HomeMy WebLinkAboutCONSENT ILA re Nurse Family Partnership 615 Sheridan Street
Port Townsend, WA 98368
ce11ehson www.JeffersonCountyPublicHealth.org
Consent Agenda
Public Healt
JEFFERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
AGENDA REQUEST
TO: Board of County Commissioners
Josh Peters, County Administrator
FROM: Apple Martine, Public Health Director
Denise Banker, Community Health Director
DATE: /3 , 2F 2-S
SUBJECT: Agenda Item - Interlocal Agreement with Washington State Department of
Children, Youth and Families (DCYF); July 1, 2025 - July 31, 2026;
$446,836.63.
STATEMENT OF ISSUE:
Jefferson County Public Health (JCPH) is requesting Board approval for an Interlocal Agreement with
Washington State DCYF contract for funding Home Visiting Services; July 1, 2025 - July 31, 2026;
$446,836.63.
ANALYSIS/STRATEGIC GOALS/PROS and CONS:
This agreement funds the visiting nurse services JCPH has provided, based on efficacy studies conducted by
Nurse Family Partnership (NFP), and in keeping with NFP model requirements, to support families in an effort
to alleviate the effects of poverty, single parenthood, parental unemployment or underemployment, parental
disability, education attainment, and family engagement in child welfare on child development. The grant
allows JCPH community nursing staff to make home visits in Jefferson and Clallam Counties, and supports
Kitsap County, via subcontracting. The purpose of this contract is to provide funding for services through July
31, 2026 to carry out the statement of work (SOW).
FISCAL IMPACT/COST BENEFIT ANALYSIS:
Fully funded by Washington State DCYF with state dollars for a total of $446,836.63.
RECOMMENDATION:
JCPH management requests approval of the Washington State DCYF agreement for funding Home Visiting
Services; July 1, 2025 -July 31, 2026; $446,836.63
REVIEWED BY:
a-6-0- ,v) / 78-s---
Josh eters, County Administrator Date
Community Health
Developmental Disabilities Environmental Public Health
360-385-9400 360-385-9444
360-385-9401 (f) (f) 360-379-4487
Always working for a safer and healthier community
N-25-065
CONTRACT REVIEW FORM I Clear Form
(INSTRUCTIONS ARE ON THE NEXT PAGE)
CONTRACT WITH: Washington Dept. of Children, Youth and Families Contract No: N-25-065
Contract For: Nurse Family Partnership; Home Visiting Svcs Term: 7/1/2025 - 7/31/2026
COUNTY DEPARTMENT: Public Health
Contact Person: Denise Banker
Contact Phone: X438
Contact email: dbanker@co.jefferson.wa.us
AMOUNT: $446,836.63 PROCESS: — Exempt from Bid Process
Revenue: $446,836.63 _ Cooperative Purchase
Expenditure: Competitive Sealed Bid
Matching Funds Required: _ Small Works Roster
Sources(s) of Matching Funds _ Vendor List Bid
Fund # 127 — RFP or RFQ
Munis Org/Obj 12756200 ✓ Other: State funded
APPROVAL STEPS:
STEP 1: DEPARTMENT CERTIFIES COMP . E WI i +.080 AND CHAPTER 42.23 RCW.
CERTIFIED: N/A:l:1 Sept. 3, 2025
Signature Date
STEP 2: DEPARTMENT CERTIFIES THE PERSON PROPOSED FOR CONTRACTING WITH THE
COUNTY (CONTRACTOR) HAS NOT BEEN DEBARRED BY ANY FEDERAL, STATE, OR LOCAL
AGENCY.
CERTIFIED: N/A: Iv Sept. 3,2025
Signature Date •
STEP 3: RISK MANAGEMENT REVIEW (will be added electronically through Laserfiche):
Electronically approved by Risk Management on 9/4/2025.
STEP 4: PROSECUTING ATTORNEY REVIEW(will be added electronically through Laserfiche):
Electronically approved as to form by PAO on 9/4/2025.
ILA with DCYF - State prepared agrement. Hard to change.
STEP 5: DEPARTMENT MAKES REVISIONS & RESUBMITS TO RISK MANAGEMENT AND
PROSECUTING ATTORNEY(IF REQUIRED).
STEP 6: CONTRACTOR SIGNS
STEP 7: SUBMIT TO BOCC FOR APPROVAL
1
WASHINGTON STATE
Department of DCYF Contract Number: 26-1141
.'�41;; Children, Youth, and Families Contract Maximum: $446,836.63
From-To:07/01/2025-07/31/2026
INTERLOCAL AGREEMENT
Home Visiting Services Account: Nurse Family Partnership
THIS CONTRACT is made and entered into by and between the State of Washington, acting by and through the
Department of Children, Youth, and Families, a department of Washington State government (hereinafter referred
to as "DCYF") and Jefferson County, a Municipality , (hereinafter referred to as"Contractor"), located at 615
Sheridan Street, Port Townend WA 98368.
CONTRACTOR BUSINESS ADDRESS CONTRACTOR CONTRACT MANAGER
Jefferson County Denise Banker
615 Sheridan Street Community Health Division Director
Port Townend WA 98368 dbanker@co.jefferson.wa.us
TIN: 91-6001322 Phone: (360) 385-9438
UBI: 161-001-169
DCYF ADDRESS DCYF PROGRAM CONTRACT MANAGER
Department of Children, Youth, and Families Ivon Urquilla
PO Box 40970 Prevention Services Program Specialist
Olympia WA 98504-0970 ivon.urquilla@dcyf.wa.gov
Phone:
THIS CONTRACT CONTRIBUTES TO THE FOLLOWING AGENCY GOALS:
• Health - Healthy Birthweight.
• Resilience - Children/youth are supported by healthy relationships with adults.
• Resilience - Parents/caregivers are supported to meet the needs of their children/youth.
THE PURPOSE OF THIS CONTRACT is to provide high quality home visiting services to vulnerable families for
the purpose of improving outcomes for participants and strengthening coordination of services.
THEREFORE, IT IS MUTUALLY AGREED THAT:
1. CONTRACT MANAGEMENT
a. Contract Managers
(1) The Contract Manager as shown on page 1 for each of the parties shall be the contact person for
all communications and billings regarding the performance of this Contract.
(2) Each party shall provide the other party with written notice of any changes of the name and
contact information regarding either party's designated Contract Manager. The written notice shall
not be effective until fourteen business days from the date of mailing. The requirements contained
in the Section titled Contractor Staff of exhibit D shall apply to this Section (Section 1.a).
b. Notices
(1) Any notice or demand or other communication required or permitted to be given under this
Contract or applicable law shall be effective only if it is in writing, properly addressed, and either
emailed, delivered in person or by a recognized courier service, or deposited with the United
States Postal Service as first-class certified mail, postage prepaid and return receipt requested, to
the parties at the addresses listed in Section 1.a.
Contract Number: 26-1141 Printed Date: 9/2/2025 Page 1 of 3
JeffCo:N-25-065
(2) Notwithstanding RCW 1.12.070, such communications shall be effective upon the earlier of
receipt or four calendar days after mailing or emailing. The notice address as provided herein may
be changed by written notice given as provided on page 1.
2. EXHIBITS AND ATTACHMENTS
Attached hereto and incorporated herein as though set forth in full are the following exhibits and attachments:
• Exhibit A - Statement of Work
• Exhibit B - Budget Report
• Exhibit C - Deliverables Report
• Exhibit D - General Terms and Conditions
• Attachment 1 - Confidentiality and Non-Disclosure Agreement
• Attachment 2 - Certification of Data Disposition
• Attachment 3 - Contract Monitoring, Compliance and Non-Compliance
• Attachment 4 - Data Collection, Reporting and HVSA Aligned Measures
The parties agree that the exhibits and attachments listed in this paragraph shall be enforceable against the
parties and are a part of this Contract.
3. STATEMENT OF WORK
The Contractor shall perform the activities and obligations as set forth and described in Exhibit A. The Contractor
shall also furnish the necessary personnel, equipment material and/or service(s) and otherwise do all things
necessary for or incidental to the performance of the work as set forth and described in Exhibit A. The Contractor
shall provide the services, goods, products and activities at the costs set forth in this Contract.
4. PERIOD OF PERFORMANCE
The effective date of this contract, shall commence on July 1, 2025 and must be completed on or before July 31,
2026. Performance on this Contract shall not begin before the effective date.
The funding period of this Contract is from July 1, 2025 through June 30, 2026 and all services must be provided
by June 30, 2026; however, the end date of this contract is extended to July 31, 2026, to allow time for data to be
received and final reports to be completed.
5. COMPENSATION
The cost of accomplishing the work described in this Contract shall not exceed $446,836.63. Any additional
authorized expenditures, for which reimbursement is sought, must be submitted as written documentation to the
DCYF Contract Manager for pre-approval by the DCYF Secretary or the Secretary's delegate as described in this
Contract, and established by a written Contract Amendment. Exhibit B is an actual budget of the costs associated
with this Contract. If the Contractor reduces its prices for any of its services during the term of this Contract,
DCYF shall receive the immediate benefit of such lower prices for services following the price reduction.
Compensation for services will be paid upon the timely completion of services as described in Exhibit A and is
contingent upon acceptance of relevant work products and approval of vouchers by DCYF as described in this
Contract.
6. BILLING PROCEDURE
a. The Contractor shall submit, not more than semi-monthly, properly completed A-19 vouchers (the
"voucher") to one of the following:
The Department of Children, Youth, and Families
Attn: Ivon Urquilla
PO Box 40970
Olympia WA 98504-0970
Or, email a scan of an original, signed A-19 voucher directly to the DCYF Contract Manager at
home.visiting@dcyf.wa.gov
Contract Number: 26-1141 Printed Date: 9/2/2025 Page 2 of 3
b. Payment to the Contractor for approved and completed work shall be made by warrant or Electronic
Funds Transfer by DCYF and considered timely if made within 30 days of receipt of a properly completed
voucher. Payment shall be sent to the address designated by the Contractor and set forth in this Contract.
c. Each voucher must clearly reference the DCYF Contract Number and the Contractor's Statewide Payee
Registration number assigned by the Office of Financial Management (OFM).
d. Properly completed vouchers and attachments completed by the Contractor must contain the information
described in Exhibit A under the Section titled "Reporting and Documentation".
e. For Statewide Payee Registration: OFM maintains a central contractor registration file for Washington
State agencies to use for processing contractor payments. This allows many contractors to receive
payments by direct deposit. The Contractor must be registered in the Statewide Payee Registration
system, https://ofm.wa.gov/it-systems/statewide-vendorpayee-services, prior to submitting a request for
payment under this Contract. No payment shall be made until the Statewide Payee Registration is
complete.
f. Upon the expiration of this Contract, any claim for payment or voucher not already made shall be
submitted to DCYF no later than forty-five (45) days following the expiration date of this Contract. In the
event the Contractor does not provide to DCYF a claim for payment or voucher within forty-five (45) days
following the expiration date of the Contract, DCYF shall have no obligation to pay such claim for payment
or voucher even if the service or product has been delivered and/or accepted. The final voucher shall
certify that the Contractor has completed all requirements of this Contract.
7. SIGNATURES
THIS CONTRACT, including the exhibits and attachments described in Section 2, is executed by the persons
signing below who warrant they have read and understand this Contract, including the exhibits and attachments.
The persons signing below further represent they have the authority to execute this Contract.
Jefferson County DEPARTMENT OF CHILDREN,
YOUTH, AND FAMILIES
Signature Signature
Heidi Eisenhour
Name Name
Chair, Board of County Commissioners
Title Title
Date Date
Ap roves as only:
for 09/04/2025
Philip C. Hunsucker, Date
Chief Civil Deputy Prosecuting Attorney
Contract Number: 26-1141 Printed Date: 9/2/2025 Page 3 of 3
WASHINGTON STATE DCYF Contract Number: 26-1141
Department of Contract Maximum: $446,836.63
4 Children, Youth, and Families
From-To:07/01/2025-07/31/2026
Exhibit A - Statement of Work
Table of Contents
1. Definitions. 1
2. Background 4
3. Model Fidelity 5
4. Program Participants: Funded Slots, Service Area, and Priority/Focus Populations 5
5. Staffing, Supervision and Training 6
6. Participant-Engagement (Outreach, Recruitment, Enrollment, Retention) 9
7. Home Visits Frequency and Content 10
8. Systems Connections 10
9. Data Collection and Evaluation Requirements 11
10. Continuous Quality Improvement (COI) 13
11. Technical Assistance 13
12. Budget and Financial 14
13. Performance-Based Contract 18
14. Publicity, Publication and Acknowledgements 19
15. Contract Reporting, Monitoring, and Deliverables 20
1. Definitions.
The following terms, as used throughout this Contract, shall have the meanings set forth below:
a. "Active Engaged Participant Caseload" means the sum of unduplicated counts of Encountered
Families and unduplicated counts of Visited Families during a reporting period, typically a month.
b. "Administrative Supervision" means supervision provided to staff involving adhering to and
implementing agency policy and procedures, paperwork, data collection, report writing,
coordinating, monitoring productivity, and evaluating performance.
c. "At-Risk Community" means a community for which indicators of risk are present in greater
proportion than in Washington as a whole according to the statewide Home Visiting Needs
Assessment.
d. "Benchmarks" means the federally or state required performance measures that will be
measured and reported on through this Contract.
e. "Clinical Supervision" means regular supervision of staff involving program methods and
models, fidelity, curriculum, screening tools and procedures, case reviews, goal setting with
families, reviewing and evaluating client progress, teaching, and providing guidance and advice.
f. "Confidential Information" means information that is protected from public disclosure by law.
There are many state and federal laws that make different kinds of information confidential. In
Washington State, the two most common are the Public Records Act RCW 42.56, and the
Healthcare Information Act, RCW 70.02. This includes names; postal address information (other
than town or city, state and zip code); telephone numbers, fax numbers, e-mail addresses; social
security numbers; medical record numbers; health plan beneficiary numbers; account numbers;
certificate/license numbers; vehicle identifiers and serial numbers, including license plate
numbers; device identifiers and serial numbers; web universal resource locators (URLs); internet
protocol (IP) address numbers; biometric identifiers, including finger and voice prints; and full face
photographic images and any comparable images.
Contract Number: 26-1141 Printed Date: 9/2/2025 Page 1 of 21
g. "Continuous Quality Improvement (COI)" means a systematic approach to specifying the
processes and outcomes of a program or set of practices through regular data collection and the
application of changes that may lead to improvements in outcomes, process, and performance.
h. "Cultural Adaptations" means proactive learning and engagement regarding the distinct cultural
practices of others, referencing specific elements that could be recognized as particular to their
cultural ways. Modifications made to practices, customs, or expectations to better accommodate
a specific culture's values and norms. This includes providing culturally competent training to staff
to ensure a comprehensive understanding of local needs, employing linguistically and culturally
specific communication and access strategies, and adjusting intervention methods to align with
diverse family structures and belief systems.
"Culturally Responsive" means proactively engaging with people in ways that are appropriate
with their cultural values, behaviors, and norms. Culture includes the shared social behaviors and
norms within a society that may include shared knowledge, believes, laws, arts, customs, habits,
priorities, expectations, and many other shared practices.
j. "DCA" means Dedicated Cannabis Account, formerly referred to as i502 funding source.
Program data systems may reference either or both funding source names.
k. "DCYF" means the Department of Children, Youth and Families.
"De-identified Data" means health information that does not identify an individual and that there
is no reasonable basis to believe that the information can be used to identify an individual, as
specified in 45 C.F.R. § 164.514(e)(1).
m. "Deliverable" means the delivery of home visiting services and/or a tangible work product
resulting from this contract which is to be documented, described, reported and/or provided to
DCYF in the form and manner required by this contract.
n. "DOH" means the Department of Health.
o. "DSA" means Data Sharing Agreement.
p. "Encounter" means a substantive, two-way interaction with a enrolled family via in-person, email,
text or phone call that includes minimal or no program model content; the interaction would not be
considered a home visit by the program model.
q. "Encountered Families" means those enrolled home visiting program participants have
engaged in at least one (1) encounter, but no home visit during the monthly reporting period. This
may include participants who newly enrolled in the period and did not receive a home visit.
r. "Enhancements or Adaptations to home visiting model" means adaptations to programs
including changes to the model that have not been tested with rigorous impact research but are
determined by the Model Developer not to alter the core components related to program impacts.
s. "Enrollment" means a family is considered to be enrolled in a home visiting program as of the
date of the first home visit during which the participant voluntarily consents to participate and
signs a written participant agreement. All services must be voluntary.
t. "Evidence-based Home Visiting Models" means home visiting models meeting specific
evidence standards as outlined and approved by the federal Health Resources and Services
Administration's (HRSA) MIECHV program and selected by local implementing agencies for
funding through the HVSA.
u. "FERPA" means "Family Educational Rights and Privacy Act" that protects the privacy of student
education records, with regulations found at 34 CFR Part 99.
v. "FLO" means the Penelope data collection system to be used by the national Nurse Family
Partnership program.
