SERVICE SCHEDULE FOR EDUCATION BASED REHABILITATION ASSESSMENT SERVICE CONTRACT NO: EBRASXXXX A. QUICK REFERENCE INFORMATION 1. TERM FOR PROVIDING EDUCATION BASED REHABILITATION ASSESSMENT SERVICE The Term for the provision of Education Based Rehabilitation Assessment Service is the period from 1 December 2017 ( Start Date ) until the close of 30 November 2020 ( End Date ) or such earlier date upon which the period is lawfully terminated or cancelled. Prior to the End Date, the parties may agree in writing to extend the Term of this Service Schedule for two further terms of two years each. Any decision to extend the Term of this Service Schedule will be based on: 1.1.1. The parties reaching agreement on the extension in writing prior to the End Date; and 1.1.2. ACC being satisfied with the performance of the Services by the Supplier; and 1.1.3. All other provisions of this Service Schedule either continue to apply during such extended Term or are re-negotiated to the satisfaction of both parties. There is no obligation on the part of ACC to extend the Term of the Service Schedule, even if the Supplier has satisfactorily performed all the Services. 2. NAMED SERVICE PROVIDERS (Part B, clause 7.9 7.10) Table 1 Named Service Providers First Name Surname ACC Provider Number Professional Qualification Service Region / TLA Coverage 3. SERVICE LOCATION AND SPECIFIED AREA (Part B, clause 4) XXXX 4. SERVICE ITEMS AND PRICES (Part B, clause 15) Table 2 - Service Items and Prices Service Item Code ES03 Service Item Description Education Based Rehabilitation Assessment or Reassessment Allied Health Service Item Definition Comprehensive Education Based Rehabilitation Assessment completed by a Speech-Language Therapist, Physiotherapist or Occupational Therapist that Price (excl GST) Pricing Unit $667.92 Set fee per Assessment
Service Item Code Service Item Description Service Item Definition Price (excl GST) Pricing Unit Professional determines the Client s Education Support needs and resulting options for addressing these needs. In accordance with Part B, clause 5. ES05 Education Based Rehabilitation Assessment or Reassessment - Psychologist Comprehensive Education Based Rehabilitation Assessment completed by a Registered Psychologist that determines the Client s Education Support needs and resulting options for addressing these needs. $939.87 Set fee per Assessment In accordance with Part B, clause 5. ES06 Education Based Rehabilitation Assessment case conference Allied Health Professional Where requested by ACC, the Named Service Provider will attend/facilitate a case conference to discuss the Assessment and/or advice to ACC. In accordance with Part B, clause 5.7. $111.32 Set fee, one per referral ES07 Education Based Rehabilitation Assessment case conference - Psychologist Where requested by ACC, the Named Service Provider will attend/facilitate a case conference to discuss the Assessment and /or advice to ACC. $156.64 Set fee, one per referral In accordance with Part B, clause 5.7. ES01 Complex Assessment Top Up - Allied Health Professional Where the Assessment is deemed to be Complex (through completion of the Complexity Framework Tool). In accordance with Part B, clause 5.3. $111.32 Per hour or part thereof. Maximum of 2 hours per referral ES10 Complex Assessment Top Up - Psychologist Where the Assessment is deemed to be Complex (through completion of the Complexity Framework Tool). In accordance with Part B, clause 5.3. $156.64 Per hour or part thereof. Maximum of 2 hours per referral EST6 All Other Travel Costs for return travel by ferry, taxi, rental car, public transport and parking when: return travel is via the most direct, practicable route; and the return travel exceeds 20km Actual and reasonable cost Per trip
Service Item Code Service Item Description Service Item Definition Price (excl GST) Pricing Unit Note 1: where the Supplier has no base or facility in the Service provision area return travel will be calculated between the start point and end point closest to the Client as agreed by ACC Note 2: ACC will only pay for actual and reasonable costs and receipts must be retained and produced if requested by ACC. If more than one client (ACC and/or non-acc) receives services then invoicing is on a pro-rata basis ESTA1 Air Travel Air travel when a Service Provider is: requested by ACC to travel to an outlying area that is not the Service Provider s usual area of residence or practice to deliver Services; and air travel is necessary and has been approved by ACC. Note: ACC will only pay for actual and reasonable costs and receipts must be retained and produced if requested by ACC. If more than one client (ACC and/or non-acc) receives services then invoicing is on a pro-rata basis. Actual and reasonable cost Per trip ESTD10 Travel Distance A contribution towards travel: for return travel via the most direct, practicable route; and where the return travel exceeds 20km Note 1: where the Supplier has no base or facility in the Service provision area return travel will be calculated between the start point and end point closest to the Client as agreed by ACC) Note 2: ACC does not pay for the first 20km of travel and this must be deducted from the total distance travelled. If travel includes more than one client (ACC and/or non-acc) then invoicing is on a pro-rata basis. $0.62 Per Kilometre
