2-26139 Scope of Work.docx

SCOPE OF WORK

Article 1

BACKGROUND

1.1 Background. The Department of Health and Human Services, Utah State Developmental Center (“DHHS/USDC”) seeks to provide physical therapy services to approximately 200 or more residents with intellectual and physical disabilities and behavioral and physical issues.

Article 2

CONTRACTOR QUALIFICATIONS

2.1 Contractor Qualifications. The Contractor shall:

(1) ensure all its staff, prior to providing services, are licensed by the Utah Division of Occupational and Professional Licensing as a Physical Therapist or Physical Therapist Assistant, and provide a copy of each current license to the DHHS/USDC superintendent;

(2) ensure its Physical Therapist Assistant(s) are:

(A) eligible for registration by the American Physical Therapy Association; or

(B) a graduate of a two-year college-level program approved by the American Physical Therapy Association or another comparable body;

(3) have at least three years of professional experience working with individuals who have developmental and cognitive disabilities and possible behavioral and physical issues;

(4) disclose any previous or pending disciplinary actions, even if resolved satisfactorily, to the DHHS/USDC superintendent prior to any contact with, or access to, DHHS/USDC individuals;

(5) comply with the background screening requirements contained in Attachment A Client Service Terms, and provide an authorization and release that allows the results of each background check to be provided to the DHHS/USDC superintendent; and

(6) be a Utah Medicaid provider and an enrolled Medicare provider.

Article 3

SERVICE REQUIREMENTS

3.1 Physical Therapy Reporting Requirements. The Contractor shall:

(1) provide written physical therapy evaluations and Individual Program Plan (“IPP”) goals for every individual admitted to DHHS/USDC; and

(2) work in conjunction with DHHS/USDC treatment teams to perform a new evaluation and goals under the following circumstances:

(A) new admissions to DHHS/USDC;

(B) recommendation for ongoing therapy upon discharge from DHHS/USDC;

(C) meeting with guardians and treatment team before the annual IPP;

(D) post hospital stays resulting in new physical therapy conditions;

(E) if the treatment team has a concern about an individual's health or behavior, as it relates to physical therapy needs; and

(F) electronic reporting into the DHHS/USDC electronic I-Chart system that includes:

(i) the evaluations described above;

(ii) Contractor’s treatment instructions to DHHS/USDC staff;

(iii) monthly prescriptive therapy progress notes to include progression or regression of goals; and

(iv) creation of prescriptive therapy goal(s) in accordance with Title XIX Active Treatment regulations.

3.2 Physical Therapies.

(a) The Contractor shall perform evaluations and implement individualized gait training programs for individuals with intellectual disabilities residing on campus. Initial and ongoing assessments must address gait mechanics, balance, posture, endurance, motor planning, and the need for assistive devices, while also considering cognitive, sensory, and behavioral factors that may impact safe ambulation. The Contractor shall focus Interventions on task-specific, functional mobility training across campus environments. Training must include navigation of environmental challenges such as uneven terrain, stairs, ramps, and crowded settings, with an emphasis on promoting independence and participation in daily routines.

(b) The Contractor shall perform evaluations and implement individualized Range of Motion (“ROM”) programs for individuals with intellectual disabilities residing on campus. Evaluations must address active and passive ROM, joint integrity, muscle length, tone, postural alignment, and the presence of contractures or movement limitations, while also considering cognitive, sensory, and behavioral factors that may influence participation. Interventions must include active, active-assisted, and passive ROM exercises designed to maintain or improve joint mobility, prevent contractures, reduce pain and stiffness, and support functional movement patterns.

(c) The Contractor shall perform evaluations and implement individualized positioning programs for individuals with intellectual disabilities to promote optimal postural alignment, prevent secondary complications, and support functional participation across campus environments. Evaluations must address postural control, muscle tone, range of motion, skeletal alignment, skin integrity, and tolerance to various positions, while also considering cognitive, sensory, and behavioral factors that may influence compliance and comfort. Interventions must include the prescription and implementation of appropriate positioning strategies in supine, prone, sitting, and standing, utilizing adaptive equipment such as specialized seating systems, cushions, wedges, and orthotic supports as indicated. The Contractor shall emphasize pressure relief, prevention of contractures and deformities, respiratory support, and facilitation of functional activities.

