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HomeMy WebLinkAboutAging - ReliableCare USA Inc.PERSONAL CARE / HOME SUPPORT CONTRACT (ReliableCare USA Inc.) This AGREEMENT is mutually made between ReliableCare USA Inc., 979 York Street, Suite 1, Hanover, PA 17331, herein called PROVIDER, and the County of Franklin, 272 North Second Street, Chambersburg, PA 17201, herein called COUNTY. A. Term of Contract. Subject to its provisions and availability of Federal, State and COUNTY funds, the term of this AGREEMENT shall commence on March 1, 2026, and end on June 30, 2027. B. Services provided. Services to be performed through this AGREEMENT are known as Personal Care Services and Home Support as hereafter, through the COUNTY program. The focus of the program is to keep individuals living in the community as long as appropriate through the provision of in-home services to clients who are at least sixty (60) years of age and qualify for intermediate care or skilled nursing care. These services are provided to the client in a more timely and intensive manner than other services as the result of the involvement of persons with social and health expertise in assessment, care planning and the monitoring process. Because of the intense nature of these services and frail condition of the consumers, these services are needed (7) seven days/week. PROVIDER shall be capable of starting services within 24 hours of receiving a referral. Any individual not receiving approval from COUNTY for personal care or home support shall be ineligible for services and PROVIDER shall not be paid for services provided to ineligible individuals. C. Nature and Scope of Service. Personal Care and Home Support are provided in the consumer's home. Services are provided by a trained, supervised direct-care worker when there is no family member or other responsible person available or capable of providing such services. D. Response to Referrals. PROVIDER must initiate services no more than 3 days after referral is accepted. If the initiation of services must be greater than 3 days, the PROVIDER must contact COUNTY Care Manager so another PROVIDER may be obtained. E. Definitions: The following words or phrases used in this AGREEMENT shall have the following meanings for purposes of this AGREEMENT: 1. Personal Care Services a. PERSONAL CARE SERVICES – The provision in a consumer’s home of “hands-on” care related to personal hygiene, functional activity of daily living that an individual cannot meet independently. Personal care may only be provided in accordance with the care plan developed in compliance with PDA Policy and Procedure Manual, Chapter VIII: Options. Activities may include but are not limited to: i. Bathing – Assistance to the consumer with bathing in the tub, shower or bed. (Totally dependent, bedridden people who are unable to direct the bathing activity by the personal care worker, and/or are unable to provide any assistance in washing themselves or are unable to move independently in bed are not appropriate for bathing by a personal care worker. However, when care is under nurse management, a personal care worker can augment the medically supervised care as long as the Personal Care tasks are limited to those allowed under the Personal Care definition. ii. Skin Care - routine application of lotion to unbroken, uninfected, undiseased skin surfaces. iii. Mouth Care - assistance in care of teeth and mouth including care of dentures. iv. Dressing – includes assistance with clothing as well as application of previously self-applied prostheses. v. Grooming – includes hair care, shaving, cleaning and filing of nails. (The diabetic consumer’s nails may not be cared for by the personal care worker.) vi. Toileting – includes assistance with transfers on and off commode or toilet, emptying commodes and catheter bags. vii. Ambulation and Transfer – Includes steadying support and supervision to assist a consumer with walking and transferring. viii. Change of Position and Turning Consumer – does not include range of motion exercises, except when such care is under nurse management. ix. Feeding – which may also include mashing of food for easier management and/or assistance in preparation and serving a meal. x. Medication – assistance with self-administered medication. Assistance is limited to reminding the consumer to take medications, placing medication within reach, obtaining the necessary equipment, pouring water for oral medication, opening bottle caps, checking dosage, storing water for oral medication, opening bottle caps, checking dosage, storing the medication and reassuring the consumer that he/she has obtained and taken the correct dosage. xi. Observation – reporting of changes in consumer condition and needs as observed during performance of personal care. xii. Instruction to Informal Caregivers – in the delivery of the above listed activities. xiii. Respite to Informal Caregivers – from the provision of the above-listed activities. xiv. Personal Care service may also include provision of supplemental housekeeping service as long as the primary service rendered is for personal care. These activities may include: 1. Washing dishes and clean-up after meal preparation. 2. Making beds and linen change for the consumer. 3. Shopping for the consumer. 4. Washing the consumer’s personal laundry 5. Light housekeeping is essential to maintaining a healthful living environment for the consumer. 6. Preparing and serving nutritious meals. 7. Assistance with home management. 2. Health Maintenance Activities a. HEALTH MAINTENANCE ACTIVITIES – Those activities which are necessary to maintain the consumer’s optimum health, as directed by the physician responsible for the consumer’s medical/health plan of care. These activities would be carried out primarily by the consumer if he/she were physically able or family members if available. These activities include, but are not limited to, catheter irrigations; administration of medication, enemas, suppositories; and wound care. 3. Home Support a. HOME SUPPORT SERVICES – Services designed for those individuals who, because of functional disability, are unable to perform independently some or all of the tasks needed to establish a favorable home climate and have no formal supports available to provide service. b. Home Support services will include specifically assigned tasks the consumer has been determined unable to perform and will be provided in such a way as to encourage the consumer to maintain or improve his/her level of functioning. c. Activities under Home Support are labor-intensive maintenance, cleaning and home management activities and non-overnight home companion activities provided to ensure a safe and sanitary environment for consumers. The service is not to be rendered as routine household assistance with cleaning and chores. Home Support activities will be delivered for the duration and frequency specified in service order. d. Home Support Activities include: i. Basic housekeeping and home management necessary to ensure safe and sanitary conditions. ii. Instruction in home management. Home management includes such things as maintaining an orderly environment, proper food storage, preparation of shopping lists, maintaining appliances in safe working conditions. iii. Shopping assistance with or without the consumer. iv. Personal laundry and mending of clothing. v. Transportation of the consumer by a Home Support worker to complete chores or keep appointments. Said Transportation shall only occur when Transportation services are inappropriate or unavailable. vi. Labor-intensive low-cost home repair chores necessary for reasons of a consumer’s health and safety, which would approximate the hourly cost of other home support services. vii. Ground maintenance, such as lawn-mowing and snow removal, when absolutely necessary to maintain a consumer in his/her home. viii. Non-overnight home companion services to provide respite to a primary caregiver from the provision of the above activities. In some cases, non-overnight home companion services could be used to combat disorientation and/or depression which could result from prolonged aloneness. e. Activities not covered under Home Support include non-recurring high cost or capital- intensive home repairs, fumigation, modification, or rehabilitation services are not eligible home support activities. These activities are eligible under the Department’s Environmental Modifications Services. F. Licensure and Standards – Department of Health Regulation. PROVIDER must be licensed by the Pennsylvania Department of Health to operate in the Commonwealth of Pennsylvania and must provide a copy of its license to COUNTY/Agency upon execution of this AGREEMENT. PROVIDER must provide proof that it complies with Pennsylvania Department of Health regulations regarding Home Care agencies, to include required criminal background and child abuse clearances on applicable staff, tuberculosis screening for all staff with direct consumer contact. Proof of compliance shall be proffered immediately upon request by COUNTY. All Personal Care Providers must be in compliance with 28 PA Code Chapter 51 (General Regulatory Requirements) and 28 PA Code Chapter 611 (Home Care Agencies and Home Care Registries). G. Training Standards 1. Personal Care Workers a. Each person employed or contracted with the PROVIDER and providing Personal Care service shall be trained for all services to be performed. The PROVIDER is responsible for ensuring that all personal care workers have received training as prescribed below. b. Personal Care Workers must meet the PA Chapter 611, HCA & HCR; 611.55 Competency requirements (Attachment #2). c. COUNTY requires Personal Care providers to require all direct care worker staff members to complete 12 hours of ongoing in-service training. 2. Home Support Workers shall: 4. Be oriented to the purpose and background of the Franklin County Area Agency on Aging. 5. Demonstrate knowledge and ability to perform the activities assigned. Methods for determining this include, but are not limited to the following: i. Previous job experience, or ii. Verification by previous employer, or iii. Receive regular in-service training for Home Support staff. Topic areas must include the following, but are not limited to: 1. Principles of cleanliness and home safety. 2. Communication with older persons. 3. Understanding aging and functionally impaired persons. 4. Observing, appraising, and reporting changes in consumer’s situations. H. Supervision Standards 1. Personal Care Services. a. Supervisory visits are defined as a visit made to the consumer’s home to monitor the performance of the Personal Care worker. Supervisory visits, made by the RN or Non- RN Supervisory staff member, shall occur at a minimum of 90 day intervals. The Personal Care worker is not required to be present during the supervisory visit. b. Direct supervision of the Personal Care direct-care workers includes: i. Giving written and oral assignments and directions which include specific instructions on how care is to be rendered and how and what changes in the consumer’s condition must be observed and reported. ii. Establishing schedules iii. Counsels and reviews employee’s work and to resolve any related problems, concerns or issues as needed. iv. Effective performance includes but is not limited to: 1. Arriving at and leaving the consumer's home when scheduled. 2. Satisfactory accomplishment of tasks outlined in the individual consumer's written assignment sheet. 3. Being aware of changes in consumer's needs and reporting these changes to the supervisor. 4. Consumer satisfaction with direct-care worker's performance. 5. All consumers with intense needs as identified by COUNTY will receive more frequent supervisory visits. I. Standards for Recruitment. PROVIDER shall utilize qualifications for selection of Personal Care Services direct-care workers by following personnel policies that include: 1. A personal interview and required follow-up of personal and employment references must be completed. 2. Recruitment direct-care workers must provide appropriate references: a. Preferably two verifiable work references indicating a minimal length of employment of two years. b. If the references described in Subsection (a) are not available, two verifiable work references and at least one verifiable personal reference. c. If the references described in Subsection (b) are not available, one verifiable work reference and at least two verifiable personal references. d. If the references described in Subsection (c) are not available, three verifiable personal references. 