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Deliverable Number
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Commodity/Service Type
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Major Deliverable
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Method of Payment
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Individual health screening and assessment services
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Work with the local CHD, School district and the county SHAC to develop the biennial School Health S...
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Fixed Price - Lump Sum
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| Major Deliverable: Work with the local CHD, School district and the county SHAC to develop the biennial School Health Services Plan in accordance with F.A.C. rule 64F-6.022, as needed or a directed by the department. |
| Deliverable Price: $0.00 |
| Non Price Justification: Price cannot be determined until the work has been completed |
| Performance Metrics: Work with the local County Health Department, School district and the SHAC to develop the School Health Services Plan as specified. |
| Financial Consequences: 1% reduction in that quarter's invoice amount |
| Source Documentation Page Reference: 17 |
| Deliverable Number: |
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Individual health screening and assessment services
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Ensure written parent or guardian consent is obtained prior to providing school health services. Con...
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Fixed Price - Lump Sum
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| Major Deliverable: Ensure written parent or guardian consent is obtained prior to providing school health services. Consent for school health services must include the language specifying the healthcare services to be offered to students in schools and the option to withhold consent or decline specific services. |
| Deliverable Price: $0.00 |
| Non Price Justification: Price cannot be determined until the work has been completed |
| Performance Metrics: Ensure written parent or guardian consent is obtained prior to providing school health services. |
| Financial Consequences: 1% reduction in that quarter's invoice amount |
| Source Documentation Page Reference: 17 |
| Deliverable Number: |
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Individual health screening and assessment services
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Send student emergency information cards or equivalent records in writing or electronically, to pare...
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Fixed Price - Lump Sum
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| Major Deliverable: Send student emergency information cards or equivalent records in writing or electronically, to parents and guardians throughout the current school year as required (either upon initial entry of student into a school or other locally defined instance).Ensure that emergency information cards or equivalent records are updated by parents or guardians for each student annually and list the contact person, family physician, allergies, significant health history, and permission for emergency care for the student. |
| Deliverable Price: $0.00 |
| Non Price Justification: Price cannot be determined until the work has been completed |
| Performance Metrics: Collect student emergency information cards. |
| Financial Consequences: 1% reduction in quarterly invoice, respectively |
| Source Documentation Page Reference: 17 |
| Deliverable Number: |
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Individual health screening and assessment services
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Collect 45% of the estimated student population emergency information cards or equivalent records by...
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Fixed Price - Lump Sum
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| Major Deliverable: Collect 45% of the estimated student population emergency information cards or equivalent records by September 30 of each school year and 95% of the estimated student population emergency information cards or forms by December 31 of each school year. |
| Deliverable Price: $0.00 |
| Non Price Justification: Price cannot be determined until the work has been completed |
| Performance Metrics: Collect student emergency information cards. |
| Financial Consequences: 1% reduction in quarterly invoice, respectively |
| Source Documentation Page Reference: 17 |
| Deliverable Number: |
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Individual health screening and assessment services
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Ensure emergency information cards or equivalent records are reviewed for a minimum of 15% of studen...
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Fixed Price - Lump Sum
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| Major Deliverable: Ensure emergency information cards or equivalent records are reviewed for a minimum of 15% of students by September 30, a minimum of 50% of students by December 31, and a minimum of 90% of students by March 31, of each school year to ensure the documents list the contact person, family physician, allergies, significant health history, and permission for emergency care for the student is accurate and up to date. If information is missing or outdated, use locally defined processes to update and obtain accurate information. |
| Deliverable Price: $0.00 |
| Non Price Justification: Price cannot be determined until the work has been completed |
| Performance Metrics: Collect student emergency information cards |
| Financial Consequences: 1% reduction in quarterly invoice, respectively |
| Source Documentation Page Reference: 17-18 |
| Deliverable Number: |
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Individual health screening and assessment services
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The procedures, processes, forms, and methodologies implemented locally to achieve the specified met...