Contract Number: 26-1141 Printed Date: 9/2/2025 Page 2 of 21
w. "HIPAA Rules" means the "Health Insurance Portability and Accountability Act Rules" and
includes the Privacy, Security, Breach Notification, and Enforcement Rules at 45 C.F.R., Part 160
and Part 164.
x. "Home Visit" means an in-person, virtual, or telephone visit with an enrolled participant meeting
model expectations for content and duration.
y. "HRSA" means the United States Department of Health and Human Services: Health Resources
and Services Administration.
z. "HV" means home visiting.
aa. "HVSA" means the Home Visiting Services Account established in RCW 43.216.130.
bb. "HVSA Aligned Measures" means those performance measures described in the Attachment
entitled Data Collection, Reporting and HVSA Aligned Measures of this Contract.
cc. "Implementation HUB" means the central administration of Implementation Science-informed
supports, training, coaching, and technical assistance for home visiting services in Washington
State as provided by Start Early. "Implementation Hub" is also known as `The HUB.'
dd. "Implementation Science" (IS) means, a framework to promote the full and effective use of
evidence- based programs and evidence-informed innovations so that outcomes shown in
research are achieved and sustained.
ee. "Local Implementing Agency (LIA)" means local agency funded through the HVSA contract that
provides direct home visiting services and tasked with establishing the local infrastructure
necessary for successful implementation and provision of the selected evidence-based HV
research based or promising practices home visiting models.
ff. "Maximum Service Capacity" means the greatest number of families or households that could
potentially be enrolled in the Contractor's home visiting program at any point in time if the
program were operating with a full staff, as described in Section 5.a., and at full enrollment, as set
forth in Section 4. b..
gg. "Memorandum of Understanding (MOU)" means an agreement, between Contractor and
partners, organizations, individuals, agencies and/or other entities in the local service area to
provide wraparound services, additional resources, in-kind services, and/or use of facilities to
Contractor in order to best meet the goals of the Local HVSA Program. MOUs will serve to
leverage community resources and address the existing service gaps and needs of participants
and promote successful implementation and operation of the Local HVSA Program.
hh. "Model Developer" means an entity or its designee responsible for the development of an
identified evidence-based HV model for defining and monitoring fidelity to the model.
ii. "NFP" means the Nurse-Family Partnership home visiting model. Nurse-Family Partnership
(NFP), considered an evidence-based model for the purposes of this contract. Nurse Family
Partnership National Service Office, www.nursefamilypartnership.org.
jj. "PSRS" means the Prevention Services Reporting System, an online electronic reporting system
managed by the Department of Children, Youth, and Families for contractor submission of
deliverables.
kk. "Priority Populations" means the populations from which clients who receiving home visiting
services through this Contract are recruited, defined in Section 4.e. of this Contract.
II. "Promising Practices Home Visiting Models" means home visiting models approved by
Washington State HVSA that have demonstrated impacts through evaluation results and selected
by local implementing agencies for implementation through the HVSA. This definition includes a
program or practice model that is based on statistical analysis or a well-established theory of
change, shows potential for meeting the `evidence-based' or'research-based' criteria, which
Contract Number: 26-1141 Printed Date: 9/2/2025 Page 3 of 21
could include the use of a program that is evidence-based for outcomes other than the alternative
use, but does not meet the evidence-based standards for Maternal, Infant and Early Childhood
Home Visiting program funding.
mm. "Reflective Supervision (RS)" means a distinctive form of competency-based professional
development provided to multidisciplinary early childhood home visitors that emphasizes
relationship development between home visitor and supervisor, between home visitor and parent,
and between parent and infant/toddler. Reflective supervision attends to the emotional content of
the work and how reactions to the content affect the work.
nn. "Service Area" means the geographical area defined by geographic boundaries where the
priority populations reside or where a specific group of eligible participants will be served by
Contractor.
oo. "Start Early" means the private partner to be responsible for supporting the HVSA account by
providing TTA through the implementation Hub to LIAs as described in RCW 43.216.130.
pp. "State Model Lead" means the HV program model representative that provides contractors with
HV services, supports and TTA in coordination with the Implementation HUB.
qq. "TANF" means Temporary Assistance for Needy Families administered through the Department
of Social and Health Services (DSHS).
rr. "TTA" means Training and Technical Assistance and may include coaching and consultation
activities.
ss. "Visited Families" means those enrolled home visiting program participants who have
participated in at least one (1) home visit as defined by the program model within the month
reporting period.
tt. "WorkFirst" means the program for TANF families who are required to participate in certain work-
related activities.
2. Background
a. The Home Visiting Service Account (HVSA) is a legislatively mandated private- public partnership
(RCW 43.216.130) that funds high quality home visiting programs so that:
(1) Children are healthier and better prepared for school
(2) Parent-child bonds are stronger
(3) Abuse and neglect are less likely
b. The HVSA prioritizes funding towards meeting the needs of Washington's diverse populations,
particularly those families and communities demonstrating the highest needs.
c. Ultimately, the HVSA is working to ensure that home visiting services are embedded in and
contribute towards comprehensive, high quality early childhood systems so that families have
access to high quality information, services and supports prenatally through kindergarten entry.
d. Programs funded through the HVSA and administered by DCYF aim to improve the health and
well-being families furthest from opportunity, understanding there are windows of opportunity to
influence family and child development that occur in the context of community and society.
Contractor shall implement the HVSA-approved home visiting model with the intent of improving
outcomes for participants and strengthening coordination of services.
e. Washington's home visiting programming is impacted by a wide range of contextual factors and
circumstances. This contract allows for minor shifts in contract terms that are aligned with
program model expectations and the goals set forth in section 2.a. Such shifts must be approved
in writing by DCYF.
Contract Number:26-1141 Printed Date: 9/2/2025 Page 4 of 21
3. Model Fidelity
a. The Contractor shall maintain fidelity to the Nurse Family Partnership (NFP) program model,
defined as ongoing adherence to specified criteria and components described by the NFP Model
Developer. Contractor will work with the DCYF-authorized provider of technical assistance to
adhere to model fidelity indicators established in prior contracts throughout the term of this
contract.
(1) National Model Standing: Contractor will ensure adherence to NFP program model
standards for the duration of this contract, as indicated through a written letter with
certification of good standing status and/or active, ready to implement status from the
NFP national organization for evidenced based programs. The letter shall be delivered to
DCYF with the Quarter 2 Progress Report.
(2) Contractor must obtain prior written approval by the model developer and DCYF before
implementing enhancements or adaptations to the home visiting model.
b. If Contractor subcontracts for delivery of home visiting services, then the subcontract must
receive prior approval from DCYF, and the subcontractor must comply with all sections of this
Scope of Work.
4. Program Participants: Funded Slots, Service Area, and Priority/Focus Populations
a. The Maximum Service Capacity, or total number of funded slots, apportioned by funding source,
for this contract shall be:
a. b. c. d. f.
MIECHV TANF DCA (i502) General State HVSA
Funded Funded State Funded Funded Total
Total 0 0 29 33 62
b. Caseload Maintenance: Contractor shall build and maintain a caseload in accordance with this
contract and NFP model requirements, aiming to serve throughout the entire term of this contract
an active Maximum Service Capacity of 62 families.
(1) The Contractor's monthly Actively Engaged Participant Caseload, which is the sum of the
unduplicated count of Visited Families and unduplicated count of Encountered Families in
each month, per the definitions in this Contract, must meet or exceed 85% of the
Maximum Service Capacity (funded slots).
(2) DCYF will initiate review and improvement processes described in the Attachment
entitled Contract Monitoring. Compliance and Non-Compliance if the Contractor's
Cumulative Families Served falls below 85% of the Maximum Service Capacity for 6
consecutive months.
c. Service Area:
Contractor agrees to deliver home visiting services to priority populations, defined in Section 4.e
and f who reside in the following counties or sub-county areas:
(1) 13 (GSF) families in Clallam County; 17 (11 DCA slots, 6 GSF slots) families in
Jefferson County and 32 (18 DCA slots, 14 GSF slots) families in Kitsap County.
(2) Contractor shall serve families in the service areas described in (1) above according to
the following funding sources:
Service Area by MIECHV TANF DCA (i502) General State
slots Funded Funded State Funded Funded
Total 29 33
Clallam 13
Jefferson 11 6
Kitsap 18 14
Contract Number: 26-1141 Printed Date: 9/2/2025 Page 5 of 21
Geographic Area
d. Age of Service
Findings in brain science research confirms the importance of supporting families and caregivers
during the first years in a child's life. The Contractor shall prioritize enrollment for prenatal
families, and families with infants and toddlers, up to 36 months.
e. Priority Populations:
Contractor shall sustain internal practices to serve from among the HVSA Priority Populations.
Priority Populations are defined as eligible participants with two or more of the following
characteristics:
(1) Demographic Characteristics:
(a) American Indian/Alaskan Native
(b) Poverty/Low Income
(c) Teen Parents
(d) Non-English Speaking or Recent Immigrant
(e) Enrolled in WorkFirst/TANF
(2) Adverse Experiences
(a) Prior Child Welfare System Involvement
(b) Intimate Partner Violence
(c) Familial History or current experience with Substance Use, including Tobacco
(d) Caregiver Mental Illness
(e) Current and Previously Incarcerated Parents
(f) Homeless/Unstable Housing
(3) Other Characteristics
(a) Caregivers with Low Educational Attainment
(b) Caregivers with Developmental Delays or Disabilities
(c) Caregiver currently or formerly in the Military
(d) Children with Developmental Delays or Disabilities, especially those not linked
with early intervention services
5. Staffing, Supervision and Training
a. Staffing Level: -
(1) Contractor shall maintain staffing levels sufficient to comply with the home visiting
program model to meet required goals and objectives through adherence to the staffing
plan outlined as follows:
a. b. c. d. f.
Staffing Plan by Position Type MIECHV TANF DCA (i502) General HVSA
Funds Funds State Funds Funds State Total
Home Visitor FTE Total .94 1.47 2.41
HV Supervisors FTE Total -- time delivering
home visiting services, if applicable
•
Supervisor FTE Total --time dedicated to 07 .26 .33
supervision
Admin Support Staff FTE Total
Data Support Staff FTE Total
Contract Number: 26-1141 Printed Date: 9/2/2025 Page 6 of 21
Program Management Staff FTE Total
Additional Direct Service Staff FTE Total
(a) Contractor shall comply with DCYF and program model requirements for the ratio
of supervisors to home visitors throughout the term of this contract. If no model
requirements exist, Contractor shall comply with requirements established with
the DCYF-authorized technical assistance provider throughout the term of this
contract.
(2) Documentation of staffing — Contractor shall report staffing by individual in the Quarterly
Profess Report of the PSRS; this shall include home visitor and supervisor positions by
FTE and funding source, including filled and vacant positions.
b. The minimum expected caseload for Home Visitors shall be 25 families/participants for each 1.0
FTE home visitor. Any variance to caseload must be approved in advance by DCYF.
c. Home Visiting Supervisor and Home Visitor Qualifications:
(1) The Contractor shall comply with the NFP home visitor supervisor and staffing
qualification requirements throughout the term of this contract. If there are no model
requirements, the Contractor shall work with the DCYF-authorized provider of technical
assistance to establish qualifications. The definitions shall be included with the model
fidelity letter submitted by the Contractor as described in Section 3.a.
(2) The Contractor shall adhere to these definitions of home visitor and supervisor
qualifications throughout the entire term of this contract.
d. Sub-Contracting: With prior approval from DCYF, Contractor may hire directly or subcontract with
clinical staff, other support staff, or consultants to provide topic-specific expertise or clinical
support to home visiting staff. If Contractor hires clinical staff or contracts out for other support
services, Contractor will be required to adhere to DCYF and model, personnel and data collection
requirements and provide periodic updates on the activities carried out by the clinical staff,
consultant, and/or subcontract.
e. Background Checks:
The Contractor shall conduct reference and background checks on home visiting staff prior to
allowing home visiting staff to perform work pursuant to this contract. Reference and background
check information for each employee shall be retained in the employee's personnel files.
f. Supervision Schedule Hours:
Contractor shall comply with the following supervision schedule, unless exceeded by model
standards:
(a) A minimum of two (2) hours per month of individual reflective supervision for
each home visitor working .5 FTE or more; and
(b) A minimum of one (1) hour per month of group supervision, case conferencing,
or staff meetings for all home visitors;
(c) A minimum of one (1) hour per month for each home visitor working 0.5 FTE of
administrative and clinical supervision;
(d) The parties may agree in writing to an alternative supervision schedule.
g. Staff Training and Ongoing Professional Development:
(1) The Contractor shall ensure that all home visitor and supervisor staff adhere to the
training requirements, professional development, and continuing education requirements
established by the model developer and DCYF. Training requirements for home visitors,
supervisors, and home visiting coordinators shall include, but not be limited to the
following pre-service and in-service learning:
(a) New and ongoing model training
Contract Number: 26-1141 Printed Date: 9/2/2025 Page 7 of 21
(b) Ongoing professional development and continuing education required by the
NFP model,
(c) Staff release time, access, and use of HVSA Foundational trainings, materials
and recordings as needed, to meet service delivery contract requirements,
including:
Model Required Assessments
ii. HVSA Orientation webinars for newly contracted LIA's and staff new to
HVSA contracted home visiting programs
iii. Home Visitor Safety
iv. Caregiver Depression Screening and Referrals
v. Parent- Child Interaction Screening
vi. Child Development Screenings and Referrals
vii. Intimate Partner Violence Screening and Referrals
viii Data System and Data Reporting Requirements
ix. Aligned Measures (c) Staff release time, access, and use of HVSA
Foundational trainings, materials and recordings as needed. to meet service
delivery contract requirements. including:
Model Required Assessments
ii. HVSA Orientation webinars for newly contracted LIA's and staff new to
HVSA contracted home visiting programs
Home Visitor Safety
iv. Caregiver Depression Screening and Referrals
v. Parent- Child Interaction Screening
vi. Child Development Screenings and Referrals
vii. Intimate Partner Violence Screening and Referrals
viii Data System and Data Reporting Requirements
ix. Aligned Measures
2) Upon request, the Contractor shall deliver to DCYF documentation pertaining to all staff
training, professional development, and continuing education described in this Section.
h. HVSA Orientations, Webinars and Meetings:
Contractor shall attend and participate in statewide HVSA Meetings to occur on dates to be
determined including, but not be limited to, the following:
(1) DCYF Monthly Office Hours and Semi-Annual Training and Learning Supports webinars
to be attended by Supervisors and/or Lead Program Staff.
(2) At least two (2) half-day Semi-Annual Statewide All HVSA Program Meetings, held
remotely. Both days shall be attended by at least one Contractor Program Staff, either
the Home Visiting Program Supervisor or Program Manager; the second day may be
attended by all Contractor staff funded by this contract and shall center on Home Visitor
Professional Development.
(3) At least three (3) NFP Supervisor Meetings— Supervisors.
Staff Retention Practices:
To ensure continuity of high-quality service delivery, the Contractor shall develop and implement
policies and practices to recruit and retain qualified staff in the home visitor and supervisor
positions.
j. Staffing Vacancy Plans:
To avoid service disruption in the event of a short-or long-term staffing vacancy, the Contractor
Contract Number: 26-1141 Printed Date: 9/2/2025 Page 8 of 21
shall establish and implement vacancy plans to fill vacant home visitor and supervisor positions to
ensure continuity of home visiting services, minimal client turnover, and adequate supervision.
6. Participant-Engagement (Outreach, Recruitment, Enrollment, Retention)
a. Annually, the contractor shall create a comprehensive plan for participant outreach and
engagement, to include participant recruitment, enrollment, and retention, aligned with the NFP
program model to ensure ongoing service to priority populations described in Section 4 of this
contract. This plan will be submitted to DCYF as part of the Quarter 1 Progress Report.
b. Outreach Efforts: The Contractor shall implement the participant outreach and engagement plan
throughout the term of this contract.
c. The Contractor shall document in the PSRS Quarterly Progress Reports to DCYF outreach efforts
and referral sources for potential and enrolled participants, including those who decline services.
(1) Contractor shall also submit to DCYF in its quarterly reports description of barriers to
reaching the intended populations.
d. Any proposals to adapt the priority population must be supported by community data and receive
prior approved by DCYF.
e. Voluntary Services: The Contractor shall implement program policies and procedures to ensure
home visiting services are provided to program participants on a voluntary basis. For every
participant enrolled, Contractor must obtain consent to participate indicating that expectant
parents, parents, or caregivers agree to voluntarily enroll in Contractor's home visiting services.
Consent forms or participant agreements must explicitly state that home visiting services are
voluntary, and the consent must be agreed upon with electronic or paper format including the
date by the participant upon enrollment. Consent must be maintained in the participant file in
paper or electronic form. Consent agreement should be written in plain language and be available
in multiple languages. When potential participants have barriers with literacy, the consent should
be explained in the participant's primary language, which may require interpretation. When
interpretation is utilized, signatures should be obtained on the consent form from the interpreter.
Sample consent form(s) are available on the home visiting page of the DCYF web site.
f. Policies and Procedures for Participant Enrollment, Disenrollment, Re-Enrollment, and Transfer:
Contractor shall develop, maintain, and implement written policies and procedures that are
consistent with and in alignment with NFP model fidelity. The written policies and procedures
shall include, but not be limited to, the following:
(1) Enrollment and Disenrollment: A description of the timeline and process for dis-enrolling
families upon graduation as well as what measures are taken and the timeline when
contact with a family is lost. If the program model allows for an alternative visit schedule,
the Contractor must have documented procedures for how alternative visit schedules are
determined and approved.
(2) Re-enrollment: A description of the process for responding to families who reapply for
program participation to allow for re-enrollment in the program. Procedures should
include an assessment of prior home visiting program participation, and upon re-
enrolling, programs will have a system for determining if/how re-enrollment impacts
timelines for program curriculum, assessment, and services as well as how families are
re-oriented to the home visiting program. Programs should allow for re-enrolling families
when eligible by model and when appropriate.