3. Assurance of compliance with Title VI of the Civil Rights Act of 1964, as amended, in recruiting. 4. Assurance of applicant's ability to read, write and follow simple instructions. 5. In order to make available a variety of competencies, efforts should be made to recruit Personal Care direct-care workers with knowledge of language and/or skills which address the special needs of older chronically ill individuals. 6. There must be assurance that Personal Care direct care workers comply with state and CMI health requirements related to communicable disease. 7. HIPPA release of employee information for auditing purposes. 8. All Personnel assigned to carry out responsibilities for these services must have a criminal history check from the State Police. The PROVIDER shall retain a copy of the Personal Care/Home Support worker’s record prior to the commencement of employment. A listing of prohibitive offenses is contained in Attachment #1 in this contract. This list of prohibitive offenses is identical to the list contained in Act 169 of 1996 as Amended by Act 13 of 1997, Criminal Offenses, with one exception: as the 3900 Series pertains to theft, absolutely no offenses in this category will be tolerated. J. Eligibility and Service Coordination. Eligibility for Personal Care Service is processed through Care Management of the COUNTY. The process includes: 1. COUNTY staff will prepare and transmit to PROVIDER for each consumer before service can begin, and individualized care plan/service plan, which includes the service orders for services. 2. Authority to purchase service for a specific consumer is restricted to COUNTY-designated case managers. If not specified on the COUNTY assignment sheet and care plan, the dates and times of service will be determined by the PROVIDER with maximum consideration given to consumer choice or convenience and in coordination with other services and supports. 3. Consumer's day, time or staff person assignment shall not be changed with consumer except in an emergency unless one of the following conditions prevail: a. An emergency prevents the usual service from continuing. b. Resignation of staff person. c. Dissatisfaction of consumer with PROVIDER's staff; however, PROVIDER service will not be required to make more than two (2) changes of staff for chronic complainers. d. If service cannot be provided, consumer must be contacted prior to the expected time of visit or as quickly thereafter as possible and no less than twenty-four (24) hours after to set another appointment within forty-eight (48) hours of the missed date. PROVIDER will make every effort to find replacement staff and contact COUNTY if PROVIDER can’t find said replacement. This will be documented and kept in PROVIDER’s file at COUNTY for future reference. 4. The final decision-making authority to initiate, continue, terminate, reduce or expand service to any consumer eligible for this service shall rest with the Franklin County Area Agency on Aging care management staff. 5. PROVIDER is required to report any observations, signs of or suspicions of abuse, neglect, exploitations, or abandonment of any consumer age 60 or older. PROVIDER shall notify COUNTY by phone immediately and shall include pertinent details of the report. The COUNTY will document this information in a Protective Services Report of Need. Within 48 hours of making the oral report, the employee or administrator shall make a written report to the AAA. 6. Direct-care workers must wear an employee identification badge while on duty. 7. It is expressly forbidden for PROVIDER employees to: a. Handle or move any belongings of consumer except as necessary to perform assigned tasks. If moved, objects must be restored to their original locations. b. Hold conversations with consumers concerning personal business or relationships. c. Ask consumer personal questions, except as necessary to develop a care plan. d. Eat or drink in consumer's home except with the permission of supervisor. e. Make personal telephone calls while at consumer's home. It is acceptable to use consumer's phone to call the supervisor for assistance or advice in the event of a crisis or immediate problem. f. Make suggestive remarks or behave in a sexually suggestive manner to or around consumers. g. Smoke, drink alcohol or use illicit drugs while on duty. h. Accept any money or gifts from a consumer, or anyone connected with this AGREEMENT; nor give or agree to give to, any person, any gratuity from any person connected with this AGREEMENT, including their contributions for service (unless sealed in an envelope to be mailed). Handling consumer's money to pay bills, make deposits, or purchase supplies is permissible only if specifically authorized in the care plan. Such activities must be supported by receipts or other documentation to the consumer. i. Disclose any information about consumer, including name and address in emergency situations. j. Introduce any person into consumer's home except personnel authorized by contract or the COUNTY. k. Direct-care workers cannot take consumers anywhere in their vehicles on service time. l. Abuse, neglect or exploit any consumer or persons related to each case. K. Universal Precautions: All personal care and home support workers will follow Universal Precautions and OSHA (Occupational Safety and Health Administration) standards in the performance of their assigned duties. L. Reports and Project Control 1. PROVIDER will maintain program statistical records required by the Franklin County Area Agency on Aging and to produce and deliver program narrative, statistical data and individual consumer records and service logs at times prescribed by and on forms furnished or approved by the Franklin County Area Agency on Aging. The following reports shall be provided to the Franklin County Area Agency on Aging no later than the fifteenth (15th) of each month, unless otherwise indicated, and shall include, but is not limited to: Statistical information on units of service for consumers served, including monthly service logs indicating consumers served, dates of service, direct-care worker's name, hours of service, time of day of service, visits without service, and reason for no service, unduplicated consumers served as of the beginning of contract year according to APD for "Program and Financial Reporting Requirements", consumer characteristics coding, if applicable. Fiscal invoice for service and budget justification if required. Fiscal invoice must be complete, including tracking of units used and available and remaining contract encumbrance. Pertinent consumer information obtained during the Supervisory Visits must be included in a report shared with the COUNTY within a week of the visit. Routine information shall be reported within 30 days. PROVIDER will submit a referral reply when services have been started stating service start date. PROVIDER will notify COUNTY within 72 hours in writing, of significant changes in consumers. This report should include admissions/discharges from the hospital and/or nursing homes, or significant changes in a consumer’s ADLs or condition, for the better or worse. PROVIDER will not be paid for time spent in the home of a consumer when ordered services are not being provided, as when a consumer is in the hospital. M. Audit Requirements 1. The Service PROVIDER must comply with all applicable Federal and State grant requirements including The Single Audit Act Amendments of 1996; 2 CFR Part 200 as amended, and Administration Bulletin No. 2015-03 DHS Audit Policy. 2. General policy: a. Less than $500,000 of Combined State/Federal Funding: No Audit Required b. $500,000-$749,999 of Combined State/Federal Funding: Compliance Attestation c. $750,000 or more of Combined State/Federal Funding: Yellow Book (GAGAS) Audit with Compliance Attestation d. $750,000 or more of Federal Funding: Single Audit with Compliance Attestation 3. The Service PROVIDER is responsible for obtaining the necessary audit and securing the services of a certified public accountant or independent governmental auditor. 4. The COUNTY reserves the right for federal and state agencies or their authorized representatives to perform additional audits of a financial or performance nature, if deemed necessary by COUNTY, Commonwealth or federal agencies. Any such additional audit work will rely on work already performed by the PROVIDER's auditor and the costs for any additional work performed by the federal or state agencies will be borne by those agencies at no additional expense to the PROVIDER. 5. Audit documentation and audit reports must be retained by the PROVIDER's auditor for a minimum of five years from the date of issuance of the audit report, unless the PROVIDER's auditor is notified in writing by the Commonwealth, the cognizant federal agency for audit, or the oversight federal agency for audit to extend the retention period. Audit documentation will be made available upon request to authorized representatives of the COUNTY, the Commonwealth, the cognizant federal agency for audit, the oversight federal agency for audit, the federal funding agency, or the GAO. N. Billing Procedure 1. PROVIDER agrees that they shall submit invoices to COUNTY on PROVIDER’s Letterhead on or before the 15th day of the following month for services rendered during that month. The COUNTY shall process all invoices or payment requests provided that the invoice complies with all contracting requirements and all services billed therein have been deemed valid by COUNTY/Agency, Fiscal and/or other designated COUNTY personnel. In the event that COUNTY/Agency makes payment of an invoice that is later determined by COUNTY/Agency, by audit or otherwise, to not comply with all contracting requirements and/or service invoiced and paid for is deemed invalid or not pursuant to the AGREEMENT, nothing in this AGREEMENT waives COUNTY/Agency’s right to make an adjustment to a future invoice or seek refund for overpayment upon providing Provider notice. In the event PROVIDER fails to submit an invoice on or before the 15th day following the month for which they are seeking payment of services, COUNTY/Agency shall suspend any and all payments to the PROVIDER until such time as they receive the past due invoice. On or before January 15th of each year, the PROVIDER shall submit to COUNTY/Agency and the Fiscal Department a statement of the number of units which have been performed and paid and the estimated balance of available units and balance of sums available to the PROVIDER. Failure to comply with this term may result in termination of this AGREEMENT at the sole election of COUNTY/Agency. PROVIDER acknowledges that it shall monitor the number of units provided and the number of units paid for under the terms of this contract so that they do not exceed the number of units contracted or the amount to be paid. Personal Care is normally ordered in a one (1) hour minimum block of time. One (1) unit Personal Care equals one (1) hour. Recording Partial Service Delivery – A unit of service = 1 hour. Partial units of service delivery are to be recorded in quarter hour increments including .25, .50 and .75 units. PROVIDER acknowledges that if they provide additional units in excess of the units contracted, they do so at their sole discretion and without obligation for payment by COUNTY/Agency regardless of whether or not said services are approved by COUNTY/Agency employees or agents. PROVIDER acknowledges that it has read the entire terms of this contract and understands the number of units for which it is contracted and the reimbursement terms for the units contracted. PROVIDER shall only provide additional units beyond the units contracted if having the first received written approval to perform said units by COUNTY/Agency Director or COUNTY/Agency Director’s designated agent identified herein and if they provide units beyond those contracted, they may not be paid as said units which have not been expressly set forth in this contract. 2. All billing for contracted year must be received by COUNTY no later than July 15th of the following fiscal year. Bills received after July 15th of the following fiscal year will not be paid by COUNTY. PROVIDER shall receive payment 30 days after COUNTY receives billing invoice. SERVICE UNIT COST Personal Care $20.50 Home Support $20.50 Invoice should be sent to: aginginvoices@franklincountypa.gov (preferable) Franklin County Area Agency on Aging 600 Norland Avenue, Suite 11 Chambersburg, PA 17201 3. The COUNTY, in consideration of the services performed by the PROVIDER under this agreement and other costs as specified, shall pay the costs of the services rendered on a unit-of-service basis. The fee schedule and/or rates for services as agreed upon by the COUNTY and PROVIDER are listed in Attachment #3. O. Contract Monitoring. As outlined in the COUNTY Options Procedure Manual, COUNTY will: 1. Conduct on-site monitoring of each PROVIDER on no less than an annual basis. If three or more deficiencies are documented, the COUNTY staff will perform a follow-up monitoring visit within three months to ensure corrective action has been taken or a plan is in place. Failure to comply may result in subsequent monitorings or termination of this AGREEMENT. 