435279-O22-1131REHABSC-00 Attachment 1 SOW.pdf

Statement of Work (SOW) Project: S1131 DCTS-23 SWC Therapy Services

GENERAL INFORMATION

1.0 Scope of Work:

The Wisconsin Department of Health Services (DHS) is seeking Therapy Services to include Occupational, Physical and Speech Therapy Services at Southern Wisconsin Center, 21425 Spring Street, Union Grove, WI 53182. Therapy normal business hours are 8:00 AM – 4:30 PM, CDT, Monday – Friday.

2.0 Background:

The Department of Health Services, Southern Wisconsin Center (SWC) retains the ultimate professional and administrative responsibility for services rendered with the scope of this agreement. Liaison with SWC will be through the Director of Residential Services, or designee, who will represent SWC’s interest in the review and quality, quantity, rate of progress and relations considerations.

Awarded Supplier shall be responsible for providing Occupational, Physical and Speech Therapy Services in compliance with Chapter DHS 134, applicable federal codes, SWC’s general administrative policy and such other policies as required by the Division of Care and Treatment Services and Department of Health Services.

Southern Wisconsin Center functions as a Title XIX Intermediate Care Facility for the Intellectually Disabled and must, therefore, comply with the appropriate federal rules and regulations and Wisconsin Administrative Code. The population at SWC is approximately one hundred and ten (110) individuals that may potentially need new and ongoing Therapy services as their functioning and abilities may change. Caseloads include but are not limited to:

Physical Therapy – one hundred twenty (120) hours/week (possibly up to 140 hours/week) Occupational Therapy – ninety (90) hours/week

• Speech Therapy – ninety (90) hours/week

CONTRACTOR REQUIREMENTS / DELIVERABLES

4.0 Government Provided and Related Policies:

• The Contractor’s staff will be given access to Southern Wisconsin Center located at, 21425 Spring Street, Union Grove, WI.

• Contractor must comply with Wisconsin Administrative Code chapters DHS 12 and 13 that all employees meet the requirement for employment in a healthcare setting. DHS 12, Caregiver Background Checks and DHS 13, Reporting and Investigation of Caregiver Misconduct can be viewed at http://doc.legis.wisconsin.gov/code/admin_code/dhs.

• Contractor’s therapy staff must be familiar with the federal and state Standards of Care for their profession as they relate to the provision of treatment for clients, and must adhere to these requirements in their direct resident services.

• Contractor’s must comply with and observe all state and federal regulations which are in effect during the term of the contract, and which in any manner affect the provision of services.

DocuSign Envelope ID: AE44E7AF-9CED-4456-883E-4A28647E569E http://docs.legis.wisconsin.gov/code/admin_code/dhs

• The Contractor’s therapy staff shall follow DHS Bureau of Health Services policies, procedures and work rules. Therapy staff shall be required to read, sign and comply with DHS rules and regulations as well as SWC policies and procedures.

• Supplies and equipment necessary for the assessment and treatment of clients shall be the responsibility of the Contractor and shall include, but not limited to: adaptive spoons, dishes, plate guards, and cups for occupational therapy service; bolsters, walkers, wedges, and mats for physical therapy services; electronic software and hardware (i.e. iPads, iPods), sign books, picture books, and symbol books for speech therapy services.

Equipment needed for the active treatment and daily living of clients as identified in client’s individual plan including durable goods needed for home placement, will not be the responsibility of the Contractor.

Much of the equipment and supplies presently on the premises belonging to SWC shall be available for Contractor use. The Contractor shall pay for any necessary periodic maintenance repair, cleaning and calibration to keep the equipment used for therapy, owned by the Contractor, in a safe and optimal working condition.

• Southern Wisconsin Center shall provide to the Contractor:

Office space, various computer equipment and network, minimal IT support, mail and postage service, and treatment areas will be provided for the treatment of SWC clients only. This does not include office equipment such as copiers, multifunction devices, laminators and miscellaneous office supplies unless approved by SWC Administration.

• SWC shall keep the clinic treatment sites in good repair and shall furnish heat, light, water, housekeeping services, laundry/linen service and on-grounds telephone/fax services.

5.0 Deliverables / Schedule:

• Contractor shall assume managerial and professional responsibility for the operation of the Therapy Services as provided in this bid. This includes responsibility for compliance with all directives governing provision of occupational, physical and speech therapy.

Specifically, for those clients who require direct services from a licensed therapist, there shall be appropriate professional documentation.

• Contractor’s therapy staff shall provide treatment only, upon a prescribed referral of a duly licensed Physician or Nurse Practitioner.

• Contractor’s Therapy Staff shall provide “client centered services” to be in the best interest of the individual client with respect to timing of other programs and treatment, as deemed appropriate by the SWC management.

• Contractor’s Therapy Staff shall schedule to accommodate the needs of the client, not to interfere with other programs and activities, which may include weekend and evening service provisions.

• Contractor’s therapy staff shall develop a priority training objective within the ISP, with a training schedule listed in the ISP, based on the identified needs. Monthly progress notes are required for each priority objective in ISP.

