SERVICE SCHEDULE FOR SUPPORTED ACTIVITIES SERVICE CONTRACT NO:

SERVICE SCHEDULE FOR SUPPORTED ACTIVITIES SERVICE CONTRACT NO: A. QUICK REFERENCE INFORMATION 1. TERM FOR PROVIDING SUPPORTED ACTIVITIES SERVICE The Term for the provision of Supported Activities Service is the period from the date of signing ( Commencement Date ) until the close of 31 October 2018 (the Date of Expiry ) or such earlier date upon which the period is lawfully terminated or cancelled. 2. SPECIFIED AREA AND SERVICE LOCATION (Part B, Clause 4) Provision of Services will be specific to the following geographic locations XXX 3. SERVICE ITEMS AND PRICES (Part B, Clause 14) Table 1 - Service Items and Prices Service Service Item Service Item Definition Item Code Description SAC00 SAC01 SAC10 Introductory Meeting Development of Service Plan Supported Activities - Services to support Outcomes Meeting arranged by ACC Client Service Staff introducing a new Client, their support people and Supplier to ensure mutual understanding of Client s goals and confirm the right Client/Supplier match. Refer Part B, clause 3.2.2. Supplier works with Client, whanau and other supports to develop a detailed plan of the Client s social goals and how these will be achieved and the anticipated number of support hours required. The Supplier completes the IPQA or Role and Activity Checklist. Refer Part B, Clause 5.2. One on one time spent with Client and/or co-ordination of individual activities distinct from group activities as set out in the Service. The hours of individual and group Service must not overlap though can run concurrently in the same referral period. This is exclusive of the time for progress or closure reporting. Refer Part B, Clause 2.1. Price (excl. GST) Pricing Unit $42.82 For actual client contact. Capped at 1 hour $813.58 Per client $30.35 Per hour Service Schedule for Supported Activities Service Page 1 of 19

Service Item Code SAC15 SAC02 SAC03 Service Item Description Progress Reports Group Programme full day Group Programme Half-Day Service Item Definition The Supplier arranges a Service Plan review meeting for the Client, and invites ACC Support Staff and other appropriate support Services to review progress against goals. The Supplier submits report at 3 months for an active referral, or at 6 months for an ongoing referral or sooner if required. Refer Part B, clause 5.3. Client attendance for a day (minimum 6 hours) at a Group Programme where they are provided with activities, monitoring and maintenance of participation in accordance with Part B, Clauses 5.2.4.7. Client attendance for a half-day (minimum 3 hours) at a Group Programme where they are provided with activities, monitoring and maintenance in accordance with Part B, Clause 5.2.4.7. SAC16 Closure Report Supplier arranges meeting with Client, whanau, any other supports and ACC Client Service Staff to review the Service Plan and document progress/achievements against goals. Supplier facilitates completion of the Impact on Participation and Autonomy Questionnaire for an active referral and the Role and Activity checklist for ongoing support. Submitted at maximum 6 months for an active phase and 12 months for ongoing support. Refer Part B, clause 5.4. SACDNA Did not attend fee Group Programme When given less than 24 hours notice of the Client s inability to attend a planned session the Supplier may claim 40% of the applicable Service fee for Client non-attendance at the Group half or full day Programme The Supplier may claim up to a maximum of two missed group session attendances per Client per Service referral. Price (excl. GST) Pricing Unit $42.82 Hourly rate to a maximum of 4 hours per report. $256.92 Fixed rate per session $128.46 Fixed rate per session $685.12 Per client $102.77 $51.38 Day rate Half-day rate Refer Part B, clause 5.5. Service Schedule for Supported Activities Service Page 2 of 19

Service Item Code SACDNA1 Service Item Description Did Not Attend Fee Individual Support SACTT5 Travel Time - 1st hour for individual support only SACTT1 Travel Time- Subsequent hours individual support time only Service Item Definition The Supplier may claim up to a maximum of two missed session attendances per Client per Service referral when given less than 24 hours notice of inability to attend. The payment will be based on the session scheduled and approved in the Service plan up to a maximum of 6 hrs per session. Refer Part B, clause 5.5. ACC will pay for the Supplier s travel time to deliver individual support Services to a Client, if: the travel is necessary, and the Supplier travels via the most direct, practical route available between their base/facility and the Client s address, and the distance the Supplier travel exceeds 20km return and/or the time the Supplier travels exceeds 30 minutes. SACTT5 is payable for the first hour or less of travel time on any one day. Paid for return travel time after the first 60 minutes in a day paid under SACTT5, where: the travel is necessary; and the Service Provider travels via the most direct, practicable route available between their base/facility and where the services are provided; and additional travel time is required after the first hour of travel. Note1: 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 pro-rata basis. Price (excl. GST) Pricing Unit $30.35 Per hour 6 hours maximum per session $19.42 Per hour or part thereof for actual travel time $30.35 Per hour or part thereof for actual travel time after the first hour Service Schedule for Supported Activities Service Page 3 of 19

