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Contracted%20Services%20SpEd%20SY%2024-25.pdf

Document typecontract
Date2024-04-30
Source URLhttps://go.boarddocs.com/wv/rand/Board.nsf/files/D5RJXE4F4CA2/$file/Contracted%20Services%20SpEd%20SY%2024-25.pdf
Entityrandolph_county_schools (Randolph Co., WV)
Entity URLhttps://boe.rand.k12.wv.us/
Raw filenameContracted%20Services%20SpEd%20SY%2024-25.pdf
Stored filename2024-04-30-0835c2746567e86efbb15e0721c142f3-contract.txt

Parent document: Regular Board Meeting - 5_30 p.m. - Amended-06-04-2024.pdf

Text

RENEWAL OF
MEMORANDUM OF UNDERSTANDING

THIS RENEWAL TO MEMORANDUM OF UNDERSTANDING (“Renewal”), is
made and entered into this 30 day of April, 2024 (“Effective Date”), by and between WEST
VIRGINIA UNIVERSITY BOARD OF GOVERNORS on behalf of WEST VIRGINIA
UNIVERSITY and itt SCHOOL OF MEDICINE, DEPARTMENT OF
OPHTHALMOLOGY AND VISUAL SCIENCES (“WVU”) and the RANDOLPH COUNTY
BOARD OF EDUCATION (“Affiliate”), (collectively the “Parties” and sometimes individually
as a “Party”),

WITNESSETH:

WHEREAS, WVU and Affiliate entered the Memorandum of Understanding commencing
on July 11, 2023 (“MOU”), and which has been renewed and is set to expire on June 30, 2024,

WHEREAS, the Parties desire to renew the MOU for an additional term.

WHEREAS, the parties desire to place their agreement in writing.

NOW, THEREFORE, WITNESSETH, that for and in consideration of the mutual
promises, covenants and undertakings herein, the parties agree as follows:

1. The MOU shall be and is hereby renewed for an additional one-year term from July
1, 2024 through June 30, 2025.

2. This Renewal may be executed in any number of counterparts, all of which taken
together shall constitute one and the same instrument, and any party hereto may execute this
Renewal and Amendment by signing any such counterpart.

3. Unless expressly amended or modified by written agreement, each and every term

and provision of the MOU shall hereafter remain of full force and effect. The MOU, as amended

ywo1on407.1} Page 1 of 2



and modified, constitutes the entire understanding of the Parties with respect to the subject matter

hereof.
IN WITNESS WHEREOF, the parties have caused their respective names to be

signed by their duly authorized officers.

WEST VIRGINIA UNIVERSITY BOARD OF GOVERNORS
on behalf of WEST VIRGINIA UNIVERSITY and its SCHOOL OF MEDICINE,
E. Gordon Gee, J.D., Ed-D., President, by

Clay B. Marsh, M.D. Date
Chancellor and Executive Dean of WVU Health Sciences

RANDOLPH COUNTY BOARD OF EDUCATION

Debra Schmidlen Date
Superintendent

4W0100407.1} Page 2 of2



GREE MENT

This Agreement made and entered into on this 1* day of July 2024, by and between the Randolph County Board

of Education, 40 11" Street, Elkins, West Virginia, 26241 (hereinafter called “Board”), and
__Mristen Thompson | __.. (hereinafter called “Service Provider’).

WHERBAS, the Board desires to contract with Service Provider for services in conjunction with
psychological evaluations and reports.

WHEREAS, Service Provider desires to provide this contracted service to the Board on a part-
time/temporary basis:

NOW, therefore, based upon the mutual promises contained herein, it is hereby agreed that Service
Provider will provide the following contracted services:

i. Service Provider agrees to provide such services as are attached hereto and incorporated by reference as
though set forth herein, in compliance with Titles 18 and 19 of the Social Security Act intermediary
requirements.

To provide psychological testing for clients, upon referral from the Board.

To provide services at locations as agreed upon:

To observe, record and report the client’s responses to treatment and changes in the client’s conditions:

if indicated, to make recommendation for the provision of more extensive evaluation or treatment.

To record evaluation and treatment sessions, as appropriate, on the progress notes for inclusion in the

composite client record including Medicaid reports. This information will be kept current so that it will

be available to other members of the health team per facility requirements.

To provide evidence of current liability insurance and licensure, and workers compensation coverage.

8. The term of this agreement shall commence 7/1/24 and continue through and including 6/30/25 at which
time the Service Provider shall perform the services provided herein.
NOW, therefore, based upon the mutual promises contained herein, it is further agreed as follow:

9. The Board agrees to compensate the Service Provider for services in accordance with the established
twice per month pay period process. Invoices are to be submitted to the Board no later than five (5)
business days following the end of each billing period (which is designated as a twenty-day cycle).
Uniess Service Provider by law or practice is required to bill the reimbursement source directly, the
Board shall compensate the Service Provider for treatments and evaluations in accordance with the
attached hereto.

10. The service provider, as an independent contractor, is responsible for providing for workers
compensation coverage for themselves and any employee for the service provider. The Board is not
providing workers compensation coverage under this agreement and has no responsibility for doing so.

11. Compensation for said services will be based on the following:

* Standard Battery (Intelligence, Achievement, Visual-Motor) - $325.00
* Supplemental data {i.e., adaptive skills) to Standard Battery - $50.00/scale

Dia se wh

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e® © @® @ © @¢ S$ &¢ @ @

Preschool/Developmental Evaluation - $200.00

Consultation (i.¢., EC meetings) - $75.00/meeting

Intelligence Evaluation only (WISC-1V) - $200.00

Inteligence Evaluation only (Binet-V) - $200.00

Achievement Evaluation only (WIAT-ID - $175.00

Achievement Evaluation only (Woodcock-Johnson-II} - $175.00

Supplemental Data only (i.e. Adaptive Skills) - 975 .00/scale

ADOS Evaluation only — 200.04

ADOS and Rating Scales — 400.00

Administrative Fee - *During summer employment, in the event a scheduled client does not keep
his/her appointment, Kristen Thompson, sss shall be compensated \% the regular rate for
the evaluation that was to be undertaken (i.¢., if a standard battery ($325.00) was scheduled, then the
compensation would be $81.25 (1/4 of $325.00)

. The service provider, as an independent contractor is responsible to provide a criminal background

check.

. Beginning from the first facility visited each day, mileage compensation at a rate established by county

policy and will be available for travel between school sites, ending at the last facility visited for the
purpose of rendering psychological testing.

. The Board agrees to provide the appropriate material needed for therapy and evaluations.
. This Agreement supersedes all previous agreements, oral or written between the parties and

embodies the complete agreement between the parties.

Superin

Randolph County Board of Education, President
i a a ” "yey SG. ty

Licensed Schoo! Psychologist


AGREEMENT

This Agreement made and entered into on this I“ day of July 2024, by and between the Randolph County Board
of cee nia —_ Sieh, Elkins, West Virginia, 26241 (hereinafter called “Board”), and

(hereinafter called “Service Provider”).

WHEREAS, the Board desires to contract with Service Provider for services in conjunction with

psychological evaluations and reports.

WHEREAS, Service Provider desires to provide this contracted service to the Board on a part-

time/temporary basis:

NOW, therefore, based upon the mutual promises contained herein, it is hereby agreed that Service

Provider will provide the following contracted services:

1,

oe a eee

0 >

10.

Service Provider agrees to provide such services as are attached hereto and incorporated by reference as
though set forth herein, in compliance with Titles 18 and 19 of the Social Security Act mtermediary
requirements.