• Contractor’s therapy staff must participate in the integrated care planning focus for each individual client treated.

• Contractor’s therapy staff must participate in SWC’s facility-wide training as directed by SWC administrator or designee.

• Contractor’s therapy staff must provide updates to the IDT as required.

• Contractor’s therapy staff must provide classroom consultation support for group programming activities and/or individual recommendations.

Item No.

Key Deliverables

Objective

Expectations

1 Timely Treatment and Submission of Progress Notes

The Contractor therapy staff shall be given authority to treat clients as prescribed by the referring physician. The Contractor shall maintain written progress notes for each client evaluated and/or treated and have the progress notes available along with other pertinent documentation regarding the client to the referring physician. Progress notes shall be provided to the Interdisciplinary Team (IDT) monthly using the Individual Support Plan (ISP).

Progress notes complete same day of treatment

2 Assessments Contractor therapy staff shall complete an assessment per physician’s order and document the results in the ISP or other case management software. For new admissions, this must be completed within ten (10) days, prior to the admission meeting.

Upon a prescribers order an assessment shall be done immediately or within 72hrs.

New short term admission assessments within 72 hours, to be submitted within ten (10) day after admission.

3 Documentation Contractor therapy staff must complete electronic health record documentation within Cerner or the identified database as required per policy and procedures or per the direction of DHS contract liaison which includes, but is not limited to: therapy staff meeting reports, assessments, evaluations, progress notes, and therapy/MD order proposals.

Same day Therapy is provided

5 Administrative Reviews Regular administrative review of contract services by

Contractor supervisor to include quarterly meetings with SWC Director or his/her representative and informal/formal reports as requested.

Quarterly

6 Business Meetings Bi-annual business meeting with the SWC administration in regards to overall services.

Every 6 months

7 Scheduling Submitting a weekly schedule, in advance of services to be provided to the living unit and IDT. This schedule will be submitted to the SWC designee as mutually determined by the Contractor and the SWC designee.

Weekly in advance of service

8 Treatment Records Maintaining a daily record of actual time of service provided to individuals in their living area or program area. Cancellations, change of schedules or deviations must be coordinated in advance with the living unit.

Maintained Daily

9 Meetings Attend monthly and/or weekly client care staffing meetings, dorm meetings, and pre-placement meetings as scheduled.

Attend discharge staffing meeting, if a client is discharged or transferred from SWC.

Attend any other in-house committee where their input is desired by Administration, such as Fire and Safety Committee, Quality Assurance, etc.

Monthly/weekly As Needed

10 Transfer/Ambulation Transfer/Ambulation – Assessments in transfer and ambulation of clients shall be made monthly (minimally) or as needed, with updated recommendations reported to IDT in a timely manner. Contractor shall provide training to SWC staff with appropriate techniques for transfer/ambulation of clients.

Weekly, Monthly, or as needed per treatment schedule.

11 Home Visitations Home Visitation, Pre-placement Program and Community Hospital - Contractor shall believe in the value of home and group home visits for the purpose of training the family (foster or natural) or staff in special therapeutic handling techniques. If a client will be spending time in the care of a family member or sponsor, a home visit with the client shall ensure a more positive experience for all.

There shall be no extra charge for the home visit (usually, at least one (1) hour, plus travel time) beyond the usual clinic treatment fee. Staff shall provide their own transportation to off site and on-site locations.

As Needed per facility approval.

6.0 Travel: Must be approved by facility prior to traveling. Contractor will provide reimbursements for staff travel.

7.0 Staffing:

Contractor must provide professional/paraprofessional as well as support staff for the areas listed below, based on anticipated case load provided but not limited to:

Physical Therapy – one hundred twenty (120) hours/week (possibly up to one hundred forty

(140) hours/week)

Occupational Therapy – ninety (90) hours/week

Speech Therapy – ninety (90) hours/week

• Contractor must provide regular, on site staff supervision to be responsible and accountable for the daily activities and conduct of the therapy department. Staff must comply with DHS Attachment – G Code of Conduct.

• Contractor shall be responsible for all state, federal and social security taxes regarding the Contractor’s Therapy Staff.

• Contractor shall schedule staff accordingly for wheelchair clinic, orthotic/prosthetic clinic, assessment/assistance as appropriate to staff caseload.

• Contractor shall appoint a contact person who will be available to consult with SWC personnel during normal business hours (8:00 am – 4:30 pm, CDT, Monday – Friday), for ongoing communication and resolution of day-to-day questions.

8.0 Security Requirements: Contractor’s staff will have a background check and be identified by using a SWC issued Photo ID with the name of the person.

9.0 Data Rights: Per BAA Agreement

10.0 Invoicing

Item No.

Key Deliverables

Objective

Due

1 Invoicing Invoices presented for payment must be submitted in accordance with instructions contained on the purchase order including reference to purchase order number and submittal to the correct address for processing to include date, hourly rate by provider (PT,OT etc), hours of service etc.

To be completed by the 5th day of the following month of service.

Attachment: Bidder’s Response Sheet