Service Item Code SACTD10 Service Item Description Travel Distance for individual support time only Service Item Definition 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. Price (excl. GST) Pricing Unit $0.62 Per kilometre 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. 4. RELATIONSHIP MANAGEMENT Table 2 - Relationship Management Level ACC Supplier Frequency Client ACC Client Service Staff Individual staff or operational contact Branch Branch Manager Operational contact Region Designated Supplier Manager Account Management Service Schedule for Supported Activities Service Page 4 of 19

5. ADDRESSES FOR NOTICES (Part 1, Schedule 2) NOTICES FOR ACC TO: ACC Health Procurement Justice Centre 19 Aitken Street Wellington 6011 ACC Health Procurement P O Box 242 Wellington 6140 Marked: Attention: Procurement Specialist 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) Service Schedule for Supported Activities Service Page 5 of 19

TABLE OF CONTENTS 1. PURPOSE... 7 2. SERVICE OBJECTIVES... 7 3. SERVICE COMMENCEMENT... 8 4. SERVICE LOCATION and SPECIFIC AREA (Part A, Clause 2)... 8 5. SERVICE REQUIREMENTS... 9 6. SERVICE SPECIFIC QUALITY REQUIREMENTS... 10 7. SERVICE EXIT... 14 8. EXCLUSIONS... 15 9. LINKAGES... 15 10. PERFORMANCE REQUIREMENTS... 15 11. REPORTING REQUIREMENTS... 16 12. OPERATIONAL CONTACT... 17 13. RELATIONSHIP MANAGEMENT... 17 14. PAYMENT AND INVOICING... 17 15. DEFINITIONS AND INTERPRETATION... 18 Service Schedule for Supported Activities Service Page 6 of 19

B. SERVICE SPECIFICATIONS FOR SUPPORTED ACTIVITIES SERVICE 1. PURPOSE 1.1. ACC wishes to purchase Supported Activities Services. The purpose of Supported Activities is: 1.1.1. For all Clients to receive Services that promote physical and mental wellbeing and supply or provide access to age-appropriate group activities that provide meaning, promote participation and maintain their independence to the maximum extent practicable, reducing their likely need for further rehabilitation, increasing the use of natural supports and community participation and requirement for other ACC funded services; and 1.1.2. Provision of Active Services - by identifying the Client s goals and increased participation aspirations, then actively working to achieve these within a 6 month period; or 1.1.3. Provision of On-going Services - by continuing to support the Client to maintain the achieved levels of participation, within any 12 month period. 1.1.4. Supported Activities Services will be provided as a Group programme (half day or full day), as individual sessions (provided hourly), or as a combination. Individual and group session Services must not overlap in any one day. 1.2. The purpose of Supported Activities is: 1.2.1. For all Clients to receive Services that promote physical and mental wellbeing and /or provide access to age-appropriate activities that provide meaning, promote participation and maintain their independence to the maximum extent practicable, reducing their likely need for further rehabilitation, increasing the use of natural supports and community participation and requirement for other ACC funded services. 1.2.2. For ACC to maintain outcomes achieved for Clients by purchasing high quality, timely and consistent Services, from appropriately qualified and experienced Suppliers that meet a Client s social rehabilitation needs. 1.2.3. Provision of Active Services - to identify the Client s goals and increased participation aspirations, and actively work to achieve these within a 6 month period. 1.2.4. Provision of Ongoing Services - to continue to support the Client to maintain the achieved levels of participation, within any 12 month period. 1.3. Underpinning Disability Support Services (DSS) is the New Zealand Disability Strategy vision of a fully inclusive society where people will be integrated into community life on their own terms, their abilities will be valued, their diversity and interdependence will be recognised, and their human rights will be protected. 2. SERVICE OBJECTIVES 2.1. The objectives of Supported Activities are to: 2.1.1. Support the Client to achieve their goals and maintain their independence in daily life to the maximum extent practicable by providing training, monitoring and meaningful age appropriate activities to maintain the Client s functional ability in one or more of the areas of independence (as outlined in Clause 12 of Schedule 1 of the AC Act), which may include any of the following: 2.1.1.1. Domestic activities (cleaning, laundry, meal preparation and associated shopping activities); Service Schedule for Supported Activities Service Page 7 of 19

