims arising solely from the negligent or willful acts or omissions of the Indemnitee, be indemnified by Contractor from and against any and all claims. It is agreed that Contractor will be responsible for primary loss investigation, defense and judgment costs where this indemnification is applicable. In consideration of the award of this contract, the Contractor agrees to waive all rights of subrogation against the State, its officers, officials, agents and employees for losses arising from the work performed by the Contractor for the State. INSURANCE REQUIREMENTS: Contractor and subcontractors shall procure and maintain until all of their obligations have been discharged, including any warranty periods under this Contract are satisfied, insurance against claims for injury to persons or damage to property which may arise from or in connection with the performance of the work hereunder by the Contractor, his agents, representatives, employees or subcontractors. The insurance requirements herein are minimum requirements for this Contract and in no way limit the indemnity covenants contained in this Contract. The State in no way warrants that the minimum limits contained herein are sufficient to protect the Contractor from liabilities that might arise out of the performance of the work under this contract by the Contractor, his agents, representatives, employees or subcontractors and Contractor is free to purchase additional insurance as may be determined necessary. A. MINIMUM SCOPE AND LIMITS OF INSURANCE: Contractor shall provide coverage with limits of liability not less than those stated below. An excess liability policy or umbrella liability policy may be used to meet the minimum liability requirements provided that the coverage is written on a following form basis. 1. Commercial General Liability Occurrence Form General Aggregate $2,000,000 Products Completed Operations Aggregate $1,000,000 Personal and Advertising Injury $1,000,000 Each Occurrence $1,000,000 a. The policy shall be endorsed to include coverage for physical/sexual abuse and molestation. b. The policy shall be endorsed to include the following additional insured language: The State of Nevada, Rehabilitation Division, 1370 S. Curry St., Carson City, NV 89703, shall be named as an additional insured with respect to liability arising out of the activities performed by, or on behalf of the Contractor. 2. Automobile Liability Bodily Injury and Property Damage for any owned, hired, and non-owned vehicles used in the performance of this Contract. Combined Single Limit $1,000,000 a. The policy shall be endorsed to include the following additional insured language: "The State of Nevada shall be named as an additional insured with respect to liability arising out of the activities performed by, or on behalf of the Contractor, including automobiles owned, leased, hired or borrowed by the Contractor". Page 1 of 3 Rev: 09/17/13 Approved: 04/03/13
ATTACHMENT BB INSURANCE SCHEDULE b. This requirement shall not apply when a contractor or subcontractor has declared they are not transporting clients by executing the appropriate DETR, Rehabilitation, Intent to Transport form. 3. Worker s Compensation and Employers Liability Worker s Compensation Statutory Employers Liability Each Accident $100,000 Disease Each Employee $100,000 Disease Policy Limit $500,000 a. Policy shall contain a waiver of subrogation against the State of Nevada. b. This requirement shall not apply when a contractor or subcontractor is exempt under NRS, and when such contractor or subcontractor executes the appropriate sole proprietor waiver form. 4. Professional Liability (Errors and Omissions Liability) The policy shall cover professional misconduct or lack of ordinary skill for those positions defined in the Scope of Services of this contract. Each Claim $1,000,000 Annual Aggregate $2,000,000 a. In the event that the professional liability insurance required by this Contract is written on a claims-made basis, Contractor warrants that any retroactive date under the policy shall precede the effective date of this Contract; and that either continuous coverage will be maintained or an extended discovery period will be exercised for a period of two (2) years beginning at the time work under this Contract is completed. 5. Fidelity Bond or Crime Insurance Bond or Policy Limit $100,000 a. The bond or policy shall include coverage for all directors, officers, agents and employees of the Contractor b. The bond or policy shall include coverage for third party fidelity and name the State of Nevada and their clients as loss payee where as their interests may appear. c. The bond or policy shall include coverage for extended theft and mysterious disappearance. d. The bond or policy shall not contain a condition requiring an arrest and conviction. e. Policies shall be endorsed to provide coverage for computer crime/fraud. B. ADDITIONAL INSURANCE REQUIREMENTS: The policies shall include, or be endorsed to include, the following provisions: 1. On insurance policies where the State of Nevada is named as an additional insured, the State of Nevada shall be an additional insured to the full limits of liability purchased by the Contractor even if those limits of liability are in excess of those required by this Contract. 2. The Contractor's insurance coverage shall be primary insurance and non-contributory with respect to all other available sources. Page 2 of 3 Rev: 09/17/13 Approved: 04/03/13