Service Item Code Service Item Description Service Item Definition Price (excl GST) Pricing Unit ESTT5 Travel Time first hour Paid for the first 60 minutes (or less) of total travel in a day where: the travel is necessary; and the Service Provider travels via the most direct, practicable route between their base/facility and where the services are provided; and $55.66 (Allied Health Professional) $78.32 (Psychologist) Actual travel time per hour or part thereof for the first hour. the distance the Service Provider travels exceeds 20km return; and/or the time the Service Provider travels exceeds 30 minutes Note 1: where the Supplier has no base or facility in the Service provision area return travel will be calculated between the start point and end point closest to the Client as agreed by ACC; Note 2: If travel includes more than one client (ACC and/or non- ACC) then invoicing is on a prorata basis. ESTT1 Travel Time subsequent hours Paid for return travel time after the first 60 minutes in a day paid under ESTT5, where: the travel is necessary; and $111.32 (Allied Health Professional) Actual travel time per hour or part thereof. the Service Provider travels via the most direct, practicable route available between their base/facility and where the services are provided; and $156.64 (Psychologist) additional travel time is required after the first hour of travel; Note 1: where the Supplier has no base or facility in the Service provision area return travel will be calculated between the start point and end point closest to the Client as agreed by ACC. Note 2: the first 60 minutes must be deducted from the total travel time and if travel includes more than one client (ACC and/or non- ACC) then invoicing is on a prorata basis
Service Item Code Service Item Description Service Item Definition ESAC Accommodation Payable when an Assessor has been requested by ACC to complete an assessment in an outlying area that is not the Assessor s usual area of residence or practice and overnight accommodation is necessary. ACC will pay actual and reasonable accommodation costs of up to a maximum of $225.00 plus GST per day with prior ACC Coordinator approval and receipts provided. Hotels Maximum of $150.00 + GST per night Meal and Incidental Allowances Actual and reasonable up to the following maximums $75.00 + GST per 24 hour period where overnight stay is required. No reimbursement for alcohol, including mini-bar expenses. Price (excl GST) Actual and reasonable cost Pricing Unit Per night Max Price Review ACC will review pricing when, at ACC s sole discretion, we consider a review necessary. The factors ACC may take into account during a review include, but are not limited to: general inflation changes in service component costs substantial changes in the market If ACC finds that the factors we take into account have not had a significant impact on price, the prices will remain unchanged. If ACC provides a price increase, the supplier must agree any adjustment in writing. The price increase will take effect from a date specified by ACC. 5. RELATIONSHIP MANAGEMENT Table 3 - Relationship Management Level ACC Supplier Frequency Client ACC Client Service Staff Individual staff or As required operational contact Branch Branch Manager Operational contact As required Region Designated Supplier Manager Operational contact As required, at least annually Account Management Portfolio Manager Operational contact, contract holder As required, at least annually
6. ADDRESSES FOR NOTICES (Standard Terms and Conditions, clause 23) NOTICES FOR ACC TO: ACC Health Procurement Justice Centre 19 Aitken Street Wellington 6011 P O Box 242 Wellington 6140 Marked: Attention: Health Procurement Phone: 0800 400 503 Email: health.procurement@acc.co.nz (for delivery) (for mail) NOTICES FOR SUPPLIER TO: (insert street address including postcode) (insert postal address including postcode) Marked: Attention (contact person) Phone: Mobile: Fax: Email: (for delivery) (for mail)
TABLE OF CONTENTS 1. PURPOSE... 8 2. SERVICE OBJECTIVES... 8 3. SERVICE COMMENCEMENT... 8 4. SERVICE LOCATION and specified area... 9 5. SERVICE REQUIREMENTS... 9 6. TIMEFRAMES... 10 7. SERVICE SPECIFIC QUALITY REQUIREMENTS... 11 8. SERVICE EXIT... 13 9. EXCLUSIONS... 13 10. LINKAGES... 13 11. PERFORMANCE REQUIREMENTS... 13 12. REPORTING REQUIREMENTS... 14 13. OPERATIONAL CONTACT... 14 14. RELATIONSHIP MANAGEMENT... 14 15. PAYMENT AND INVOICING... 15 16. DEFINITIONS AND INTERPRETATION... 15 17. APPENDIX 1 COMPETENCY FRAMEWORK... 15