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Fixed Price - Lump Sum
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| Major Deliverable: The procedures, processes, forms, and methodologies implemented locally to achieve the specified metrics in task 3(a)(b) must be documented and submitted to the contract manager within 30 calendar days following contract execution for the Department to review and approve. Ensure the plan contains the following: i. A method to measure the local estimated student population if it will differ from the definition as established in the Attachment I.
ii. The method the provider will use to measure and track the collection of emergency information cards or equivalent records.
iii.The method and timeline for reporting compliance with items 3(a)(b) to the contract manager that aligned with the minimum established baselines.
iv.The agreed method and process that may be used for the contract manager to verify, audit, and be accountable for the data submitted by the provider.
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| Deliverable Price: $227,143.00 |
| Non Price Justification: |
| Performance Metrics: Document school health services data collection methods |
| Financial Consequences: 3% reduction in quarterly invoice, respectively |
| Source Documentation Page Reference: 18 |
| Deliverable Number: |
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Individual health screening and assessment services
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Provide Basic School Health Services at all schools listed in Attachment IV in accordance with the c...
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Fixed Price - Lump Sum
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| Major Deliverable: Provide Basic School Health Services at all schools listed in Attachment IV in accordance with the current School Health Services Plan; section 381.0056, F.S.; F.A.C. rules 64F-6.001 through 6.006; and the Department’s School Health Administrative Resource Manual available at, http://www.floridahealth.gov/programs-and-services/childrens-health/school-health/reports-information.html, as revised. At a minimum, provide the following Basic School Health Services unless the student is exempt (i.e. has a parent or guardian opt-out form or other written exemption, is not able to be screened due to profound disability, or is currently in treatment for the condition): a) Perform Vision Screenings for a minimum of 45% of non-exempted students in the estimated student population for kindergarten, first, third, and sixth grade by December 31 and a minimum of 95% by March 31 of each contract year. |
| Deliverable Price: $0.00 |
| Non Price Justification: Price cannot be determined until the work has been completed |
| Performance Metrics: Provide vision screenings for mandatory grade levels at all Basic School Health Service Schools |
| Financial Consequences: 1% reduction in that quarter's invoice amount |
| Source Documentation Page Reference: 18 |
| Deliverable Number: |
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Individual health screening and assessment services
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Perform Hearing Screenings for a minimum of 45% of non-exempted students in the estimated student po...
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Fixed Price - Lump Sum
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| Major Deliverable: Perform Hearing Screenings for a minimum of 45% of non-exempted students in the estimated student population for kindergarten, first, and sixth grade by December 31 and a minimum of 95% by March 31 of each contract year. |
| Deliverable Price: $0.00 |
| Non Price Justification: Price cannot be determined until the work has been completed |
| Performance Metrics: Provide hearing screenings for mandatory grade levels at all Basic School Health Service Schools |
| Financial Consequences: 3% reduction in quarterly invoice, respectively |
| Source Documentation Page Reference: 18 |
| Deliverable Number: |
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Individual health screening and assessment services
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Perform Scoliosis Screenings for a minimum of 45% of non-exempted students in the estimated student ...
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Fixed Price - Lump Sum
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| Major Deliverable: Perform Scoliosis Screenings for a minimum of 45% of non-exempted students in the estimated student population for sixth grade by March 31 and a minimum of 95% by June 30 of each contract year. |
| Deliverable Price: $0.00 |
| Non Price Justification: Price cannot be determined until the work has been completed |
| Performance Metrics: Provide scoliosis screenings for mandatory grade levels at all Basic School Health Service schools |
| Financial Consequences: 3% reduction in that quarter's invoice amount |
| Source Documentation Page Reference: 18 |
| Deliverable Number: |
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Individual health screening and assessment services
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Perform Growth and Development Screenings for a minimum of 45% of non-exempted students in the estim...