(3) Avoiding Dual Enrollment A description of the processes to assess a family's prior and
current participation in home visiting services upon application for enrollment. If a family
is currently enrolled in another HVSA funded program or model, in dialogue with the
family, the Contractor's staff shall determine which program is most appropriate to meet
the family's circumstances and the family will remain in the previous program or be
seamlessly transitioned into the new program. It is the intent of the parties that if the
family is meeting participation expectations in the originally enrolled program, enrollment
should be maintained in the original program. When there is a clinical need or planned
service transition for dual enrollment, Contractor will document this need in the client file
and the plan for coordination of services. Contractor will develop and implement policies
Contract Number: 26-1141 Printed Date: 9/2/2025 Page 9 of 21
and procedures to seamlessly transfer enrolled families to alternate home visiting models
if it best meets the interests and needs of the family and considers risks to disrupting an
existing positive relationship between home visitor and family. When there are multiple
HVSA funded contracted programs or models in the same service area, it is
recommended that the Contractor develop a formal agreement with each program, such
as a Memorandum of Understanding, to describe how the organizations will coordinate
recruitment and enrollment of home visiting services.
7. Home Visits Frequency and Content
a. Frequency of Home Visits: The content, number and frequency of home visits delivered to family
participants shall be based on the NFP program model requirements. If there are no model
requirements, the Contractor shall develop with Start Early definitions of"model content" and
"expected frequency". The Contractor shall submit to DCYF a written definition of"model
content" and "frequency" after such definition has been developed. The definition shall be
included with the materials submitted as part of the model fidelity letter submitted by the
Contractor as described in Section 3.a.
(1) Seventy-five percent (75%) of all home visits conducted by the contractor must be in-
person modality.
(2) While Contractor may offer participating participants a mix of in-person and virtual visit
modalities; the contractor shall offer every participant at least one in-person visit per year.
b. Assessments, Service Content, and Referrals: The Contractor shall administer individualized
assessments of participant families, and offer services in accordance with those assessments,
family strengths and needs, and in compliance with the NFP model requirements.
(1) Screenings and Assessments: The Contractor shall administer screenings and
assessments with the tools and frequency consistent with fidelity to the NFP program
model requirements.
(2) If not required by the program model, as noted in (1) above, the Contractor shall assess
for the following, using valid and reliable assessment tools as determined by DCYF, and
using the methods and frequency described in the Data Collection, Reporting and HVSA
Aligned Measures Attachment.
(a) Depression Screening
(b) Well-Child Visits
(c) Parent Child Interaction
(d) Early Language and Literacy Activities
(e) Child Developmental Screening
(f) Intimate Partner Violence Screening
(g) Breastfeeding
(3) Referrals: The Contractor shall refer participants to services needed as identified by
individual assessments and document referrals and results of referrals in the participants'
files.
(4) The Contractor shall document in the FLO data collection system the assessment scores
and findings, as well as any referrals arising from the assessments.
c. During extenuating circumstances (e.g. the COVID-19 pandemic), as directed by DCYF, the
specific frequency, content, assessment, and other model-required components of home visits
may be modified per guidance from the program model developer and DCYF.
8. Systems Connections
a. Local Engagement and Collective Impact: The Contractor shall participate in local interagency
efforts to support, coordinate and build connections among local early childhood partners, early
Contract Number:26-1141 Printed Date: 9/2/2025 Page 10 of 21
intervention, Early Supports for Infants and Toddlers, child welfare, and economic support
services; these may include early learning local or regional coalitions, Community Prevention and
Wellness Initiative Coalitions, Local Planning Area meetings, and other interagency groups.
DCYF recommends Contractor develop Memoranda of Understanding with the Early Supports for
Infants and Toddlers (ESIT) program, early intervention service providers, Early Childhood
Education and Assistance Program, child welfare services, other non-HVSA home visiting
programs and early learning providers within the service area. The intended purpose of the
MOUs is to describe the role of each partner in service coordination, referrals, information
sharing, and family transitions. Contractor shall provide copies of these MOUs upon request.
(1) Contractor shall document community engagement and coordination activities in the
PSRS Monthly Enrollment Report.
9. Data Collection and Evaluation Requirements
a. Evaluation Purpose and Overview: The parties understand and agree that the HVSA data
collection and evaluation requirements are designed to (1) inform the various stakeholders of
home visiting in Washington State, (2) provide an understanding for how home visiting programs
are working in Washington, and (3) describe how home visiting programs contribute to an early
learning system that ensures all children start life with a solid foundation for success. The HVSA
also reports to federal, state, and private funders the impacts of their investments.
(1) While DCYF is the administrator of the HVSA, DCYF contracts with the Department of
Health (DOH) to lead data collection, management, data sharing, quality assurance,
reporting to support program quality and continuous quality improvement and overall
HVSA evaluation efforts. DOH is the DCYF-specified contractor for data management
and reporting.
b. Data Collection: The Contractor shall collect data from all families, adults, and children enrolled in
the home visiting program as described in this Section (Section 9). Such data collection shall
comply with requirements set forth by the NFP model, DCYF and the HVSA as described in the
Attachment entitled Data Collection, Reporting and HVSA Aligned Measures and outlined below:
(1) Performance Measures, defined in the Attachment entitled Data Collection, Reporting
and MIECHV/HVSA Aligned Measures:
(a) System and Program Performance Indicators;
(b) Enrollment and Service Utilization;
(c) Demographic Information; and
(d) Performance Payment Measures.
(2) Upon notification by DCYF, Contractor shall comply with any changes in data collection
expectations as required of DCYF by federal or state funding sources.
c. Data Management: The Contractor shall collect and input the home visiting data described in this
Section 9 into the FLO data collection system. The data shall be stored, maintained, and
protected as described in Exhibit D General Terms and Conditions of this Contract.
d. Data Accuracy: The Contractor shall ensure that data collected represent accurately the
experience of the home visiting participants, including the required screenings and assessments
administered as designed. This includes assigning all clients a funding code as designated by
DOH (see Section 9.f for data sharing requirements).
e. Timely Data Collection: The Contractor shall comply with data collection timelines and the
Performance Measures requirements described in the Attachment entitled Data Collection,
Reporting and HVSA Aligned Measures. Data shall be entered into the FLO data collection
system within five (5) business days of data collection.
f. Data Sharing: The Contractor and all subcontractors delivering direct home visiting services must
share with DCYF 's contractor of record, DOH, the data necessary to meet data collection
requirements specified in Section 9.b. and described in the Attachment entitled Data Collection,
Reporting and HVSA Aligned Measures.
Contract Number: 26-1141 Printed Date: 9/2/2025 Page 11 of 21
(1) Data Sharing Agreement (DSA):The Contractor and all subcontractors delivering direct
home visiting services shall maintain an executed data sharing agreement with DOH to
share confidential information, outreach, referral, enrollment, service utilization, program
performance and staffing data as described in Section 9.b. to be effective throughout the
term of the contract. And submit written notice to the NFP National Service Office (NSO)
authorizing the release of data to DOH in coordination with the NSO; the Contractor shall
submit a copy of the notice to DCYF.
The Contractor shall maintain documentation of execution of the data sharing agreement
with DOH and submit notice to any third party data warehouse used by the Contractor
within 30 days.
•
(2) Parental Consent: With consultation and support from DCYF and DOH, the Contractor
will make every effort to seek Parental Consent to share Confidential Information with
DOH throughout the entire term of the Contract; the Contractor shall seek this consent
from all newly enrolled participants within the first three home visits. Required language
to be used in consent agreement(s) are available on the Home Visiting page at
DCYF.wa.gov.
(a) Participants who do not provide consent to share confidential information remain
eligible to receive home visiting services.
(b) The Contractor shall share with DOH the consent status according to the process
outlined in the Attachment entitled Data Collection, Reporting and HVSA Aligned
Measures at the same frequency as their routine data sharing via Managed File
Transfer(MFT) in section (a) above.
g. Quality Assurance: The Contractor shall ensure that data provided to DOH is complete and
accurate.
(1) The Contractor shall respond within 10 business days of any request from DOH to
resolve any errors or missing information for all data required in section 9.b.; this includes
review and corrections arising from DOH Quality Assurance Report.
(2) The Contractor shall strive for less than five percent missing data of all data required in
Section 9.b.
(3) The Contractor shall review Dashboards, Quality Assurance Reports, and other data
reports prepared by DOH to facilitate reflection, quality assurance and program
improvement efforts.
h. Evaluation: The Contractor shall participate in and cooperate with HVSA, DCYF and DCYF-
specified evaluations and studies. This shall include responding to emerging and non-routine data
and evaluation requests from HVSA funders and working with DCYF specified contractors.
Evaluation activities shall include, but are not limited to, the following:
(1) Interviews, focus groups, observations and surveys;
(2) Planning for Performance Based Contracting;
(3) Other DCYF or funded evaluation efforts.
(4) Completion of all documentation required by the research projects within the timeframes
presented.
Training and Technical Assistance on Data Collection and Evaluation: The Contractor shall
participate in and cooperate with training and technical assistance related to the topics listed
below. Such participation shall include in-person and remote meetings, staff training, technical
assistance opportunities, and reviews of data, reports and organizational policies and procedures.
DOH may support the Contractor in working towards and achieving contract expectations on
topics including, but not limited to, the following:
(1) Data collection;
(2) Data sharing;
(3) Reporting process;
Contract Number: 26-1141 Printed Date: 9/2/2025 Page 12 of 21
(4) Analysis and interpretation of data;
(5) Quality assurance.
10. Continuous Quality Improvement(CQI)
a. Purpose and Framework: The purpose of Continuous Quality Improvement (CQI) is to promote
learning, creativity and innovation in order to strengthen practice and improve outcomes for
families engaged in home visiting services.
b. Training and Technical Assistance: The Contractor shall participate in ongoing training and
technical assistance associated with CQI. DCYF-specified contractors providing this training and
technical assistance include Start Early and DOH who will also support the Contractor with data
collection and measurement, quality improvement methodologies, implementing PDSA (Plan Do
Study Act) cycles, topic specific CQI tools and resources, and the CQI Toolkit.
c. CQI Structure: The Contractor shall implement the following CQI Structure during the entire
contract term:
(1) Focus CQI activities on one of the following topics:
(a) Family Engagement and Retention;
(b) Staff engagement and retention (Team Support and Well-Being);
(c) Caregiver Mental Health;
(d) Or other topic areas approved by DCYF
(2) Establish an internal CQI staff team to oversee, support, and implement CQI activities to
assess program processes and outcomes; the CQI Team members are expected to
participate in regular CQI team meetings, CQI webinars, and CQI project activities.
d. CQI Activities: The Contractor shall participate in the following CQI Activities throughout the
contract term:
(1) Create a CQI-specific goal to be included in the annual Technical Assistance Plan;
participate in CQI Technical Assistance as defined in the TA plan and led by the DCYF-
specified contractor(Start Early WA) for CQI technical assistance; this may include
coaching, group learning, webinars, on-site visits, and other modalities;
(2) Conduct and track data ongoing rapid cycle PDSA tests and ramps, at least monthly, to
test, adapt, and implement changes and reflect on that data;
(3) Report on CQI Activities and Reflections to DCYF through existing deliverables - Monthly
Enrollment Reports and Quarterly Progress Reports; DCYF will share these with Start
Early WA and DOH for review and feedback to the Contractor;
(a) As part of ongoing quarterly progress reports, the contractor will share details
about their ongoing PDSA testing, data collected, reflections, and any
adaptations.
(b) Contractors experiencing Minimum Active Enrollment Caseload below 85% of the
Maximum Service Capacity, as established in Section 4 (a) of this Statement of
Work, will report monthly via the Monthly Enrollment Report on CQI activities,
including PDSA tests, data and reflections, to address understanding and
improving their Active Enrollment Caseload.
(4) Create a plan for sustaining gains made through CQI activities.
(5) DCYF will not monitor the Contractor for CQI outcomes but rather for progress on
implementing the CQI Activities as outlined in this Section 10
11. Technical Assistance
a. Technical Assistance (TA) is available to the Contractor to assist in maintaining model fidelity,
implementing best practices, and assuring improving quality of home visiting service delivery.
Contract Number:26-1141 Printed Date: 9/2/2025 Page 13 of 21
DCYF contracts with Start Early WA to provide technical assistance for the HVSA. The Contractor
shall work with DCYF 's designated technical assistance provider for support in achieving
contract milestones including, but not limited to, the following areas:
(1) Program model fidelity as described by the NFP model developer and Section 3 of this
Statement of Work;
(2) Staff qualifications, and selection and onboarding of home visitors and supervisors;
(3) Reflective supervision process;
(4) Staff retention and vacancy planning;
(5) Participant outreach, recruitment, enrollment and retention;
(6) Model specific service delivery and case planning;
(7) Leadership development and organizational support for home visiting model; and
(8) CQI planning, implementation and analysis.
b. Technical Assistance Plan and Participation: The Contractor shall work with the DCYF-specified
contractor for technical assistance to develop a Technical Assistance Plan within the first four
months of this Contract; the Technical Assistance Plan will integrate fidelity goals developed via
model-specific processes.
(1) The Contractor shall submit to DCYF their completed annual Technical Assistance Plan
on or before November 20, 2025.
(2) Technical Assistance and Coaching: The Contractor shall participate in technical
assistance with the DCYF-specified contractor for technical assistance to implement the
Technical Assistance Plan throughout the duration of this Contract; this may include
coaching, group learning, webinars, on-site visits, and other modalities.
(3) Contractor shall report quarterly on progress and impacts of technical assistance in the
Quarterly Progress Reports.
c. Additional or other Technical Assistance: The Contractor shall work with the DCYF-
specified contractor for technical assistance to participate in other technical assistance
should other areas of assistance arise as identified by Contractor or DCYF.
12. Budget and Financial
a. Program-Funding Specific Budget: The Contractor understands and agrees that funds provided
under this Contract shall be expended by June 30, 2026 as specifically itemized line by line in
Exhibit B Budget.
(1) Any requests for shifts between categories (payment points of the budget)within a
funding source must receive prior written approval from DCYF; transfers across expense
categories (pay points of the budget) in excess of 10% of the total for each funding
source shall not be made without prior written approval from DCYF and may require a
contract amendment.
(2) No shifts may occur across funding sources.
b. Financial Management: The Contractor must maintain a financial management system with
written policies and procedures ensuring strong internal controls. Written policies and procedures
include, but are not limited to: accounts payable, payroll, procurements, sub-
recipients/subcontractors, travel, and equipment inventory processes. The Contractor shall make
such policies and procedures available to DCYF upon request.
(1) Expenditures must be identifiable and clearly tracked throughout fiscal records as
assigned to the work of this contract.
(2) The Contractor must track expenditures to each funding source (e.g. MIECHV, TANF,
DCA, GFS) unique to this contract separately and may not comingle with funding sources
for other programs, grants, contracts outside of this contract.
Contract Number: 26-1141 Printed Date: 9/2/2025 Page 14 of 21
c. Supplantation: The Contractor shall ensure that HVSA funds received under this contract will be
used to supplement and not supplant the amount of federal, state, and local funds otherwise
expended for work performed under this Contract.
d. Travel: The Contractor shall receive compensation only for lodging, per diem, and meal expenses
at current state travel reimbursement rates and in accordance with the State of Washington Office
of Financial Management Travel Regulations. Current rates for travel may be accessed at:
http://www.ofm.wa.pov/resources/travel.asp. When the lowest available lodging rate exceeds the
current state travel reimbursement rates or the lodging provider requires a government-issued
identification card in order to receive the state per diem rate and the Contractor is not a
government-based entity, an exception may be made only when pre-approved in writing by the
Contractor's director or authorized designee (i.e. finance director), documented, and available for
review. Travelers must be prudent when planning and conducting essential business travel,
ensuring they select travel alternatives that are the most economical. Appropriate planning must
take place to avoid unnecessary travel in the performance of work assignments, seeking
alternatives such as teleconference calls, video and web collaboration, and conferencing.
Contractor's travel policy is subject to review during ongoing or in-depth fiscal monitoring.
(1) Additional training or other professional development opportunities may be presented
throughout the term of this contract. DCYF at its sole discretion may pay for these costs
directly.
e. Indirect Costs: The Contractor may claim the indirect rate based on one of three options: the rate
negotiated with its cognizant federal agency, also known as the federally approved cost allocation
plan; the rate negotiated with DCYF, not to exceed the federally approved cost allocation plan; or
the rate calculated at 10% of modified total direct costs.
(1) If claiming the federally negotiated rate, the Contractor must supply, preferably via email,
the most current documentation verifying the federally approved rate. The Contractor's
indirect rate plan and procedure are subject to review during ongoing or in-depth fiscal
monitoring.
(2) The Contractor's indirect cost plan must comply with the CFR part 200.56.57 and
200.414 Certification of cost allocation plan or indirect(facilities & administrative (F&A)
cost rate proposal. The CFR can be found at the following link: Electronic Code of
Federal Regulations.
f. Use of Funds:
(1) When expending funds under this contract for items, personnel or services also used by
other programs or individuals, funds from this contract may only be spent for the share
used solely for services supporting this Statement of Work. Applicable federal,
MIECHV/HHS, and state regulation should be consulted in order to ensure all
expenditures charged to the contract are allowable. The following types of expenditures
may be considered allowable provided they meet the outlined criteria and all required
documentation is retained/available for any in-depth reviews:
(a) Meals:
Meals as part of a per diem or subsistence allowance are allowable if
provided in conjunction with preapproved/allowable travel and do not
exceed the OFM rate at the time of travel.