To provide psychological testing for clients, upon referral from the Board.

To provide services al locations as agreed upon:

To observe, record and report the client’s responses to treatment and changes in the client’s conditions:
If indicated, to make recommendation for the provision of more extensive evaluation or treatment.

To record evaluation and treatment sessions, as appropriate, on the progress notes for inclusion in the
composite client record including Medicaid reports. This information will be kept current so that it will
be available to other members of the health team per facility requirements.

To provide evidence of current liability insurance and licensure, and workers compensation coverage.

. The term of this agreement shall commence and continue through and including at which

time the Service Provider shall perform the services provided herein.

NOW, therefore, based upon the mutual promises contained herein, it is further agreed as follow:
The Board agrees to compensate the Service Provider for services in accordance with the established
twice per month pay period process. Invoices are to be submitted to the Board no later than five (5)
business days following the end of each billing period (which is designated as a twenty-day cycle).
Unless Service Provider by law or practice is required to bill the reimbursement source directly, the
Board shall compensate the Service Provider for treatments and evaluations in accordance with the
attached hereto.

The service provider, as an independent contractor, is responsible for providing for workers
compensation coverage for themselves and any employee for the service provider. The Board is not



il.

12.

13.

14.
15.

providing workers compensation coverage under this agreement and has no responsibility for doing so.
Compensation for said services will be based on the following:

e® @@ 6 © © @ @ @ & @ @

Standard Battery Untelligence, Achievement, Visual-Motor) - $325.00

Supplemental data (i.¢., adaptive skills) to Standard Battery — $50.00/scale
Preschool/Developmental Evaluation - $200.00

Consultation (i.e., EC meetings) - $75.00/meeting

Intelligence Evaluation only (WISC-IV) - $200.00

Intelligence Evaluation only (Binet-¥V) - $200.00

Achievement Evaluation only (WIAT-ID - $175.00

Achievement Evaluation only (Woodcock-Johnson-ID ~ $175.00

Supplemental Data only (i.e. Adaptive Skills) - $75.00/scale

ADOS Evaluation only — 200.00

ADOS and Rating Scales ~— 400.00

Administrative Fee - “During parhuser Bt employment, in the event a scheduled client does not keep her
appointment, f ess __. shall be compensated 'A the
regular rate for the evalu n fhaty was to be undertaken (i.e., if a standard battery ($325.00) was
scheduled, then the compensation would be $81.25 (1/4 of $3 25.00)

The service provider, as an independent contractor is responsible to provide a criminal background
check,

Beginning from the first facility visited each day, mileage compensation at a rate established by county
policy and will be available for travel between school sites, ending at the last facility visited for the
purpose of rendering psychological testing.

The Board agrees to provide the appropriate material needed for therapy and evaluations.

This Agreement supersedes all previous agreements, oral or written between the parties and
embodies the complete agreement between the parties.

Superintendent’s Signature

acignpaihemnan ieee
Randolph County Board of Education, President

Lieend schoot Psychologist

& lial 3/deay
' Date



A Stepping Stones Group Company

This contract is made and entered into on this 15" day of May, 2024 by and between Randolph County
Schools, 40 Eleventh Street, Elkins, WV 26241, and Best Life Therapy, LLC, PO Box 220,
Bridgeport, WV 26330.

WHEREAS, the board desires to contract for occupational therapy services, AND WHEREAS, Best Life
Therapy, LLC, desires to provide assistance to the Board:

1. Best Life Therapy will perform occupational therapy evaluations and treatment at Randolph County
Schools for the 2024-2025 school year. Caseload/location to be assigned/determined by the special
education director for the course of this contract. Commencement of these activities may begin upon
verification from the West Virginia Board of Examiners in Occupational Therapy of licensure of the
above named agency.

2. The Board will pay for these services at a rate of seventy-seven dollars ($77.00) per hour. All
evaluation protocols will be provided by the board. Services will be paid for from the federal and
county funds upon submission of monthly time sheets.

3. The Board shall exercise no control over the performance of the evaluations or treatment except to
assure that the services meet normal competency standards. It is the intent of all parties that this
arrangement is one that is not employer-employee but is instead strictly and independent contract
agreement. Prior to assuming their duties, Best Life Therapy, LLC is to furnish evidence to the
Board of sufficient liability insurance covering any errors or omissions with a minimum of One
Million and 00/100 dollars ($1,000,000.00) per occurrence coverage.

4. Best Life Therapy, LLC, will assume responsibility for requirements from the special education
department including but not limited to: background checks and fingerprinting for Medicaid
requirements.

5. Conversion to Teletherapy or Alternative Therapy Services. If any delay in the performance,
fulfillment or satisfaction of this Agreement, or the provision of therapy services to students,
individuals or children, is caused by acts of God, war, riot, embargoes, acts or omissions of civil or
military authorities, compliance with any law or governmental order, rule, regulation or direction,
fires, floods, accidents, quarantine restrictions, plague, virus, pandemic, outbreaks of infectious
disease, any public health crisis, employee restrictions, strikes, shortage or inability to obtain critical
material or supplies to the extent not subject to the reasonable control of a party hereto, or other
unforeseeable events or circumstances Best Life shall have the right, but not the obligation, to convert


the in-person therapy services set forth in this Agreement to teletherapy services or alternative therapy
services such as home intervention services, such services to be provided through either Best Life or
an affiliated entity, at the same rates and upon the same general terms and conditions set forth in
this Agreement. The parties shall utilize their best efforts to fulfill the provisions set forth above, and
both parties shall participate in the conversion of the services to be provided hereunder. The Board
shall execute and deliver all further documents and instruments, and provide such further assistance,
that may be reasonably necessary or desirable, as requested by Best Life, to carry out the provisions
of this Agreement or to effectuate the purposes or intent of this provision within the Agreement.

Interruption to Agreement. The Board expressly acknowledges that it is a fundamental expectation of
Contractor that this Agreement will provide Contractor with a steady supply of therapy services during
the commonly accepted academic school year or the period of this Agreement. Accordingly, the Board
shall endeavor to avoid and minimize any interruptions to this Agreement. The Board shall give notice
to Contractor promptly upon the occurrence of any event which interrupts, or is reasonably likely to
interrupt, this Agreement. As soon as practicable thereafter, the Board shall give a report to Contractor
covering the following matters to the best of Board’s knowledge at the time of giving the report: (i) the
nature of the interruption or threatened interruption; (ii) the circumstances and cause of the same; (iii)
the likely duration of the interruption; and (iv) details of the efforts that have been made and are
planned by the Board to avoid or minimize the interruption and the effects thereof on performance
under this Agreement. Board and Contractor shall collectively work to mitigate interruptions to the
Agreement.

If any delay in the performance or satisfaction of this Agreement is caused by acts of God, war, riot,
embargoes, acts or omissions of civil or military authorities, compliance with any law or
governmental order, rule, regulation or direction, fires, floods, accidents, quarantine restrictions,
plague, virus, pandemic, outbreaks of infectious disease, any public health crisis, employee
restrictions, strikes, shortage or inability to obtain critical material or supplies to the extent not
subject to the reasonable control ofa party hereto, or other unforeseeable events or circumstances,
that cannot be cured as set forth in Clause 6 through Teletherapy or Alternative Therapy Services,
this Agreement shall be suspended by the parties, upon the application of Contractor for such a
contractual suspension, for a reasonable period of time so that services can promptly be resumed and
provided to students, individuals or children who were being served prior to, or at the time of, such
delay. During this period, the parties shall utilize their best efforts to determine a timeframe for
resumption of the Agreement, and the new end date for the existing Agreement, as well as the
method of resumption.