2. COUNTY will generate a monitoring report, showing findings, recommendations and corrective actions. Reports will be shared with Contracting Agency. 3. Monitoring visits will be directly based on contract specifications. The COUNTY reserves the right to terminate this AGREEMENT at any time within the stated contracting period by providing a written notice to the PROVIDER sixty (60) days in advance of the date of termination. PROVIDER, in turn, may also terminate this AGREEMENT by providing the COUNTY with the same written notice, sixty (60) days in advance. Fewer days notice may be given if both the COUNTY and the PROVIDER are in AGREEMENT of the written termination date. The COUNTY reserves the right to terminate this AGREEMENT immediately upon written notice for any violation of this AGREEMENT by PROVIDER that risks the health and/or welfare of any persons being provided with services. COUNTY and PROVIDER will review utilization of service funds throughout the term of this AGREEMENT. If it is determined that PROVIDER will not be utilizing full encumbrance, COUNTY may contact PROVIDER and adjust contract accordingly to utilize funds to meet other client services. Intensive services are defined as services provided as often as daily, including weekends and holidays at no additional cost (additional cost is defined as any cost over the unit cost of the AGREEMENT) to COUNTY. PROVIDER is responsible for purchased service not directly rendered by the PROVIDER. COUNTY will reimburse PROVIDER for purchased service hours at the contracted rate as specified herein. No other charges are to be incurred by COUNTY and/or its consumers that exceed the contracted rates of this AGREEMENT for services provided through this AGREEMENT. These expenses shall include, but are not limited to, travel expenses incurred by PROVIDER and/or its employees and any amount of services provided that exceed the authorized number of monthly units on the individual consumer’s care plan as determined by COUNTY and provided to the PROVIDER unless PROVIDER and consumer enter into a mutual AGREEMENT for specified additional services. Should PROVIDER and a COUNTY consumer enter into a mutual AGREEMENT for additional services not capable/authorized of being supplied through the COUNTY care plan, PROVIDER must complete and have both parties sign and date an “Additional Services Notification/AGREEMENT Form” prior to the delivery of the specified additional services. PROVIDER must also remit the original signed form to COUNTY and provide the consumer with a copy of the signed form prior to the delivery of the specified additional services. PROVIDER is also required to retain a copy of this form in the consumer’s file. This contract must be amended if the gross contract amount is exceeded and/or if a material change in scope of services occurs. An amendment is not required for increases in selected units of service within the contract, provided that the COUNTY has authorized such increases in advance. PROVIDER’s signature below confirms that PROVIDER is currently certified to operate and has not been disbarred and/or suspended from operating. P. BUSINESS ASSOCIATE AGREEMENT. This AGREEMENT and the HIPAA BUSINESS ASSOCIATE AGREEMENT ADDENDUM constitutes the entire AGREEMENT between the PROVIDER and the COUNTY (Attachment #4). With respect to the subject matter hereof and there are no other written or oral AGREEMENTs with respect hereto except as specifically noted within the contract. No variation or modification of this AGREEMENT and no waiver of its provisions shall be valid unless reduced to writing and signed by the duly authorized officers of the PROVIDER and the COUNTY. If any part or provision of this AGREEMENT is found to be null and void due to a change in statute or regulation, the remainder shall be in effect during the entire period of this AGREEMENT. In the event that the parties are desirous of continuing the relationship set forth in this AGREEMENT but, as of the expiration of the term set forth herein, have not executed a new AGREEMENT, this AGREEMENT shall continue on a month to month basis under the same terms and conditions until such time as either party shall give thirty (30) days’ notice of termination. If the COUNTY continues to purchase services under this AGREEMENT beyond the term specified herein but has not executed a new contract pending finalization of State or Federal funding allocations, or should the parties fail to agree on rates applicable to the next AGREEMENT year, all terms and conditions of this AGREEMENT shall continue to apply and be binding on the parties for the services described herein until a new AGREEMENT has been executed. 1. This AGREEMENT is subject to the provisions of all pertinent Federal, State and local laws and regulations and all amendments made thereto applicable to the delivery and funding of social services to older persons. This AGREEMENT is entered into with the understanding that definitions of services, eligibility of recipients of service and other limitations on the purchase of the services established in this AGREEMENT are subject to modification by amendments to Federal, State and local laws and regulations and may require contract changes or cancellations. 2. During the performance of this contract, PROVIDER must comply with all the requirements of Title VI of the Civil Rights Act of 1964, Section 504 of the Rehabilitation Act of 1973, Title IX of the Education Amendments of 1972, the Age Discrimination Act of 1975, the American with Disabilities Act, 28 C.F.R. 35.101 et seq., and the Pennsylvania Human Relations Act. 3. By signing this AGREEMENT, the Service PROVIDER, in accordance with 45 CFR Part 76 and Part 82, agrees and certifies that it shall provide a drug-free workplace by: a. Establishing and maintaining a drug-free awareness program to inform employees about: i. The dangers of drug abuse in the Workplace; and ii. The policy of the COUNTY of maintaining a drug-free workplace; and iii. Any available drug counseling, rehabilitation, and employee assistance programs; and iv. The penalties that may be imposed upon employees for drug abuse violations occurring in the workplace. b. Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession or use of a controlled substance, or being under the influence of a controlled substance, is prohibited in the Service PROVIDER’s workplace and specifying the actions that shall be taken against employees for violations of such prohibitions. c. Require that each employee, as a condition of employment, shall: i. Abide by the terms of the policy noted above. ii. Notify the employer of any criminal drug statute conviction for a violation occurring in the workplace not later than three (3) days after such a conviction. d. Notify Franklin COUNTY within five (5) days after receiving notice under subparagraph (C) (3) (b), above, from an employee or otherwise receiving actual or constructive notice. e. Taking one of the following actions, within thirty (30) days of receiving notice under subparagraph (C) (3) (b), above, with respect to any employee who is so convicted: f. Taking appropriate personnel action against such an employee, up to and including termination; or g. Requiring such an employee to participate satisfactorily in drug abuse assistance or rehabilitation program approved for such purposes by a federal, state, or local health, law enforcement, or other appropriate agency. 4. PROVIDER further agrees that COUNTY and its agencies do not discriminate in hiring or any other employment decision on the basis of race, religion, sex, citizenship, national origin, ancestry, age or disability to perform the work required or any protected class. 5. PROVIDER must take affirmative action to ensure that applicants are employed, and the employees are treated during employment without discrimination. Such action must include, but not be limited to, the following: employment, upgrading, demotion or transfer; rates of pay or other forms of compensation, and selection for training, including apprenticeships. PROVIDER shall not apply a policy of mandatory retirement to positions. PROVIDER agrees to post, in conspicuous places available to employees and applicants for employment, notices available from the Department of Public Welfare and the Department of Labor and Industry, setting forth the provisions of the Equal Opportunity clause. 6. PROVIDER must, in all solicitations or advertisements for employees placed by or on behalf of the PROVIDER; state that all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, age, psychiatric disability or handicap, or any protected class. 7. In the event of PROVIDER non-compliance with this Equal Opportunity and Non- Discriminatory delivery of services section of this contract, this contract will be canceled, terminated, or suspended, in whole or in part, and PROVIDER may be declared ineligible for any further contracts with COUNTY. 8. PROVIDER must furnish all necessary employment documents and records to, and permit access to its books, records, and accounts by, the COUNTY and the Human Relations Commission, for purposes of investigation to ascertain compliance with the provisions of the Contract Compliance Regulations, pursuant to Section 49.35 of these Regulations. If PROVIDER does not possess documents or records reflecting the necessary information requested, it must furnish such information on reporting forms supplied by the COUNTY 9. PROVIDER must include the provisions of this non-discrimination clause in every subcontract so that such provisions will be binding upon subcontractors. 10. The PROVIDER shall not assign any interest in this AGREEMENT and shall not transfer any interest in the same without the prior written approval of the Franklin County Area Agency on Aging (COUNTY) thereto. 11. The PROVIDER warrants that no person or selling agency has been employed or retained to solicit or secure this AGREEMENT upon an AGREEMENT or understanding for a commission, percentage, brokerage or contingent fee (expecting bona fide employees or bona fide established commercial or selling agencies maintained by the PROVIDER for the purpose of securing business). 12. No officer, member or employee of the County of Franklin, who exercises any function or responsibilities under this AGREEMENT shall participate in any decision relating to this AGREEMENT which affects his personal interest or the interest of any corporation, partnership or association in which he is, directly or indirectly, interested; nor shall any such officer, member or employee of the COUNTY have any interest, direct or indirect, in this AGREEMENT or the proceeds thereof. 13. The PROVIDER covenants that it presently has no interest and shall not acquire any interest, direct or indirect, which would conflict in any manner or degree with the performance of its services hereunder. The PROVIDER further covenants that in the performance of this AGREEMENT, it shall not knowingly employ any person having such an interest. PROVIDER further certifies that no member of the board of the PROVIDER or any of its officers or directors have such an adverse interest. 