A. Contractor shall provide required backup documentation for
these expense to include travel preapproval (describing purpose
as it relates to the contract); if applicable, conference registration
(or certificate of completion) and conference agenda. If a
contractor reimburses travel expenses based off actual costs
rather than travel per diem rates, the contractor must retain
itemized receipts for all meals for future review if requested by
DCYF.
ii. Meals as part of a conference/training/all-staff meeting are not allowable
with these contract dollars.
Contract Number:26-1141 Printed Date: 9/2/2025 Page 15 of 21
iii. Meals as part of client engagement are not allowable with these contract
dollars.
(b) Promotional Items are allowable only for those items necessary as part of the
outreach effort in order to comply with the terms and conditions of this contract;
promotional items include items with program and organization's logos that are
given to program participants or those eligible but not yet enrolled as an incentive
to enroll are allowable.
The contractor shall provide documentation to include: Purchase
preapproval with purpose as it relates to the contract; and an itemized
receipt
(c) Medical Supplies are allowable if the items align with the definition of special
purpose equipment needed to conduct contract activities, part of the routine care
of clients, or necessary to safely execute the terms and conditions of the contract
(i.e. alcohol wipes, sterilizing supplies, personal protective equipment,
stethoscopes, and etcetera).
Required documentation includes: Purchase preapproval with purpose
as it relates to the contract and an itemized receipt
(d) Gift Cards for Contractor Employees: Purchase of gift cards for contracted
employees is not an allowable use of funds under this contract.
(2) Purchase Approvals: The contractor must:
(a) Obtain prior written approval from DCYF before purchasing, in whole or in part
with DCYF funds, of all assets with a unit cost (including ancillary costs) of at
least$10,000 or greater.
b) Conduct all procurement transactions in a manner that provides full and open
competition and is consistent with the standards of RCW 39.26 and CFR §
200.320.
Direct Buy
A. All Procurement transactions with a total of$40,000 or less may
be purchased without competition.
Competitive Procurement
A. Formal procurement methods are required when the value of the
procurement transaction is over Direct Buy Level. Formal
procurement methods are competitive and require public notice.
B. Request for proposals require all evaluation factors and their
relative importance must be identified. Proposals must be
solicited from multiple qualified entities. To the maximum extent
practicable, any proposals submitted in response to public notice
must be considered.
A. Contracts must be awarded to the bidder responsible whose
proposal is most advantageous considering price and other
factors.
(c) The Contractor must maintain records sufficient to detail the history of each
procurement transaction. These records must include the rationale for the
procurement method, contract type selection, contractor selection or rejection,
and the basis for the contract price.
g. Inventory
(1) The Contractor must submit a written request for pre-approval to DCYF for the purchase I
whole or in part with DCYF funds, of all assets with a unit cost (including ancillary costs)
of at least$10,000 or greater.
Contract Number: 26-1141 Printed Date: 9/2/2025 Page 16 of 21
(2) Maintain a list of all inventory purchased in whole or in part with the DCYF funds with unit
costs of at least $10,000 or greater. Include the following in the inventory list and
supporting records, if applicable:
A. Description of the asset;
B. Manufacturer or trade name:
C. Quantity;
D. Serial number;
E. Inventory control number;
F. Contractor's acquisition date;
G. Order number from purchasing document;
H. Total cost or value at time of acquisition;
I. Ownership status, for example if shared by multiple funding sources;
J. Depreciation for capital assets;
K. Location of item;
L. Useful life, in years; and
M. Disposal date, method, and salvage value.
h. Treatment of Assets:
(1) The Contractor holds title to equipment purchased in whole or in part with the DCYF
funds.
(2) The Contractor must request approval from the DCYF prior to selling or disposing of
equipment from the Contractor's Inventory List, and the DCYF must have the option of
recapturing the equipment.
A. If the DCYF gives approval for the Contractor to sell the DCYF equipment, the
Contractor shall use the income for home visiting services.
B. If a Contractor ceases provision of HV Services, the Contractor must transfer title
and return to the DCYF any equipment purchased all or in part with the DCYF
funds or the proceeds from current market-value sale of such equipment, at the
DCYF 's discretion.
C. If a Contractor ceases provision of HV Services at a site or Subcontractor, the
Contractor must transfer equipment purchased all or in part with the DCYF funds,
or the proceeds from current market value sale of such equipment to another the
DCYF site or return it to DCYF.
Invoicing, Financial Reporting and Documentation:
(1) The Contractor shall submit at least monthly, but not more often than semi-monthly, a
properly completed A-19 Voucher accompanied by the following documentation of the
actual expenses incurred during that period:
(a) Monthly or Semi-monthly Expense Summary by fund source (e.g. GFS, DCA) as
produced by Contractor's accounting system and clearly detailing expenses
incurred for each Pay Point in that period's A-19 Voucher;
(b) Contractor's Monthly or Semi-monthly Payroll Summary by fund source (e.g.
GFS, DCA) describing reimbursed hours for each staff person paid under the
contract for that period; and
(c) Documentation supporting all single expenses exceeding $5.000 by fund source
(e.g. GFS, DCA).
(2) Payment shall be based upon approval of financial expenditures using the billing
submission procedure outlined in this contract, with the total payment not to exceed what
is set forth in Exhibit B Budget.
j. In-Depth Financial Review: DCYF will conduct an annual in-depth financial review of the
Contractor's expenditures charged to the Contract. In preparation for the Annual Site Visit, the
Contract Number: 26-1141 Printed Date: 9/2/2025 Page 17 of 21
Contractor shall provide to DCYF upon request the financial documents listed below. Based
upon this review, if questions arise, DCYF may request additional data and documentation.
(1) Contractor's most recent Annual Financial Audit, Single or Program-Specific Audit, as
applicable;
(2) General Ledger activity detail of all expenditures allocated to this Contract incurred within
the dates to be determined and in agreement with A-19 invoices submitted to DCYF.
Detail will be defined by DCYF and will include indirect costs, accounts payable
transactions, and time and effort transactions;
(3) Contractor's Indirect Cost Allocation Plan or Indirect Cost Proposal, or Indirect Rate
Agreement, whichever is applicable;
(4) Chart of Accounts;
(5) Written policies and procedures to include, but not limited to: accounts payable, payroll,
procurements, sub-recipients/subcontractors, travel, and equipment inventory processes;
(6) Other detailed supporting financial documentation upon request-such as employee time
sheets, travel and major expense documentation-to be further defined by DCYF.
13. Performance-Based Contract
a. DCYF will review data provided by the Contractor to DOH within the timeframe specified in this
Statement of Work to confirm achievement of the milestones described in this Section.
b. Quarterly Home Visiting Enrollment Performance Milestone:
The Contractor's Quarterly Enrollment Performance defined as the average Active Enrollment
over the three months of the reporting quarter equal to or greater than 90% of the Maximum
Service Capacity; the calculation is limited to prenatal families and families with children up to and
including 60 months of age.
(1) The Contractor maintains an Active Enrollment (unduplicated Visited Families plus
unduplicated Encountered Families) of 85% or greater of their Maximum Service
Capacity during the quarter, as measured by the average of the number of families
actively enrolled on the last day of each of Month 1, Month 2 and Month 3 of the quarter
divided by the Maximum Service Capacity (total number of possible families as defined in
Section 6.c.).
(a) The calculation of Enrollment for this performance award will be limited to the
number of prenatal families and families with enrolled children up to 60 months of
age.
c. Family Retention Performance Milestone:
(1) Twelve-month Family Retention Performance Milestone:
The Contractor's 12-month participant engagement performance, as defined by the
number of participants engaged in the program for 12 months after enrollment.
(a) Each participant who has not exited and remains engaged in the program for 12
months after enrollment, as indicated by receiving a home visit on a date
between 30 days before and 30 days after the 12-month anniversary of their
enrollment date, as defined in the Attachment entitled Data Collection, Reporting
and HVSA Aligned Measures.
(b) Each participant who meets the 12-month retention milestone above and reports
at least two of the demographic characteristics related to early exits as described
in Attachment entitled Data Collection, Reporting and HVSA Aligned Measures.
(2) Eighteen-month Family Retention Performance Milestone:
The Contractor's 18-month participant engagement performance, as defined by the
number of participants engaged in the program for 18 months after enrollment.
Contract Number: 26-1141 Printed Date: 9/2/2025 Page 18 of 21
(a). Each participant who has not exited and remains engaged in the program for 18
months after enrollment, as indicated by receiving a home visit on a date
between 30 days before and 30 days after the 18-month anniversary date of their
enrollment date, as defined in the Attachment entitled Data Collection, Reporting
and HVSA Aligned Measures.
(b) Each participant who meets the 18-month retention milestone above and reports
at least two of the demographic characteristics related to early exits as described
in the Attachment entitled Data Collection, Reporting and HVSA Aligned
Measures.
(c) For either the 12-month or 18-month retention milestones, if participant data is
missing for the demographic characteristics related to early exits, the milestone
will be calculated assuming the participant has no characteristics related to early
exits.
(d) For either the 12-month or 18-month retention milestones, if the anniversary
home visit occurs after June 30, the milestone will be calculated in the
subsequent fiscal year.
e. Depression Screening and Follow-up Performance Milestones:
(1) Depression Screening Performance Milestone:
The Contractor's performance on HVSA Depression Screening Performance Measure
defined in the Attachment entitled Data Collection, Reporting and HVSA Aligned
Measures. Contractor completion of a depression screening for a participating primary
caregiver using an approved, validated tool within 3 months postpartum (if enrolled
prenatally) or 3 months after enrollment (if enrolled postnatally).
(2) Follow-Up to Positive Depression Screening Performance Milestone:
The Contractor's performance on follow-up to Caregiver Depression Screening:
Contractor follow-up with a referral to or connection with appropriate services for a
participating primary caregiver who screened positive for depression.
f. Healthy Birthweight Outcome Performance Milestones:
(1) The Contractor's performance on healthy birthweight outcomes during the contract year,
as indicated by the number of participants who give birth to an infant of healthy
birthweight during the contract year as defined in the Attachment entitled Data Collection,
Reporting and HVSA Aligned Measures.
(a) Each participant who gives birth to an infant of healthy birthweight using the
definition in the Attachment entitled Data Collection, Reporting and HVSA
Aligned Measures,
The milestone calculation will not include those participants for whom the
following data are not available or incomplete: date of birth of the child,
or child's birthweight.
(b) Each participant who gives birth to an infant of healthy birthweight during the
contract year and with at least one HBW Criteria for Additional Support using the
definition in the Attachment entitled Data Collection, Reporting and HVSA
Aligned Measures.
If a participant's data is missing for the HBW Criteria for Additional Support, the
birthweight will be recorded as having no HBW Criteria for Additional Support when the
milestone is calculated.
14. Publicity, Publication and Acknowledgements
a. DCYF may include information on this Contract in their periodic public reports and may make
information about this Contract public at any time in their web pages and as part of press
releases, public reports, speeches, newsletters, and other public documents related to the
Contract or the HVSA. DCYF must comply with Washington State public disclosure law (Chapter
42.56 RCW) and with regulations set forth in HIPAA and FERPA.
Contract Number: 26-1141 Printed Date: 9/2/2025 Page 19 of 21
(1) If the Contractor wishes to issue a press release or public report announcing this
Contract, or otherwise use DCYF 's name for purposes related to this Contract, the
Contractor shall contact the DCYF Contract Manager, identified on page 1 of this
Contract at least five (5) business days before the desired announcement or publication
date to obtain prior approval.
(2) For all press releases or public reports approved by DCYF, the Contractor shall include
acknowledgement of funding by the State of Washington, Washington Department of
Children Youth and Families and the Home Visiting Services Account using the following
recommended language: "This program is supported in part by funding from the
Washington State Department of Children, Youth & Families."
15. Contract Reporting, Monitoring, and Deliverables
a. Any mention of quarters one through four referenced in this document are defined as:
(1) Quarter 1 — July 1, 2025 to September 30,2025
(2) Quarter 2 — October 1, 2025 to December 31,2025
(3) Quarter 3 —January 1, 2026 to March 31,2026
(4) Quarter 4 —April 1, 2026 to June 30, 2026
b. Reporting: The Contractor shall submit program and expense reports, as well as perform all other
requirements outlined in this Statement of Work, on or before the dates indicated in this Section
and the Reference Document titled Timeline for Reporting and Submission of Deliverables. Due
dates may be adjusted atthe discretion and approval of the DCYF Contract Manager. DCYF
reserves the right to aggregate, disaggregate, analyze, reproduce, and/or disseminate the data
provided in Program Reports, Financial Activity Reports, or any other reports submitted to DCYF
with respect to the Contract.
(1) Contractor must create and maintain at least one active user account in the Prevention
Services Reporting System (PSRS) and use that system to submit monthly enrollment
reports, quarterly progress reports, and other deliverables when available. Information
submitted into the PSRS may be shared with DOH and Start Early.
(2) While funding for this Contract encompasses expenditures from July 1, 2025 through
June 30, 2026, deliverables describing services rendered in the months of the Contract
term will be due no later than July 31, 2026 and will be submitted at no additional cost to
DCYF.
c. Monitoring: As described in the Attachment of this Contract entitled Contract Monitoring,
Compliance and Non-Compliance, DCYF will monitor compliance with contract requirements,
model standing, progress toward completion of deliverables, enrollment performance, and
financial activity through review of submitted reports, meetings, phone calls and other
communication with the Contractor.
(1) The Contractor shall provide a right of access to its facilities to DCYF, personnel
authorized by DCYF, or to any other authorized agent or official of the State of
Washington or the federal government at all reasonable times in order to monitor and
evaluate performance, compliance, and/or quality assurance under this Contract. DCYF
will work with Contractor to determine a mutually acceptable date.
(2) Monitoring activities may include, but not be limited to: monthly monitoring calls and on-
site or virtual visits to review records, observe implementation of services, or follow up on
compliance issues.
(3) If DCYF (a) encounters non-compliance with the terms outlined in this Contract on the
part of Contractor, or(b) is not satisfied, in its sole discretion, with the quality of
Contractor's work, DCYF will make a reasonable attempt to assist Contractor with
technical assistance to resolve issues that impede quality and compliance. In the event
that compliance and/or quality issues are not resolved through standard technical
assistance, Contractor will be engaged in corrective action through Implementation
Improvement processes, as outlined in the attachment entitled Contract Monitoring,
Compliance and Non-Compliance. Any program with prior compliance or improvement
Contract Number: 26-1141 Printed Date: 9/2/2025 Page 20 of 21
issues, including Implementation Improvement Status and Implementation Improvement
Plans, shall continue until resolved and approved by DCYF.
d. Summary of Deliverables and Timelines
(1) Monthly Enrollment Reports: The Contractor shall submit Monthly Enrollment Data
Reports no later than the 20th day following the month of service submitted using the
template in the PSRS.
(2) Invoices: The Contractor shall submit A-19 invoices on or before the 30th day following
the month of service for expenditures accompanied by the financial documentation.
(3) Quarterly Progress Reports: The Contractor shall submit four (4) Quarterly Progress
Reports using the template in the PSRS. The Contractor shall submit this report each
quarter into the PSRS no later than the 20th day following the quarter of service.
(a) Contractor shall submit letter of model fidelity, as described in Section 3 of this
Statement of Work accompanying the Quarter 2 Report submission.
(4) Annual TA Plan submitted as an attachment to the November Monthly Enrollment Report
in the PSRS.
(5) Annual Pre-Contract Questionnaire: The Contractor shall complete and submit the FY27
HVSA Pre-Contract Questionnaire and FY27 Proposed Budget on a date to be
determined in May 2026 using the template provided by DCYF.
(6) The deliverables and reports associated with this Contract Statement of Work are
summarized in the Reference Document entitled Timeline for Reporting and Submission
of Deliverables.
(a) Some expectations associated with this Contract, including attendance at the
HVSA Semi-Annual Statewide Meetings and Supervisor Meetings are not
included in this table as the dates of these events will be determined after
contract execution.
(b) If due dates occur on a weekend or holiday, the Contractor shall submit the
report before 8am of the following business day.
Contract Number: 26-1141 Printed Date: 9/2/2025 Page 21 of 21
WASHINGTON STATE DCYF Contract Number: 26-1141
I Department of Contract Maximum: $446,836.63
ib Children, Youth, and Families
From-To:07/01/2025-07/31/2026
Exhibit B - Budget Report
Contractor agrees that all funds under this Contract shall be expended by June 30, 2026 as specifically itemized
line by line in Exhibit B, and that transfers within expense categories of the budget in excess of 10% of the
contract amount will not be made without prior written approval from DCYF and may require a contract
amendment.
State Fiscal Year 2026 (July 1 2025 - June 30 2026):
Payment Point Budget Limit Note
1. DCA (1502) — $37,651.25
Contractor Personnel
2. DCA (1502) —Goods $1,218.91
and Services
3. DCA (1502) —Travel $0.00
4. DCA (1502) — $121,958.93
Contracted/Professional
Services
5. DCA (1502)— $16,082.91
Administrative/Indirect
Charges
6. General Fund State— $111,351.50
Contractor Personnel
7. General Fund State— $2,382.72
Goods and Services
8. General Fund State— $2,500.00
Travel
9. General Fund State— $129,153.08
Contracted/Professional
Services
10. General Fund State $24,537.33
—Administrative/Indirect
Charges
Total: $446,836.63
Contract Maximum: $446,836.63
Contract Funding Source(s)
State Funds $446,836.63
Contract Number: 26-1141 Printed Date: 9/2/2025 Page 1 of 1
WASHINGTON STATE DCYF Contract Number: 26-1141
Department of Contract Maximum: $446,836.63
Children, Youth, and Families
From-To:07/01/2025-07/31/2026
Exhibit C - Deliverables Report
State Fiscal Year 2026 (July 1 2025 - June 30 2026):
Deliverable Title, Due Note, Description Due Date
1.00 Consenting Clients to DOH No Date
Due by the sixth (6th) business day of the month immediately following services.