2.1.1.2. Educational participation; 2.1.1.3. Financial management; 2.1.1.4. Health care; 2.1.1.5. Hygiene care; 2.1.1.6. Mobility; 2.1.1.7. Motivation; 2.1.1.8. Safety management; 2.1.1.9. Sexuality; 2.1.1.10. Cognitive tasks of daily living; and 2.1.1.11. Use of transport. 2.1.2. Sustain the Client s functional ability in area(s) of independence and stabilise or reduce the Client s likely need for further rehabilitation and requirement for ACC funded services, by providing meaningful activities. 2.1.3. Provide Services for Clients who are unable to increase their function to a level in which they can independently access meaningful activities and/or do not have the support to access meaningful activities or maintain their current level of independence. 2.1.4. Use the Client s interests, goals and aspirations as a basis for continued motivation and facilitation of the use of skills and knowledge. The Client s own usual environment (home/community) needs to be considered. 3. SERVICE COMMENCEMENT 3.1. Eligibility for Service 3.1.1. This Service is for Clients who, as a result of their covered injury, have a significant impairment or disability and require substantial support to promote participation and maintain their independence to the maximum extent practicable, reducing their likely need for further rehabilitation, increasing the use of natural supports and community participation. 3.2. Referral Process 3.2.1. ACC will refer Clients through the following process: 3.2.2. ACC will contact the Supplier to discuss referral and arrange an Introductory meeting between the Supplier the Client, their supports and ACC. 3.2.3. The purpose of the Introductory meeting is to ensure mutual understanding of the Client s social goals and to confirm the right Client/Supplier match. 3.2.4. ACC will send a written referral to the Supplier within 2 working days of the Introductory meeting. The referral will include copies of the most recent Social Rehabilitation Assessment(s) and Individual Support Plan. 3.2.5. The Supplier will email ACC Client Service Staff with confirmation of acceptance or decline of referral within 2 working days of receiving a referral. 3.2.6. The Service commences for the Client on the date the Supplier formally accepts the Referral of the Client into the Service. 4. SERVICE LOCATION AND SPECIFIC AREA (Part A, Clause 2) 4.1. The Service will be provided to Clients in the geographical areas specified in Part A Quick Reference Information, clause 2. Service Schedule for Supported Activities Service Page 8 of 19

4.2. The Service will be provided in the Client s home, or other appropriate community location or the Supplier s facility. 5. SERVICE REQUIREMENTS The Supplier will provide the Service elements that are necessary and appropriate for each Client as specified in the Individual Service Plan approved by ACC. The key elements of the Service are: 5.1. Supported Activities Coordinator 5.1.1. The Supplier will ensure every Client has a Supported Activities Coordinator. The Coordinator will be the main contact for the Client, significant others and ACC Client Service Staff. 5.2. Service Plan 5.2.1. The Supplier will arrange a Service Plan meeting with the Client and significant others, and for re-referral Suppliers will additionally invite the ACC Client Service Staff. In both instances the meeting will be held within 10 days of acceptance of referral. 5.2.2. The Supplier will develop a Service Plan within 10 Working Days following the Service Plan meeting and submit the Service Plan to ACC Client Service Staff on the designated template for approval. 5.2.3. ACC Client Service will advise the Supplier in writing within 2 Working Days of their approval or wish to negotiate changes. 5.2.4. The Service Plan will: 5.2.4.1. Reflect relevant information from the ACC Support Needs Assessment (SNA) or other relevant Needs Assessment, and/or ACC Individual Plan. 5.2.4.2. Include the baseline scores of the Impact on Participation and Autonomy Questionnaire (IPQA) for an Active Service or Role and Activity (R and A) checklist for On-going Service. 5.2.4.3. Identify the Client s objectives documented in the Individual Plan and agree actions to achieve these, using an appropriate evidence-based goal setting framework 5.2.4.4. Identify the timeframes in which the agreed goals will be achieved and who will be responsible for completing them. 5.2.4.5. Facilitate the integration of any other services concurrently supplying support. 5.2.4.6. Identify the maximum hours per week required for Supported Activities Services. 5.2.4.7. Group programmes will be delivered either as a half day (minimum of 3 hours) or a full day (minimum of 6 hours) and be delivered in the facility or an appropriate community setting to meet the Service Objectives as per Clause 2.1. 5.2.4.8. Individual Services to Support Outcomes will support the Client to achieve specified goals that increase social activity and participation e.g. for clients living in rural locations to undertake activities in their own community. These are delivered in hourly units. 5.3. Progress Report 5.3.1. The Supplier will arrange a Service Plan review meeting with the Client and significant others to review and document the progress made against the goals. Service Schedule for Supported Activities Service Page 9 of 19