Best Life Therapy will communicate directly with the Board’s Special Education Director or
designated therapist. Best Life Therapy, LLC will complete a written log of all services provided to
each child. Best Life Therapy, LLC will obtain appropriate consent, obtain appropriate
documentation from parents and teachers, Medicaid billing, and provide an appropriate diagnostic
report for each child evaluated. In addition, Best Life Therapy, LLC, will complete an appropriate
Eligibility Committee Report and Individualized Education Program for each student they evaluate

Page 2 of 4


that meets WVDE eligibility requirements for an applicable therapy. Medicaid billing forms will
also be completed on a timeline designated by the special education director.

9, Best Life Therapy, LLC and all affiliates will be responsible for maintaining appropriate
confidentiality of all student information.

10. This contract shall become effective for the 2024-2025 school year and shall be binding upon the
heirs, devisees, personal representatives, successors and assigns of Board of Contractor for the
school term 2024-2025,

Witness signatures, the Randolph County Board of Education as signed by the duly authorized officials and

Best Life Therapy, LLC.

ae 5/15/24
Authorized Representative, Randolph County Schools Date Rhea Dyer, Owner Best Life Therapy, LLC Date

Page 3 of 4



PRIDGEPORTIAWY 26330

his contracts: ered into on this 15" day of May, 2024 by and between Randolph
Schools, 40 Elevenith Street, Elkins, WV 26241, and Best Life Therapy, LLC, PO Box 220,
Bridgeport, WV 26330.

WHEREAS, the board desires to contract for audiology services, AND WHEREAS, Best Life Therapy, LLC,
desires to provide assistance to the Board:

Ll,

Best Life Therapy will provide services related to audiology needs at Randolph County Schools for
the 2024-2025 school year. Caseload/location to be assigned/determined by the special education
director for the course of this contract.

The board will pay for these services when the mobile equipment unit is utilized at a rate of one
hundred eighty-five ($185) per hour. The board will pay for these services when the audiologist
provides services without the mobile unit at a rate of one hundred thirty five ($135) per hour.

The Board shall exercise no control over the performance of the evaluations or treatment except to
assure that the services meet normal competency standards. It is the intent of all parties that this
arrangement is one that is not employer-employee but is instead strictly and independent contract
agreement. Prior to assuming their duties, Best Life Therapy, LLC is to furnish evidence to the’
Board of sufficient liability insurance covering any etrors or omissions with a minimum of One
Million and 00/100 dollars ($1,000,000.00) per occurrence coverage.

Best Life Therapy, LLC, will assume responsibility for requirements from the special education
department including but not limited to: background checks and fingerprinting for Medicaid
requirements. ,

. Best Life Therapy will communicate directly with the Board’s Special Education Director or

designated therapist. Best Life Therapy, LLC will complete a written log of all services provided to
each child. Best Life Therapy, LLC will obtain appropriate consent, obtain appropriate
documentation from parents and teachers, Medicaid billing, and provide an appropriate diagnostic
report for each child evaluated. In addition, Best Life Therapy, LLC, will complete an appropriate
Eligibility Committee Report and Individualized Education Program for each student they evaluate
that meets WVDE eligibility requirements for an applicable therapy. Medicaid billing forms will
also be completed on a timeline designated by the special education director.


6. Best Life Therapy, LLC and all affiliates will be responsible for maintaining appropriate
confidentiality of all student information,

7. This contract shall become effective for the 2024-2025 school year and shall be binding upon the
heirs, devisees, personal representatives, successors and assigns of Board of Contractor for the
school term 2024-2025.

Witness signatures, the Randolph County Board of Education as signed by the duly authorized officials and

Best Life Therapy, LLC.

5/15/24

Authorized Representative, Randolph County Schoals Date Rhea Dyer, Owner Best Life Therapy, LLC Date

Page 2 of 3


A Stepping Stones Group Company

This contract is made and entered into on this 15th day of May, 2024 by and between Randolph
County Schools, 40 Eleventh Street, Elkins, WV 26241, and Best Life Therapy, LLC, PO Box 220,
Bridgeport, WV 26330.

WHEREAS, the board desires to contract for various special education services, AND WHEREAS, Best Life
Therapy, LLC, desires to provide assistance to the Board:

1. Best Life Therapy will perform a selected service from attachment at Randolph County Schools for
the 2024-2025 school year. Caseload/location to be assigned/determined by the special education
director for the course of this contract. Commencement of these activities may begin upon
verification of licensure from the appropriate licensing entity/entities.

2. The Board will pay for these services at a rate outlined in attached fee schedule based on selected
service per hour. All evaluation protocols will be provided by the board. Services will be paid for
from the federal and county funds upon submission of monthly time sheets.

3. The Board shall exercise no control over the performance of the evaluations or treatment except to
assure that the services meet normal competency standards. It is the intent of all parties that this
arrangement is one that is not employer-employee but is instead strictly and independent contract
agreement. Prior to assuming their duties, Best Life Therapy, LLC is to furnish evidence to the
Board of sufficient liability insurance covering any errors or omissions with a minimum of One
Million and 00/100 dollars ($1,000,000.00) per occurrence coverage.

4. Best Life Therapy, LLC, will assume responsibility for requirements from the special education
department including but not limited to: background checks and fingerprinting for Medicaid
requirements.

5. Conversion to Teletherapy or Alternative Therapy Services. If any delay in the performance,
fulfillment or satisfaction of this Agreement, or the provision of therapy services to students,
individuals or children, is caused by acts of God, war, riot, embargoes, acts or omissions of civil or
military authorities, compliance with any law or governmental order, rule, regulation or direction,
fires, floods, accidents, quarantine restrictions, plague, virus, pandemic, outbreaks of infectious
disease, any public health crisis, employee restrictions, strikes, shortage or inability to obtain critical
material or supplies to the extent not subject to the reasonable control of a party hereto, or other
unforeseeable events or circumstances Best Life shall have the right, but not the obligation, to convert
the in-person therapy services set forth in this Agreement to teletherapy services or alternative therapy


services such as home intervention services, such services to be provided through either Best Life or
an affiliated entity, at the same rates and upon the same general terms and conditions set forth in
this Agreement. The parties shall utilize their best efforts to fulfill the provisions set forth above, and
both parties shall participate in the conversion of the services to be provided hereunder. The Board
shall execute and deliver all further documents and instruments, and provide such further assistance,
that may be reasonably necessary or desirable, as requested by Best Life, to carry out the provisions
of this Agreement or to effectuate the purposes or intent of this provision within the Agreement.

Interruption to Agreement. The Board expressly acknowledges that it is a fundamental expectation of
Contractor that this Agreement will provide Contractor with a steady supply of therapy services during
the commonly accepted academic school year or the period of this Agreement. Accordingly, the Board
shall endeavor to avoid and minimize any interruptions to this Agreement. The Board shall give notice
to Contractor promptly upon the occurrence of any event which interrupts, or is reasonably likely to
interrupt, this Agreement. As soon as practicable thereafter, the Board shall give a report to Contractor
covering the following matters to the best of Board’s knowledge at the time of giving the report: (i) the
nature of the interruption or threatened interruption; (i1) the circumstances and cause of the same; (111)
the likely duration of the interruption; and (iv) details of the efforts that have been made and are
planned by the Board to avoid or minimize the interruption and the effects thereof on performance
under this Agreement. Board and Contractor shall collectively work to mitigate interruptions to the
Agreement.