14. PROVIDER agrees to obtain all supplies and equipment for use in the performance of this AGREEMENT at the lowest practicable cost after obtaining several estimates and within the boundaries established within the approved budget. a. Title to all property furnished in-kind by the COUNTY shall remain with the COUNTY. b. Title to all personal property acquired by the PROVIDER, including purchase by lease- purchase AGREEMENT, for the cost of which the PROVIDER is to be reimbursed under this AGREEMENT, shall vest in the PROVIDER during the term of this AGREEMENT. Upon cancellation or termination of this AGREEMENT, title to such personal property shall revert to COUNTY and disposition made according to applicable Pennsylvania Department of Aging General Terms and Conditions. c. Proposed expenditures for such property shall be identified in the budget justification provided to the COUNTY in the proposal to provide services. No other purchases may be made without amendment to the budget approved in writing by COUNTY. d. All property procured with funds obtained from COUNTY including purchase by lease- purchase AGREEMENT, or for which the PROVIDER is to be reimbursed under this AGREEMENT shall be deemed COUNTY property for the purpose of the following provisions. i. PROVIDER shall maintain and administer in accordance with sound business practice a program for the maintenance, repair, protection, preservation and insurance of COUNTY property so as to assure its full availability and usefulness. ii. COUNTY property and any property purchased under this AGREEMENT shall be used only for the performance of this AGREEMENT unless otherwise provided herein or approved in writing by COUNTY. iii. In the event that the PROVIDER is indemnified, reimbursed or otherwise compensated for any loss or destruction of or damage to COUNTY property, they shall use the proceeds to repair, renovate or replace the COUNTY property involved, or shall credit proceeds against the cost of the work covered by the AGREEMENT or shall otherwise reimburse COUNTY as directed by COUNTY. COUNTY will be promptly notified of any loss or destruction and will direct the manner in which compensation will be used. 15. All facilities operated for clients or entered by clients in the course of service request or provision must be approved by the Pennsylvania Department of Labor and Industry or be in the process of obtaining such approval. Such facilities must also meet all local health and safety regulations. All food contractors shall comply with all Federal, State and local regulations governing the preparation, handling and transportation of food: shall procure and keep in effect all necessary licenses, permits and food handler cards as required by law, and shall post such licenses, permits and cards in a prominent place in meal preparation areas as required. 16. No PROVIDER may charge COUNTY a higher price for a similar unit of service than the price for that service to private for free clients. 17. Services funded through COUNTY will be provided to eligible residents of Franklin County without discrimination based upon sex, race, color, financial status, geographic location, handicap or religious affiliation, as more fully set forth hereinabove. 18. Authority to purchase service for a specific client is restricted to COUNTY-designated case managers, unless authority is delegated in writing to specific providers. 19. In cases of dispute concerning service, the final decision-making authority to initiate, continue, terminate, reduce or expand service to any client eligible under this AGREEMENT shall rest with COUNTY. 20. Any PROVIDER contractor employee observing conditions hazardous to a client's health or safety shall make appropriate referrals for further evaluation and action by COUNTY. 21. PROVIDER shall report in writing, with its reasons therefore, any failure to provide to any client services requested by the COUNTY, provided, however, that compliance with this provision shall not be deemed legal justification or legal excuse for any breach or non- performance by PROVIDER, nor shall COUNTY be deemed to have waived any remedies for breach solely by reasons of having accepted such written report. 22. All programs funded by COUNTY must be accessible to handicapped persons. Program accessibility may be accomplished by moving programs to accessible areas, providing transportation to a barrier-free location, or providing assistance to disabled persons. 23. PROVIDER will advise applicants and recipients of service of their right to appeal denial or exclusion from any program, or failure of the program to recognize the recipient's choice of a service, and of their right to a fair hearing in these respects. Whenever an applicant or recipient requests a fair hearing, COUNTY will make arrangements to provide such a hearing through the COUNTY Advisory Council Appeals Committee. Failure to resolve the difficulty locally will render the applicant or recipient eligible to make an appeal to the Pennsylvania Department of Aging. 24. Each provider will ensure that registered clients are aware that service is being provided by COUNTY and shall distribute and make available COUNTY services brochures to clients as appropriate. 25. All PROVIDER contractors' full or part-time employees whose positions are funded in whole or in part by the terms of this AGREEMENT shall abide by the conditions of this contract. Such employees shall not, however, be employees of the Franklin County Area Agency on Aging. a. All PROVIDER contractors' COUNTY-funded workers must be qualified for their positions at a level of experience and training no less than those required by the Pennsylvania Civil Service Commission for similar classification. b. Salaries of PROVIDER contractors' COUNTY-funded personnel shall be within the Civil Service ranges for each classification unless specific waiver is sought in writing by PROVIDERs and approval in writing is granted by COUNTY. 26. When the PROVIDER contractor has any open positions that are funded by COUNTY, such open positions must be publicly advertised in local newspapers. Copies of such advertisements must be furnished to COUNTY upon demand. 27. Employee files shall include a completed employment application, written verification of contract with at least two references, written proof of competency for the position classification or license if required, training record and personnel action summary. Such files shall be made available to COUNTY officials for monitoring purposes upon request. 28. PROVIDER contractors should develop a planned program to meet their staff's training needs on an annual basis. 29. All employees with direct client contact should take at least one course of basic gerontology within their first year of employment if available. 30. PROVIDER under this AGREEMENT is fully responsible and liable for compliance with these regulations for services covered by this AGREEMENT whether directly or under sub- contract. 31. PROVIDER may not enter into any sub-contract for goods or services related to this AGREEMENT without prior written approval of COUNTY, which shall be attached to and made a part of the original AGREEMENT. 32. Such sub-contracts shall be subject to the same terms and conditions as apply to this AGREEMENT, however, no such approval shall in any way be deemed to provide the incurrence of any obligation upon COUNTY in addition to the total agreed-upon price. 33. PROVIDER agrees to minimize pollution and shall strictly comply with all applicable environmental laws and regulations. (Clean Streams Law, Act of June 22, 2937, P.L. 1987, as amended, the Pennsylvania Solid Waste Management Act, Act of July 7, 1980, P.L. 380, as amended, and the Water Obstructions Act, Act of June 25, 1913, P.L. 555, as amended). 34. PROVIDER agrees to provide services in compliance with 25 PA Code 151 et seq., relating to Environmental Health and Safety regulations for food protection, and 34 PA Code 50.135 seq., relating to Fire and Panic regulations. Q. INSURANCE. The PROVIDER shall have in place and provide evidence of insurance in the form of a Certificate of Insurance, naming the County of Franklin and the Franklin County Area Agency on Aging as the Certificate Holders and giving 30 days’ notice of cancellation or non-renewal of required insurance to include Commercial General Liability insurance naming the County of Franklin and the Franklin County Area Agency on Aging as an Additional Insured at minimum limits of $1,000,000 per occurrence and aggregate; Automobile Liability insurance for any auto to include owned, leased, hired, borrowed, and non-owned vehicles at a combined single limit of $1,000,000 each accident and aggregate; Workers' Compensation and Employers' Liability insurance at statutory limits; and Employee Dishonesty coverage at a $25,000 per occurrence limit. Evidence of insurance shall be provided, upon signing this AGREEMENT and annually thereafter. 1. Collision – Actual cash value of the vehicles and equipment on the vehicles. (Applies only to vehicles and equipment purchased entirely or in part with Department of Aging funds.) 2. Service PROVIDER must also carry insurance which is adequate to cover liabilities incurred as a result of escort activities. 3. PROVIDER may be liable for insurance claims in excess of insurance limits. R. GRIEVANCES. Any unresolved claims against COUNTY with respect to contract award or contract management shall be referred by COUNTY to the Franklin County Board of Commissioners. If satisfactory resolution cannot be achieved, COUNTY shall refer the grievance to the Pennsylvania Department of Aging for hearing process. Any and all regulations pertaining thereto being incorporated by reference herein as they exist at the applicable time should be provided. S. FISCAL RECORDS. PROVIDER agrees to maintain books, records, documents and other evidence pertaining to the costs and expenses of this AGREEMENT (hereinafter collectively referred to as "the records") to the extent and in such detail as will properly reflect all costs, direct or indirect, of labor, materials, equipment supplies and services and other costs and expenses of whatever nature for which reimbursement is claimed or payment is made under the terms of this contract. PROVIDER agrees to make available at the office of the PROVIDER at all reasonable times during the term of this AGREEMENT and for a period of five (5) years from the date of final payment following termination or partial termination of the work under this AGREEMENT, any of the records for inspection, audit or reproduction by any authorized representative of the COUNTY, PDA, Auditor General or Federal Auditors, except that records relating to litigation in may be retained longer than five (5) years. Records which relate to litigation or the settlement of claims arising out of the performance of this AGREEMENT, or costs or expenses of this AGREEMENT as to which exception has been taken by the auditors, shall be retained by the PROVIDER until such litigation, claims or exceptions shall have reached final dispositions. Except for records described in Paragraph (c) (above), PROVIDER may, in fulfillment of his obligation to retain records as required by this AGREEMENT substitute photographs, microphotographs or other authentic reproduction of such records, after the expiration of two years following the final payment under this AGREEMENT. PROVIDER agrees to collect statistical data of a fiscal nature on a regular basis and to make fiscal and statistical reports as prescribed by, and on forms furnished by, COUNTY. T. PROGRAM RECORD. PROVIDER agrees to maintain program records required by COUNTY and agrees that a program and facilities review for monitoring and evaluation purposes may be conducted at any reasonable time by COUNTY, PDA and Federal staff and other persons duly authorized by COUNTY. Such a review may include meetings with consumers, review of service records, review of service policy and procedural issuance, review of staffing ratios and job descriptions and meetings with any staff directly or indirectly involved in the provision of services. Program records to be reviewed will include but not be limited to: 1. Client records including intake documents, assessments, referrals, service plans, service delivered intake documents, narrative, notes and client signed permission forms. 2. Personnel files. 3. Policy and procedure manuals and documents. 4. Programs provided according to specifications. PROVIDER agrees to maintain program statistical records required by COUNTY and to produce and deliver program narrative, statistical data and individual client records at times prescribed by and on forms furnished or approved by COUNTY. U. REQUIRED REPORTS. Monthly Reports. The following reports shall be provided to COUNTY no later than the fifteenth (15th) of each month and shall include, but not limited to: a. Statistical information on units of service for clients served a. Fiscal invoice for service and budget justification if required. 2. Annual Reports a. Annual report of expenditures shall be provided to COUNTY no later than 20 days after the close of the fiscal years covered by this AGREEMENT or at any time during the contract period. b. PROVIDER shall secure the services of a registered/certified Public Accountant to provide an audit in compliance with existing statutory guidelines. PROVIDER shall furnish two copies of the audit report to COUNTY within 90 days after the close of the fiscal years covered by this AGREEMENT. c. If there are subcontractors involved in fulfilling the requirements of this contract, COUNTY reserves the right to require subcontractors to have an audit; contractors should include such a provision in their contracts with subcontractors. d. COUNTY reserves the right to require an audit of any or all records of any PROVIDER by the audit firm selected by COUNTY either at the close of the fiscal years covered by this AGREEMENT or at any time during the contract period. 