5.3.2. For Active Services this will occur at 3 months and for On-Going Services at 6 months. 5.3.3. The Supplier will complete the Progress Report and submit to ACC Client Service Staff on the supplied template. 5.4. Closure Report 5.4.1. The Supplier will arrange a final Service Plan review meeting with the Client and significant others and ACC Client Service Staff to review and document progress/achievements against the goals. 5.4.2. For Active Services, the Supplier will complete the Closure Report at 6 months (or earlier if the Client exits prior to this) and submit to ACC Client Service staff. The IPAQ score will be documented in the specified template. 5.4.3. For On-going Services, the Supplier will complete the Closure Report at 12 months (or earlier if the Client exits prior to this) and submit to ACC. The R and A checklist will be documented in the specified template. 5.5. Client Does Not Attend Appointment 5.5.1. The Supplier will take into consideration the support and communication needs of the Client. 5.5.2. If the Client gives the Supplier less than 24 hours notice of inability to attend a session, a DNA fee may be claimed as described in Part A Quick Reference Information (Table 1) of this Service Schedule. 5.5.3. The ACC Client Service Staff will be advised in writing of each DNA, when appropriate, the steps that were taken to minimise this occurring and the reason for the DNA within 1 Working Day. 6. SERVICE SPECIFIC QUALITY REQUIREMENTS 6.1. In addition to the requirements specified in Part 1 of this Agreement, the Supplier will meet the following requirements in providing the Services: Table 3 Service Timelines Requirement ACC will arrange an Introductory meeting with the Client, Supplier and ACC prior to referral. ACC will send referral to the Supplier The Supplier will provide ACC with confirmation of acceptance or decline of referral The Supplier will arrange a Service Plan meeting with Client and other key parties The Supplier will provide a completed Service Plan to ACC for approval. Impact on Participation and Autonomy scores are will be included for an Active referral and the Role and Activity checklist for on going 12 month referral. ACC will advise the Supplier in writing working of agreement to the Service Plan or wish to negotiate changes. Timeframe Prior to referral Within 2 Working Days of meeting the Client Within 2 Working Days of receipt of Referral Within 10 Working Days or alternative time frame agreed in writing with ACC Within 10 Working Days of Service Plan meeting Within 2 Working Days Service Schedule for Supported Activities Service Page 10 of 19

Requirement The Supplier will provide updated Service Plan information through progress reports. The Supplier will arrange a final Service Plan review meeting and will submit a Closure Report prior to Client exit from the Service. The Closure Report will include an updated IPAQ score for an Active Service episode or Role and Activity checklist for On-going Service episode. Timeframe 3 months for Active Service episode or 6 months for On-going Service episode from the approval date of the Service Plan 6 months for an Active Service episode, 12 months for On-going Service episode or earlier if the Client is exiting the Supported Activities Service. 6.2. The Supplier will not vary any specified time frames without agreement from ACC Client Service Staff. 6.3. Service Standards and Guidelines 6.3.1. The Supplier will deliver Services which comply with the New Zealand Disability Strategy. 6.3.2. The Supplier will ensure the original copies of the IPAQ and Role and Activity checklist assessments will be maintained on the Client s file. 6.4. Risk Management 6.4.1. The Supplier will develop and maintain a Risk Management Plan (RMP) relative to the level of needs of each Client. The RMP will detail how risks to the health and safety of the Client will be identified and mitigated. 6.5. Staffing Requirements 6.5.1. The Supplier will ensure Services are delivered by a team comprised of appropriately qualified or experienced staff who work in a co-ordinated manner to manage the Programme for each Client; and 6.5.2. Have demonstrated familiarity and competency in applying the principles and objectives of the New Zealand Disability Strategy. 6.5.3. The Service must be overseen and supervised by a Rehabilitation Professional who must maintain registration with the appropriate responsible authority under the Health Practitioners Competency Assurance Act 2003 and who can provide evidence of the following requirements: Staffing Type Rehabilitation Professional being one of the following: Registered Psychologist; Registered Nurse; Occupational Therapist; Physiotherapist; Speech Language Therapist; Counsellor; Dietician; Social Worker. Competencies/qualifications A current annual practising certificate from the relevant registering authority for Registered Psychologist, Registered Nurse, Occupational Therapist, Physiotherapist and Dietician; or Registration with ACC as a counsellor under regulations for mental injury caused by physical injury for Counsellors and Social Workers; or Membership with the New Zealand Speech Language Therapists Association for Speech Language Therapists. And: Demonstrated post graduate clinical expertise working in rehabilitation for people with traumatic or acquired brain injury conditions, over three years, where this group make up equivalent to a minimum of 50% of a full time caseload; and Demonstrated post graduate expertise in community Service Schedule for Supported Activities Service Page 11 of 19