. [fany delay in the performance or satisfaction of this Agreement is caused by acts of God, war, riot,
embargoes, acts or omissions of civil or military authorities, compliance with any law or
governmental order, rule, regulation or direction, fires, floods, accidents, quarantine restrictions,
plague, virus, pandemic, outbreaks of infectious disease, any public health crisis, employee
restrictions, strikes, shortage or inability to obtain critical material or supplies to the extent not
subject to the reasonable control of a party hereto, or other unforeseeable events or circumstances,
that cannot be cured as set forth in Clause 6 through Teletherapy or Alternative Therapy Services,
this Agreement shall be suspended by the parties, upon the application of Contractor for such a
contractual suspension, for a reasonable period of time so that services can promptly be resumed and
provided to students, individuals or children who were being served prior to, or at the time of, such
delay. During this period, the parties shall utilize their best efforts to determine a timeframe for
resumption of the Agreement, and the new end date for the existing Agreement, as well as the
method of resumption.

Best Life Therapy will communicate directly with the Board’s Special Education Director or
designated therapist. Best Life Therapy, LLC will complete a written log of all services provided to
each child. Best Life Therapy, LLC will obtain appropriate consent, obtain appropriate
documentation from parents and teachers, Medicaid billing, and provide an appropriate diagnostic
report for each child evaluated. In addition, Best Life Therapy, LLC, will complete an appropriate
Eligibility Committee Report and Individualized Education Program for each student they evaluate
that meets WVDE eligibility requirements for an applicable therapy. Medicaid billing forms will
also be completed on a timeline designated by the special education director.

Best Life Therapy, LLC and all affiliates will be responsible for maintaining appropriate
confidentiality of all student information.

Page 2 of 4


7. This contract shall become effective for the 2024-2025 school year and shall be binding upon the
heirs, devisees, personal representatives, successors and assigns of Board of Contractor for the
school term 2024-2025.

Witness signatures, the Randolph County Board of Education as signed by the duly authorized officials and

Best Life Therapy, LLC.

ae 5/15/24
Authorized Representative, Randolph County Schools Date Rhea Dyer, Owner Best Life Therapy, LLC Date

2024-2025 Randolph County Schools Fee Schedule per Service

Page 3 of 4



Speech Pathology: $72.00 per hour

Physical Therapy: $77.00 per hour

DHH Services: $79 per hour

Vision Services: $79.00 per hour

Behavioral/Mental Health Services: $44.00 per hour

Academic Services (Gifted/SPED/General Ed.}: $60.00 per hour

**All other needed services will be assigned an hourly rate at the request of Randolph County Schools.

Authorized Representative, Randolph County Schools Date Rhea Dyer, Owner Best Life Therapy, LLC Date

Page 4 of 4


oA

Mountainside ABA

Randolph County School System
BCBA
$75 /hour

$75 /hour

NA

$75/hour

$75 /hour $50/hour

-

Assessments
Direct ABA Therapy 1:1
with client

Direct ABA Therapy with
sroup of clients

Direct supervision of staff
Clinical meeting to review
client progress

Teacher training and
coaching
Other case management
related activities (i.e.
presence in IEP meetings
Other classroom support
(i.e. making materials,
supporting multiple
students, meeting with
teacher

*Notes:

- Services may be billed simultaneously, such as Direct ABA Therapy and Direct supervision
of staff.

Locations where services can be provided
Community (if Telehealth
relevant to child}

Home (if home-
based)

All charges will come directly from Mountainside Behavior Analysis Services. Contact
information below:

Mountainside Behavior Analysis Services, LLC
Attn: Elizabeth Simons

25 Thistle Lane,

Davis, WV 26260

liz@mountainsideaba.com

Phone: 304-851-6643 Fax: 304-362-0025


PERFORMANCE AGREEMENT FOR CONSULTANTS

THIS AGREEMENT made this 22 day of May 2024, in the County of Randolph, West Virginia,
by and between the Randolph County Public School System (hereinafter “DISTRICT") and
Mountainside Behavior Analysis Services, (hereinafter "CONSULTANT").

DISTRICT AND CONSULTANT hereby agree to the following:

1. TERM. The term of this Agreement shall be for the period July 1, 2024, through June 30,
2025 inclusive,

2. SERVICES. The CONSULTANT shall furnish the following services: assessments including
but not limited to Functional Behavior Assessments, developmental assessments, and/or
language assessments; treatment plan including but not limited to behavior reduction goals
and skill acquisition goals; behavior intervention plan as applicable; direct Applied
Behavior Analysis services provided by a staff from Mountainside Behavior Analysis
Services; coaching of teacher by a staff from Mountainside Behavior Analysis Services;
ongoing progress reports developed by Mountainside Behavior Analysis Services; teacher
training events such as workshops. CONSULTANT shall be responsible for all
cost/expenses incident to the performance of services rendered to the DISTRICT. DISTRICT
shall nat be responsible for any expenses incurred by the CONSULTANT except as provided
by the agreement: Conduct Applied Behavior Analysis consultation per student's IEP, coach
others in Applied Behavior Analysis as agreed upon by DISTRICT and CONSULTANT.

3. LOCATION, The services listed in paragraph 2 shall be provided at the current schooling
site of the assigned students.

4, DISTRICT'S OBLIGATIONS. The district will provide the location for services, and any
equipment required for events (i.e. projector for presentation).

5. COMPENSATION. In consideration of the services to be rendered by CONSULTANT and
subject to the payment provisions expressed herein, DISTRICT agrees to pay CONSULTANT
up to $70 per hour upon submission of a properly documented demand for payment which
shall be submitted not less than 30 days from the end of the month in which the services
were rendered, and upon approval of such demand by the DISTRICT.

6. INDEMNITY. The CONSULTANT agrees and shall defend, indemnify, save and hold
harmless the DISTRICT, its agents, officers and employees from any and all claims, costs
and liability for any damages, from any cause whatsoever arising directly or indirectly from
or connected with the operations or services of the CONSULTANT, its agents, officers,
employees, or subcontractors hereunder, and any other person, firm, or corporation
furnishing or supplying work, services, materials, or supplies in connection with the
performance of this agreement and all claims and losses accruing or resulting to any
person, firm, or corporation who may be injured or damaged by the CONSULTANT in the
performance of this agreement.


7. INSURANCE. The CONSULTANT will maintain general liability insurance, including
automobile coverage, in an amount as may be reasonably necessary to assure compliance
with the indemnification provision in paragraph 6. The requirements of this provision may
be waived by the DISTRICT; however, any waiver shall not affect the CONSULTANT's
liability to the DISTRICT under paragraph 6. The CONSULTANT shall provide workers’
compensation insurance or self-insure his/her services. The CONSULTANT agrees to
provide proof of required insurance upon request by the DISTRICT.

8. STATUS OF CONSULTANT. This agreement is by and between two independent parties
and is not intended to and shall not be construed to create the relationship of agent,
employee, partnership, joint venture, or association. In executing this agreement, the
CONSULTANT certifies that no one who has or who will have any financial interest under
this agreement is an officer or employee of the DISTRICT. It is expressly understood that
CONSULTANT is acting as an independent contractor and not as an officer, agent, or
employee of the DISTRICT.

9. TERMINATION. This contract may be terminated at the sole discretion of the DISTRICT,
upon five-day advance written notice thereof to the CONSULTANT. CONSULTANT shall be
paid the reasonable value of the services rendered up to the date of such termination, as
determined by the DISTRICT, and CONSULTANT hereby expressly waives any and all
claims for damages or compensation arising under this Agreement, except as set forth
herein. Contract may be cancelled immediately by written mutual consent by both the
DISTRICT AND CONSULTANT.

