Common use of Provider Eligibility Clause in Contracts

Provider Eligibility. The Provider agrees to the provisions of 7 AAC 81, Grant Services for Individuals (Appendix A), as well as all other applicable state and federal laws; and declares and represents that it meets the eligibility requirements for a Service Provider for this Agreement. A. A signed General Relief Assisted Living Home Provider Agreement (Rev. 10/19); B. A State of Alaska Provider Verification Number (PVN) administered by the Division of Finance at ▇▇▇-▇▇▇-▇▇▇▇ or ▇▇▇.▇▇▇.▇▇▇▇▇▇.▇▇▇▇▇▇▇▇@▇▇▇▇▇▇.▇▇▇. This number is to be documented on the Contact Form (attachment 4); C. A Direct Secure Messaging (DSM) email address. To sign up for DSM visit ▇▇▇▇://▇▇▇▇▇▇▇.▇▇▇/inpriva/index.php/ak-dsm-ss2. Once obtained, record your DSM email address on the Contact Form (attachment 4); D. Current State of Alaska Business License; E. Current Assisted Living Home(s) License(s) to provide assisted living home services in the State of Alaska; F. Certificate(s) of Insurance per Section IX (B) of this Provider Agreement; G. Alaska Native entities1 entering into a Provider Agreement with DHSS must provide a waiver of immunity from suit for claims arising out of activities of the Provider related to this Agreement using Appendix G. By submission for the signed Agreement, the Provider further agrees that they will comply with the following: A. Facilities and staff utilized for delivery of services meet current State of Alaska Health Care Facilities Licensing Assisted Living Home licensure requirements as outlined in AS 47.33 and 7 AAC 75. B. Assisted living ▇▇▇▇ ▇▇▇▇▇ are considered mandated reporters and will report the abuse, neglect, and exploitation of vulnerable adults as outlined in AS 47.24. C. The provisions of Appendix F, Privacy & Security Procedures for Providers. D. Facilities utilized for delivery of services meet current fire code, safety and ADA standards and are located where clients of the program services have reasonable and safe access. E. During the effective period of this Agreement, the provider agrees to keep current any and all licenses, certifications and credentials required of the provider agency, staff and facility to qualify for providing services to DHSS clients through this Agreement and to keep current the necessary documentation on file with DHSS to demonstrate compliance. Failure to maintain current licenses, certifications, credentials, and insurance will result in the immediate termination of the provider agreement.