B. SERVICE SPECIFICATIONS FOR EDUCATION BASED REHABILITATION ASSESSMENT 1. PURPOSE 1.1. ACC wishes to purchase Education Based Rehabilitation Assessment Services ( the Services ) for Clients, aged 21 or under, who are undertaking Early Childhood, primary, intermediate or secondary level education and require injury related support. 2. SERVICE OBJECTIVES 2.1. ACC will measure the success of this service based on the following objectives: 2.1.1. Clients receive a specialised Education Based Rehabilitation Assessment or Reassessment within the timeframes set out in Clause 6.1 that includes: 2.1.1.1. Completion of a comprehensive Assessment that provides sufficient evidenced-based and substantiated information to enable ACC to make a decision as to the nature and extent of ACC funded services and supports; 2.1.1.2. Identification of the injury related needs and resulting options for the Client to develop or maintain engagement in education that are consistent with their rehabilitation and participatory goals as documented in their Individual Rehabilitation Plan or Serious Injury Individual Support Plan; 2.1.1.3. Completion of an assessment report using the ACC345 Education based rehabilitation assessment report template that identifies the Client s injury related education support needs and advises a range of options for ACC to consider to address these needs. 3. SERVICE COMMENCEMENT 3.1. Eligibility Criteria 3.1.1. A Client is eligible for this Service if they are aged 21 or under and meet one of the following criteria: 3.1.1.1. Attend a licensed early childhood centre (including home-based care) or primary, intermediate or high school; 3.1.1.2. Are exempt from enrolling at school and are home-schooled under section 21 or 22a of the Education Act 1989, or under section 26 but not subsection (1)(b)(iii); 3.1.1.3. Are being taught at home while enrolled at Te Aho o Te Kura Pounamu, the Correspondence School; AND 3.1.1.4. they are referred to the Service by ACC in accordance with clause 3.2. 3.2. Referral process 3.2.1. ACC will provide the Supplier with referral information on the ACC081 referral form. At a minimum, the referral will contain the following information: 3.2.1.1. The Client s name, contact details, claim number, demographic details and a description of their injury; 3.2.1.2. The reason for the referral based on the Client s identified needs and goals; 3.2.1.3. The Client s current and /or intended educational facility;
3.2.1.4. Where relevant, attendance records, most recent Individual Education Programme, most recent school report, print out of results of any standardised assessments; 3.2.1.5. Any previous Assessment or medical reports relevant to the current circumstances; 3.2.1.6. Any known risks associated with providing Services to the Client. 3.2.2. For Clients requiring an Education Based Rehabilitation Assessment as a result of a sensitive claim, the Supplier will ensure the requirements of clause 7.6 are met. 3.2.3. The Supplier must return any referral to ACC if it contains inadequate information and request further details before accepting the referral. 3.2.4. Upon receipt of a Referral, the Supplier will: 3.2.4.1. Notify the ACC referrer within one Business Day that the referral has been accepted; and 3.2.4.2. Contact the Client, their family/whanau or caregiver and the Client s Educational Facility within two School Days to: Explain the assessment process; Answer any questions; Confirm whether the Client requires a support person; and, Arrange a suitable time to undertake the Assessment. 4. SERVICE LOCATION AND SPECIFIED AREA 4.1. The Services will be provided at the following locations: 4.1.1. At the Client s Educational Facility; or, 4.1.2. Another location in the local area as agreed between the Client, their family/whanau and/or caregiver and the Named Service Provider 4.2. The Service will be provided by the Supplier for Clients in the geographical areas as specified in Part A, clause 3. 5. SERVICE REQUIREMENTS 5.1. At the beginning of the first meeting with the Client and their family/whanau, the Named Service Provider will provide a full explanation of the assessment process. 5.2. The Named Service Provider will work with the Client, their family/whanau, relevant Educational Facility and other agencies as appropriate to complete this assessment, 5.3. The Named Service Provider will complete the Complexity Framework, using the template provided by ACC, to determine the level of complexity of the Assessment, and submit it to the Case Owner. 5.3.1. If the Case Owner disagrees with the Named Service Provider s determination of the complexity level, the Named Service Provider will provide further rationale to support their assessment of the complexity level. 5.3.2. If the Named Service Provider is unable to provide sufficient rationale to support their determination, the Assessment will be deemed to be of standard complexity. 5.4. The Named Service Provider will use a variety of assessment tools consistent with current accepted practice to complete the Assessment, for example, School Function Assessment (SFA) and Academic Competence Evaluation Scales (ACES).