10. COMPLETENESS OF AGREEMENT: This agreement constitutes the entire understanding
of the parties and any change or modification shall be in writing and signed by both parties
hereto.

11. GOVERNING LAW. The validity of this agreement and any of its terms or provisions as
well as the rights and duties of the parties hereunder shall be governed by the laws of the
State of West Virginia.

12. TAX REPORTING/PAYMENT RESPONSIBILITIES. DISTRICT shall provide an annual
statement (IRS form 1099) of compensation paid if said amount for services is greater than
$600, CONSULTANT is responsible for payment of any federal and/ or state tax amount
due.

13. CRIMINAL RECORDS CHECK. CONSUL TANT shall not permit any employees to have
any contact with DISTRICT pupils until such time as CONSULTANT has verified in writing
to the DISTRICT that all employees have completed a federal and state background check
and completed mandated reporter training. This section may be waived (site administrator
initial to waive ___} if the DISTRICT determines that CONSULTANT and/or its employees
will have limited contact with DISTRICT pupils or if CONSULTANT and/or its employees
will be supervised at all times by DISTRICT employees.



14, ASSIGNMENT. This agreement is not assignable by the CONSULTANT in whole or in
part without the express written consent of the DISTRICT.

15. Complete a W-9 Form.

IN WITNESS WHEREOF, the parties hereto have caused this contract to be effective as of
the day, month and year first written above.

CONSULTANT DISTRICT

Signature Signature

Elizabeth Simons, MA, MEd, BCBA
Printed name and credentials Printed name and credentials Randolph
Mountainside Behavior Analysis County Public School System
Services, LLC


HEALTH CARE STAFFING AGREEMENT FOR ApHIOOL SERVICES

“THIS AGREEMENT (this. “Agreement’) | is made and entered inte’ this 40t day of

id betwéen Interim HealthCare of Pittsburgh, Inc. Dba Inter althCare
of Morgantown (hereinafter "Service Pro ider”) and Randoiph County Schools":
(hereinafter the “School District’): ee

RECITALS ©

agencies for the provisior

chool District is authorized to contract with ‘health care @ staffing
f health care staffing services; and P

WHEREAS, Service Provider ia -agen placing health care staff on a :.
temporary basis with those entities in need of su C Berviges, and. .

WHEREAS, the School District desires that Service Provider provide a full range
of health care staffin services in such disciplines as needed by the School, District (the
“Services”); and ees.

. WHEREAS, Service Provider‘ is s capable’ f and willing to provide the ° Servis’ to
the School District;

NOW THEREFORE, in consideration of the mutual promises and covenants
contained in this Agreement, the parties hereto mutually agree as follow

: 4. This Agreement shail take effect c on July tst, 20204, andr remain.in effect
through June. 30; 2025; unless terminated earlier in accordance with the terms set forth
herein.

2. Service Provider viaerants that it is duly licensed and authorized to perform the
services that are described herein and has never been excluded from Medicare,
Medicaid or any health cake Benen program funded by the Federal government.

3. Service Provider warrants that it will provide the School District with licensed (if

applicable) and qualified individuals to provide the:Services. Service Provider represents.
that all individuals provided will possess documentation evidencing such ficense
qualifications as required by Federal, State or local statutes, rules, regulations and
orders.

4, Service Provider shall ensure that each individual providing Services to the
School District has: (a) completed a Skills Checklist and Competency Exam; (b) has the
appropriate nursing license, if applicable; and (c) has at least two (2) professional
references that Have been checked by. Service Provider prior to providing any services to
_ the Schoo! District. Service Provider further represents that the personnel that it sends to
the School. District are covered by current malpractice insurance, have submitted a

Each Interim Healthcare office is an independenily owned and operated franchise business,



completed Employment Eligibility Verification (Form {-9), ind are etigiole | to work at the
School District's schools. We i

6. Service Provider agrees to obtain and submit o the School District such health
an concerning the personnel it provides to the School District as it requires,
consistent with applicable law.

6.. Service Provider understands and agrees that it will comply and is responsib
for complying with all-applicable Federal, State and local tes rules and ordinances.
Service Provider shall adhere to alt requirements and pro [ere] i hed by and
communicated to it thy the Schoo! District. -

7. Alb ervice Provider personnel providing services to the School District shall. be
subject to approval by the School District. The School District reserves the right to rej
the placement of any individual provided to. it by Service Reavider, consistent with
applicable law.

B. ‘Service Provider shall provide the School District with personnel ‘subject to the
availability: I ropriate personnel, on an as needed and as requested: basis.

9. In consideration for the Services to be rendered by Service Provider to the “EE
School District for the period of this Agreement, upon presentation of an invoice by
Service:Provider evidencing such attendance in accordance with the terms set forth —
below, the School District will pay Service Provider at the following rates:

RN ‘$48.00 per hour
_ LPN $45.00 per hour

‘The above: rates apply to all shifts. For each shift worked by one of its personnel,

whather a traditional school nurse or private duty school nurse, Service Provider shall bill
_the School District for each hour worked. Service Provider. will bill the Schaol District i in
_fifteen (15) minute increments for partial hours worked.

The School District will be notifi ed in writing of any rate changes. Service Provider
will submit these rate’ changes with 30 (thirty), Says of notice prior to rate change taking
effect.

In the event that the same nurse works for the @ School District for more than forty
_ (40) billable hours during any week, the School District shall pay.one and one half (14)
~ times the hourly rate of pay for each hour in excess of the. forty (40) billable hour work
“week. Service Provider shall be available to provide health care staffing services to the
School District: swenty=four (24} hours.a day, seven (7) days a week for the entire
calendar year.

Revised 7/20 Each Interim Healthcare office 13 an independently ovned and aperated franchise business. a2



if the School District hires any of the personnel provided-by Service Provider with 1
: School District by such personnel, the’ -
School District shall pay Service Provider a Hiscenent fee j in accordance with the
following schedule: .

: Parcentage of anniiat selary upon

the School District. The appropriate School: District designee must sign each time
sheet/card. The School District shall maintain a copy o completed time sheets/cards
for verification purposes. These time sheets/cards shall be use “by the Service Provider
to assess invoice amounts. eae aE

11. Service Provider shall submit weekly invoices for services rendered at the
- end of each week:fer. which Services have been provided. The School District shall pay
each invoice within thirty: (30) days ofits receipt. The invoice shall include time sheets...
and attendance, types of services rendered.and fees payable. The School District shall
give Service Provider notice of any invoice dispute within: twenty (20) days of its receipt
and may withhold payment pending the resolution. of such: dispute. Failure to timely
dispute any invoice shall not be deemed as acceptance and. does not act as a waiver of
the School District's rights or prevent the School'District from availing itself of any remedy
- or course of action it has at law or in equity at a later date. The School District shail have
_ the right to examine any.and all accounting records as they pertain to Services provided
7 by Service Provider.

—s 12. The School District shall have the right to cancel any scheduled: shift before
the shift is. scieduled to begin, provided the School District notifies Service Provider at
least two: (2) hours prior to the scheduled shift. .

43. . The School District shall not incur-any charges for Health Care persorinel
placed by Service Provider who fail-to fulfill a scheduled assignment for any reason seis
whatsoever. Service Provider shall make. every effort to locate substitute personnelfor .
the-School District upon request. :

14... Either party shall have the right to terminate this Agreement with or without
cause upon thirty (30) days prior written notice. In event of termination, the School
District shall pay ail accounts due immediately and Service Provider will provide no
additional Services beyond the date of termination.