Staffing Type Competencies/qualifications based rehabilitation, over three years, where this makes up equivalent to a minimum of 50% of a full time caseload (this expertise may be gained concurrently with the clinical expertise); and Ongoing Attendance at appropriate post-graduate training courses/conferences relevant to traumatic or acquired brain injury and community based rehabilitation of a minimum of two days per year; and Regular supervision as required by the HPCA Act and professional body. 6.5.4. The Rehabilitation Professional must also provide advice and guidance to Programme staff and oversight for development and review of all Service Plans. 6.5.5. The Supplier will nominate a Service Manager to be responsible for the day to day running of the Group and Individual support services and the requirements under this Service Schedule. 6.5.6. Any other staff that are engaged in Service delivery must: 6.5.6.1. Have demonstrated familiarity and competency in applying the principles and objectives of the New Zealand Disability Strategy; 6.5.6.2. Have skills in applying adult learning and effective teaching techniques; 6.5.6.3. Do so under the supervision of the Rehabilitation Professional and Service Manager as outlined above; and 6.5.6.4. Have at least 1 year s experience in working with people with a brain injury. 6.5.7. One or more of the Service Providers must: 6.5.7.1. Have current first aid and CPR certificates; and 6.5.7.2. Have experience in providing attendant care. 6.5.7.3. Have knowledge and experience ensuring culturally appropriate services are delivered. 6.5.8. For each Client, a Rehabilitation Professional who meets the criteria outlined in Clause 6.5.3, or the manager of the Group Programme shall be nominated by the Supplier as the Key Worker. The Key Worker will work with the Client, family, other service providers, ACC and the Supplier s team for the duration of the Supported Activities Programme. Payment for the Key Worker is included in the day or half-day rate. This person will act as the primary contact for the Client, family and ACC. Other primary responsibilities of the Key Worker are: 6.5.8.1. Liaison with ACC; 6.5.8.2. Coordination of Supported Activities Services provided to the Client; 6.5.8.3. Ensuring that the Services provided to the Client comply with this Service Schedule; 6.5.8.4. Any administrative matters that would normally be required when undertaking provision of the Services and which will allow the Supplier to monitor the quality of the Service provided; 6.5.8.5. Completing the Service Plan and Reports; 6.5.8.6. Ensuring timeframes are met and reports are completed accurately; 6.5.8.7. Monitor and record Client satisfaction; 6.5.8.8. Managing relationships with other providers of services to the Client; 6.5.8.9. Monitoring the Client and notifying ACC of any issues or concerns, and recommending other services the Client may require. Service Schedule for Supported Activities Service Page 12 of 19

6.6. Safety 6.5.9. The Supplier must ensure that these staffing requirements are met at all times. Failure to do so is considered a breach of this Agreement and ACC may decide to terminate an Agreement immediately, or provide the Supplier with a Notice of Breach in accordance with Clause 9.1 of Schedule 2 of Part 1 of this Agreement. 6.6.1. The Supplier will provide Services that ensure the safety of staff, the Client and any visitors to facilities. 6.6.2. Each facility used for the Services must comply with the Building Act 2004 by: 6.6.2.1. The Supplier will provide to ACC a copy of the Code Compliance Certificate (issued by the local council once facilities are built or alterations are made), and 6.6.2.2. the Supplier will provide annually to ACC a copy of the Building Statement of Fitness or Warrant of Fitness (issued by the local council annually). 6.6.3. The Supplier will have written and applied Health and Safety Policies, including an occupational health and safety policy that (without limitation): 6.6.3.1. Outlines the responsibility and accountability of all staff; 6.6.3.2. Specifies who is responsible for doing what, and the specific arrangements which are in place for identifying hazards, assessing risks and then controlling them; 6.6.3.3. Is effectively communicated to all employees; 6.6.3.4. Is periodically reviewed to ensure that the policy remains up to date; and 6.6.3.5. Covers staff, Clients, visitors and others who have contact with the Services provided. 6.6.4. The facility will have appropriate first aid equipment which is to be readily available at all times. This includes a first aid box or cabinet that is kept stocked with first aid equipment and materials appropriate for the number of staff and Clients attending the Services. The first aid box or cabinet will be clearly identified, kept clean and tidy and regularly replenished. 6.6.5. Emergency procedures will be developed and practised regularly. This will include notices of exit procedures and assembly points, in a format that is readily understood by Clients (e.g. pictures). 6.6.6. All facilities will comply with the requirements of the New Zealand Fire Service in matters pertaining to fire safety. This includes the number, type and placement of detectors, alarms and fire fighting devices such as extinguishers or hoses. This will include the display of safety warning signs. All fire safety equipment and material will be regularly checked and maintained. 6.6.7. Appropriate protective clothing and equipment must be used that complies with the relevant standards to ensure it provides the protection for which it is intended. 6.6.8. The Supplier must ensure that the Client is not at risk of harm or re-injury at any time during provision of the Services. 6.6.9. The Supplier will eliminate or reduce all hazards at the facility, and for any community visits undertaken. Hazard identification will be completed regularly, particularly with respect to preventing slips, trips and falls. 6.6.10. All visits to the community will be done in a manner which ensures the safety of the Clients and staff at all times. Any accidents or injuries that occur will be reported to ACC in writing on the Supplier Incident/Accident reporting form. 6.6.11. The New Zealand Patient Handling Guidelines will be used to assess and manage the risk in Client handling situations. Service Schedule for Supported Activities Service Page 13 of 19