The Contractor shall share with DOH the consent status according to the process
outlined in Attachment titled Contract Monitoring, Compliance and Non-Compliance.
2.00 Monthly Enrollment Reports No Date
By the 20th of the following month of service.
The Contractor shall submit Monthly Enrollment Data Reports using the template in the
PSRS and described in Attachment titled Monthly Enrollment Data Report Components.
2.01 TA Plan Nov 20, 2025
Due by 11/20/2025
Contractor shall submit TA Plan on November 20, 2025 accompanying Monthly
Enrollment Report
3.01 Quarterly Progress Reports Oct 20, 2025
By the 20th day following the quarter of service.
The Contractor shall submit Quarterly Progess Reports using the template in the PSRS
as described in the Attachment titled HVSA Quarterly Progress Report Components.
3.02 Quarterly Progress Reports Jan 20, 2026
3.03 Quarterly Progress Reports Apr 20, 2026
3.04 Quarterly Progress Reports Jul 20, 2026
4.00 DSA with DSHS No Date
By August 30, 2025 if DSA is amended.
The Contractor shall provided copies of executed DSA with DSHS to access the eJas, if
amended.
5.00 Annual Pre-Contract Questionnaire May 16, 2026
Due by 5/16/2026 for contractors planning to continue services in the following fiscal
year.
The Contractor shall complete and submit the FY27 HVSA Pre-Contract Questionnaire
and FY27 Proposed Budget using the template provided by DCYF.
Contract Number: 26-1141 Printed Date: 9/2/2025 Page 1 of 1
WASHINGTON STATE DCYF Contract Number 26-1141
�,. Department of Contract Maximum: $446,836.63
Children, Youth, and Families
From-To:07/01/2025-07/31/2026
Exhibit D - General Terms and Conditions
Table of Contents
1. DEFINITIONS 1
2. ADVANCE PAYMENTS PROHIBITED 3
3. AMENDMENT 3
4. ASSIGNMENT 3
5. ATTORNEY FEES 3
6. CHOICE OF LAW AND VENUE 3
7. COMPLIANCE WITH LAWS, RULES, AND REGULATIONS 4
8. CONTRACTOR STAFF 5
9. CONTINUED PERFORMANCE 5
10. COPYRIGHT 5
11. DATA SHARE AND PROTECTION OF CONFIDENTIAL INFORMATION 6
12. DISALLOWED COSTS 10
13. DISPUTES 10
14. DUPLICATE PAYMENT 11
15. ENTIRE CONTRACT 11
16. EXPENSES 11
17. FUNDING CONTINGENCY 11
18. INDEMNIFICATION 11
19. HEADINGS 12
20. INDUSTRIAL INSURANCE COVERAGE 12
21. LIMITATION OF AUTHORITY 12
22. INSURANCE 12
23. MONITORING 12
24. NEUTRAL AUTHORSHIP 13
25. ORDER OF PRECEDENCE 13
26. OVERPAYMENT 13
27. PUBLICITY 13
28. RECAPTURE 14
29. RECORDS MAINTENANCE 14
30. REMEDIES 14
31. SEVERABILITY 14
32. SITE SECURITY 14
33. SUBCONTRACTING 14
34. TERMINATION FOR CAUSE 15
35. TERMINATION FOR CONVENIENCE 15
36. TERMINATION PROCEDURE 15
37. TREATMENT OF ASSETS 16
38. WAIVER 17
39. CONTRACTOR REPRESENTATIONS AND WARRANTIES 17
40. WITHHOLDING PAYMENTS 18
1. DEFINITIONS
The following terms as used throughout this Contract shall have the meanings as set forth below.
Contract Number: 26-1141 Printed Date: 9/2/2025 Page 1 of 18
a. "Confidential Information" means information that may be exempt from disclosure to the public or other
unauthorized persons under either chapter 42.56 RCW or other state or federal laws. Confidential
Information includes, but is not limited to, Personal Information, agency source code or object code, and
agency security data.
b. "Contract" or"Agreement" means the entire written agreement between DCYF and the Contractor,
including any Exhibit, attachments, documents, program agreement, materials incorporated by reference,
and all amendments hereto. The parties may execute this contract in multiple counterparts, each of which
is deemed an original and all of which constitute only one agreement. E-mail or Facsimile transmission of
a signed copy of this Contract shall be the same as delivery of an original.
c. "Contractor" means one not employed by the department that is the individual or entity performing
services pursuant to this Contract and includes the Contractor's owners, members, officers, directors,
partners, employees, and/or agents, unless otherwise state in this Contract. For purposes of any
permitted Subcontract, "Contractor" includes any Subcontractor and its owners, members, officers,
director, partners, employees, and/or agents.
d. "Converted Data" means the data which has been successfully converted by the Contractor for
processing by DCYF's computer system.
e. "Data" means DCYF's records, files, forms, data, information and other documents in electronic or hard
copy form, including but not limited to Converted Data.
f. "Debarment" means an action taken by a State or Federal agency to exclude a person or business entity
from participating in transactions involving certain federal or state funds.
g. "DCYF" or"Department" means the Washington State Department of Children, Youth, and Families,
including any division, section, office, unit or other entity thereof, or any of the officers or other officials
lawfully representing DCYF.
h. "In-home Caregiver" means an in-home child care provider that (1) provides regularly scheduled care
for a child; (2) receives child care subsidies; and (3) is either licensed by the state or is exempt from
licensing.
i. "Materials" means all items in any format and includes, but is not limited to, Data, reports, documents,
pamphlets, advertisements, books, magazines, surveys, studies, computer programs, films, tapes, and/or
sound reproductions. Ownership includes the right to copyright, patent, register and the ability to transfer
these rights.
j. "Overpayment" means any payment or benefit to a recipient or to a vendor in excess of that to which is
entitled by law, rule, or contract, including the amounts in dispute.
k. "Personal Information" means information identifiable to any person, including, but not limited to,
information that relates to a person's name, health, finances, education, business, use or receipt of
governmental services or other activities, addresses, telephone numbers, social security numbers, driver
license numbers, email addresses, credit card information, law enforcement records or other identifying
numbers or Protected Health Information, any financial identifiers, and other information that may be
exempt from disclosure under either chapter 42.56 RCW or other state and federal statutes.
I. "RCW" means the Revised Code of Washington. All references in this Contract to RCW chapters or
sections shall include any successor, amended, or replacement statute. Pertinent RCW chapters can be
accessed at http://apps.leg.wa.gov/rcw/.
m. "Regulation" means any federal, state, or local rule, rule, or ordinance.
n. "Sensitive Personal Information" means personally identifying information including, but not limited to:
names, addresses, GPS [global positioning system] coordinates, telephone numbers, email addresses,
social security numbers, driver's license numbers, or other personally identifying information.
Contract Number: 26-1141 Printed Date: 9/2/2025 Page 2 of 18
o. "Staff" means the Contractor's directors, officers, employees, and agents who provide goods or services
pursuant to this Contract. "Staff' also means Subcontractors' directors, officers, employees, and agents
who provide goods or services on behalf of the Contractor. The term "Staff' also means the
Subcontractors' directors, officers, employees, and agents who provide goods or services on behalf of the
Subcontractor and Contractor.
p. "Subcontract" means a contract or contractual action entered into by the Contractor or Subcontractor for
the purpose of obtaining supplies, materials, equipment, or services of any kind under this Contract. The
terms "subcontract" and "subcontracts" means subcontract(s) in any tier.
q. "Subcontractor" means a person, partnership, company, or other entity that is not in the employment of
or owned by Contractor and that is performing services under this Contract under a separate contract with
or on behalf of the Contractor. The terms "subcontractor" and "subcontractors" mean subcontractor(s) in
any tier.
r. "WAC" means the Washington Administrative Code. All references in this Contract to WAC chapters or
sections shall include any successor, amended, or replacement regulation. Pertinent WAC chapters or
sections can be accessed at http://apps.leg.wa.gov/wac/.
2. ADVANCE PAYMENTS PROHIBITED
No payments in advance or in anticipation of goods or services to be provided under this Contract shall be made
by DCYF.
3. AMENDMENT
This Contract may be amended by mutual agreement of the parties. Such amendments shall not be binding
unless they are in writing and signed by personnel authorized to bind each of the parties.
4. ASSIGNMENT
a. Assignment by Contractor. With the prior written consent of DCYF's Contract Administrator, which
consent shall not be unreasonably withheld, the Contractor may assign this Contract including the
proceeds hereof, provided that such assignment shall not operate to relieve the Contractor of any of its
duties and obligations hereunder, nor shall such assignment affect any remedies available to DCYF that
may arise from any breach of the sections of this Contract, or warranties made herein including but not
limited to, rights of setoff.
b. Assignment by DCYF. DCYF may assign this Contract to any public agency, commission, board, or the
like, within the political boundaries of the state of Washington, provided that such assignment shall not
operate to relieve DCYF of any of its duties and obligations hereunder.
5. ATTORNEY FEES
In the event of litigation or other action brought to enforce this Contract, each party agrees to bear its own
attorney fees and costs.
6. CHOICE OF LAW AND VENUE
a. This Contract shall be governed by the laws of the State of Washington without regard to the conflict of
law rules of any jurisdiction. Every dispute concerning the interpretation or effect of this Contract and/or
the use of the goods or services described in this Contract must be resolved in the federal or state courts
located in Washington. The Contractor agrees to the exclusive personal jurisdiction, and subject matter
jurisdiction of these courts. Thurston County shall be the venue of any litigation arising out of this
Contract.
b. The Contractor agrees that the United States Bankruptcy Court, Western District of Washington in
Seattle, shall be the venue of any and all bankruptcy proceedings that may involve the Contractor.
Contract Number: 26-1141 Printed Date: 9/2/2025 Page 3 of 18
7. COMPLIANCE WITH LAWS, RULES, AND REGULATIONS
a. Assurances. The Contractor agrees that all activity pursuant to this Contract will be in accordance with all
applicable current federal, state and local laws, rules, and regulations, including but not limited to the
Public Records Act (chapter 42.56 RCW), the Freedom of Information Act (5 U.S.C. 522) and the Records
Retention Act (chapter 40.14 RCW).
b. Child Health, Safety, And Well Being And Child Abuse Or Neglect. In the delivery of services under
this Contract, children's health, safety, and well-being shall always be the primary concern of the
Contractor. Contractors shall fully comply with the mandatory reporting requirements of RCW 26.44.030
pertaining to child abuse or neglect. In addition, pursuant this Contract, when the Contractor has
reasonable cause to believe that a child has suffered abuse or neglect at the hands of any person, the
Contractor shall immediately report such incident to Child Protective Services (CPS) Intake at 1-866-
ENDHARM.
c. Civil Rights Laws
(1) During the performance of this Contract the parties shall comply with all federal and state
nondiscrimination laws including, but not limited to chapter 49.60 RCW, Washington's Law
Against Discrimination, and 42 U.S.C. § 12101 et seq., the Americans with Disabilities Act (ADA).
(2) Nondiscrimination Requirement. During the term of this Contract, Contractor, including any
subcontractor, shall not discriminate on the bases enumerated at RCW 49.60.530(3). In addition,
Contractor, including any subcontractor, shall give written notice of this nondiscrimination
requirement to any labor organizations with which Contractor, or subcontractor, has a collective
bargaining or other agreement.
(3) Obligation to Cooperate.Contractor, including any subcontractor, shall cooperate and comply
with any Washington state agency investigation regarding any allegation that Contractor, including
any subcontractor, has engaged in discrimination prohibited by this Contract pursuant to RCW
49.60.530(3).
(4) Default.Notwithstanding any provision to the contrary, DCYF may suspend Contractor, including
any subcontractor, upon notice of a failure to participate and cooperate with any state agency
investigation into alleged discrimination prohibited by this Contract, pursuant to RCW
49.60.530(3). Any such suspension will remain in place until DCYF receives notification that
Contractor, including any subcontractor, is cooperating with the investigating state agency. In the
event Contractor, or subcontractor, is determined to have engaged in discrimination identified at
RCW 49.60.530(3), DCYF may terminate this Contract in whole or in part, and Contractor,
subcontractor, or both, may be referred for debarment as provided in RCW 39.26.200. Contractor
or subcontractor may be given a reasonable time in which to cure this noncompliance, including
implementing conditions consistent with any court-ordered injunctive relief or settlement
agreement.
(5) Remedies for Breach.Notwithstanding any provision to the contrary, in the event of Contract
termination or suspension for engaging in discrimination, Contractor, subcontractor, or both, shall
be liable for contract damages as authorized by law including, but not limited to, any cost
difference between the original contract and the replacement or cover contract and all
administrative costs directly related to the replacement contract, which damages are distinct from
any penalties imposed under Chapter 49.60, RCW. DCYF shall have the right to deduct from any
monies due to Contractor or subcontractor, or that thereafter become due, an amount for
damages Contractor or subcontractor will owe DCYF for default under this provision.
d. Conflict of Interest
(1) Notwithstanding any determination by the Executive Ethics Board or other tribunal, DCYF may, in
its sole discretion, by written notice to the Contractor terminate this Contract if it is found after due
notice and examination by DCYF there is a violation of the Ethics in Public Service Act, Chapter
42.52 RCW, or any similar statute involving the Contractor in the procurement of, or performance
under, this Contract.
Contract Number: 26-1141 Printed Date: 9/2/2025 Page 4 of 18
(2) In the event this Contract is terminated as provided above, DCYF shall be entitled to pursue the
same remedies against the Contractor as it could pursue in the event of a breach of the contract
by the Contractor. The rights and remedies of DCYF provided for in this clause shall not be
exclusive and are in addition to any other rights and remedies provided by law. The existence of
facts upon which DCYF makes any determination under this clause shall be an issue and may be
reviewed as provided in the "Disputes" clause of this Contract.
e. Licensing, Accreditation and Registration. The Contractor and its Subcontractors shall comply with all
applicable local, state, and federal licensing, accreditation and registration requirements/standards
necessary for the performance of this Contract.
f. Noncompliance with Laws, Regulations, or Policies. The Contractor shall be responsible for and shall
pay any fines, penalties, or disallowances imposed on the State or Contractor arising from any
noncompliance with the laws, regulations, policies, guidelines and Collective Bargaining Agreements that
affect the Services, goods, or Deliverables that are to be provided or that have been provided by
Contractor. its Subcontractors or agents.
g. Registration with Department of Revenue and Payment of Taxes
The Contractor must pay all taxes including, but not limited to, sales and use taxes, Business and
Occupation taxes, other taxes based on the Contractor's income or gross receipts, or personal property
taxes levied or assessed on the Contractor's personal property. The Contractor shall complete registration
with the Washington State Department of Revenue and be responsible for payment of all taxes due on
payments made under this Contract.
8. CONTRACTOR STAFF
a. Contractor staff list and job description. Prior to the effective date of this Contract, the Contractor shall
have provided to DCYF a list of Contractor Staff that will be performing services pursuant to this Contract.
The list shall also include Staff member's job title and his or her job description.
b. All Staff proposed by Contractor as replacements for other Staff shall have comparable or greater skills
for performing the activities as performed by the Staff being replaced. The Contractor shall provide DCYF
with written notice of any Staff changes that the Contractor proposes. The written notice shall not be
effective until fourteen (14) business days from the date of the mailing.
9. CONTINUED PERFORMANCE
If DCYF, in good faith, has reason to believe that Contractor does not intend to, or is unable to perform or has
refused to perform or continue performing all material obligations under this Contract, DCYF may demand in
writing that Contractor give a written assurance of intent to perform. Failure by Contractor to provide written
assurance within the number of days specified in the demand (in no event less than five (5) business days) may,
at DCYF's option, be the basis for terminating this Contract under the terms and conditions or other rights and
remedies available by law or provided by this Contract.
10. COPYRIGHT
a. Unless otherwise provided, all Materials produced under this contract shall be considered "works for hire"
as defined by the U.S. Copyright Act and shall be owned by DCYF. DCYF shall be considered the author
of such Materials. In the event the Materials are not considered "works for hire," under the U.S. Copyright
Laws, Contractor hereby irrevocably assigns all right, title, and interest in Materials, including all
intellectual property rights, to DCYF effective from the moment of creation of such Materials.
b. For Materials that are delivered under the Contract, but that incorporate preexisting materials not
produced under the Contract, Contractor hereby grants to DCYF a nonexclusive, royalty-free, irrevocable
license (with rights to sublicense others) in such Materials to translate, reproduce, distribute, prepare
derivative works, publicly perform, and publicly display. The Contractor warrants and represents that
Contractor has all rights and permissions, including intellectual property rights, moral rights and rights of
publicity, necessary to grant such a license to DCYF.
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c. The Contractor shall exert all reasonable effort to advise DCYF, at the time of delivery of Data furnished
under this Contract, of all known or potential invasions of privacy contained therein and of any portion of
such document which was not produced in the performance of this Contract. DCYF shall receive prompt
written notice of each notice or claim of infringement received by the Contractor with respect to any Data
delivered under this Contract. DCYF shall have the right to modify or remove any restrictive markings
placed upon the Data by the Contractor.