5.5. The Service Provider will complete and submit an Assessment report to ACC using the ACC345 Education Based Rehabilitation Assessment Report template provided by ACC. This report will include: 5.5.1. The specific support needs of the Client that are different from other students of the same age, 5.5.2. The likely duration of the limits arising from the injury for which the Client has cover, 5.5.3. The resources that exist within the Educational Facility to support participation by young people with disabilities, 5.5.4. Support received from other agencies. For example, Ongoing and Reviewable Resourcing Scheme (ORRS) funding and school funded services, 5.5.5. The Client s preferences for receiving support, 5.5.6. Advice to ACC on options to address the Client s injury related education support needs, 5.5.7. The benefit to the Client of the proposed options, 5.5.8. Where support from an Education Support Worker, Teacher s Aide, Specialist Teacher or Tutor is identified as an option for addressing the Client s need, information on the specific issue this resource will address and a weekly plan showing how the resource will be used, 5.5.9. A copy of the Client s most recent Individual Plan (IP) if in Early Childhood or Individual Education Plan (IEP) for school aged Clients. 5.6. If ACC considers that the Assessment Report is unsatisfactory then ACC will advise the Named Service Provider and the Named Service Provider will submit a revised report to ACC at no further cost to ACC. 5.7. Where requested by ACC, during or after the assessment, the Named Service Provider will participate in/ facilitate a case conference. 5.7.1. The purpose of the case conference is to discuss the assessment and/or advice given to ACC as a result of the assessment. 5.7.2. The case conference will include the Client, their family/whanau, staff from the Client s Educational Facility and/or other parties where appropriate. 5.7.3. The Named Service Provider will make brief notes on the content and any outcomes of the case conference and make these available to ACC and any other parties in consultation with ACC. 5.7.4. The case conference will be initiated by ACC. 5.7.4.1. Discussions with the ACC Client Case Owner, Client, family/whanau and/or school staff as part of the Assessment are not considered to be case conferences. 6. TIMEFRAMES 6.1. The Supplier will meet the following timeframes: Requirement Notify the ACC referrer that the Referral has been accepted Contact the Client and the Client s family/whanau and/or caregiver and Educational Facility to explain the assessment process, Applicable Timeframe Within one Business Day of receiving the referral Within two School Days of receiving the referral
Requirement answer any questions, confirm whether the Client requires a support person and arrange a suitable time to undertake the Assessment. Complete the Assessment Complete and submit an Assessment Report to ACC using an ACC template ACC will advise the Supplier in writing if the Assessment Report is not of an appropriate standard. The Named Service Provider will submit a revised Assessment report to ACC if the first report is unsatisfactory. Applicable Timeframe Within 15 School Days of accepting the referral If the timeframe will not be met the Named Service Provider will contact ACC to inform ACC of the delay, the reason why and advise date of assessment. Within five Business Days of completion of the Assessment Within five Business Days of receiving the Assessment Report Within five Business Days of notification by ACC that the Assessment report is unsatisfactory. 7. SERVICE SPECIFIC QUALITY REQUIREMENTS 7.1. The Supplier will ensure that all Named Service Providers have a clear understanding of the ACC7638 Protocol between Ministry of Education and ACC (on the ACC website). 7.2. Assessment tools used must be consistent with current accepted practice. 7.3. The service philosophy of the Supplier must align with the principles of the New Zealand Disability Strategy (NZDS). 