Revised 7/20 "Bach interin Healtheare Office is an independently owned and operated franchise business. 3



-conducted by. the schod District for Service: Provi

17, Service Provider shalt make personnel available to the School District for
54 internal peer reviews, external audit systems, grievarice Be Previn and any
ide:

agrees to pare ees in-any case confererice or. continuing in-service education. =
ars staff, at the Seno District's.

All employees of Service Provider sha be deamed employees of Service
rall purposes and Service Pravider alone shall be responsible for their work,
duct, direction, and compensation. Service Provider acknowledges that H
itself, its officers, its ernployees and/or its agents out as employees of the ~
School District. Service Provider is retained by the School District only for the purposes ~
and to the extent set forth in this Agreement, and its relationship to the School District.
shall during the term hereof be that of an independent Service Provider. Neither Service ©
Provider nor its personnel assigned hereunder shall be considered as having empioyee.

. _ .8tatus with the School District and shall not be entitled to participate in any of the School

t's. worker's compensation, retirement, fringe benefits, unemployment i insurance,

roy. insurance, ‘disability i insurance, or other similar employee benefit programs.

. Service Provider and its employees shall not share or accept any. feo: or
stetuty fr fort the School District for service provided pursuant to-this Agreement.

20. Service Provider shall identify: and hold harmless the School District and its
agents and employees from and against all claims, damages, losses and expenses,
including but not limited to attorney's fees, arising out of or resulting from the
performance of the Services under this Agreement, provided that any claim, damages,
loss or expense is (i) attributable to bodily injury, sickness, disease or death, or to injury

~ to or destruction of tangible property, including the loss ‘of use resulting therefrom, and (ii}

caused in whole or in part by any negligent act or omission of Service Provider, anyone
directly or indirectly employed by Service Provider or anyone for whose acts Service
Provider may be liable, but only to the extent such claims, damages, losses or expenses

- are not caused in whole or in part by a party indemnified hereunder. This Section 20

tbe construed to negate, abridge, or otherwise reduce any other right or

ol igation of indenanity that either party would otherwise have under applicable law.”

24. The ‘Service Provider agrees to maintain insurance in such limits as 5 set
forth below.

Revised 7/28 Each Interim Healikcare office isan independently owned and operated franchise dusiness. Fj



1. Commercial General Liability Insuran
. occurrence/$3,000,000 aggregate; ~ oS .
. Automobile Liability: $1,000,000 combined single. lirnit for owned, hired and
borrowed and non-owned motor vehicles;

Ill.  Statutery. Workers’ Compensation; and a
IV. Professional Liability Insurance: $1,000,000 per pédurrencel$4: 0 OC
aggregate. 7

23. Sarvicas rovidéd pursuant to this. Agreement shall be provided withiot
regard to race, creed, color, sex, age, disability, | ia 1 rientation, national-origin or
Spe orship.

~ 24, All notices required or permitted shall be made j in 7 writing by hand delivery or
by registered or'cartified mail, or by a recognized courier service. Notice Shall'be deemed
given on the date of delivery. or upon Frecelpt. twatice shall be delivered or mailed tox.

Service Provider:

. Interim HealthCare of Pittsburgh, inc.
~<. Dba Interim HealthCare of Morgantown
1111 Van Voorhis Rd; Suite 2, Second Floor
Morgantewn, WV 26505 .

School District:

Randolph County, Schools
40 Eleventh Street
Elkins, WV 26241

25. Neither party shall assign, transfer, or convey any of its respective fights or
obligations under this Agreement without: the prior wotien consent of the other party.

26. This Agreement shail be govemed by the laws of the State where the

: School District is located. If any portion of this Agreement is found by a court of

competent jurisdiction to: be invalid or unenforceable, the remainder of this Agreement
shall Femain in full force and effect. re OE

27. “This Agreement constitutes the full and complete Agreement between ihe
School District and Service Provider, and supersedes all prior written and oral
agreements. This Agreement may not be altered, changed, added to, deleted from, or
modified except through the mutual written. consent of the parties.

Revised 7/20 .. . . Each Interim Healthcare office is an independently owned and operated franchise business. gO “


“28. © The undersigned representative of Servi ce ‘Provider hereby fipreseits and
warrants that the undersigned is an officer, director; of agent of Service Provider with full
legal rights; power, and authority to enter into this Ag nt on behalf a Service —

ment has been. arrived at mutually and is not to be constitied
saan any party hereto as being the drafter hereof or causing the same to be drafted.

IN 1 WITH 3S: HEREOF, the parties have. executed this. ‘Agreement on the date first
above written. : -

Interim HealthCare ot Pittsburgh, ino. Loe
Dba Interim HealthCare of Morgantown -. Randolph County Schools

SIGNATURE:

SIGNA TURE las Reiser (May 40,2024 25:07 EDT}
PRINTED NAME: | Nicholas Reiser _ PRINTED NAME:
TITLE: CQO | TITLE:

DATE: __May 10, 2024 DATE:

Billing and Invoicing addressed to:
- Contact Printed Name: _
Title:
Address:
Phone:

Fax:

Revised 7/20 . Each Interim Healiicare office is an independently owned and operated franchise business,



anc action of activity oF provides
services of a type for COVERED ENTITY. that makes BUSINE! TE. “business associate” for
PUpORes ‘of the HIPAA privacy regulations. " *

Definitions. All terms and ee in this have’ ¢ same meanings as defined in 45 CFR
intitin z Seneraliy of the foregoing. as used in this

(a) “HIPAA privacy tegulations” shall mean the regulat i FR S60 ad $164, subparts A

‘and E,

“HIPAA eecarity regulations” shall mean the regulations at 45C RE §160 an 164, subpart Cc.

“HIPAA Br ach Notification Rule” shall mean the regulations at 45CFR g164, subpart D;

“HIPAA Rules” shall mean the HIPAA. privacy regulations, the HIPAA security regulations, the
HIPAA Breach Notification Rule, and the HIPAA enforcement rule at as CFR 0

? shall nean: the Secretary of the United States Department of Health and Human 7 4
(f)
(z) "Electronic protected health information” s all meant: ndividu ¥ — health information

that is transmitted by or maintained in electronic media. It includes devices in computers and.any
removable/transportable digital memory medium. Transmission media include the Internet,
extranet or intranet, leased lines, dial-up lines, private networks, and physical. movement of

: bigfrangportable media. Certain tratisrissions, including of paper, vid: facsim: pad of .



(c)

{d)

BUSINESS ASSOCIATE’S Obligations.

(a)

“Management. and Administration. BUSINESS. ASSOC!

ssful unauthorized access, use, disclosur
ce with system operations in:an

modification, or des
information system.

of:.or to nrovide services to, COVERED ENTITY for the following p purposes, iEsuch use of
disclosure of protected health information would nat violate the HIPAA privacy regulations if

ay tse and disclose protected
health information for the proper management and admini: of BUSINESS ASSOCIATE ar
to carry aut the legal responsibilities of BUSINESS ASSO IATE, provided:

The disclosure i is required by law; or, .

BUSINESS ASSOCIATE obtains reasonable assurances from the person to wi
information ig dig¢losed that it will be held confidentially and’used or further disci
only as required by law. ‘ose for which it was disclosed to the person and
the person will immedi ify the BUSINESS ASSOCIATE of any instances of *:
“which it is aware if a wick ‘the confidentiality’ of the: information has.been breached... ~

Date Aggregation Services. BUSINESS ASS may useand disclose protected health
information to‘provide data aggregation services relating to the health care operations of
COVERED ENTITY,

Violations of Law. BUSINESS ASSOCIATE may use protected h ealth information to report
violations of law to appropriate Federal.and State authorities, ¢ consis with 45 CFR
§164,502(/)(1).