6.6.12. Occupational Safety and Health requirements and legislation will be complied with at all times. This includes ensuring any activities and the people delivering activities meeting these requirements, and complying with inspections where required. 6.6.13. Any Service Provider using equipment in delivery of the Group and Individual support will demonstrate their compliance with all Occupational Safety and Health requirements in regard to Clients accessing and using the equipment. 6.6.14. All materials, equipment and facilities required for Service delivery and activities are the responsibility of the Supplier. Where a product is produced by an activity, the Client has ownership of the product. For example, art work or wood work produced can be taken home by the Client, if they wish. Cooking produced by the Client can be eaten by the Clients attending the Group Programme. All travel to any activities away from the base facility and the costs of such activities is the responsibility of the Supplier. No additional payment will be made by ACC, nor will the Client be required to make any additional contribution in respect of any of the Services. 6.6.15. All personal care, attendant care, health and medication management required by the Client while participating in the Service is included in the day or half-day cost. This includes facilities for provision of personal care, appropriate staff to deliver such care, privacy and respect of the Client. The Client should bring any personal care consumables or medication required with them to the Group Programme. Failure to provide adequate resources or facilities to attend to personal care while the Client is in attendance will be considered neglect and a serious breach of this Agreement. 6.6.16. The Supplier will ensure that all staff providing Services have knowledge and experience ensuring culturally appropriate services are delivered. 6.7. Re-referral or Closure of Service 6.7.1. ACC Client Service Staff will indicate a decision prior to the formal cessation of the Programme for a Client relating to continuation, and may require an independent assessment, before making a decision to cease Services, or to refer the Client to an alternative Supplier and/or services. ACC s decision is final and no negotiation will be entered into with the Supplier. 6.7.2. The discussions and outcome measures completed at the time of Closure Reporting will inform ACC Client Service Staff s decision making. 6.7.3. If ACC approves continuation of a Client s on-going participation in the Programme with the Supplier, a referral will be issued and a new Service Plan will be developed. 6.8. Subcontracting 6.8.1. With the consent of ACC (consent not to be unreasonably withheld), the Supplier may enter into a written agreement to subcontract any part or all of the Supported Activities Service to a third party, known as a Subcontractor. Any subcontracting arrangement does not relieve the Supplier from any liability or obligation under this Service Schedule. 7. SERVICE EXIT 7.1. This Service is complete for a Client when: 7.1.1. The Supplier has fully implemented the Service Plan, or at 6 months for an Active Service episode or 12 months for an On-going Service episode (whichever date is earliest). 7.1.2. The Supplier will notify ACC and significant others within 1 Working Day if a Client voluntarily exits the Supported Activity Service. 7.1.3. The Supplier will notify ACC within 1 Working Day of becoming aware of the Client s death. Service Schedule for Supported Activities Service Page 14 of 19