(d) The Contractor shall perform evaluations and implement strength training programs for individuals with intellectual disabilities to improve muscular strength, endurance, and functional performance. Assessments must address baseline strength, motor control, posture, balance, and movement patterns, in addition to cognitive, sensory, and behavioral factors that may influence participation and safety. Interventions must incorporate progressive resistance training using body weight, manual resistance, therapeutic equipment, and functional task-based activities, with emphasis on major muscle groups required for mobility, transfers, and activities of daily living. The Contractor shall utilize structured cueing (verbal, visual, tactile), repetition, and task-specific practice to support motor learning and engagement, while ensuring proper technique and injury prevention.

(e) The Contractor may perform evaluations and implement other prescriptive goals, with the approval of DHHS/USDC, that enhance the overall physical health of the individual and align with the individual's IPP.

3.3 Wheelchair Seating and Mobility. The Contractor shall perform a biannual evaluation for each individual in a wheelchair, that includes:

(1) evaluation to establish mobility-related impairment and prescription of proper mobility assistive equipment;

(2) seating evaluation for custom seating prescription with Signature Fit system for proper and safe positioning in wheelchair;

(3) establishing and maintaining relationships with vendors of mobility-related equipment;

(4) coordinating with practitioners and other DHHS/USDC medical providers, and a medical assessment of mobility-related equipment for individuals;

(5) participating in the DHHS/USDC wheelchair clinics to adjust wheelchairs; and

(6) working with the treatment team to recommend the proper wheelchair to purchase to meet the individual's needs.

3.4 Aquatic Therapies. The Contractor shall:

(1) assess, develop, and implement individualized hydrotherapy programs for individuals with intellectual disabilities to promote mobility, strength, balance, relaxation, and overall functional participation;

(2) perform evaluations to consider physical status (e.g., range of motion, strength, endurance, balance), medical history, skin integrity, and contraindications to aquatic therapy, as well as cognitive, sensory, and behavioral factors that may impact safety and engagement in a water-based environment;

(3) ensure its therapeutic interventions utilize the properties of water—buoyancy, resistance, and hydrostatic pressure—to support gait training, range of motion, strengthening, postural control, and coordination activities;

(4) structure sessions to incorporate task-specific and functional movements, with appropriate use of adaptive equipment and individualized cueing (verbal, visual, tactile) to facilitate participation and motor learning; and

(5) work on individual’s hydrotherapy programs, in the pool, at least 4 hours a week.

3.5 Assistive Devices. The Contractor, in conjunction with the DHHS/USDC treatment team, shall conduct functional assessments to identify appropriate assistive devices and adaptive technologies for participating individuals. The Contractor shall document findings and provide recommendations that explicitly account for the intersection of the individuals' intellectual disabilities and/or physical limitations. All recommended devices must be accessible, intuitive, and physically manageable for the intended users and staff.

3.6 Work Schedule. The Contractor shall provide one physical therapist professional, eight hours per day, Monday through Friday. The schedule of hours may deviate if the service requirements of this contract are met and the revised schedule is more effective and efficient as decided in collaboration with DHHS/USDC. Work schedules must be established at least one month in advance. Any deviations from the work schedule must be approved in advance by the DHHS/USDC clinical director. The Contractor shall notify the DHHS/USDC clinical director or designee of any planned time off with sufficient notice to allow for proper coverage. In cases of unplanned absences, the Contractor shall notify the DHHS/USDC clinical director as soon as possible.

Article 4

DHHS/USDC EMPLOYEE TRAINING AND COLLABORATION

4.1 DHHS/USDC Employee Training. The Contractor shall train and instruct DHHS/USDC staff on: (1) proper positioning; (2) gait; (3) transfer of individuals to and from wheelchairs, lifts, and other assistive devices; (4) prescriptive therapies; (5) use of appropriate equipment (i.e. lifts, slings, seat belts, walkers, etc.); and (6) hydrotherapy needs.