11. DATA SHARE AND PROTECTION OF CONFIDENTIAL INFORMATION
a. Scope of Protection. This Section (DATA SHARE AND PROTECTION OF CONFIDENTIAL
INFORMATION AND SENSITIVE PERSONAL INFORMATION) applies to Data, information, or Materials
related to the subject matter of this Contract which is received, created, developed, revised, modified, or
amended by DCYF, the Contractor, or Subcontractors. Such Data, information, and Materials shall
include but is not limited to all Confidential Information and Sensitive Personal Information.
b. Use of Confidential Information and Sensitive Personal Information
(1) For Sensitive Personal Information, Data, and Confidential Information that is collected, used, or
acquired in connection with this Contract the parties shall comply with the following:
(a) All federal and state laws and regulations, as currently enacted or revised, regarding the
protection, security, and electronic interchange of Sensitive Personal Information of In-
home Caregivers, data, and Confidential Information; and
(b) All federal and state laws and regulations, as currently enacted or revised, regarding the
use, disclosure, modification or loss of Sensitive Personal Information, data, and
Confidential Information.
(2) DCYF does not warrant or guarantee the accuracy of the Sensitive Personal Information of In-
home Caregivers, Data, or Confidential Information provided pursuant to this Contract. The
Contractor understands all the risks and liabilities of the use and misuse of the information
provided pursuant to this Contract.
c. Protection of Sensitive Personal Information
(1) The Contractor agrees to protect the confidentiality of Sensitive Personal Information.
(2) The Contractor further understands and agrees that Sensitive Personal Information may only be
released or disclosed if required by this Contract, or a lawfully issued court order. The Contractor
further understands and agrees that before the Contractor can release the Sensitive Personal
Information pursuant to a third party request, or for any other reason, the Contractor must comply
with all the requirements, including notice requirements, contained in this Section (Protection of
Sensitive Personal Information).
(3) Notice of Third Party Request and Intended Disclosure
(a) Written Notice Required. If a third party requestor seeks from the Contractor the
Sensitive Personal Information, or the Contractor intends to release or disclose the
Sensitive Personal Information for any other reason not related to a third party request,
the Contractor shall give notice to DCYF of such request and/or the Contractor's intent to
release or disclose such information.
(b) Notice Deadline: Third Party Request. The notice required under this Section (Notice of
Third Party Request and Intended Disclosure) shall be provided to DCYF's program
contact within five (5) calendar days from the date of the request, to allow DCYF to seek a
protective order from the proper tribunal.
(c) Notice Deadline: Disclosure for any Other Reason. If the Contractor intends to release
or disclose the Sensitive Personal Information for a reason that is unrelated to a particular
third party request, the Contractor shall provide written notice to DCYF no less than
twenty-one (21) calendar days prior to the intended release date.
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(d) Basis for Disclosure. The Contractor understands and agrees that it will not release the
Sensitive Personal Information without the express written consent from DCYF, or a
lawfully issued court order in which DCYF has been given an opportunity to oppose prior
to entry of the order.
(4) If the Contractor is required by this Contract to release or disclose the Sensitive Personal
Information, prior to such release or disclosure the Contractor must obtain from the recipient of
such Sensitive Personal Information a signed Statement of Confidentiality and Non-Disclosure
Agreement consistent with Attachment 1 to this Contract.
(5) The Contractor understands and agrees that before the Contractor releases or discloses,
pursuant to the terms of this Contract, the Sensitive Personal Information to a subcontractor, the
Contractor must obtain prior written approval from DCYF agreeing to such disclosure.
d. Information Technology Security Standards
(1) The Contractor and its Staff and the Subcontractors and their Staff shall comply with the following:
(a) All security standards, practices, and procedures which are equal to or exceed those of
the DCYF (which security standards, practices, and procedures of DCYF shall have been
provided to Contractor in writing); and
(b) The Washington State Office of the Chief Information Officer IT Standards.
(2) The parties agree to implement physical, electronic, and managerial policies, procedures, and
safeguards to prevent the unauthorized access, use, or disclosure of Sensitive Personal
Information, Data, and Confidential Information. The Contractor shall make the Sensitive Personal
Information, Data, and Confidential Information available to amend as directed by DCYF and
incorporate any amendments into all the copies maintained by the Contractor or their
Subcontractors.
e. Confidentiality Protection
To safeguard the confidentiality of all Sensitive Personal Information, Data, and Confidential Information,
and in addition to the requirements contained in this Section (DATA SHARE AND PROTECTION OF
CONFIDENTIAL INFORMATION AND SENSITIVE PERSONAL INFORMATION) the Contractor must:
(1) Ensure that the Contractor's Staff, Subcontractors, and the Subcontractors' Staff use Sensitive
Personal Information, Data, and Confidential Information solely for the purposes of accomplishing
the services set forth in this Contract. The term "Staff' shall have the same meaning as set forth in
Section (DEFINITIONS).
(2) Limit access to Sensitive Personal Information, Data, and Confidential Information to the
Contractor's Staff and Subcontractors' Staff requiring access for performance of their assigned
duties.
(3) Require that the Contractor's Staff and Subcontractors' Staff having access to Sensitive Personal
Information, Data, or Confidential Information sign a Statement of Confidentiality and Non-
Disclosure Agreement consistent with Attachment 1. Sensitive Personal Information, Data, and
Confidential Information shall not be released to the Contractor's Staff person(s) or
Subcontractors' Staff person(s) until the following conditions have been met:
(a) DCYF approves the Contractor's Staff person, or Subcontractor's Staff person, to work on
this Contract; and
(b) DCYF must receive the signed original Statement of Confidentiality and Non-Disclosure
Agreement, signed by the Staff person, from the Contractor or Subcontractor.
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(4) Notify its Staff person(s) and ensure its Subcontractors notify the Subcontractors' Staff person(s)
of the requirements of Section (COMPLIANCE WITH LAWS, RULES AND REGULATIONS), and
this Section (DATA SHARE AND PROTECTION OF CONFIDENTIAL INFORMATION AND
SENSITIVE PERSONAL INFORMATION).
(5) Ensure that Sensitive Personal Information, Data, and Confidential Information is not released,
disclosed, published, modified, transferred, sold, or otherwise made known to unauthorized
persons without the prior written consent of the individual named or as otherwise authorized by
law.
(6) Ensure that Sensitive Personal Information, Data, and Confidential Information is protected from
loss and from unauthorized physical or electronic access.
(7) Ensure that the input of user identifications and passwords are necessary and required before the
Contractor, the Contractor's Staff, or Subcontractor's Staff can access electronically stored
Sensitive Personal Information, Data, and Confidential Information.
(8) Destroy all Sensitive Personal Information, Data, and Confidential Information so that it cannot be
accessed by unauthorized individuals and cannot be recovered when the information is no longer
required or used for providing services under this Contract, and retention is no longer required by
the Records Retention Act (chapter 40.14 RCW) or Section (RECORD MAINTENANCE),
whichever is longer. Unless the Washington State Office of the Chief Information Officer IT
Standards require a different method for the destruction of Sensitive Personal Information, Data,
or Confidential Information, the information required to be destroyed under this Section (DATA
SHARE AND PROTECTION OF CONFIDENTIAL INFORMATION AND SENSITIVE PERSONAL
INFORMATION) must be destroyed as follows:
(a) For paper documents containing Data, but not Sensitive Personal Information or
Confidential Information, a contract with a paper shredding firm is acceptable, provided
the contract ensures that the confidentiality of the Data will be protected. Such documents
may also be destroyed by on-site shredding, pulping, or incineration.
(b) For paper documents containing Data, but not Sensitive Personal or Confidential
Information, a contract with a paper shredding firm is acceptable, provided the contract
ensures that the confidentiality of the Data will be protected. Such documents may also be
destroyed by on-site shredding, pulping, or incineration.
(c) If Sensitive Personal Information, Data, or Confidential Information has been contained on
optical discs (e.g. CDs or DVDs), the Contractor shall either destroy by incineration the
disc(s), shredding the discs, or completely deface the readable surface with a coarse
abrasive.
(d) If Sensitive Personal Information, Data, or Confidential Information has been stored on
magnetic tape(s), the Contractor shall destroy the Sensitive Personal Information, Data, or
Confidential Information by degaussing, incinerating or crosscut shredding.
(e) If Sensitive Personal Information, Data, or Confidential Information has been stored on
server or workstation data hard drives or similar media, the Contractor shall destroy the
Sensitive Personal Information, Data, or Confidential Information by using a "wipe" utility
which will overwrite the Sensitive Personal Information, Data, or Confidential Information
at least three (3) times using either random or single character data, degaussing
sufficiently to ensure that the Sensitive Personal Information, Data. or Confidential
Information, cannot be reconstructed, or physically destroying disk(s).
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(f) If Sensitive Personal Information, Data, or Confidential Information has been stored on
removable media (e.g. floppies, USB flash drives, portable hard disks, or similar disks),
the recipient shall destroy the Sensitive Personal Information, Data, or Confidential
Information by using a "wipe" utility which will overwrite the Sensitive Personal
Information, Data, or Confidential Information at least three (3) times using either random
or single character data, degaussing sufficiently to ensure that the Sensitive Personal
Information, Data, or Confidential Information cannot be reconstructed, or physically
destroying disk(s).
(9) Ensure that within fifteen (15) calendar days after the completion of the requirements contained in
Section (Confidentiality Protection) the Contractor shall complete and deliver to DCYF a signed
Certification of Data Disposition (Attachment 2).
(10) Ensure that paper records are protected by storing the records in a secure area which is only
accessible to authorized personnel. When not in use, such records must be stored in a locked
container, such as a file cabinet, locking drawer, or safe, to which only authorized persons have
access.
(11) Shall immediately notify DCYF after becoming aware of any potential, suspected, attempted or
actual breaches of security including, but not limited to, unauthorized access, use or disclosure,
and compromised Data, or compromised login IDs or passwords. The Contractor shall take all
necessary steps to mitigate the harmful effects of such breach of security. The Contractor agrees
to defend, protect and hold harmless DCYF for any damages related to a breach of security by
their officers, directors, employees, Subcontractors or agents. Immediately after becoming aware
of a suspected, attempted, or actual breach the Contractor must contact the DCYF Shall
immediately notify DCYF after becoming aware of any potential, suspected, attempted or actual
breaches of security including, but not limited to, unauthorized access, use or disclosure, and
compromised Data, or compromised login IDs or passwords. The Contractor shall take all
necessary steps to mitigate the harmful effects of such breach of security. The Contractor agrees
to defend, protect and hold harmless DCYF for any damages related to a breach of security by
their officers, directors, employees, Subcontractors or agents. Immediately after becoming aware
of a suspected, attempted, or actual breach the Contractor must contact the DCYF Contract
Manager, DCYF's Help Desk at (360) 407-1960 or dcyf.servicedesk@dcyf.wa.gov and DCYF
Privacy Officer at privacyofficer@dcyf.wa.gov.
f. Confidentiality Breach
(1) In the event of a breach by the Contractor of this Section (DATA SHARE AND PROTECTION OF
CONFIDENTIAL INFORMATION AND SENSITIVE PERSONAL INFORMATION) and in addition
to all other rights and remedies available to DCYF, DCYF may elect to do any of the following:
(a) Terminate the Contract;
(b) Require that the Contractor return all Sensitive Personal Information and Confidential
Information to DCYF that was previously provided to the Contractor by DCYF;
(c) Require that the Contractor destroy all Sensitive Personal Information and Confidential
Information so it cannot be accessed by unauthorized individuals and cannot be
recovered; or
(d) Suspend the Contractor's on-line access to accounts and other information.
g. Method of Transfer
(1) All Data transfers to or from the Contractor shall be made by using an approved solution that
meets agency and state IT security standards.
(2) Approved options include:
(a) MFT service provide Washington Technology Solutions (WaTech)
Contract Number: 26-1141 Printed Date: 9/2/2025 Page 9 of 18
(3) Any information containing sensitive data elements must be encrypted and password protected
using a tool such as WinZip, 7zip, or something similar.
(4) An account is required to access either of the above solutions, you will need to make a request by
contacting the contract contact listed on the cover page of this Agreement.
(5) Any other solutions must be approved by the DCYF Information Security Office. To obtain
approval, contact the contract contact listed on the first page of this Agreement. Request must
include the name of the solution, as well as, any information to help in the approval process.
h. Public Disclosure
(1) Either party to this Contract may designate certain Confidential Information as "Confidential
Information/Notice Requested." This designation shall be made by clearly stamping,
watermarking, or otherwise marking each page of the Confidential Information. The party who
owns the Data is responsible for informing the other party what it considers Confidential
Information.
(2) If a third party requestor seeks information that has been marked "Confidential Information/Notice
Requested," notice shall be given to the marking party prior to release of the information. Such
notice shall be provided to the program contact no less than five (5) business days prior to the
date of the disclosure, to allow the party objecting to disclosure to seek a protective order from the
proper tribunal.
i. Access to Data
(1) In compliance with RCW 39.26.180, the Contractor shall provide access to Data generated under
this Contract to DCYF, the Joint Legislative Audit and Review Committee, and the State Auditor at
no additional cost. This includes, but is not limited to, access to all information that supports the
findings, conclusions and recommendations of the Contractor's reports, including computer
models and methodology for those models.
12. DISALLOWED COSTS
The Contractor is responsible for any audit exceptions or disallowed costs incurred by the Contractor or that of its
Subcontractors.
13. DISPUTES
a. Except as otherwise provided in this contract, when a dispute arises between the parties and it cannot be
resolved through discussion and negotiation, either party may request a Dispute Resolution Board
("DRB").
b. A request for a DRB must:
(1) Be in writing;
(2) State the disputed issues;
(3) State the relative positions of the parties;
(4) State the Contractor's name, address, and contact telephone number; and
(5) Be mailed to the other party's (respondent's) Contract Manager after the parties agree that they
cannot resolve the dispute.
c. The respondent shall mail a written answer to the requester's Contract Manager within ten (10) business
days of the receipt of the request for a DRB.
Contract Number: 26-1141 Printed Date: 9/2/2025 Page 10 of 18
d. Once a party requests a DRB, each party shall designate a representative. The representatives shall
mutually select a third member. The DRB shall evaluate the facts, Contract terms and applicable statutes
and rules and make a determination by majority vote. The decision shall not be admissible in any
succeeding judicial or quasi-judicial proceeding concerning the Contract. The parties agree that the DRB
shall precede any action in a judicial or quasi-judicial tribunal.
14. DUPLICATE PAYMENT
DCYF shall not pay the Contractor if the Contractor has charged or will charge the State of Washington, or any
other party under any other contract or agreement, for the same services or expenses.
15. ENTIRE CONTRACT
This Contract, including all referenced exhibits and attachments, contains all the terms and conditions agreed
upon by the parties. No other understanding, written, oral, or otherwise regarding the subject matter of this
Contract shall be deemed to exist or to bind any of the parties hereto.
16. EXPENSES
All expenses not provided for specifically in this Contract shall be the responsibility of the Contractor unless
otherwise mutually agreed upon by the parties.
17. FUNDING CONTINGENCY
a. In the event funding from state, federal, or other sources is withdrawn, reduced, or limited in any way after
the effective date of this Contract and prior to completion of the work in this Contract, DCYF may:
(1) Terminate this Contract with ten (10) days advance notice. If this Contract is terminated, the
parties shall be liable only for performance rendered or costs incurred in accordance with the
terms of this Contract prior to the effective date of termination;
(2) Renegotiate the terms of the Contract under the new funding limitations and conditions;
(3) After a review of project expenditures and deliverable status, extend the end date of this Contract
and postpone deliverables or portions of deliverables; or
(4) Pursue such other alternatives as the parties mutually agree to in writing.
b. Any termination under this Section (FUNDING CONTINGENCY) shall be considered a Termination for
Convenience.
18. INDEMNIFICATION
a. To the fullest extent permitted by law, Contractor shall indemnify, defend and hold harmless State,
agencies of State and all officials, agents and employees of State, from and against all claims for injuries
or death arising out of or resulting from the performance of the Contract. Contractor's obligation to
indemnify, defend. and hold harmless includes any claim by Contractors' agents, employees,
representatives, or any Subcontractor or its employees.
b. Contractor expressly agrees to indemnify, defend, and hold harmless the State for any claim arising out of
or incident to Contractor's or any Subcontractor's performance or failure to perform under the Contract.
Contractor's obligation to indemnify, defend, and hold harmless the State shall not be eliminated or
reduced by any actual or alleged concurrent negligence of State or its agents, agencies, employees and
officials.
c. Contractor waives its immunity under Title 51 RCW to the extent it is required to indemnify, defend and
hold harmless State and its agencies, officials, agents or employees.
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19. HEADINGS
The headings throughout this Contract are for reference purposes only, and the words contained therein shall in
no way be held to explain, modify, amplify or aid in the interpretation, construction or meaning of the provisions of
this Contract.
20. INDUSTRIAL INSURANCE COVERAGE
The Contractor shall comply with the provisions of Title 51 RCW(Industrial Insurance). If the Contractor fails to
provide industrial insurance coverage or fails to pay premiums or penalties on behalf of its employees, as may be
required by law, DCYF may collect from the Contractor the full amount payable to the Industrial Insurance
accident fund. DCYF may deduct the amount owed by the Contractor to the accident fund from the amount
payable to the Contractor by DCYF under this Contract, and DCYF may also transmit the deducted amount to the
Department of Labor and Industries (L&I), Division of Insurance Services. This provision does not waive any of
L&I's right to collect from the Contractor.
21. LIMITATION OF AUTHORITY
Only the Contractor's agent or agent's delegate by writing (delegation to be made prior to action) and DCYF's
agent or agent's delegate by writing (delegation to be made prior to action) shall have the express, implied, or
apparent authority to alter, amend, modify, or waive any clause or condition of this Contract. Furthermore, any
alteration, amendment, modification, or waiver of any clause or condition of this Contract is not effective or
binding unless made in writing and signed by the agents for both parties.