"Representation and Acknowledgment. BUSINESS:ASSOCIATE represents that it has .

complie and-will comply with the requirements of the HIPAA Rules applicable to it a

Sifoguayds. BUSINESS ASSOCIATE shall use appropriate safeguards, and: comply, where. ~
applicable, with the HIPAA security regulations with respect.to electronic protected health
information, to prevent use or disclosure of protected health: information other than as permitted or
required by this Contract or ag required by law. 2



{d)

(e)

(f)

(g}
(h)

i)

0

)

, Security 4 Electronic Protected Health Information. a BUS ESS ASSOCIATE shall
]

’. {nformatian:

ee COVERED ENTITY in the performance ef such, hab

()

of protected health new ac not permitted by:
including breaches of unsecured Str ‘hea

ep
as possible after BUSINESS ASSOCIATE dissbvers't!
t more than twenty (20) days after the discovery.

i ertissible use or

BUSINESS K SOCIATE shall ensure that any subcoritractors, that create or :
receivé protected health. inform half of BUSINESS ASSOCIATE, agree to the same
restrictions and conditions that apply to BUSINESS ¢ ae with respect to:such

viding Electronic Protected Health Information to Agents or Subcontractors. BUSINESS
ASSOCIATE shall etisure.that any agent, including a subcontractor, to. whom‘it provides
electronic. protected health information, agrees to implement reasotiable and: ap cupeTate

wotecied health iiifomriaticn.

Individual’s Access to Information. BUSINESS ASSOCIATE shall make available and permit _
access to protected health information about an i ual by that individual in aceordance with 45
CFR §164.524. :

Aimendment of Protected Health iuifcrraation. BUSINESS / §SOCIATE shall make available
to. COVERED ENTITY protected health information for amendme d.ingorporate any
é +526.

’ shall make pein the in ation required to provide an accounting of disclosures i in:
- accordance with 42 CFR. 8164. §28. Such information shall be given ta COVERED ENTITY by:
BUSINESS ASSOCIATE within twenty (20) days after COVERED ENTITY notifies BUSINESS

ASSOCIATE of COVERED ENTITY’s need-for the information. cs

Comply with COVERED ENTITY’s Obligations. To the extent BUSINESS ASSOCIATE is to’
carryout COVERED ENTITY’s obligations ‘under, the HIPAA privacy regulations, BUSINESS
ASSOCIATE shalt comply with the requiremen ¢ HIPAA privacy regulations that apply * to
ations.

Practices, Books and Records. BUSINESS ASSOCIATE shalf' make its.internal practices,
books, and records relating to the use and disclosure of protected t ealth information received
from, or created or received by BUSINESS ASSOCIATE on behalf of COVERED ENTITY, to
the: Secretary for the purpose of determining COVERED ENTITY’s compliance with the HIPAA

Mitigation. BUSINESS ASSOCIATE. shail mitigate, to the extent practicable, any. taints sffect



that is known to BUSINESS ASSOCIATE or to COVERED ENT TY of ause or disclosure of
protected health information i in violation of BUSINESS ASSOCI¢ ATE’s papier and Procedures,

a)

§164.520, to the extent that such limitation may y affect B SINESS AS' ;
disclosure of protected health informatie

COVERED ENTITY shall notif ;
revocation of, permission: by an ini
to the extent that such changes may a
of protected health infomnation.

or r disclosure of protected health information that COVERED ENTITY hi : sates to in
accordancé with 45 CFR § 164.522, to the extent that such restriction may affect
BUSINESS. ASSOCIATE’ suse or disclosure of of protected health information.

(b) Permissible Requests by COVERED EN I

COVERED ENTITY shall not request BUSINESS ASSOCIATE to use or disclose protected
health information in any manner that would.not be penmnis: s ne under the HIPAA privacy

-.,, Regulations if done by COVERED ENTITY.

to COVERED ENTITY. In the event of iis discovery ofa breach: of unsecured seinecead :
information disclosed or made available to-it by COVERED ENTITY, BUSINESS:
ASSOCIATE shall provide notification of such breach to COVERED ENTITY as required by the
HIPAA Breach:Notification Rule, Provided, however, notwithstanding anything in that Rule to
the contrary or'in paragraph (16).of thig Contract, such notice shall be given to COVERED. _
ENTITY by BUSINESS ASSOCIATE as soon as possible after BUSINESS ASSOCIATES's
discovery of the breach, ‘but i in ne case more a twenty (20) calendar days after its discovery 2 of
the breach, me

(b) Notice of Breach to Aivcied Individuals; Costs:.: Whether or not notification of the breach shall
be given to affected individuals and, if so, the which the notification shall be given
shall be determined by COVERED ENTITY, in its so e-discretion. If required by COVERED -
ENTITY in its sole discretion, BUSINESS ASSOCIATE shall give any such notice(s) at such -
times and in such manner as determined by COVERED ENTITY. In all. cases, BUSINESS
‘ASSOCIATE shall pay to COVERED ENTITY the costs incurred by COVERED ENTITY due to
. the breach. Such:costs shall include, but are not limited to printing and | copying costs, postage,
delivery charges, telephone charges-and employee wages.

(s} Proof of Encryption. In the event of a breach of secured protected health ‘information, ;
BUSINESS ASSOCIATE shall notify COVERED ENTITY of the breach as stated in
subparagraph (6)(a), above, and, within twenty days (26) calendar days after giving such notice to



{7}

8)

Term

@

COVERED ENTITY, provide proof Satisfactory t to COVERED ENTITY that such protecte
health information was not unsecured protected health i

hen all. of the protected health information provided by COVERED ENTIFY
or receiv by BUSINESS ASSOCIATE on behalf of

and shall tefminate'v
to BUSINESS ASSOCIATE, or create

accordance with the termination onovisions i this Para

(b)

fc) Termination for Cause, Upon COVERED ENTITY’s knowledge of amaterial breach of this
Contract by. BUSINESS ASSOCIATE, COVERED: ENTITY shall either:

ti nal & eeitient. This Contract may be sscihiuatna by: mutual written agreement of the parties.

(1) Provide an:opportunity for BUSINESS ASSOCIATE to cure the breach or end the’:
violation and terminate this Contract if BUSINESS: ASSOCIATE does not.cure. the:
‘breach or end the violation. within the time spe ‘COVERED ENTITY;

(2) Immediately terminate this Contract if BUSINESS ASSOCIATE has breached a material
: : term, of this Contract and cure is not possible.

{d} Effect. of Termination.

() Except as: provided in paragraph (2) below, upon termination of this Contract, for'any
reason, BUSINESS ASSOCIATE ‘shall return or destroy all protected health information
received from. COVERED ENTITY, or created ‘or recei
‘on behaif of COVERED ENTITY, that BUS S$ ASSOCIATE maintains in any foim.

This provision also shall apply to protected health information that.is-in the possessiotrof
subcontractors of BUSINESS ASSOCIATE. BUSINESS ASSOCIATE shall retain no -
pple of the protected health information. -

at that BUSINESS ASSOCIATE determines that tsttuining or destroying the
Ith information t is not feasible, BUSINESS ASSOCIATE shall Provide to to

protected = Buh information and limit farther-wses and disclosures.of such protected
health information to those purposes that make the return or destruction not feasible, for
so long as BUSINESS ASSOCIATE maintains such protected health information.