4.2 Collaboration. The Contractor shall collaborate with DHHS/USDC practitioners and the treatment team by:

(1) attending and participating in monthly meetings for individuals in physical therapy services;

(2) providing recommendations for adaptive durable medical equipment; and

(3) attending and giving recommendations for the Physical Medicine & Rehabilitation clinic held at the DHHS/USDC approximately every six weeks.

Article 5

POLICIES AND PROCEDURES COMPLIANCE

5.1 Policies and Procedures Compliance. The Contractor shall comply with all DHHS/USDC policies and procedures and ensure its staff:

(1) abide by the DHHS/USDC’s tobacco-free campus rules when working on the DHHS/USDC campus;

(2) are up to date on all training as required by DHHS/USDC; and

(3) are administered a Tuberculosis test by DHHS/USDC before working with individuals.

Article 6

EQUIPMENT

6.1 Equipment. The Contractor will have access to and use of:

(1) equipment located in the Comprehensive Medical Therapy Building;

(2) network and database access necessary to provide services while on DHHS/USDC campus;

(3) Mandt System training; and

(4) tilt tables, easy standers, treadmills, recumbent bicycles, therapeutic pool, wheelchairs, and walkers.

Article 7

OUTCOMES

7.1 Physical Agility and Mobility.

(a) Outcome: The Contractor produces measurable improvement or maintenance in physical agility and mobility for DHHS/USDC individuals. The Contractor provides comprehensive training to DHHS/USDC staff to ensure the best medical outcomes of mobility and comfort.

(b) Measure: The Contractor shall ensure a minimum of 80% of participating individuals maintain or improve their baseline mobility scores annually. The Contractor shall deliver comprehensive staff mobility and positioning training within 30 days of contract start, with refresher training completed semi-annually.

(c) Reporting: DHHS/USDC will review yearly medical examination results and cross-reference them with documented DHHS/USDC staff observation logs to evaluate compliance and mobility success.

7.2 Assistive Device Optimization.

(a) Outcome: The Contractor improves the overall comfort, fit, and safest positioning of wheelchairs and assistive devices used by DHHS individuals to produce desired health outcomes. The Contractor provides ongoing wheelchair evaluations and recommendations for necessary device modifications.

(b) Measure: The Contractor shall conduct regular assistive device evaluations and submit written recommendations for modifications or replacements within five business days of identifying an issue. The Contractor shall achieve a target of zero instances of health degradation or skin breakdown caused by improper device fit.

(c) Reporting: DHHS/USDC will review the doctor’s ongoing exams and incident tracking reports to evaluate any improvement or degradation of a client's health resulting from the fit of wheelchairs.

7.3 Regulatory Compliance and Clinical Documentation.

(a) Outcome: The Contractor creates clear and concise prescriptive therapy goals in strict accordance with Title XIX Active Treatment regulations, producing useful annual evaluation reports and monthly notes for the medical records.

(b) Measure: The Contractor shall establish Title XIX-compliant prescriptive goals for 100% of evaluated individuals. The Contractor shall deliver annual physical and assistive device evaluation reports within 10 business days of the evaluation date, and submit monthly prescriptive therapy notes no later than the 5th business day of the following month.

(c) Reporting: DHHS/USDC will perform yearly audits of submitted medical records, annual evaluation reports, and progress notes to verify regulatory compliance and submission timeliness.

Article 8

BILLING

8.1 Billing.

(a) The Contractor will be paid a rate of _______ per hour for the services provided.

(b) Time spent training DHHS/USDC staff is billable at the contracted rate.

(c) All costs associated with Contractor services, such as work preparation and travel, are included in the hourly rate and may not be billed separately.

(d) The Contractor shall submit invoices for services monthly by the 20th day of each following month to the DHHS/USDC clinical director located at 895 North 900 East, American Fork, UT 84003. Billings must be prepared using the “DHHS/USDC Professional Services Verification Form” provided by the DHHS/USDC fiscal staff.