22. INSURANCE
The Contractor, a local government of the State of Washington, warrants that it is self-insured. The intent of the
required insurance is to protect DCYF should there be any claims, suits, actions, costs, damages or expenses
arising from any negligent or intentional act or omission of the Contractor or Subcontractors, or agents of either,
while performing under the terms of this Contract.
23. MONITORING
a. DCYF has the right to monitor and evaluate performance, compliance, and quality assurance under this
Contract. The Contractor shall provide a right of access to its facilities to DCYF, personnel authorized by
DCYF, or to any other authorized agent or official of the State of Washington or the federal government at
all reasonable times in order to monitor and evaluate performance, compliance, and/or quality assurance
under this Contract.
b. Monitoring activities may include, but not be limited to:
(1) Review of the deliverables and other requirements listed in Exhibit A.
(2) Site visits to review records, observe implementation of services or follow up on compliance
issues. These visits may be unannounced.
(3) Intensive program reviews, including intensive on-site program reviews. The off-site and on-site
program reviews may include, but not be limited to, review of the following:
(a) Contractor's compliance with Section (COMPLIANCE WITH LAWS, RULES AND
REGULATIONS);
(b) Contractor's compliance with Section (DATA SHARE AND PROTECTION OF
CONFIDENTIAL INFORMATION AND SENSITIVE PERSONAL INFORMATION);
(4) On-site program reviews and site visit records reviews must be scheduled in advance with the
Contractor.
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24. NEUTRAL AUTHORSHIP
Each of the provisions of this Contract has been reviewed and negotiated, and represents the combined work
product of both parties hereto. No presumption or other rules of construction which would interpret the provisions
of this Contract in favor of or against the party preparing the same shall be applicable in connection with the
construction or interpretation of any of the provisions of this Contract.
25. ORDER OF PRECEDENCE
In the event of an inconsistency in the terms of this Contract, or between the terms and any applicable statute or
rule, the inconsistency shall be resolved by giving precedence in the following order:
a. Applicable State of Washington statutes, regulations, and policies
b. The Contract terms and conditions (pages 1 thru 4)
c. Exhibit D (General Terms and Conditions)
d. Exhibit A (Statement of Work)
e. Exhibit C (Deliverables)
f. Exhibit B (Budget)
g. Attachment 1 (Statement of Confidentiality and Non-Disclosure Agreement)
h. Attachment 2 (Certification of Data Disposition)
26. OVERPAYMENT
a. Contractor shall promptly, but in all cases within thirty (30) Days, pay to DCYF the full amount of any
erroneous payment or overpayment (a) upon Notice of an erroneous payment or overpayment to which
Contractor is not entitled with supporting documentation to substantiate such erroneous payment or
overpayment and the grounds for DCYF's determination of such erroneous payment or overpayment or
(b) when any such erroneous payment or overpayment is otherwise discovered by Contractor.
b. In addition to the requirements contained in this Section (OVERPAYMENT), the Contractor agrees that
DCYF may also recover overpayments made to the Contractor by deducting amounts owed to the
Contractor. DCYF must provide written notice to the Contractor if it elects to recover overpayments by
deducting amounts owed to the Contractor.
27. PUBLICITY
a. The award of this Contract to Contractor is not in any way an endorsement of Contractor or Contractor's
Services by DCYF and shall not be so construed by Contractor in any advertising or publicity materials.
b. The Contractor agrees to submit to DCYF all advertising and publicity matters relating to this Contract in
which the State of Washington or DCYF's name, state seal or logo is mentioned or used or language is
used from which a connection with the State of Washington or DCYF may, in DCYF's judgment, be
inferred or implied. The Contractor agrees not to publish or use such advertising and publicity matters
without the prior written consent of DCYF.
c. All publications funded, in whole or in part, under this Contract will use DCYF logo and will acknowledge
credit as either providing "funding in partnership with" or"funded by" DCYF. The full-color or black-and-
white DCYF logo, provided by DCYF Contract Manager, shall appear in its entirety, without modification.
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28. RECAPTURE
a. In the event that the Contractor fails to expend funds under this contract in accordance with state laws
and/or the provisions of this Contract, DCYF reserves the right to recapture state funds in an amount
equivalent to the extent of the noncompliance in addition to any other remedies available at law or in
equity.
b. Such right of recapture shall exist for a period not to exceed six (6) years following Contract termination.
Repayment by the Contractor of funds under this recapture provision shall occur within thirty (30) days of
demand. In the event that DCYF is required to institute legal proceedings to enforce the recapture
provision, DCYF shall be entitled to its costs thereof.
29. RECORDS MAINTENANCE
a. The Contractor shall maintain all books, records, documents, Data and other evidence relating to this
Contract and performance of the services described herein, including but not limited to accounting
procedures and practices which sufficiently and properly reflect all direct and indirect costs of any nature
expended in the performance of this Contract. Contractor shall retain such records for a period of six (6)
years following the date of final payment. At no additional cost, these records, including Materials
generated under the Contract, shall be subject at all reasonable times to inspection, review or audit by
DCYF, personnel duly authorized by DCYF, the Office of the State Auditor, and federal and state officials
so authorized by law, regulation or agreement.
b. If any litigation, claim or audit is started before the expiration of the six (6) year period, the records shall
be retained until all litigation, claims, or audit findings involving the records have been resolved.
30. REMEDIES
Except for remedies designated specifically as exclusive, no remedy conferred by any of the specific provisions of
this Contract is intended to be exclusive of any other remedy, and each and every remedy shall be cumulative
and shall be in addition to every other remedy given hereunder, now or hereafter existing at law or in equity or by
statute or otherwise. The election of any one or more remedies by either party shall not constitute a waiver of the
right to pursue other available remedies.
31. SEVERABILITY
If any provision of this Contract or any provision of any document incorporated by reference shall be held invalid,
such invalidity shall not affect the other provisions of this Contract which can be given effect without the invalid
provision, and to this end the provisions of this Contract are declared to be severable.
If any term or condition of this Contract is held invalid by any court, the remainder of the Contract remains valid
and in full force and effect.
32. SITE SECURITY
While on DCYF's premises, the Contractor, its agents, employees, or Subcontractors shall conform in all respects
with physical, fire or other security policies or regulations.
33. SUBCONTRACTING
a. Subcontractor Approval by DCYF. Neither the Contractor nor any Subcontractor shall enter into
subcontracts for any of the work contemplated under this Contract without obtaining prior written approval
from DCYF.
b. Subcontract Terms and Conditions. The Contractor must ensure that all terms, conditions, assurances
and certifications set forth in this Contract are included in any and all Subcontracts. The Contractor shall
forward to DCYF upon request, copies of all subcontracts and other materials pertaining to any and all
subcontracts.
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c. Performance. Contractor is responsible and liable for the proper performance of and the quality of any
work performed by any and all Subcontractors. In no event shall the existence of a subcontract operate to
release or reduce the liability of Contractor to DCYF for any breach in the performance of Contractor's
duties. In addition, Contractor's use of any Subcontractor shall not cause the loss of any warranty from
Contractor. All subcontracts shall be made in writing. Any failure of the Contractor or its Subcontractors to
perform the obligations of this Contract shall not discharge the Contractor from its obligations under this
Contract.
d. Direct Agreements. Upon expiration or termination of this Contract for any reason, DCYF and/or the
State will have the right to enter into direct contracts with any of the Subcontractors. Contractor agrees
that its arrangements with Subcontractors will not prohibit or restrict such Subcontractors from entering
into direct contracts with DCYF.
34. TERMINATION FOR CAUSE
a. In the event DCYF determines the Contractor has failed to comply with the conditions of this Contract in a
timely manner, DCYF has the right to suspend or terminate this Contract. DCYF shall notify the
Contractor in writing of the need to take corrective action. If appropriate corrective action is not taken
within thirty (30) days, the Contract may be terminated.
b. DCYF reserves the right to suspend all or part of the Contract, withhold further payments, or prohibit the
Contractor from incurring additional obligations of funds during investigation of the alleged compliance
breach and pending corrective action by the Contractor or a decision by DCYF to terminate the Contract.
c. In the event of termination, the Contractor shall be liable for damages as authorized by law including, but
not limited to, any cost difference between the original contract and the replacement or cover contract and
all administrative costs directly related to the replacement contract, e.g., cost of the competitive bidding,
mailing, advertising and Staff time. The termination shall be deemed to be a "Termination for
Convenience" if it is determined that: (1) the Contractor was not in default; or (2) failure to perform was
outside of Contractor's control, fault or negligence. The rights and remedies of DCYF provided in this
Section (TERMINATION FOR CAUSE) shall not be exclusive and are in addition to any other rights and
remedies provided by law or under this Contract.
d. A filing for bankruptcy by Contractor will be deemed a material breach and may result in immediate
termination of this Contract.
e. Section titled TERMINATION FOR CAUSE, sub-section a. shall not apply to conduct in the performance
of this Contract by the Contractor or sub-contractor(s) that involves child abuse or neglect. In the event
DCYF has reason to believe that in the performance of this Contract the Contractor or its sub-contractors
cause a child to be abused or neglected as defined in chapter 26.44 RCW, DCYF may immediately
suspend or terminate this Contract. DCYF may elect to notify the Contractor in writing of the need to take
corrective action before the Contract is suspended or terminated by DCYF.
35. TERMINATION FOR CONVENIENCE
DCYF may terminate this Contract in whole or in part when it is in the best interest of DCYF by giving the
Contractor at least thirty (30) calendar days' written notice. If this Contract is so terminated, DCYF shall be liable
only for payment required under the terms of this Contract for services received and accepted, or goods delivered
and accepted, prior to the effective date of termination.
36. TERMINATION PROCEDURE
a. Upon termination of this Contract the DCYF, in addition to any other rights provided in this Contract, may
require the Contractor to deliver to DCYF any property specifically produced or acquired for the
performance of such part of this Contract as has been terminated. The provisions of Section
(TREATMENT OF ASSETS) shall apply in such property transfer.
Contract Number: 26-1141 Printed Date: 9/2/2025 Page 15 of 18
b. DCYF shall pay to the Contractor the agreed upon price, if separately stated, for completed work and
service(s) accepted by DCYF, and the amount agreed upon by the Contractor and DCYF for (i) completed
work and service(s) for which no separate price is stated, (ii) partially completed work and service(s), (iii)
other property or services which are accepted by DCYF, and (iv) the protection and preservation of
property, unless the termination is for default, in which case DCYF and Contractor may agree to the
extent of the liability of DCYF. Failure to agree to the extent of the liability shall be a dispute within the
meaning of Section (DISPUTES) of this Contract. DCYF may withhold from any amounts due the
Contractor such sum as DCYF determines to be necessary to protect DCYF against potential loss or
liability.
c. The rights and remedies of DCYF provided in this Section (TERMINATION PROCEDURE) shall not be
exclusive and are in addition to any other rights and remedies provided by law or under this Contract.
d. After receipt of a notice of termination, and except as otherwise directed by DCYF, the Contractor shall:
(1) Stop work under the contract on the date, and to the extent specified, in the notice;
(2) Place no further orders or subcontracts for materials, services, or facilities except as may be
necessary for completion of such portion of the work under the Contract as is not terminated;
(3) Assign to DCYF, in the manner, at the times, and to the extent directed by DCYF, all of the rights,
title, and interest of the Contractor under the orders and subcontracts so terminated, in which
case DCYF has the right, at its discretion, to settle or pay any or all claims arising out of the
termination of such orders and subcontracts;
(4) Settle all outstanding liabilities and all claims arising out of such termination of orders and
subcontracts, with the approval or ratification of DCYF to the extent DCYF may require, which
approval or ratification shall be final for all the purposes of this clause;
(5) Transfer title to DCYF and deliver in the manner, at the times, and to the extent directed by this
Contract or by DCYF any property which, if the contract had been completed, would have been
required to be furnished to DCYF;
(6) Complete performance of such part of the work as shall not have been terminated by DCYF; and
(7) Take such action as may be necessary, or as DCYF may direct, for the protection and
preservation of the property related to this contract which is in the possession of the Contractor
and in which DCYF has or may acquire an interest.
37. TREATMENT OF ASSETS
a. Title to all property furnished by DCYF shall remain in DCYF. Title to all property furnished by the
Contractor, for the cost of which the Contractor is entitled to be reimbursed as a direct item of cost under
this Contract, shall pass to and vest in DCYF upon delivery of such property by the Contractor. Title to
other property, the cost of which is reimbursable to the Contractor under this Contract, shall pass to and
vest in DCYF upon (i) issuance for use of such property in the performance of this Contract, or(ii)
commencement of use of such property in the performance of this Contract, or (iii) reimbursement of the
cost thereof by DCYF in whole or in part, whichever first occurs.
b. Any property of DCYF furnished to the Contractor shall, unless otherwise provided herein or approved by
DCYF, be used only for the performance of this Contract.
c. The Contractor shall be responsible for any loss or damage to property of DCYF which results from the
negligence of the Contractor or which results from the failure on the part of the Contractor to maintain and
administer that property in accordance with sound management practices.
d. If any property of DCYF is lost, destroyed or damaged, the Contractor shall immediately notify DCYF and
shall take all reasonable steps to protect the property from further damage.
e. The Contractor shall surrender to DCYF all property of DCYF prior to settlement upon completion,
termination or cancellation of this contract.
Contract Number: 26-1141 Printed Date: 9/2/2025 Page 16 of 18
f. All reference to the Contractor under this clause shall also include Contractor's employees, agents or
Subcontractors.
38. WAIVER
A failure by either party to exercise its rights under this Contract shall not preclude that party from subsequent
exercise of such rights and shall not constitute a waiver of any other rights under this Contract. Waiver of any
default or breach shall not be deemed to be a waiver of any subsequent default or breach. Any waiver shall not be
construed to be a modification of the terms of this Contract unless stated to be such in writing signed by
personnel authorized to bind each of the parties.
39. CONTRACTOR REPRESENTATIONS AND WARRANTIES
Contractor makes each of the following representations and warranties as of the effective date of this Contract:
a. Qualified to do Business. Contractor represents and warrants that it is in good standing and qualified to
do business in the State of Washington, that it possesses and shall keep current all required licenses
and/or approvals, and that it is current, in full compliance, and has paid all applicable taxes owed to the
State of Washington.
b. Suspension & Debarment. Contractor represents and warrants that neither it nor its principals or
affiliates presently are debarred, suspended, proposed for debarment, declared ineligible, or voluntarily
excluded from participation in any governmental contract by any governmental department or agency
within the United States.
c. Quality of Goods or Services. Contractor represents and warrants that any goods and/or services sold
pursuant to this Contract shall be merchantable, shall conform to this Contract, shall be fit and safe for the
intended purposes, shall be free from defects in materials and workmanship, and shall be produced and
delivered in full compliance with applicable law. Contractor further represents and warrants it has clear
title to the goods and that the same shall be delivered free of liens and encumbrances and that the same
do not infringe any third party patent. Upon breach of warranty, Contractor will repair or replace (at no
charge to DCYF) any goods and/or services whose nonconformance is discovered and made known to
the Contractor. If, in DCYF's judgment, repair or replacement is inadequate, or fails of its essential
purpose, Contractor will refund the full amount of any payments that have been made. The rights and
remedies of the parties under this warranty are in addition to any other rights and remedies of the parties
provided by law or equity, including, without limitation, actual damages, and, as applicable and awarded
under the law, to a prevailing party, reasonable attorneys' fees and costs.
d. Wage Violations. Contractor represents and warrants that, during the term of this Contract and the three
(3) year period immediately preceding the effective date of this Contract, it is not determined, by a final
and binding citation and notice of assessment issued by the Washington Department of Labor and
Industries or through a civil judgment entered by a court of limited or general jurisdiction, to be in willful
violation of any provision of Washington state wage laws set forth in RCW chapters 49.46, 49.48, or
49.52. For purposes of this Subsection (Wage Violations) and pursuant to RCW 49.48.082, "willful" shall
mean a knowing and intentional action that is neither accidental nor the result of a bona fide dispute, as
evaluated under the standards applicable to wage payment violations under RCW 49.52.050(2).
e. Pay Equality. Contractor represents and warrants that, as required by Washington state law (Laws of
2019, Chap. 415, §225(4)(f)), during the term of this Contract the Contractor agrees to equality among its
workers by ensuring similarly employed individuals are compensated as equals.
(1) For purposes of this Subsection (Pay Equality), employees are similarly employed if the
individuals work for the same employer, the performance of the job requires comparable skill,
effort, and responsibility, and the jobs are performed under similar working conditions. Job titles
alone are not determinative of whether employees are similarly employed.
(2) For purposes of this Subsection (Pay Equality), the Contractor may allow differentials in
compensation for its workers based in good faith on any of the following: a seniority system; a
merit system; a system that measures earnings by quantity or quality of production; a bona fide
job-related factor or factors; or a bona fide regional difference in compensation levels.
Contract Number: 26-1141 Printed Date: 9/2/2025 Page 17 of 18
(a) A bona fide job-related factor or factors may include, but not be limited to, education,
training, or experience, that is: consistent with business necessity; not based on or
derived from a gender-based differential; and accounts for the entire differential.
(b) A bona fide regional difference in compensation level must be consistent with business
necessity; not based on or derived from a gender-based differential: and account for the
entire differential.