Injunction. Notwithstanding any other rights or r remediés provided for in this Contract, ‘COVERED
ENTITY retains all rights to injunctive relief to’prevent or stop the unauthorized use or disclosure of
protected health information by BUSINESS. ASSOCIATE, or any agent, subcontractor or other third party
that received protected health information from BUSINESS ASSOCIATE.

indenanifi cation, BUSINESS ASSOCIATE shall indemail old COVERED ENTITY harmless from.
and ‘against any and all loss, cost, damage, or expense, including reasonable attorneys’ fees, that arise out

of: any breach by BUSINESS ASSOCIATE of this Contract; the HIPAA privacy regulations, the HIPAA
security regulations, or.the HIPAA Breach Notification: Rule, or, the need for COVERED ENTITY to
enforce any provision of this Contract.



BUSINESS ASS
regulations.

‘delivery will be obtained, and’ rr shal be,
din a prior written notice to the

If to COVERE ENTITY

Randolph County Schools
40.Eleventh Street
Elkins, WV 26241

Morgantown, WV 26505

a suet notice shall be deemed to be. given on 1 the date. it

pnally to:a party if it is handed to the‘
ive of the party to whom the notice must be addressed or:if left at his‘or her office located at the
8s'to which a notice would be mailed.

(12) Amendment. :Contract may not be changed, modified, or amended eNcee by a written agreement
executéd on behalf of gach of the parties.

13) No Waiver. No waiver-of one or more of the provisions of this Contiact 6 or the failure t to enforce any
provision of this Contractby either party shall be construed as a waiver of any ‘subsequent breach of this.
Contract, nor a waiver of the Fight at: any time ¢ thereaftcr to require’strict compliande. witli all of its terms.

(14) Entire Agreement. This Cottvact sats: forth the entire agreement and understanding between the parties as
to the matters contained in it, and supersedes all prior discussions, agreements, and understandings of every
kind and nature between them.

Headings. The headings placed before the various pa raphs and subparagraphs of this Contract are
inserted for ease of reference only, do not constitute a part ofthis Contract, and shall-not be uséd:in any
way whatsoever in the construction or interpretation of this Contract.

(16) Interprétation. Any ambiguity: in this Contract shall be resalved to permit COVERED ENTITY to |
comply’ with the HIPAA Privacy Rule, 45 CFR § 164.500 et seq., the HIPAA Security Rule, 45‘CFR'§ ©
164.302 et seq,.and the HIPAA Breach Notification Rule, 45 CFR Re AGO ef seg., as each may be
amended from fie to time. &

(17) .. Governing Law. This Contract shall be construed and enforced in accordance with, and governed by, the
laws of the State of West Virginia. |

IN WITNESS WHEREOF, the parties licreto have caused this Contract to be executed by their duly authorized



representatives on the dates set fortit below.

(interiin Healthcare of Morga niown)

By: mene Ratner [May LO, 2024 15:07 EOT) .

Title: COO.

Date:



ADDENDUM TO HEALTH CARE STAFFING AGREEMENT FOR
SCHOOL SERVICES

This Addendum modifies the Health Care Staffing Agreement for School Services
entered of this same date. To the extent this Addendum conflicts with any provision of the

Agreement, this Addendum shall control.

l. Mandatory Reporting. Service Provider agrees that during the course of
providing its services to the School District, it will abide by the mandatory reporting
requirements of West Virginia Cade Section 49-2-801 through -814. The parties agree that
Service Provider's employees qualify as mandatory reporters under those Code Sections, and as
such, Service Provider agrees to ensure that its employees are familiar with and comply with

those Code Sections.

2. Background Checks. Service Provider agrees that it has conducted or will
conduct appropriate background checks of any employees who will provide services to the
District's students. Service Provider agrees fo provide the results of any background check to the
District upon the District's request. Service Provider agrees not to permit any employee who has
been convicted of or pled guilty to a felony of Tense to provide services to the District's students.

3. Confidentiality and Educational Records. | The parties understand and
agree that during the course of providing services to the School District's students, Service

Provider's employees may be privy to educational records, as that term is defined by the Family
Educational Rights and Privacy Act ("FERPA"). Service Provider agrees to instruct its
employees, and the School District may enforce that any and all educational records are the
property of the Schoo! District and are to be treated as strictly confidential, Without the prior
wnitten consent of School District, Service Provider shall not directly or indirectly, during the

term of this Agreement and after termination divulge to any person, or use for its own benefit,


any confidential information or educational records viewed by its employees during the
performance of their duties hereunder, it being the intent of the parties to restrict Service
Provider from disseminating or using any educational records of School District's students.

4, Video Recording. Service Provider acknowledges that, pursuant to West
Virginia Code Section 18-20-11, video cameras may be required in certain of the classrooms in
which Service Provider's employees may be providing services to Schoo! District's students.
These cameras are capable of capturing both video and audio of the classroom setting. Service
Provider understands that no individual providing services in these classrooms may ‘opt out' of
their image or voice being captured. Service Provider agrees to provide the following notice to
any employee who will be providing services to School District's students in Schoo! District's
buildings, prior to the first day on which such employee provides services under this Agreement:

“Please be advised that pursuant to West Virginia Code Section 18-
20-1 1, for the purposes of ensuring the health, wellbeing, and
safety of students receiving special education and related services,
Randolph County Schools is required to provide video cameras in
any self-contained classroom, which is a classroom in which a
majority of the students in regular attendance are provided special
education instruction. Where provided, these video cameras capture
both video and audio in all areas of self-contained classrooms. As
such, should you provide services to a Randofph County student in
a self-contained classroom during the course of a school day, your
image and voice may be recorded by these cameras. The principal

at each school is the custodian of these recordings, and they will be


maintained for at least three months (longer, if the schoo! is

notified of an incident occurring within the self-contained

classroom). These recordings are confidential and may only be

viewed or accessed by certain individuals, as discussed in Code

Section 18-20-11."

3. School Grounds. Service Provider will ensure that its employees, agents,

representatives, subcontractors, consultants, or others under its direction comply with
prohibitions in West Virginia law conceming the possession of drugs, alcohol, tobacco, or

weapons on school grounds.

6. Policies. Service Provider and its employees and subcontractors shall, at all
times, comply with all of School District's written Policies and/or Procedures applicable to
independent contractors. The Policies and Procedures may be accessed at the School District's
website: https://go. boarddocs.com/wvirand /Board.nsf/Public#tab-policies

7. Modification. Paragraph 12 of the Agreement is modified auch that the
following language shall be added after the existing language of Paragraph 12: “For any
scheduled shift that is canceled at least two hours before the scheduled start of the shift, the
School District shall not be responsible for any of Service Provider's fees during such shift,
including if Service Provider's employees provide services to a student in the student's home or
at another location during the same day, pursuant to a separate agreement or arrangement
between the student's parents and Service Provider."

8. Individual Agreements, | The parties anticipate that individual students’

needs may dictate that Service Provider's employees should participate in the creation of



Individualized Education Programs (LEP) for such students or that Service Provider's employees

may at least need to provide input conceming the student's health care needs for the creation of

an LEP. As such, and with the agreement of the students’ parents, the parties agree that they will

collaborate in individual cases and if necessary, put in writing any specific policies and

procedures that should apply to the services to be provided to such students, on a case-by-case

basis. To the extent Service Provider's employees are required to attend any IEP meetings,

Service Provider shall be comperisated-using the same methods identified within the Agreement.

Dated this 17" of May, 2024.

Interim HeaithCare of Bridgeport

(Randoiph County Board of Education).

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