7.1.4. The Supplier must give a minimum of 10 Working Days written notice (inclusive of Closure Report) to ACC before terminating Service provision for a Client. 7.1.5. ACC must give a minimum of 10 Working Days written notice to the Supplier to cease Service provision for a Client. 8. EXCLUSIONS 8.1. Services are not purchased under this Service Schedule when they can be purchased under other Service Schedules. 9. LINKAGES 9.1. The Supplier will ensure that communication is maintained with all services that are being concurrently provided to a Client in order to ensure a co-ordinated and collaborative approach. 9.2. Suppliers will maintain good relationships and linkages with medical practitioners and other organisations to facilitate access and information to enable the Client to link with a variety of individuals and agencies as required. 9.3. The Supplier will establish and maintain local community specific linkages to ensure optimal opportunities for the Client to explore options and successfully achieve outcomes. 9.4. The Supplier will establish and maintain a collaborative relationship with ACC Client Service Staff to ensure: 9.4.1. they understand the Client s support network; and 9.4.2. any concerns relating to the Client are raised and to seek clarification and make recommendations about the Client s support package. 9.4.3. they seek clarification and make recommendations about the Client s support package. 10. PERFORMANCE REQUIREMENTS 10.1. The Supplier s performance will be measured as shown in Table 4 Performance Measurement. Table 4 Performance Measurement Objective Performance measure Target Data Source 1 Client Complexity Reporting 100% compliance 2 Client Achievement of Outcomes 1 : Home & Living, Work and Education, Recreation & Leisure and Community Participation Completion of the IPAQ and Role and Activity checklist (a) % of outcomes not achieved, partially achieved, achieved, achieved beyond expectation at each Progress Report and on closure (b) % of Clients having improved their IPAQ or R and A Score Annually Per closed case Comparable with other Suppliers Supplier s Client reports to ACC. ACC summarises and reports data. Supplier s Client report to ACC. ACC summarises and reports data. 1 Note Client complexity profile will be considered in performance monitoring. Service Schedule for Supported Activities Service Page 15 of 19

Objective Performance measure Target Data Source 3 Timeliness Compliance with ACC service delivery requirements 100% compliance Supplier s Client report to ACC. ACC summarises and reports data. 4 Efficiency and effectiveness Average cost per Client Annually Per closed case Comparable with industry baseline ACC cost data. 10.2. Service Improvement Process 10.2.1. If performance monitoring identifies an issue with Supplier performance, the process outlined in the Agreement for Services will be followed: 10.2.1.1. ACC and the Supplier will consider the information reported under Clause 9.1 and other relevant information on a regular basis. 10.2.1.2. Discussion between the Supplier and ACC will occur to better understand the information and decide if performance could be expected to change or if there are other factors that provide a reasonable basis for the identified performance. 10.2.1.3. If a change in performance is deemed appropriate, further analysis and a follow-up discussion will be undertaken 3 months after the initial discussion between the Supplier and ACC. 10.2.1.4. If a change is observed such that performance is within appropriate parameters, the performance monitoring process will provide feedback to the Supplier. 10.2.1.5. If a change in performance is still deemed appropriate, a performance improvement plan will be documented that includes the required action(s) by either party and the timeframes for this to occur. 10.2.1.6. Further analysis and discussion will occur at the end of the period stated in the performance improvement plan. If no change is observed, ACC may issue a notice of breach of contract in accordance with Part 1 Schedule 2 Clause 9.1. 10.3. ACC will measure the success of this Agreement and Supplier performance based on evidence of compliance with the following: 10.3.1. the ability to deliver the Services within stated timeframes. 10.3.2. the achievement of Client outcomes as measured by the IPAQ and Role and Activity checklist on completion of Service. 10.3.3. the reduction in Client liability based on average comparable cost per Client. 10.3.4. Client achievement of outcomes as documented in the Service Plan and Closure Report. 11. REPORTING REQUIREMENTS 11.1. To effectively monitor at individual Supplier and sector levels ACC requires the following: 11.1.1. that all fields in the Service Plan, Progress and Closure Reports are accurately completed by the Supplier on the template supplied and submitted within the time frames specified in clause 6. 11.1.2. that any additional ad hoc information reasonably required by ACC be supplied in a timely manner and at no additional cost. Service Schedule for Supported Activities Service Page 16 of 19

12. OPERATIONAL CONTACT 12.1. During the Term of this Service Schedule, 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: 12.1.1. Have primary responsibility for relationships with ACC and the operation of this Service on a day to day basis; 12.1.2. Be proactive in informing ACC of issues with provision of Services as outlined; 12.1.3. Raise issues and suggest solutions regarding this Service; 12.1.4. Ensure that the Service is operated in accordance with this Service Schedule; 12.1.5. Represent the Supplier in discussions on performance; and 12.1.6. Ensure that ACC is advised promptly when the person s contact details or circumstances change. 13. RELATIONSHIP MANAGEMENT 13.1. To ensure the continuing effective operation of the Service, formal working relationships are to be maintained as defined in Clause 4 of the Quick Reference Information in Part A of this Service Schedule. 14. PAYMENT AND INVOICING 14.1. ACC agrees to pay the prices as set out in Part A, Clause 3 for Services provided in accordance with this Service Schedule. 14.2. The Supplier must raise a separate GST Invoice for each Client following completion of a service delivery component or monthly. The GST Invoice must contain information consistent with that received in the ACC purchase order, particularly with regard to Service Item Codes. 14.3. Wherever practical, the GST invoice will be submitted electronically via a process agreed with ACC s ebusiness team. 14.4. The GST Invoice must be addressed to ACC as the recipient of the Service and will contain: 14.4.1. Supplier s name, address and ACC Vendor ID. 14.4.2. Supplier s GST number. 14.4.3. The words Tax Invoice should be prominent. 14.4.4. Invoice number and date. 14.4.5. ACC purchase order number. 14.4.6. Description of Services and their Service Item Codes as per the ACC purchase order. 14.4.7. Supplier s name and ACC Supplier number for each service if Supplier registration is prescribed in this Service Schedule. 14.4.8. Name and claim number of the Client receiving the Service. 14.4.9. Date and quantity or hours of Services delivered, or start and end dates. 14.5. If the Supplier has complied with its obligations under this Agreement, ACC will pay the invoice into the Supplier s bank account as indicated in Part 1, Schedule 1, clause 1 of the Agreement on or by the 20th day of the month following receipt of the invoice. Service Schedule for Supported Activities Service Page 17 of 19