3. The PROVIDER, being bound by all applicable State and Federal Regulations hereby expressly agrees to hold COUNTY and the Pennsylvania Department of Aging harmless against all audit exceptions arising from the PROVIDER's violation of the terms and conditions of this AGREEMENT. The PROVIDER shall make restitution to COUNTY such amounts of money which may be withheld from COUNTY due to the PROVIDER's non-compliance. Restitution shall be made no later than 30 days after receipt of notification from COUNTY that said moneys are due to COUNTY. V. INDEMNIFICATION. PROVIDER and its employees, consultants and subcontractors shall release, hold harmless, and indemnify the COUNTY, its officers, elected officials, agents, representatives, and employees acting within the scope of their official duties from and against damages, costs, and expenses (including reasonable attorneys’ fees and court costs) to the extent caused by the negligent acts, errors, or omissions of the PROVIDER, its employees, consultants, agents, servants, and/or anyone acting under the PROVIDER’s control and/or the PROVIDER’s direction, in the performance of the requirements of this AGREEMENT. The PROVIDER shall defend any lawsuit commenced against the COUNTY and shall pay any judgments and costs connected with such proceeding which are based upon the negligent acts or omissions of the PROVIDER or its employees. By entering into this AGREEMENT, the COUNTY does not waive any rights or protections of governmental immunity in accordance with the Political Subdivision Tort Claims Act, 42 Pa.C.S.A. § 8541 et. seq. and in accordance with such limits of liability set forth in the Act. W. INFORMATION. During the period of the AGREEMENT, all information obtained by the PROVIDER through work on the project will be made available to the COUNTY immediately upon demand. If requested, the PROVIDER shall deliver to the COUNTY any records or background material prepared or obtained by the PROVIDER as it relates to this AGREEMENT. Background material is defined as original work papers, notes and drafts prepared by the PROVIDER to support the data and conclusions in the final reports, and includes completed questionnaires, etc, and materials in electronic data processing form computer programs, other printed materials, pamphlets, maps, drawings and books acquired by the PROVIDER during the term of the AGREEMENT and directly related to the services being rendered. All records pertaining to clients and/or service delivery are included in this requirement. In the event of termination of this AGREEMENT, all records relating to client service delivery and to individual clients shall be delivered to the COUNTY and a proper receipt for same obtained from COUNTY. X. NOTICES. All notices, informational pamphlets, press releases, research reports and similar public notices prepared and released by the PROVIDER relative to this service shall have prior written approval of COUNTY and shall include the statement: “This project is funded, in part, under a contract with the Pennsylvania Department of Aging". Y. CERTIFICATION REGARDING LOBBYING. No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative AGREEMENT, and the extension, continuation, renewal, amendment of modification of any Federal contract, grant, loan or cooperative AGREEMENT. If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative AGREEMENT, the undersigned shall complete and submit standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. The undersigned shall require that the language of this certification be included in the award document for all sub-awards at all tiers "including subcontracts, sub-grantees, and contracts under grants, loans, and cooperative AGREEMENTs, and that all sub-recipients shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. Should PROVIDER, for any cause, fail to perform any of its obligations under this AGREEMENT in a timely and proper manner, or if PROVIDER shall violate any of the covenants or stipulations of the AGREEMENT, the COUNTY shall notify PROVIDER in writing of its intent to terminate this contract either in whole or in part at least thirty (30) days after receipt of certified mail with return receipt requested. The COUNTY's notice shall set forth in detail all allegations of failure to perform in a timely and proper manner and provide an opportunity to PROVIDER to have the matter reviewed by the COUNTY Advisory Council within thirty (30) days prior to the effective date to termination. Notwithstanding the above, PROVIDER will not be relieved of liability to the COUNTY for damages sustained by the COUNTY by virtue in any manner or degree, of PROVIDER's nonperformance of its service hereunder. The COUNTY may terminate this contract at any time by giving written notice to PROVIDER of such termination by specifying the effective date thereof, at least ninety (90) days before the effective date of such termination. Such notice must be delivered by certified mail or in person. IN WITNESS THEREOF, the parties thereto have caused this AGREEMENT to be executed by their officials thereunto duly authorized. For County of Franklin: ______________________________ Date _________________________ Dean A. Horst, Chairman ______________________________ Date _________________________ John T. Flannery, Commissioner ______________________________ Date _________________________ Robert Ziobrowski, Commissioner ______________________________ Date _________________________ Tawnya Hurley, FCAAA Director For the Provider: ______________________________ Date _________________________ Signature ______________________________ Print Name Sarah Rutledge (Feb 13, 2026 10:26:41 EST) "#"$ &'() )02/13/2026 Sarah Rutledge SarhRa utledR g(dF b13 ,2,0 b26:2 610 4ES T "#$" &'() 2,)b1),2,0 Attachment #1 Prohibitive Offenses Offense Type of Code Prohibitive Offense Conviction CC2500 Criminal Homicide Any CC2502A Murder I Any CC2502B Murder II Any CC2502C Murder III Any CC2503 Voluntary Manslaughter Any CC2504 Involuntary Manslaughter Any CC2505 Causing or Aiding Suicide Any CC2506 Drug Delivery Resulting in Death Any CC2702 Aggravated Assault Any CC2901 Kidnapping Any CC2902 Unlawful Restraint Any CC3121 Rape Any CC3122.1 Statutory Sexual Assault Any CC3123 involuntary Deviate Sexual Intercourse Any CC3124.1 Sexual Assault Any CC3125 Aggravated Indecent Assault Any CC3126 Indecent Assault Any CC3127 Indecent Exposure Any CC3301 Arson and Related Offenses Any CC3502 Burglary Any CC3701 Robbery Any CC3901 Theft Any CC3921 Theft By Unlawful Taking Any CC3922 Theft By Deception Any CC3923 Theft By Extortion Any CC3924 Theft By Property Lost Any CC3925 Receiving Stolen Property Any CC3926 Theft of Services Any CC3927 Theft By Failure to Deposit Any CC3928 Unauthorized Use of a Motor Vehicle Any CC3929 Retail Theft Any Offense Type of Code Prohibitive Offense Conviction CC3929.1 Library Theft Any CC3929.2 Unlawful Possession of Retail or Library Theft Instruments Any CC3930 Theft of Trade Secrets Any CC3931 Theft of Unpublished Dramas or Musicals Any CC3932 Theft of Leased Properties Any CC3933 Unlawful Use of a Computer Any CC3934 Theft from a Motor Vehicle Any CC4101 Forgery Any CC4114 Securing Execution of Documents by Deception Any CC4302 Incest Any CC4303 Concealing Death of a Child Any CC4304 Endangering Welfare of a Child Any CC4305 Dealing in Infant Children Any CC4952 Intimidation of Witnesses or Victims Any CC4953 Retaliation Against Witness or Victim Any CC5902B Promoting Prostitution Felony CC5903C Obscene or Other Sexual Materials to Minors Any CC5903D Obscene or Other Sexual Materials Any CC6301 Corruption of Minors Any CC6312 Sexual Abuse of Children Any CS13A12 Acquisition of Controlled Substance by Fraud Felony CS13A14 Delivery by Practitioner Felony CS13A30 Possession with Intent to Deliver Felony CS13A35 Illegal Sale of Non-Controlled Substance Felony (i), (ii), (iii) CS13A36 Designer Drugs Felony CS13Axx* Any Other Felony Drug Conviction Appearing Felony on a PA Rap Sheet Attachment #2 – 611.55 Competency Requirements 1) Prior to assigning or referring a direct care worker to provide services to a consumer, the home care agency or home care registry shall ensure that the direct care worker has done one of the following: a. Obtained a valid nurse’s license in this Commonwealth. b. Demonstrated company by passing a competency examination developed by the home care agency or home care registry which meets the requirements of subsections c. Successfully completed one of the following: i. A training program developed by the home care agency or home care registry which meets the requirements of subsections ii. A home health aide training program meeting the requirements of 42 CFR 484.36 (relating to the conditions of participation; home health aide services). iii. The nurse aide certification and training program sponsored by the Department of Education and located at www.pde.state.pa.us. iv. A training program meeting the training standards imposed on the agency or registry by virtue of the agency’s or registry’s participation as a provider in a Medicaid Waiver or other publicly funded program providing home and community-based services to qualifying consumers. v. Another program identified by the Department by subsequent publication in the Pennsylvania Bulletin or on the Department’s website. 2) A competency examination or training program developed by an agency or registry for a direct care worker must address, at a minimum, the following subject areas: a. Confidentiality. b. Consumer control and the independent living philosophy. c. Instrumental activities of daily living. d. Recognizing changes in the consumer that need to be addressed. e. Basic infection control. f. Universal precautions. g. Handling of emergencies. h. Documentation i. Recognizing and reporting abuse or neglect. j. Dealing with difficult behaviors. 3) A competency examination or training program developed by an agency or registry for a direct care worker who will provide personal care must address the following additional subject areas: a. Bathing, shaving, grooming and dressing. b. Hair, skin and mouth care. c. Assistance with ambulation and transferring. d. Meal preparation and feeding. e. Toileting f. Assistance with self-administrated medications. 4) The home care agency or home care registry also shall include documentation in the direct care worker’s file that the agency or home care registry has reviewed the individual’s competency to perform assigned duties through direct observation, testing, training, consumer feedback or other method approved by the Department or through a combination of methods. The competency review must occur at least one per year after initial competency is established, and more frequently when discipline or other sanction including for example a verbal warning or suspension, is imposed because of a quality-of-care infraction. 