ATTACHMENT BB INSURANCE SCHEDULE C. NOTICE OF CANCELLATION: Each insurance policy required by the insurance provisions of this Contract shall provide the required coverage and shall not be suspended, voided or canceled except after thirty (30) days prior written notice has been given to the State, except when cancellation is for nonpayment of premium, then ten (10) days prior notice may be given. Such notice shall be sent directly to State of Nevada Department of Employment, Training and Rehabilitation, Attn: Provider Agreement, 1370 S. Curry Street, Carson City, NV 89703. D. ACCEPTABILITY OF INSURERS: Insurance is to be placed with insurers duly licensed or authorized to do business in the state of Nevada and with an A.M. Best rating of not less than A- VII. The State in no way warrants that the above-required minimum insurer rating is sufficient to protect the Contractor from potential insurer insolvency. E. VERIFICATION OF COVERAGE: Contractor shall furnish the State with certificates of insurance (ACORD form or equivalent approved by the State) as required by this Contract. The certificates for each insurance policy are to be signed by a person authorized by that insurer to bind coverage on its behalf. All certificates and any required endorsements are to be received and approved by the State before work commences. Each insurance policy required by this Contract must be in effect at or prior to commencement of work under this Contract and remain in effect for the duration of the project. Failure to maintain the insurance policies as required by this Contract or to provide evidence of renewal is a material breach of contract. All certificates required by this Contract shall be sent directly to State of Nevada Department of Employment, Training and Rehabilitation, Attn: Provider Agreement, 1370 S. Curry Street, Carson City, NV 89703. The State project/contract number and project description shall be noted on the certificate of insurance. The State reserves the right to require complete, certified copies of all insurance policies required by this Contract at any time. F. SUBCONTRACTORS: Contractors certificate(s) shall include all subcontractors as additional insureds under its policies or Contractor shall furnish to the State separate certificates and endorsements for each subcontractor. All coverages for subcontractors shall be subject to the minimum requirements identified above. G. APPROVAL: Any modification or variation from the insurance requirements in this Contract shall be made by the Attorney General s Office or the Risk Manager, whose decision shall be final. Such action will not require a formal Contract amendment, but may be made by administrative action. IN WITNESS WHEREOF, the parties hereto have caused this Contract to be signed and intend to be legally bound thereby. Authorized Signature Date Title Signature State of Nevada Date Title Page 3 of 3 Rev: 09/17/13 Approved: 04/03/13
ATTACHMENT CC Job Development for non-supported Employment Clients Phase 1 Referral Review and Accept or Reject Referral with Report and Invoice $ 200 Phase 2 Placement Job Development Plan and Verification of Initial Placement Form $ 1,400 Phase 3 Retention and Monitoring 30 Day Job Retention and Monitoring With Report and Invoice $ 400 60 Day Job Retention and Monitoring With Report and Invoice $ 300 90 Day Job Retention and Monitoring With Report and Invoice $ 700 TOTAL $ 3,000 Job Development for Supported Employment Clients Phase 1 Referral Review and accept Referral with Report and Invoice $ 400 Rejection of referral with report and invoice $ 200 Phase 2 Pre-Employment Vocational assessment, occupation exploration, transferable skills assessment, vocational preparation, with report and invoice $ 1,800 Phase 3 Placement Job development plan and verification of initial placement form $ 1,000 Phase 4 Retention and monitoring 30 Day job retention and monitoring with report and invoice $ 500 60 Day job retention and monitoring with report and invoice $ 300 90 Day job retention and monitoring with report and invoice $ 700 TOTAL $ 4,700 Page 1 of 2 Vocational Rehabilitation Division Revised: 08/29/2013 Employment Supports Fee Schedule
ATTACHMENT CC Job Coaching Job Coaching or other ancillary employment specialist services will be paid at the standard $23.50 rate per hour. No exception. $ 23.50 per hour Community Based Assessments If a CBA becomes a job placement, placement must be appropriate, consistent with IPE and agreed to by the counselor and participant; A drug screen test will be required before CBA intake, testing will be provided through VR. CBA Intake $ 75.00 CBA Site Development New Site $250.00 CBA Site Development Existing Site $125.00 Fee Per Week (not to exceed 4 weeks) $125.00 Report/Exit Interview $75.00 TOTAL (New Site) $900.00 TOTAL (Existing Site) $775.00 Page 2 of 2 Vocational Rehabilitation Division Revised: 08/29/2013 Employment Supports Fee Schedule
ATTACHMENT CC Situational Assessments A drug screen test will be required before the start of the Situational Assessment. Testing will be provided through VR if not included as part of the SA. Intake Fee $75.00 Drug Screen (if provided by employer) $40.00 Employer Fee per day (maximum 20 days) $65.00 Client Wage per hour (current state minimum wage) $8.25 Administrative fee (23% maximum allowable overhead of client wages per hour.) $1.90 Situational Assessments Rev. 08/29/13