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Fixed Price - Lump Sum
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| Major Deliverable: Perform Growth and Development Screenings for a minimum of 45% of non-exempted students in the estimated student population for first, third, and sixth grade by March 31 and a minimum of 95% by June 30 of each contract year. |
| Deliverable Price: $0.00 |
| Non Price Justification: Price cannot be determined until the work has been completed |
| Performance Metrics: Provide growth and development screenings for mandatory grade levels at all Basic School Health Service schools |
| Financial Consequences: 3% reduction in that quarter's invoice amount |
| Source Documentation Page Reference: 18 |
| Deliverable Number: |
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Individual health screening and assessment services
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Create a follow-up plan as follows: a. Create a plan for providing follow-up on all non-exempted stu...
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Fixed Price - Lump Sum
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| Major Deliverable: Create a follow-up plan as follows: a. Create a plan for providing follow-up on all non-exempted students with abnormal screening results (referrals) that ensures parents or legal guardians are aware of the referral and its purpose. Submit the follow-up plan within 30 calendar days following contract execution to the contract manager for the Department to review and approve. Ensure the follow-up plan contains the following: 1. How Provider will conduct the initial follow-up attempt with the non-exempted students’ parent or guardian, including:
a. The method the Provider will use to conduct the initial follow-up attempt (i.e., primary point of contact, phone, email, etc.).
b. When the Provider will conduct the initial follow-up attempt (i.e., how many days after the referral Provider will conduct the initial follow-up attempt).
2. If the Provider did not contact the non-exempted students’ parent or guardian after the initial follow-up attempt, how Provider will conduct the second follow-up attempt, including:
a. The method the Provider will use to conduct the second follow-up attempt (i.e., primary point of contact, phone, email, etc.).
b. When the Provider will conduct the second follow-up attempt (i.e., how many days after the initial follow-up attempt Provider will conduct the second follow-up attempt).
3. If Provider did not contact the non-exempted students’ parent or guardian after the second follow-up attempt, how Provider will conduct the third follow-up attempt, including:
a. The method the Provider will use to conduct the third follow-up attempt (i.e., the primary point of contact, phone, email, etc.).
b. When the Provider will conduct the third follow-up attempt (i.e., how many days after the second follow-up attempt Provider will conduct the third follow-up attempt).
4. Where in the non-exempted students record Provider will document the Complete and Incomplete referral outcome and any notes for each students’ follow-up. |
| Deliverable Price: $0.00 |
| Non Price Justification: Price cannot be determined until the work has been completed |
| Performance Metrics: Create a follow-up plan for students with abnormal screenings |
| Financial Consequences: 5% reduction in quarterly invoice, respectively |
| Source Documentation Page Reference: 19-20 |
| Deliverable Number: |
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Individual health screening and assessment services
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Refer all students with abnormal screening results to the appropriate health care providers for furt...
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Fixed Price - Lump Sum
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| Major Deliverable: Refer all students with abnormal screening results to the appropriate health care providers for further evaluation and treatment within 45 days of receiving the screening results. Document the screening date, rescreening date (if applicable), result (pass or fail) and outcome of referral in the student cumulative health record. |
| Deliverable Price: $0.00 |
| Non Price Justification: Price cannot be determined until the work has been completed |
| Performance Metrics: All students with abnormal screening results must be referred to appropriate health care providers for further evaluation and or treatment |
| Financial Consequences: 1% reduction in that quarter's invoice amount |
| Source Documentation Page Reference: 20 |
| Deliverable Number: |
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Individual health screening and assessment services
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Confirm that all students referred to state contracted vision service providers have a signed parent...
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Fixed Price - Lump Sum
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| Major Deliverable: Confirm that all students referred to state contracted vision service providers have a signed parent or guardian consent form that includes permission for a Comprehensive Eye Exam, which may involve refraction and dilation. |
| Deliverable Price: $0.00 |
| Non Price Justification: Price cannot be determined until the work has been completed |
| Performance Metrics: All students referred to State contracted vision service providers must have a signed parental or guardian consent form. |
| Financial Consequences: 1% reduction in that quarter's invoice amount |
| Source Documentation Page Reference: 20 |
| Deliverable Number: |
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Individual health screening and assessment services
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Provide students who are pregnant with information on assistance, counseling, education, prenatal ca...