5) A direct care worker employed by a home care agency or rostered by the home care registry on December 12, 2009, shall achieve compliance with the competency requirements imposed by this chapter by December 12, 2011. Cross References This section cited in 28 Pa. Code § 611.51 (relating to hiring or rostering of direct care workers); and 28 Pa. Code § 611.54 (relating to provisional hiring). No part of the information on this site may be reproduced for profit or sold for profit. This material has been drawn directly from the official Pennsylvania Code full text database. Due to the limitations of HTML or differences in display capabilities of different browsers, this version may differ slightly from the official printed version. Unit Rate \ Provider: Reliable Care USA, Inc. 979 York Street, Suite 1, Hanover, PA 17331 Personal Care Home Support 1 Hour of Service 1 Hour of Service 20.50$ 20.50$ Program/Service Unit Definition Franklin County Area Agency on Aging Contract Rate Sheet Contract Period: March 1, 2026 throught June 30, 2027 Attachment 3 Attachment #4 Business Associate AGREEMENT This Business Associate AGREEMENT (this “AGREEMENT”) is entered into by ReliableCare USA Inc. (“Business Associate”) and Franklin County, Pennsylvania (“Covered Entity”), individually referred to as “Party” and collectively as the “Parties.” This AGREEMENT is effective as of [DATE] (“Effective Date”). RECITALS WHEREAS, Covered Entity is a covered entity under the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”). Covered Entity must comply with the Administrative Simplification Provisions of HIPAA, including the Privacy Rule and Security Rule, as defined in Article 1 of this AGREEMENT, and with the applicable provisions of the Health Information Technology for Economic and Clinical Health Act of 2009 (“HITECH”). WHEREAS, Covered Entity has engaged Business Associate to furnish certain services to Covered Entity pursuant to the Services AGREEMENT, as defined below. WHEREAS, Business Associate is a business associate under HIPAA. Business Associate must comply with the provisions of the Privacy Rule and Security Rule made applicable to business associates pursuant to HITECH and with all other applicable provisions of HITECH. WHEREAS, Covered Entity is not permitted to allow Business Associate to create, receive, maintain, or transmit Protected Health Information on behalf of Covered Entity without satisfactory assurances that Business Associate will appropriately safeguard the information. Therefore, Covered Entity will only disclose Protected Health Information to Business Associate or allow Business Associate to create or receive Protected Health Information on behalf of Covered Entity in accordance with the requirements of HIPAA, HITECH, and provisions of this AGREEMENT. NOW, THEREFORE, in consideration of the mutual promises below and for other good and valuable consideration, the receipt and adequacy of which are hereby acknowledged, the Parties agree as follows: ARTICLE I DEFINITIONS Terms used in this AGREEMENT that are specifically defined in HIPAA shall have the same meaning as set forth in HIPAA. A change to HIPAA which modifies any defined Page 1 of 15 Revised: November 4, 2022 Page 2 of 15 Revised: November 4, 2022 HIPAA term, or which alters the regulatory citation for the definition shall be deemed incorporated into this AGREEMENT. 1.1 Breach means the unauthorized acquisition, access, use, or disclosure of Protected Health Information which compromises the security or privacy of such information, except where an unauthorized person to whom such information is disclosed would not reasonably have been able to retain such information. The term “breach” does not include the exceptions described in 42 U.S.C. § 17921(1)(B) summarized below. (a) Certain uses or disclosures by a Covered Entity’s work-force members (defined as persons acting under the authority of the Covered Entity or Business Associate), if the use or disclosure was made in good faith, was within the scope of the disclosing individual’s authority, and does not result in a further violation of the Privacy Rule. (b) Inadvertent disclosures from one person who is authorized to access PHI to another person who is also authorized to access PHI within the same Covered Entity, Business Associate, or organized health care arrangement when the disclosed PHI is not further used or disclosed in a manner not permitted under the Privacy Rule. (c) A disclosure of PHI when a Covered Entity or Business Associate has a good faith belief that an unauthorized person to whom the disclosure was made would not reasonably have been able to retain such information. 1.2 Designated Record Set, as defined under the Privacy Rule at 45 C.F.R. § 164.501, means a group of records maintained by or for a Covered Entity that are: (a) the medical records and billing records about individuals maintained by or for a covered health care provider; (b) the enrollment, payment, claims adjudication, and case or medical management record systems maintained by or for a health care plan; or (c) used, in whole or in part, by or for the Covered Entity to make decisions about individuals. For purposes of this section, a “Record” is any item, collection, or grouping of information that includes PHI and is maintained, collected, used, or disseminated by or for a Covered Entity. Page 3 of 15 Revised: November 4, 2022 1.3 Electronic Health Record has the same meaning that applies under Section 13400(5) of ARRA and currently means an electronic record of health-related information on an individual that is created, gathered, managed, and consulted by authorized staff. 1.4 Electronic Protected Health Information (EPHI), as defined by 45 C.F.R. § 160.103, means individually identifiable health information that is transmitted by electronic media, or maintained in electronic media, but not certain education and employment records described in 45 C.F.R. § 160.103, the definition of Protected Health Information. EPHI also includes any EPHI provided by Covered Entity or created or received by Business Associate on behalf of Covered Entity. 1.5 HHS means the U.S. Department of Health and Human Services. 1.6 Individual, as defined by 45 C.F.R § 160.103, means the person who is the subject of PHI. It also includes a person who qualifies as a Personal Representative in accordance with 45 C.F.R. § 164.502(g). 1.7 Limited Date Set, as defined by 45 C.F.R. §164.514(e) is partially de- identified data that may be used or disclosed for research, public health and health care operation purposes, such as quality assurance, as long as a recipient signs a data use AGREEMENT that complies with HIPAA requirements. 1.8 Privacy Rule means the Standards for Privacy of individually Identifiable Health Information codified at 45 C.F.R. §§ 160 and 164, Subpart E, any other applicable provision of HIPAA, and any amendments to HIPAA, including HITECH. 1.9 Protected Health Information (PHI) as defined by 45 C.F.R. § 164.103, mean individually identifiable health information that is: (a) transmitted by electronic media; (b) maintained in electronic media; or (c) transmitted or maintained in any other form or medium; PHI does not include certain education and employment records described in 45 C.F.R. § 160.103, the definition of PHI. PHI includes, without limitation, any PHI provided by Covered Entity or created or received by Business Associate on behalf of Covered Entity. Unless otherwise stated in this AGREEMENT, any provision, restriction, or obligation in this AGREEMENT related to the use of PHI shall apply equally to EPHI. Page 4 of 15 Revised: November 4, 2022 1.10 Required By Law, as defined by 45 C.F.R. § 164.103, means a mandate contained in law that compels an entity to make a use or disclosure of PHI and that is enforceable in a court of law; and any additional requirements created under HITECH. 1.11 Secretary means the Secretary of the Department of Health and Human Services or his/her designee. 1.12 Security Incident, as defined by 45 C.F.R. § 164.304, means the attempted or successful unauthorized access, use, disclosure, modification, or destruction of information or interference with system operations in an information system. 1.13 Security Rule means the Security Standards for the Protection of Electronic Protected Health Information codified at 45 C.F.R. §§ 160 and 164, Subpart C, any other applicable provision of HIPAA, and any amendments to HIPAA, including HITECH. 1.14 Services AGREEMENT means the underlying AGREEMENT(s) that outline the terms of the services that Business Associate agrees to provide to Covered Entity and that fall within the functions, activities or services described in the definition of Business Associate at 45 C.F.R. § 160.103. 1.15 Unsecured PHI shall mean PHI that is not rendered unusable, unreadable, or indecipherable to unauthorized individuals through the use of a technology or methodology specified by the Secretary of HHS, such as encryption in compliance with the National Institute of Standards and Technology standards or destruction. ARTICLE II BUSINESS ASSOCIATE OBLIGATIONS 2.1 Request, Use and Disclosure of PHI. Business Associate agrees that it will only request, use and disclose PHI in accordance with the terms of this AGREEMENT, and as is Required by Law. Business Associate acknowledges that it may only request, use and disclose PHI obtained or created pursuant to this AGREEMENT with Covered Entity if the request, use or disclosure is in compliance with each applicable requirement of the Privacy Rule found in 45 C.F.R. § 164.504(e). 2.2 Permitted Requests, Uses and Disclosures. Business Associate will not request, use or disclose PHI except for the purpose of performing Business Associate’s obligations to Covered Entity as described in the Services AGREEMENT, consistent with the requirements of HIPAA and this AGREEMENT, and for other uses and disclosures permitted under this AGREEMENT. Business Associate may request, use or disclose PHI only if such request, use or disclosure does not violate the Privacy Rule or this Page 5 of 15 Revised: November 4, 2022 AGREEMENT. To the extent Business Associate is to carry out any of Covered Entity’s obligations under the Privacy Rule, Business Associate will comply with the requirements of the Privacy Rule that apply to Covered Entity in the performance of the applicable obligations. In accordance with the provisions of 45 C.F.R. § 164.504(e)(4), Business Associate also may request, use or disclose PHI, if necessary: (a) for the proper management and administration of Business Associate’s organization, or (b) to carry out the legal responsibilities of Business Associate. Business Associate may only disclose PHI for these purposes, in accordance with the provisions of 45 C.F.R. § 164.504(e)(4)(ii), if either (i) the disclosure is Required By Law, or (ii) Business Associate obtains reasonable written assurances from the person to whom Business Associate discloses the PHI that the PHI will be held confidentially and used or further disclosed only as Required By Law or for the purposes for which it was disclosed to the person and that the person agrees to notify Business Associate of any instances of which it is aware in which the confidentiality of the information has been breached. 2.3 Prohibited Requests, Use and Disclosures. Business Associate will not request, use or disclose PHI in any manner that constitutes a violation of the Privacy Rule, this AGREEMENT, or the Services AGREEMENT. 2.4 Minimum Requirements. Business Associate will only request, use and disclose the minimum amount of PHI necessary for Business Associate to perform the services for which it has been retained by Covered Entity, in accordance with 42 U.S.C. § 17935(b). Business Associate agrees to comply with the Secretary’s guidance on what constitutes minimum necessary. 2.5 Administrative, Physical and Technical Safeguards. Business Associate will develop, implement, maintain, and use appropriate safeguards to prevent any use or disclosure of the PHI other than as provided by this AGREEMENT. Business Associate will implement administrative, physical, and technical safeguards that reasonably and appropriately protect the confidentiality, integrity and availability of EPHI. Business Associate acknowledges that the Security Rule provisions regarding administrative, physical, and technical safeguards, policies and procedures and documentation Page 6 of 15 Revised: November 4, 2022 requirements found in 45 C.F.R. §§ 164.308, 164.310, 164.312 and 164.316 apply to Business Associate in the same manner as to Covered Entity and Business Associate will fully comply with such Security Rule provisions. 2.6 Unusable, Unreadable or Indecipherable Technology. Business Associate will, to the extent feasible, adopt a technology or methodology specified by the Secretary pursuant to 42 U.S.C. § 17932(h) that renders PHI unusable, unreadable, or indecipherable to unauthorized individuals. 2.7 Agents and Sub-contractors. Prior to making any permitted disclosures, Business Associate will ensure that any of its agents, including subcontractors, to whom it provides PHI received from, or created or received by, Business Associate on behalf of Covered Entity agree in writing to be bound by the same privacy and security restrictions and conditions that apply to Business Associate under this AGREEMENT, including but not limited to those conditions relating to termination of the contract for improper disclosure. Further, Business Associate shall implement and maintain sanctions against agents and subcontractors, if any, that violate such restrictions and conditions. Business Associate shall terminate any AGREEMENT with an agent or subcontractor, if any, who fails to abide by such restrictions and obligations. Business Associate shall not provide any PHI to any third party or subcontract any services described in the Services AGREEMENT without Covered Entity’s express written permission. 