#11-MOSNHV-23

AMENDMENT TO CONTRACT # 11-MOSNHV-23

This amendment is dated October 1, 2014 and amends the Menu of Services contract with beginning date of October 1, 2010 and ending date of September 30, 2014, between Iowa Vocational Rehabilitation Services and New Hope Village. The parties amend the contract as follows:

1.  IVRS renews the contract for 1 one-year term with the ending date of September 30, 2015.

2.  Update Exhibit C Annual Budget for the 10/1/2014 – 9/30/2015 year, as attached.

3.  The effect of this amendment on the total dollar amount of the contract is an increase of $29,311.00.

All other provisions of the contract remain in effect.

Iowa Vocational Rehabilitation Services

By: ______Date: ______

David Mitchell, Administrator

New Hope Village

By: ______Date: ______


EXHIBIT C

ANNUAL BUDGET

Fiscal Year October 1, 2014 – September 30, 2015

Menu of Services
D Code / Milestone Name / Proposed Number of Clients to be Served / D Code Rate 10/1/14 - 9/30/15 / Proposed Budget
D1A / Discovery – Acceptance / 6 / $ 300.00 / $1,800.00
D1B / Discovery – Dialogue / 6 / $ 140.00 / $ 840.00
D2 / Community Work Site Assessment / 6 / $ 563.00 / $3,378.00
D3 / Community Work Site Report / 6 / $ 181.00 / $1,086.00
D5 / Facility Work Site Assessment / 1 / $ 968.00 / $ 968.00
D7 / Job Shadowing Assessment / 1 / $ 371.00 / $ 371.00
D8 / Career Exploration / 3 / $ 350.00 / $1,050.00
D14 / Transportation Training / 1 / $ 90.00 / $ 90.00
D15-1 / Job Development – Placement Agreement / 3 / $ 487.00 / $1,461.00
D15-2 / Job Development – Written Report / 3 / $ 487.00 / $1,461.00
D15A / Employer Development / 3 / $ 974.00 / $2,922.00
D15B / Customized Employment / 3 / $ 368.00 / $1,104.00
D16 / Job Follow up 45 Day / 3 / $ 361.00 / $1,083.00
D17 / Job Follow up 90 Day / 3 / $ 224.00 / $ 672.00
D18 / Selected Job Coaching Stabilization / 3 / $ 744.00 / $2,232.00
D19 / Selected Job Coaching 90 Day / 3 / $ 339.00 / $1,017.00
D20 / Supported Job Coaching Assessment Report / 3 / $ 112.00 / $ 336.00
D21 / Supported Job Coaching Stabilization / 3 / $1,690.00 / $5,070.00
D22 / Supported Job Coaching 45 Day / 3 / $ 451.00 / $1,353.00
D23 / Supported Job Coaching 90 Day / 3 / $ 339.00 / $1,017.00

No other costs are allowable on a Menu of Services Contract

*The budget reflects expenditures for the federal fiscal year beginning October 1, 2014 through September 30, 2015.