7.4. The Supplier must ensure that only Named Service Providers provide Services under this Service Schedule. The Supplier must ensure that each Named Service Provider undertaking Assessments: 7.4.1. Has a professional qualification in Educational Psychology, Clinical Psychology, Speech-Language Therapy, Physiotherapy or Occupational Therapy; and 7.4.2. Maintains registration with the appropriate responsible authority under the Health Practitioners Competence Assurance Act 2003; and 7.4.3. Has demonstrated postgraduate experience of not less than two years in the assessment and rehabilitation of injury-related conditions; and 7.4.4. Has demonstrated postgraduate experience of not less than two years in working in the Early Childhood and Compulsory Education sectors and adapting the curriculum; and 7.4.5. Is able to demonstrate competence in Education Based Rehabilitation Assessments which includes annual professional development directly related to Education Based Rehabilitation Assessment; and 7.4.6. Can demonstrate knowledge of Te Whaariki and the New Zealand School Curriculum and the ability to adapt them to meets the needs of individual students; and
7.4.7. Has completed a minimum of 12 education based assessments in the preceding 12 months, for any agencies that fund or provide education based rehabilitation assessments; and 7.4.8. Meets the competency requirements as documented in Appendix 1 Competency Framework. 7.5. The Supplier must ensure that each Named Service Provider undertaking Assessments for Clients with a Serious Injury can demonstrate at least three years post graduate experience and competencies of community experience of assessing support needs and abilities of young people with injury or congenital or other acquired disability. 7.6. The Supplier must ensure that each Named Service Provider undertaking Assessments for Clients as the result of a Sensitive Claim must: 7.6.1. Be a Registered Educational or Clinical Psychologist; and 7.6.2. Have a minimum of two years, full-time post-graduate experience working in mental health (not including clinical placements and internships); and 7.6.3. Have current (i.e. obtained or maintained in the last five years) demonstrable experience in working with survivors of sexual abuse. 7.7. The Supplier must have Named Service Providers, who meet the requirements of clause 7.4, based in each of the locations included in Part A, clause 3 (Service Regions). 7.7.1. The Supplier must advise ACC immediately if, during the Term of this Service Schedule, they do not have Named Service Providers based in and available to undertake Assessments within any of the locations identified in Part A, clause 3 7.7.1.1. ACC will suspend referrals to the Supplier in the geographical area affected until Named Service Providers who meet the requirements of clause 7.4 are available and ACC has been advised in writing 7.8. The Supplier will hold auditable records of the professional development activities undertaken by staff and any contractors in accordance with Part B, clause 7.4 and provide copies to ACC on request. 7.9. Addition of Named Service Providers 7.9.1. The Supplier may, at any time during the Term of this Service Schedule, make a request to ACC that a provider be approved as a Named Service Provider. The request must be accompanied by the completed Named Service Provider Application Form (available from ACC s website). 7.9.2. ACC may, in its sole discretion, accept or decline each such request by providing written notification to the Supplier. Any acceptance may be made subject to conditions. 7.9.3. If a request is accepted under this clause, the provider will be added as a Named Service Provider from the date advised in ACC s written notice to you. 7.10. Removal of Named Service Providers 7.10.1. The Supplier may, at any time during the Term of this Service Schedule, provide written notification to ACC that a Named Service Provider is to be removed from this Service Schedule.