14.6. ACC will not pay for a Service where the invoice for that Service is not received within 12 months of the date the Service was provided, or the date cover was granted by ACC, whichever is the later date. 15. DEFINITIONS AND INTERPRETATION In this Service Schedule, unless the context requires otherwise, the following terms have the corresponding definition: Term ACC Client Service Staff Service Plan Objective Progress Report Closure Report Impact on Participation and Autonomy (IPAQ) Role and Activity Checklist Supported Activities Co ordinator Serious Injury Profile Supports Definition The staff member engaged by ACC as the case manager for the Client and located in an ACC branch for the purposes of the Accident Compensation Act 2001 (AC Act), and may also include a claims manager or other authorised ACC personnel. The Client objectives and actions from the Supplier and ongoing review of collecting data on the Clients needs, preferences, and interests as they relate to the demands of current and future educational, living and personal and social environments. An aspiration, target and/or future condition that the Client wishes to achieve in relation to them leading an everyday life. Objectives can serve more than one purpose e.g. by clarifying the desires of the Client in the Service Plan, the basis for measuring outcomes and progress can be determined. A Report completed by the Supplier and submitted to ACC at a minimum 3 months from the Service implementation date for an Active Service referral and 6 months for an On-going Service referral. The Progress Report reviews and updates Client background information, services required to secure job placement, objectives and actions. A Report completed by the Supplier and submitted to ACC prior to the Client s exit from the Supported Activities Service. The Report provides Client outcomes against plan objectives and actions as well as updated IPAQ or Role and Activity checklist scores. A self-administered questionnaire developed using the (2001): international classification of functioning, disability and health Geneva, World Health Organization (ICF) model of human functioning and disability (Cardol et al. 1999). It assesses autonomy and participation as perceived by the individual. Can be self-administered and measures an individual's involvement in nine key roles. These roles include family member, student, worker, caregiver and volunteer. The tool takes approximately ten minutes to complete and consists of two sections that firstly examines past, current and future participation in these roles and then requests the Client to indicate how significant each role is to them. Studies report that the checklist is valid and has satisfactory test re-test reliability. The checklist can be used with adolescents and adults and can be used to identify shifts in role participation. An individual who is responsible for delivering the Service on behalf of a Supplier. This includes the provision of direct and indirect support service to the person and covers all staff and management who are either employed or contracted. The National Serious Injury Service supports Clients with moderate or severe Traumatic Brain Injuries, Spinal Cord Injuries, or equivalent injuries which cause substantial impairment and on-going disability. Means both paid and natural supports. Paid supports includes those funded Service Schedule for Supported Activities Service Page 18 of 19

Term Achievement Levels (Outcome ratings) ACC Individual Plan Definition under this or other ACC Service Schedules e.g. Attendant Care & Supported Living or non ACC such as ORRS funding from the Ministry of Education. Natural Supports- means whanau, friends, work colleagues, sports groups, church, consumers groups, flat mates, Unions etc which are readily available and reasonably easy to access by Client requiring support. 1. Not achieved- the specific Outcome was not delivered e.g. if objective was within 12 months to have a job and at time of reporting the Client is not employed. 2. Partially achieved-the outcome was achieved but one or more components were not. E.g. Within 6 months I will have a job for 3 days a week and at time of reporting the Client has an employment trial but is for a lesser period. 3. Achieved- All components of the objective were achieved. 4. Achieved beyond expectation-all components delivered and achieved and one or more components are at a higher level. E.g. within 6 months I will have a job 3 days a week but placement is achieved within a shorter time frame. A legislatively required plan agreed between ACC and the Client. For Serious Injury Clients this describes their social and vocational goals. Service Schedule for Supported Activities Service Page 19 of 19