2.8 Reporting Obligations. Business Associate will report, in writing, to Covered Entity any use or disclosure of PHI that is not authorized by this AGREEMENT, including Breaches of Unsecured PHI. In addition, Business Associate will report in writing, to Covered Entity any Security Incident of which it becomes aware that it, its employees, or its agents or subcontractors experience involving or potentially involving Covered Entity EPHI. The written notice shall be provided to Covered Entity within five (5) business days of becoming aware of the non-authorized use or disclosure or Security Incident. 2.9 Notification to Covered Entity of Breach of Unsecured PHI. Business Associate will provide written notification to Covered Entity within seventy-two (72) hours of discovering a Breach of Unsecured PHI. Such notification will identify, to the extent possible, (1) each individual whose Unsecured Protected Health Information has been, or is reasonably believed by Business Associate to have been, accessed, acquired or disclosed during the Breach, (2) the nature of the non-permitted access, use or disclosure, including the date of the Breach and the date of discovery of the Breach; (3) Protected Health Information accessed, used or disclosed as part of the Breach (e.g., full name, social security number, date of birth, etc.); (4) who or what area of Business Associate’s operation made the non-permitted access, use or disclosure and who received the non-permitted disclosure; (5) identify what corrective action the Business Associate took or will take to prevent further non-permitted accesses, uses or Page 7 of 15 Revised: November 4, 2022 disclosures; (6) identify what Business Associate did or will do to mitigate any deleterious effect of the non-permitted access, use or disclosure; and (7) provide such other information that is reasonably available to Business Associate that Covered Entity may request. For purposes of the preceding sentence, Business Associate will be treated as discovering the Breach on the first day on which the Breach is known (or by exercising reasonable diligence should have been known) to Business Associate (including any employee, officer or other agent of Business Associate other than the person committing the Breach). Whether a Breach has occurred will be determined in accordance with applicable regulations or other authoritative guidance issued pursuant to the HITECH Act. A delay in notification of a Breach that qualifies as a “law enforcement delay” under 45 CFR Section 164.412 will not be treated as a violation of this AGREEMENT. Business Associate will supplement its initial notification to Covered Entity with additional information as any additional information becomes available. Business Associate will implement a reasonable system for discovery of Breaches. 2.10 Breach Notification Expenses. Business Associate agrees to indemnify, defend, and hold harmless Covered Entity and its employees, agents, and representatives from any and all direct, reasonable and actual costs, settlements, judgments, and expenses incurred by Covered Entity caused by a Breach of Unsecured Protected Health Information while in the possession of Business Associate, or its employees, subcontractors or agents. Such costs will include those related to Breach notifications sent to the affected individuals and the media, as required by Section 13402(e) of ARRA and 45 CFR Part 164, and any costs incurred by Covered Entity or its employees, agents or representatives to mitigate potential harm to individuals from the Breach. 2.11 Notification to Covered Entity of Use or Disclosure Data. Business Associate will notify Covered Entity in writing of any actual or suspected use or disclosure of data in violation of any applicable federal or state laws or regulations or any legal action against Business Associate arising from an alleged HIPAA violation. Business Associate shall take: (i) prompt action to correct any such deficiencies; and (ii) any action pertaining to such unauthorized disclosure required by applicable federal and state laws and regulations. Business Associate will provide the written notice to Covered Entity within five (5) business days of becoming aware of the violation or legal action. 2.12 Mitigation of Harmful Effect. Business Associate agrees to mitigate, to the extent practicable, any harmful effect that is known to Business Associate of a use or Page 8 of 15 Revised: November 4, 2022 disclosure of PHI by Business Associate in violation of the requirements of this AGREEMENT 2.13 Designated Record Sets. Business Associate will make PHI in Designated Record Sets that are maintained by Business Associate or its agents or subcontractors, if any, available to Covered Entity or to an individual for inspection and copying within ten (10) business days of a request by Covered Entity to enable Covered Entity to fulfill its obligations under the Privacy Rule, including, but not limited to the requirements concerning access to individuals to PHI found at 45 C.F.R. § 164.524. If Business Associate maintains Protected Health information in the form of an Electronic Health Record for any individual, Business Associate agrees to provide, at the request of Covered Entity or an individual, and in the time and manner designated by Covered Entity, a copy of such information in an electronic format to that individual or, if clearly, conspicuously and specifically directed by the individual (or by Covered Entity based on a clear, conspicuous and specific request of the individual) to transmit an electronic copy of that information directly to an entity or person designated by the individual. Any fee charged to the individual for providing such information (or a summary or explanation of such information) may not exceed Business Associate’s labor costs incurred in responding to the individual’s request. 2.14 Amendments to PHI and EPHI. Within ten (10) business days of receipt of a request from Covered Entity for an amendment of PHI or a record about an individual contained in a Designated Record Set, Business Associate or its agents or subcontractors, if any, shall make such PHI available to Covered Entity for amendment and shall incorporate any such amendment to enable Covered Entity to fulfill its obligations under the Privacy Rule, including, but not limited to, 45 C.F.R. § 164.526. If an individual requests an amendment of PHI directly from Business Associate or its agents or subcontractors, if any, Business Associate must notify Covered Entity in writing within five (5) business days of the request. Any denial of amendment of PHI maintained by Business Associate or its agents or subcontractors, if any, shall be the responsibility of Covered Entity. Upon the approval of Covered Entity, Business Associate shall appropriately amend the PHI maintained by it, or any agents or subcontractors. 2.15 Accounting of PHI and EPHI. Within ten (10) business days of notice by Covered Entity of a request for an accounting of disclosures of PHI, Business Associate and any agents or subcontractors shall make available to Covered Entity the information required to provide an accounting of disclosures to enable Covered Entity to fulfill its obligations under the Privacy Rule, including, but not limited to, 45 C.F.R. § 164.528 and any additional information required under the HITECH Act, including Section 13405(c) if Business Associate maintains information in the form of an Electronic Health Record, and any implementing regulations. Page 9 of 15 Revised: November 4, 2022 (a) If a request for an accounting is made directly to Business Associate or its agents or subcontractors, Business Associate will notify Covered Entity of the request within five (5) business days of having received the request. Covered Entity shall either inform Business Associate to provide the requested information directly to the individual or request Business Associate to immediately forward the information to the Covered Entity for compilation and distribution to the individual. (b) In the case of a direct request for an accounting from an individual related to treatment, payment or health care operations disclosures through Electronic Health Records, Business Associate will provide the accounting to the individual in accordance with 42 U.S.C. § 17935(c) and any regulations adopted subsequent to this AGREEMENT. Business Associate will confirm with Covered Entity that Covered Entity provided Business Associate’s name to the individual in response to a request for an accounting before providing the requested accounting to the individual. 2.16 Retention of Accounting Documentation. Notwithstanding termination of this AGREEMENT, Business Associate and any of its agents or subcontractors shall continue to maintain the information required for purposes of complying with this Section 2.14 for a period of six (6) years after termination of the AGREEMENT. 2.17 Business Associate’s Compliance with HHS. Business Associate will make its internal practices, books and records relating to the use and disclosure of PHI available to the Secretary of HHS in the time and manner designated by the Covered Entity or the Secretary of HHS for purposes of determining Covered Entity’s compliance with the Privacy Rule. Business Associate will notify Covered Entity regarding any PHI that Business Associate provides to the Secretary of HHS concurrently with providing the requested PHI to the Secretary of HHS. Upon request by Covered Entity, Business Associate will provide Covered Entity with a duplicate copy of the requested PHI. 2.18 Inspection by Covered Entity. Within five (5) business days of a written request by Covered Entity, Business Associate and its agents or subcontractors, if any, shall allow Covered Entity to conduct a reasonable inspection of the facilities, systems, books, records, AGREEMENTs, policies and procedures relating to the use or disclosure of PHI pursuant to this AGREEMENT for the purpose of determining whether Business Associate has complied with this AGREEMENT, the Security Rule and provisions of the Privacy Rule directly applicable to Business Associate or as deemed necessary by Covered Entity to determine whether a Breach has occurred. Both Parties agree to the following: Page 10 of 15 Revised: November 4, 2022 (a) Business Associate will cooperate with Covered Entity’s risk assessment without unreasonable delay; (b) Business Associate and Covered Entity will mutually agree in advance upon the scope, location and timing of such an inspection; and (c) Covered Entity will protect the confidentiality of all confidential and proprietary information of Business Associate to which Covered Entity has access during the course of such inspection. 2.19 Damages. Business Associate shall be responsible to compensate the affected individual for any reasonable damages as a result of a Breach caused by Business Associate. 2.20 No Ownership Rights. Business Associate agrees that Business Associate does not and will not have any ownership rights in any of the PHI. 2.21 Additional HITECH Requirements. The additional requirements of Title XIII of HITECH that relate to privacy and security and that are made applicable with respect to covered entities are also applicable to Business Associate and by this reference these requirements are hereby incorporated into this AGREEMENT. 2.22 Standard Transactions. In conducting any standard transaction that is subject to the Standard Transaction Regulations (set forth in 45 C.F.R. Part 162) on behalf of Covered Entity, Business Associate agrees to comply with all requirements of the Standard Transaction Regulations that would apply to Covered Entity if Covered Entity were conducting the transaction itself and shall require the same of any subcontractor or agent involved with the conducts of such Standard Transactions. 2.23 Limitations on Marketing. Business Associate may not use and disclose PHI for “marketing,” as defined in 45 C.F.R. § 164.501, unless expressly permitted to do so in the Services AGREEMENT. 2.24 Sale of PHI. Except for compensation set forth in the Services AGREEMENT between Business Associate and Covered Entity, Business Associate shall not receive any direct or indirect remuneration in exchange for the provision of Protected Health Information. Page 11 of 15 Revised: November 4, 2022 ARTICLE III COVERED ENTITY OBLIGATIONS 3.1 Risk Assessment of Breach by Covered Entity. Covered Entity shall make the final determination of whether for a Breach of PHI occurred. 