7.10.1.1. Following receipt of the written notice, ACC will provide written confirmation that the Named Service Provider has been removed from the Service Schedule. 7.10.2. ACC may at its sole discretion give notice to the Supplier that a Named Service Provider is removed from this Service Schedule, such notice not to be given arbitrarily. 8. SERVICE EXIT 8.1. The Services for a Client will end on the later of the following occurring: 8.1.1. Submission of an Assessment Report to ACC; 8.1.2. The Case Owner advises the Supplier that the Services are complete for the Client; 8.1.3. ACC withdraw the referral for any reason. 8.2 When a Client is transferred or discharged from the Service and accesses other appropriate services, the Supplier will transfer or discharge without avoidable delay or interruption. 9. EXCLUSIONS 9.1. The following are not included in the Services: 9.1.1. Education Based Rehabilitation Assessments for Clients in tertiary education; 9.1.2. Other Social Rehabilitation Assessment Services; 9.1.3. Therapy or other ongoing interventions with the Client. 10. LINKAGES 10.1. The Supplier will develop and maintain linkages with groups and organisations relevant to the provision of the Services. This includes but is not limited to: 10.1.1. Ministry of Education; 10.1.2. Early childhood education providers; 10.1.3. Compulsory education providers; 10.1.4. Cultural groups; 10.1.5. Ministry of Health; 10.1.6. Regulatory bodies. 11. PERFORMANCE REQUIREMENTS 11.1. The Services will align with the objectives detailed in clause 2; 11.2. The Services will be delivered within the timeframes set out in clause 6.1; 11.3. The Supplier must be able to demonstrate that mechanisms are in place to ascertain Client satisfaction with all aspects of Services; 11.4. The Supplier must have a quality improvement programme consistent with accepted good practice, and available to ACC upon request; 11.5. The Supplier must have an established peer review process for Named Service Providers undertaking Assessments that are consistent with accepted good practice;
12. REPORTING REQUIREMENTS 12.1. The Supplier will provide reports to ACC in accordance with the following table: Information Frequency When Responsibility The number of Referrals: Quarterly Quarterly from Supplier Received the Accepted commencement Declined (including reasons) date of the contract Source by ACC Branch / Contact Centre Receipt of incomplete referral information Number of assessments completed by each Named Service Provider for the preceding 12 months Any service delivery information, including but not limited to: Complaints including who made the complaint and action taken as a result of the complaint Number of times during the period that case owners have had to ask for further clarification or amendments on reports Average time between first assessment and submission of reports An annual report that includes the following: Results from annual client satisfaction surveys Details of Service Providers who have not completed the required number of Assessments as detailed in clause 7.4.7 in the previous 12 months and the reasons why. Quarterly Quarterly Annually Quarterly from the commencement date of the contract Quarterly from the commencement date of the contract Annually from the commencement date of the contract Supplier Supplier Supplier 12.1. ACC may request further information or reports on Services provided. Any such request will be reasonable and the Supplier shall provide the information within 20 Business Days of the request being received by the Supplier. 13. OPERATIONAL CONTACT 13.1. During the Term of this Agreement the Supplier will nominate a person (as specified in Clause 5 of the Quick Reference Information in Part A of this Service Schedule) to be the main contact for ACC who will undertake the functions of the Relationship Manager at clause 11 of the Standard Terms and Conditions. 14. RELATIONSHIP MANAGEMENT 14.1. To ensure the continuing effective operation of the service, formal working relationships are to be maintained as defined in Table 3 - Relationship Management.
15. PAYMENT AND INVOICING 15.1. Services prices are defined for this Service in Table 2 - Service Items and Prices. 15.2. ACC agrees to pay the prices set out in Table 2 - Service Items and Prices. 16. DEFINITIONS AND INTERPRETATION Educational Facility means the Early Childhood Centre, Kohanga Reo, primary, intermediate or secondary school, home if the Client is home schooled, Kura Kaupapa Maori or similar facility attended by the Client. Education Support Worker means a person providing support to children in Early Childhood Education. Reassessment means an Assessment completed with a Client who has previously had this type of Assessment. School Day means a day when most schools in New Zealand are open and students are expected to attend. Saturday, Sunday, public holidays and school holidays are not School Days. Social Rehabilitation Assessments means Integrated Rehabilitation Assessments, Single Discipline Assessments, Housing Assessments, Wheelchair and Seating Assessments, Transport for Independence Assessments, Assistive Technology Assessments and Equipment Assessments. Teacher s Aide means a person employed by a school to provide support to a child in the school. 17. APPENDIX 1 COMPETENCY FRAMEWORK Appendix 1 - Competency Framewo