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Fixed Fee / Unit Rate
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| Major Deliverable: Provide students who are pregnant with information on assistance, counseling, education, prenatal care, and the Healthy Start Program as needed. |
| Deliverable Price: $0.00 |
| Non Price Justification: Price cannot be determined until the work has been completed |
| Performance Metrics: At least one follow-up must be provided with the parents or guardians of students referred. |
| Financial Consequences: 1% reduction in that quarter's invoice amount |
| Source Documentation Page Reference: 20 |
| Deliverable Number: |
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Individual health screening and assessment services
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Provide additional Basic School Health Services as specified in the current School Health Services P...
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Fixed Price - Lump Sum
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| Major Deliverable: Provide additional Basic School Health Services as specified in the current School Health Services Plan. |
| Deliverable Price: $0.00 |
| Non Price Justification: Price cannot be determined until the work has been completed |
| Performance Metrics: Additional Basic Health Services are provided as specified in School Health Services Plan. |
| Financial Consequences: 1% reduction in that quarter's invoice amount |
| Source Documentation Page Reference: 20 |
| Deliverable Number: |
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Individual health screening and assessment services
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Provide health services for Full-Service Schools, identified in Attachment V in accordance with sect...
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Fixed Price - Lump Sum
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| Major Deliverable: Provide health services for Full-Service Schools, identified in Attachment V in accordance with section 402.3026, F.S. and as specified in the current School Health Services Plan |
| Deliverable Price: $0.00 |
| Non Price Justification: Price cannot be determined until the work has been completed |
| Performance Metrics: Additional Full Health Services are provided as specified in School Health Services Plan |
| Financial Consequences: 1% reduction in that quarter's invoice amount |
| Source Documentation Page Reference: 21 |
| Deliverable Number: |
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Individual health screening and assessment services
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Maintain the following documentation and information, either in written or electronic format, in acc...
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Fixed Price - Lump Sum
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| Major Deliverable: Maintain the following documentation and information, either in written or electronic format, in accordance with section 1002.22, F.S., F.A.C. rule 64F-6.005, the Family Educational Rights and Privacy Act, and HIPAA: a) Cumulative health record for each student, which contains: i. Florida Certificate of Immunization (Form DH 680) or Part A, Part B, or DH 681 exemptions. ii. School Entry Health Exam form (DH3040-CHP-07/2013) or other form as specified in section 1003.22, F.S. and F.A.C rule 6A-6.024. iii. Documented parental consent for health services. Iv. Documentation of screenings, results, referrals, follow-up attempts, and outcomes as specified in Task 4(e-f). |
| Deliverable Price: $0.00 |
| Non Price Justification: Price cannot be determined until the work has been completed |
| Performance Metrics: Health services for Full-Service Schools must be provided as specified |
| Financial Consequences: 1% reduction in that quarter's invoice amount |
| Source Documentation Page Reference: 21 |
| Deliverable Number: |
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Individual health screening and assessment services
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IHPs and ECPs for each student as applicable.
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Fixed Price - Lump Sum
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| Major Deliverable: IHPs and ECPs for each student as applicable. |
| Deliverable Price: $0.00 |
| Non Price Justification: Price cannot be determined until the work has been completed |
| Performance Metrics: Maintain documentation and information for health services provided. |
| Financial Consequences: 3% reduction in that quarter's invoice amount |
| Source Documentation Page Reference: 21 |
| Deliverable Number: |
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Individual health screening and assessment services
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Medication Management Records.
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Fixed Price - Lump Sum
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| Major Deliverable: Medication Management Records. |
| Deliverable Price: $0.00 |
| Non Price Justification: Price cannot be determined until the work has been completed |
| Performance Metrics: Maintain documentation and information for health services provided. |
| Financial Consequences: 3% reduction in that quarter's invoice amount |
| Source Documentation Page Reference: 21 |
| Deliverable Number: |
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Individual health screening and assessment services
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Medical Services management records such as medical procedures and treatments.