3.2 Restrictions. Covered Entity shall notify Business Associate of any restriction to the use or disclosure of PHI that Covered Entity has agreed to or must comply with in accordance with 45 C.F.R. § 164.522 and 42 U.S.C. § 17935(a). 3.3 Notification of Changes or Revocations of Permission . Covered Entity shall provide Business Associate with notice of any changes to, revocation of, or permission by individual to use or disclose PHI, if such changes affect Business Associate’s permitted uses or disclosures, within a reasonable period of time after Covered Entity becomes aware of such changes to or revocation of permission. 3.4 Permissible Requests by Covered Entity. Covered Entity shall not request Business Associate to use or disclose PHI in any manner that would not be permissible under the Privacy and Security Rules if done by Covered Entity. ARTICLE IV TERMINATION 4.1 Term and Survival. The term of this AGREEMENT shall be effective as of the Effective Date of this AGREEMENT and continue until terminated by Covered Entity or any underlying Services AGREEMENT expires or is terminated. Any provision related to the use, disclosure, access, or protection of PHI or EPHI or that by its terms shall survive termination of this AGREEMENT shall survive termination. 4.2 Termination for Breach. A material breach by Business Associate, or its agents or subcontractors, if any, of this AGREEMENT, as determined by Covered Entity, shall constitute a material breach of the Services AGREEMENT. As provided for under 45 C.F.R. §§ 164.314(a)(2)(i)(D) and 164.504(e)(2)(iii), the Covered Entity may immediately terminate this AGREEMENT and the Services AGREEMENT or, alternatively, the Covered Entity may choose to provide Business Associate with written notice of the material breach and an opportunity to cure the material breach or end the violation within thirty (30) calendar days. If Business Associate becomes aware of a material breach of this AGREEMENT by Covered Entity, Business Associate shall (1) provide an opportunity for Covered Entity to cure the breach or end the violation and terminate this AGREEMENT (and any applicable portion of the Services AGREEMENT between the parties) if Covered Entity does not cure the breach or end the violation within thirty (30) calendar days, or (2) immediately terminate this AGREEMENT (and any applicable portion of the Services AGREEMENT ) if Covered Entity has breached a material term of this AGREEMENT and cure is not possible. Page 12 of 15 Revised: November 4, 2022 4.3 Termination for Violation by Business Associate . Covered Entity may terminate this AGREEMENT and the Services AGREEMENT effective immediately, if (i) Business Associate is named as a defendant in a criminal proceeding for a violation of HIPAA, HITECH, or other security or privacy laws or (ii) there is a finding or stipulation that Business Associate has violated any standard or requirement of HIPAA, HITECH, or other security or privacy laws in any administrative or civil proceeding in which Business Associate is involved. 4.4 Return or Destruction of PHI. (a) Upon termination of this AGREEMENT for any reason, Business Associate shall return or, at Covered Entity’s request, destroy all PHI received from Covered Entity or created or received by Business Associate on behalf of Covered Entity that Business Associate still maintains in any form. If Business Associate destroys the PHI, Business Associate shall certify in writing to Covered Entity that such PHI has been destroyed. This provision applies to PHI that is in the possession of agents or subcontractors of Business Associate. Business Associate will retain no copies of the PHI. (b) If Business Associate determines that returning or destroying the PHI is not feasible, Business Associate shall explain to Covered Entity why conditions make the return or destruction of the PHI not feasible. If Covered Entity agrees that the return or destruction of PHI is not feasible, Business Associate will retain the PHI, subject to all of the protections of this AGREEMENT, and limit further uses and disclosures of the PHI to those purposes that make the return or destruction of the PHI infeasible for so long as Business Associate maintains the PHI. (c) If Business Associate determines that it is infeasible to obtain from an agent or subcontractor any PHI in the possession of the agent or subcontractor or to destroy the PHI, Business Associate will provide Covered Entity written notification explaining why obtaining the PHI is infeasible. If Covered Entity agrees that the return or destruction of PHI is not feasible, Business Associate will require the agent or subcontractor to extend the protections of this AGREEMENT to the PHI and limit further uses and disclosures of the PHI to those purposes that make the return or destruction of the PHI infeasible for so long as the agent or subcontractor maintains the PHI. 4.5 Termination of Services AGREEMENT. If this AGREEMENT is terminated for any reason, Covered Entity will also terminate the Services AGREEMENT between the Page 13 of 15 Revised: November 4, 2022 Parties. This provision shall supersede any termination provision to the contrary which may be set forth in the Services AGREEMENT. ARTICLE V MISCELLANEOUS 5.1 Acknowledgement. By affixing their respective signatures below, the Parties certify that they have read and understand each and every provision in this AGREEMENT. Each Party certifies that it possesses the authority to enter into the AGREEMENT. The execution and performance of this AGREEMENT by each Party has been duly authorized by all necessary laws, resolutions or corporate actions, and the AGREEMENT constitutes valid and enforceable obligations of each Party in accordance with its terms. 5.2 Amendment. This AGREEMENT shall not be amended, altered, or modified, except by an instrument in writing duly executed by the Parties to the AGREEMENT. 5.3 Assignment. This AGREEMENT may not be assigned by Business Associate without the prior written consent of Covered Entity. 5.4 Binding Effect. Subject to provisions hereof restricting assignment, this AGREEMENT shall be binding upon and shall inure to the benefit of the Parties and their respective successors and permitted assigns. 5.5 Change in Law. The Parties agree to take such action as is necessary to amend this AGREEMENT from time to time as is necessary for Covered Entity and Business Associate to comply with the requirements of HIPAA and the HITECH Act, and of the regulations issued pursuant to those laws. If Covered Entity reasonably concludes that an amendment to this AGREEMENT is needed because of change in federal or state law or changing industry standards, Covered Entity shall notify Business Associate of such proposed modification(s), “Legally-Required Modifications”. Such Legally Required Modifications shall be deemed accepted by Business Associate and this AGREEMENT so amended, if Business Associate does not, within thirty (30) calendar days following the date of notice, or within such other time period as may be mandated by applicable state or federal law, deliver to Covered Entity its written rejection of such Legally-Required Modifications. 5.6 Compliance with Laws. Business Associate will comply with all applicable federal and state security and privacy laws, to the extent that such laws apply to Business Associate or are more protective of individual privacy than HIPAA. 5.7 Entire AGREEMENT. This AGREEMENT, including attachments, constitutes the entire AGREEMENT between the Parties with respect to the subject matter hereof, and it Page 14 of 15 Revised: November 4, 2022 supersedes all prior oral or written AGREEMENTs, commitments, or understandings with respect to the matters provided for herein. 5.8 Execution. This AGREEMENT and any amendments thereto shall be executed in duplicate copies on behalf of the Parties by an official of each, specifically authorized by its respective Party to perform such executions. Each duplicate copy shall be deemed an original, but both duplicate originals together constitute one and the same instrument. 5.9 Indemnification by Business Associate. Business Associate and any of its subcontractors and agents shall indemnify, hold harmless and defend Covered Entity and its employees, officers, directors, agents, and contractors from and against any and all claims, losses, liabilities, costs, attorneys’ fees, and other expenses incurred as a result of or arising directly or indirectly out of or in connection with Business Associate’s or its subcontractors’ or agents’ breach of this AGREEMENT, violation of HIPAA, HITECH or other applicable law, or otherwise related to the acts or omissions of Business Associate or its subcontractors or agents. 5.10 Independent Contractors. This AGREEMENT establishes an independent contractor relationship between Covered Entity and Business Associate. Nothing in this AGREEMENT is intended, nor may anything be construed, to create a partner, joint venture employer/employee, or agent relationship. 5.11 Limitations on Benefits of this AGREEMENT. Nothing express or implied in this AGREEMENT is intended to confer, nor shall anything herein confer, upon any person other than Covered Entity, Business Associate, or their respective successors or assigns, any rights, remedies, obligations or liabilities whatsoever. It is the express intent of the Parties that no person or entity other than the Parties shall be entitled to bring any action to enforce any provision of this AGREEMENT against either of the Parties, and that the AGREEMENT set forth shall be solely for the benefit of, and shall be enforceable only by, the Parties to this AGREEMENT or their respective successors and assigns as permitted hereunder. 5.12 Notices. All notices which are required or permitted to be given pursuant to this AGREEMENT shall be in writing and shall be sufficient in all respects if delivered personally, by electronic facsimile (with a confirmation by registered or certified mail placed in the mail no later than the following day), or by registered or certified mail, postage prepaid, addressed to a Party as indicated below: If to Business Associate: If to Covered Entity, to: ReliableCare USA Inc. County of Franklin 979 York Street, Suite 1 272 North Second Street Hanover, PA 17331 Chambersburg, PA 17201 Notice shall be deemed to have been given upon transmittal thereof as to communications which are personally delivered or transmitted by electronic facsimile and, as to communications made by United States mail, on the third (3rd) day after mailing. The above addresses may be changed by giving notice of such change in the manner provided above for giving notice. 5.13 References. A reference in this AGREEMENT to a section in the Privacy Rule or Security Rule means the section as in effect or as amended at the time of reference and as interpreted pursuant to any applicable guidance provided by the Secretary or other responsible regulatory authority and any applicable case law. 5.14 Severability. If any part of any provision of this AGREEMENT, or any other AGREEMENT, document or writing given pursuant to or in connection with this AGREEMENT, shall be held invalid or unenforceable, the holding of invalidity or unenforceability will apply to the invalid or unenforceable part of the provision only, without in any way affecting the remaining parts of said provision or the remaining provisions of said AGREEMENT. 5.15 Sub-Contract. Business Associate may not sub-contract any services under the Services AGREEMENT without the express written consent of Covered Entity. 5.16 Waiver. Neither the waiver by either Party of a breach of or a default under any of the provisions of this AGREEMENT, nor the failure of either of the Parties, on one or more occasions, to enforce any of the provisions of this AGREEMENT or to exercise any rights or privilege hereunder shall thereafter be construed as a waiver of any subsequent breach or default of a similar nature, or as a waiver of any such provisions, rights or privileges hereunder. 5.17 Interpretation. Any ambiguity in this AGREEMENT shall be resolved in favor of a meaning that permits Covered Entity to comply with applicable requirements of HIPAA HITECH Act, the Privacy Rule and the Security Rule. Any conflict between a provision of the Services AGREEMENT and this AGREEMENT regarding the subject matter of this AGREEMENT, shall be resolved in favor of this AGREEMENT IN WITNESS WHEREOF, the parties have caused this AGREEMENT to be executed by their respective duly authorized representatives as of the dates set forth below. BUSINESS ASSOCIATE COVERED ENTITY By: By: Name: Name: Title: Title: Sarah Rutledge (Feb 13, 2026 10:26:41 EST)   ()*) Sarah Rutledge