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Fixed Price - Lump Sum
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| Major Deliverable: Medical Services management records such as medical procedures and treatments. |
| Deliverable Price: $0.00 |
| Non Price Justification: Price cannot be determined until the work has been completed |
| Performance Metrics: Maintain documentation and information for health services provided. |
| Financial Consequences: 3% reduction in that quarter's invoice amount |
| Source Documentation Page Reference: 21 |
| Deliverable Number: |
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Individual health screening and assessment services
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Clinic log used daily to record, at a minimum, student identifiers, chief complaints, dates, times o...
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Fixed Price - Lump Sum
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| Major Deliverable: Clinic log used daily to record, at a minimum, student identifiers, chief complaints, dates, times of arrival and departure, person on duty, and outcome disposition of the student. |
| Deliverable Price: $0.00 |
| Non Price Justification: Price cannot be determined until the work has been completed |
| Performance Metrics: Maintain documentation and information for health services provided. |
| Financial Consequences: 3% reduction in that quarter's invoice amount |
| Source Documentation Page Reference: 21 |
| Deliverable Number: |
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Individual health screening and assessment services
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Child-specific training and periodic follow-up monitoring of unlicensed assistive personnel assistin...
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Fixed Price - Lump Sum
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| Major Deliverable: Child-specific training and periodic follow-up monitoring of unlicensed assistive personnel assisting with the student’s medication and or medical services management as determined by the nursing process as specified in section 1006.062(4), F.S. and F.A.C., Chapter 64B9-14. |
| Deliverable Price: $0.00 |
| Non Price Justification: Price cannot be determined until the work has been completed |
| Performance Metrics: Maintain documentation and information for health services provided. |
| Financial Consequences: 3% reduction in that quarter's invoice amount |
| Source Documentation Page Reference: 21 |
| Deliverable Number: |
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Individual health screening and assessment services
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Submit a Prepared Monthly Service Report to the Contract Manager within 15 calendar days from the en...
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Fixed Price - Lump Sum
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| Major Deliverable: Submit a Prepared Monthly Service Report to the Contract Manager within 15 calendar days from the end of each month. Ensure the Monthly Service Report does not contain personal identifiable information or protected information on students. Ensure the Monthly Service Report contains, at a minimum, the following information: a) A summary of all tasks, outcomes, barriers to care, unanticipated challenges, and documentation as requested in the tasks above. |
| Deliverable Price: $0.00 |
| Non Price Justification: Price cannot be determined until the work has been completed |
| Performance Metrics: Service and screening data for the services provided in Tasks 5) and 6) must be submitted to the County Health Department |
| Financial Consequences: 3% reduction in that quarter's invoice amount |
| Source Documentation Page Reference: 21-22 |
| Deliverable Number: |
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Individual health screening and assessment services
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Service Codes as documented in the most current DHP 50-20.
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Fixed Price - Lump Sum
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| Major Deliverable: Service Codes as documented in the most current DHP 50-20. |
| Deliverable Price: $0.00 |
| Non Price Justification: Price cannot be determined until the work has been completed |
| Performance Metrics: Service Codes as documented in the most current DHP 50-20. |
| Financial Consequences: 1% reduction in quarterly invoice, respectively |
| Source Documentation Page Reference: 22 |
| Deliverable Number: |
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Individual health screening and assessment services
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Code Description: a local description of how the aggregate totals for each of the service codes are ...
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Fixed Price - Lump Sum
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| Major Deliverable: Code Description: a local description of how the aggregate totals for each of the service codes are obtained locally |
| Deliverable Price: $0.00 |
| Non Price Justification: Price cannot be determined until the work has been completed |
| Performance Metrics: Code Description: a local description of how the aggregate totals for each of the service codes are obtained locally |
| Financial Consequences: 1% reduction in quarterly invoice, respectively |
| Source Documentation Page Reference: 22 |
| Deliverable Number: |
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