(3) Notwithstanding any provision to the contrary, upon breach of this pay equality warranty
(Subsection Pay Equality) and Contractor's failure to provide satisfactory evidence of compliance
within thirty (30) days, DCYF may suspend or terminate this Contract.
f. Procurement Ethics & Prohibition on Gifts. Contractor represents and warrants that it complies fully
with all applicable procurement ethics restrictions including, but not limited to, restrictions against
Contractor providing gifts or anything of economic value, directly or indirectly, to Purchasers' employees.
g. Sensitive Personal Information of In-home Caregivers. Contractor represents and warrants that, as
required by state law (RCW 42.56.640, RCW 42.56.645, and RCW 43.17.410), it agrees to fully comply
will all applicable non-disclosure requirements that pertain to the Sensitive Personal Information of In-
home Caregivers.
40. WITHHOLDING PAYMENTS
DCYF may withhold payment to the Contractor for any services/deliverables not performed as required hereunder
until such time as the Contractor modifies or delivers services/deliverables to the satisfaction of DCYF.
Contract Number: 26-1141 Printed Date: 9/2/2025 Page 18 of 18
WASHINGTON STATE DCYF Contract Number: 26-1141
Department of Contract Maximum: $446,836.63
Children, Youth, and Families
From-To:07/01/2025-07/31/2026
Attachment 1 - Confidentiality and Non-Disclosure Agreement
STATEMENT OF CONFIDENTIALITY AND NON-DISCLOSURE AGREEMENT
Between
The Department of Children, Youth, and Families
And
Jefferson County
I. Recitals
1.1 Pursuant to Department of Children, Youth, and Families (the "DCYF") Contract Number 26-1141, attached
hereto Jefferson County (the "Contractor") has agreed to provide high quality home visiting services to
vulnerable families for the purpose of improving outcomes for participants and strengthening coordination of
services..
1.2 During the course of providing such services the Contractor and its employees, agents, and subcontractors
will have access to confidential or personal information owned by the DCYF relating to DCYF Contact
Number 26-1141 which may be protected from disclosure under the Public Records Act (chapter 42.56
ROW), the Freedom of Information Act (5 U.S.C. 522), or other state or federal statutes.
II. Definition of Confidential or Personal Information
2.1 "Confidential Information" or "Data" means information that may be exempt from disclosure under either
chapter 42.56 RCW or other state or federal statutes. Confidential Information includes, but is not limited to,
personal information, agency source code or object code, and agency security data.
2.2 "Personal Information" means information identifiable to any person, including, but not limited to,
information that relates to a person's name, health, finances, education, business, use or receipt of
governmental services or other activities, addresses, telephone numbers, social security numbers, driver
license numbers, e-mail addresses, credit card information, law enforcement records or other identifying
numbers or Protected Health Information, any financial identifiers, and other information that may be exempt
from disclosure under either chapter 42.56 RCW or other state and federal statutes.
III. Terms of Agreement
3.1 As an employee, agent, or subcontractor of the Contractor I have access to information or data described and
contained DCYF Contract Number 26-1141. This information may be confidential information or data, and I
understand that I am responsible for maintaining this confidentiality. I understand that the information may
only be used for the purposes of the work described in DCYF Contract Number 26-1141.
3.2 I understand that before I am allowed access to information and data that is described and/or contained in
DCYF Contract Number 26-1141, I must sign and agree to the following:
(A) I have been informed and understand that information provided under DCYF Contract Number 26-1141
may be confidential information or data and may not be disclosed to unauthorized persons. I agree not
to divulge, transfer, sell, or otherwise make known to unauthorized persons any information described
or contained in DCYF Contract Number 26-1141.
(B) I also understand that I am not to access or use the information that is provided under DCYF Contract
Number 26-1141 for my own personal information, but only to the extent necessary and for the purpose
of performing my assigned duties as an employee of the Contractor under this Agreement. I understand
that a breach of this confidentiality will be grounds for disciplinary action which may also include
termination of my employment and other legal action.
Contract Number: 26-1141 Printed Date: 9/2/2025 Page 1 of 3
(C) I agree to abide by all Federal and state laws and regulations regarding confidentiality and disclosure of
the information in DCYF Contract Number 26-1141.
By signing this Agreement, the undersigned agree to this Agreement being effective as of the last signing date
noted below.
Contractor Name: Employee/Sub-Contractor/Agent Name:
Jefferson County Washington
Signature: Signature:
Print Full Name: Heidi Eisenhour Print Full Name:
Job Title: Chair, Board of County Commissioners Job Title:
Date: Date:
Signature: Signature:
Print Full Name: Print Full Name:
Job Title: Job Title:
Date: Date:
Signature: Signature:
Print Full Name: Print Full Name:
Job Title: Job Title:
Date: Date:
Signature: Signature:
Print Full Name: Print Full Name:
Job Title: Job Title:
Date: Date:
Contract Number: 26-1141 Printed Date: 9/2/2025 Page 2 of 3
Signature: Signature:
Print Full Name: Print Full Name:
Job Title: Job Title:
Date: Date:
Signature: Signature:
Print Full Name: Print Full Name:
Job Title: Job Title:
Date: Date:
Signature: Signature:
Print Full Name: Print Full Name:
Job Title: Job Title:
Date: Date:
Signature: Signature:
Print Full Name: Print Full Name:
Job Title: Job Title:
Date: Date:
Signature: Signature:
Print Full Name: Print Full Name:
Job Title: Job Title:
Date: Date:
Signature: Signature:
Print Full Name: Print Full Name:
Job Title: Job Title:
Date: Date:
(The number of signature lines can be deleted and copied to meet your needs).
Contract Number: 26-1141 Printed Date: 9/2/2025 Page 3 of 3
WASHINGTON STATE DCYF Contract Number: 26-1141
Department of Contract Maximum: $446,836.63
Children, Youth, and Families
From-To:07/01/2025-07/31/2026
Attachment 2 - Certification of Data Disposition
Date of Data Disposition
I. Data Disposition Requirements
Unless the Washington State Office of the Chief Information Officer IT Standards require a different method
for the destruction of data or confidential information, data or confidential information required to be destroyed
under DCYF Contract No. 26-1141 must be destroyed as follows:
(A) For data or confidential information that is contained on optical discs (e.g. CDs or DVDs), the Contractor
shall either destroy by incineration the disc(s), shredding the discs, or completely deface the readable
surface with a coarse abrasive.
(B) For data or confidential information that is contained on magnetic tape(s), the Contractor shall destroy the
data or confidential information by degaussing, incinerating, or crosscut shredding.
(C) For data or confidential information that is contained on a server or workstation data hard drive or similar
media, the data or confidential information shall be destroyed by either
(1) Physically destroying the disk(s); or
(2) Using a "wipe" utility which will overwrite the data or confidential information at least three times using
either random or single character data, degaussing sufficiently to ensure that the data, or confidential
information cannot be reconstructed.
(D) For data or confidential information that is contained on removable media (e.g. floppies, USB flash drives,
portable hard disks, or similar disks), the data or confidential information shall be destroyed by either:
(1) Physically destroying the disk(s); or
(2) Using a "wipe" utility which will overwrite the data or confidential information at least three times using
either random or single character data, degaussing sufficiently to ensure that the data, or confidential
information cannot be reconstructed.
II. Certification
All copies of any data sets related to DCYF Contract No. 26-1141 have been wiped from data storage
systems.
All materials and non-wiped computer media containing any data sets related to DCYF Contract No. 26-
1141 have been destroyed.
All paper copies of the information related to DCYF Contract No. 26-1141 have been destroyed on-site
by cross cut shredding.
All copies of any data sets related to DCYF Contract No. 26-1141 that have not been disposed of in a
manner described above, have been returned to the DCYF's Contract Manager listed in this Contract.
The Contractor hereby certifies by the signature below that the data disposition requirements as described in this
Certification of Data Disposition and DCYF Contract No. 26-1141, have been complied with as indicated above.
Signature of Contract Manager: Date:
Print Name:
Return original to DCYF Public Records at dcyf.publicrecords@dcyf.wa.gov
Contract Number: 26-1141 Printed Date: 9/2/2025 Page 1 of 1
WASHINGTON STATE DCYF Contract Number: 26-1141
Department of Contract Maximum: $446,836.63
Children, Youth, and Families
From-To:07/01/2025-07/31/2026
Attachment 3 - Contract Monitoring, Compliance and Non-
Compliance
1. Program Reporting and Documentation
a. Reporting: The Contractor shall submit reports using the templates in the Prevention Services
Reporting System according to the schedule outlined in the Attachment named FY26 Deliverables
Timeline/Reference.
(1) Additional Documentation: The Contractor shall maintain the following information and
documentation, keeping it current on a monthly basis. At a minimum, DCYF may request
this information for review at the annual DCYF Monitoring Visit, including:
(a) Staff Training Records demonstrating compliance with HVSA and model
requirements;
(b) TA Self Reflection and TA Plan;
(c) CQI PDSA records and reflections to support reporting submitted in Quarterly
Progress Reports;
(d) Memoranda of Understanding with community providers related to referrals or
coordination of Home Visiting Services;
(e) Completed participant consent agreements for all enrollees in the program;
(f) If funded with DSHS/TANF dollars, information on TANF families served by
homeless service providers, PE Pathways and Other including number of
families served; name of family members receiving services (primary caregiver
and target child); individual client identifiers, such as date of birth; and dates of
service (by month including enrollment and exit dates).
b. Annual Monitoring Visits: The Contractor shall cooperate with up to eight (8) scheduled on-site or
virtual visits conducted for monitoring program and fiscal compliance, contractual and reporting
requirements, organizational due diligence, HVSA evaluation and data collection, quality
implementation technical assistance, and continuous quality improvement.
(1) Document Preparation: The Contractor shall assemble documents listed above, financial
information detailed in Section 12 of Exhibit A Statement of Work, and any additional
information requested by DCYF in advance of the scheduled monitoring visit.
(2) During the monitoring visits, the Contractor shall allow access to DCYF, upon request,
documentation demonstrating accomplishments of this Agreement. Such documentation
may include, but is not limited to:
(a) Services Provided, Service Dates, and Number of Service Hours, including Case
Files of Participants and completed consent agreements;
(b) Attendance Sheets and Service Logs;
(c) Data Collection and Assessments by Participants;
(d) Demographic Information of Participants;
(e) Personnel records of those staff employed through funds under this contract; and
(f) Policy and procedures documents as related to implementation of this contract
including, but not limited to, agency, human resources, and financial policies and
procedures.
2. Contract Monitoring:
The Contractor shall ensure compliance with all Contract requirements described in Exhibit A Statement
of Work of this Contract. Failure to comply with or submit timely and complete materials related to the
Contract Number:26-1141 Printed Date: 9/2/2025 Page 1 of 5
Contract requirements may result in withheld or delayed payments. DCYF may work with the Contractor
to develop a customized monitoring plan. DCYF will monitor Contractor compliance with Contract
requirements, model standing, implementation progress, enrollment performance and financial activity
through review of the following:
a. Submitted reports, invoices and documents, as detailed above and in Section 14 of Exhibit A
Statement of Work Compliance with Contract requirements.
b. Model Fidelity:
Affiliate status from the National Service Office/Indicators or model fidelity established by the
DCYF-authorized provider of technical assistance demonstrating Contractor's good standing
and/or active ready to implement status.
(1) If the Contractor does not sustain fidelity throughout the Contract Term, DCYF will
conduct a joint due diligence review of the of the Contractor's model fidelity status in
coordination with its designated contractor for technical assistance: and then DCYF may,
upon written notification to the Contractor, terminate this Contract.
(2) Achieving Model Standing: If Contractor does not have affiliate in good standing and/or
active ready to implement status as of the Start Date of this Contract, the Contractor must
obtain such status within 90 days of the Start Date. If the Contractor does not obtain such
status within 90 days of the Start Date of this Contract, then DCYF may, at its discretion
and upon written notice to the Contractor, terminate this Contract.
3. Implementation Progress:
The DCYF Contract Manager will review monthly budget/financial documentation, monthly enrollment
reports, and quarterly progress reports that depict Contractor activities and progress toward completion of
the required program elements described in Exhibit A Statement of Work:
a. Staffing, Supervision, and Training,
b. Service Area and Service to Priority Populations
c. Participant Enrollment, Retention and Caseload Maintenance
d. Home Visit Frequency and Content
e. Systems Connections: if funded with DSHS/TANF dollars, this includes Contractor relationships
with local DSHS Community Service Offices and reporting participants' program enrollment and
exit in eJas
f. Data Collection and Evaluation Requirements
g. Continuous Quality Improvement Activities
h. Quality Improvement Technical Assistance
Financial activity and documentation aligned with Contract budget
j. Delay in meeting two or more of the category areas above and/or non-compliance related to
financial activity during a quarter, may result in DCYF taking action to work with the Contractor to
develop a customized monitoring plan to include additional contract monitoring and technical
assistance focused on supporting improvement in Contractor's enrollment.
4. Enrollment Performance and Goal Tracking Plans:
On a quarterly basis, DCYF will review the Contractor's enrollment performance for the following
measure: Throughout the duration of this contract, Contractor shall maintain a minimum Active Enrollment
Caseload (as defined in Section 6 of Exhibit A Statement of Work) equivalent to or greater than 85% of
the Contractor's Maximum Service Capacity.
a. Start-Up Programs: DCYF identifies Contractors receiving first year of operational funding as
Start-Up Programs. Exhibit A Statement of Work of this Contract specifies expected enrollment
rates over the term of the contract to reach full enrollment caseload. Progress in meeting
enrollment toward building full caseload will be reviewed on a monthly basis. If the Start-Up
Program does not meet enrollment in accordance with the timeline specified in Exhibit A
Statement of Work, DCYF will inform Contractor of enrollment status and may work with
Contractor to explore causes of enrollment performance issues and develop an Goal Tracking
Contract Number: 26-1141 Printed Date: 9/2/2025 Page 2 of 5
Plan to address indicators of nonperformance and offer additional technical assistance focused
on supporting improvement in Contractor's enrollment.
b. Continuing Programs:
DCYF identifies Contractors receiving second year or beyond of HVSA funding as Continuing
Programs.
(1) If a Continuing Program's minimum Active Enrollment Caseload is less than 85% of the
Contractor's Maximum Service Capacity for up to 3 months DCYF will inform Contractor
of low enrollment status, and Contractor shall participate in a follow-up call with DCYF to
discuss barriers and strategies for increasing enrollment. The expectation of the
Contractor is that they will increase their enrollment across all three months of the
subsequent quarter. If during the subsequent quarter the Contractor does not
demonstrate improvement of active enrollment at or above 85% of maximum service
capacity at least during the final month of the quarter, DCYF may DCYF may work with
the Contractor to explore causes of enrollment performance issues and develop a Goal
Tracking Plan to address indicators of nonperformance and offer additional technical
assistance focused on supporting improvement in Contractor's enrollment performance.
(2) DCYF recognizes that Contractor's active enrollment is related to staffing. contractor
staffing; as a result, DCYF will apply either of the two actions depending on the contractor
staffing capacity:
(a) If the Contractor is fully staffed per the contract, then the above monitoring steps
identified in paragraph (1) will be used for monitoring of Contractors minimum
Active Enrollment Caseload.
(b) If the Contractor is not fully staffed per the contract, DCYF will work with the
Contractor to explore causes of enrollment performance issues and develop a
Goal Tracking Plan.
c. Contractors with and Goal Tracking Plan will be monitored at least monthly for their enrollment
performance.
(1) If the Contractor's minimum Active Enrollment Capacity rises to 85% or more of the
contractor's Maximum Service Capacity, DCYF will inform the contractor of the
improvement and regular monitoring, as described in sections 1 through 3 of this
attachment, will resume.
(2) If the Contractors' minimum Active Enrollment Capacity does not improve after three (3)
consecutive months on the Goal Tracking Plan, DCYF will provide the Contractor with
written notice of their status moving to Quality Review.
5. Quality Review and Performance Improvement Plan
a. Quality Review: The Quality Review will include examination of the contractor's data, monitoring
questionnaire, and other performance and deliverable documentation and submit an
implementation questionnaire in partnership with the contractor and other technical assistance
designees.
(1) Within 30 days of written notification of Quality Review Status by DCYF, the Contractor
will submit to DCYF an Implementation Self-Assessment provided by DCYF to address
areas impacting nonperformance to include, but not limited: model fidelity,
implementation progress, financial activity, and/or enrollment performance in need of
improvement, and other issues of compliance with contract requirements.
(2) Within 45 days of written notification by DCYF, the Contractor shall participate in Quality
Review Meeting(s)with DCYF staff to understand the organizational and programmatic
drivers resulting in the chronicity of low performance. This will include discussion of the
Self-Assessment, other information and feedback from Contractor, review of DOH and
other available program data, and review other information related topics to inform the
development of a Performance Improvement Plan. This meeting may include other DCYF
contractors of technical assistance and data management and reporting.
b. Performance Improvement Plan:
(1) Within 30 days of the Quality Review Meeting, the Contractor shall prepare a written
Performance Improvement Plan to be approved by DCYF. The Plan shall:
Contract Number: 26-1141 Printed Date: 9/2/2025 Page 3 of 5
(a) Cite and describe the Contractor's specific area(s) in need of improvement
including, but not limited to: model fidelity, implementation progress, financial
activity, and/or enrollment performance in need of improvement. For the specified
area(s) in need of improvement;
(b) Describe action steps to address drivers of low performance and support
improvement and metrics or benchmarks to serve as indicators of satisfactory
improvement.
(c) Identify technical assistance and/or other supports designated to be made
available to Contractor by DCYF to assist Contractor in achieving satisfactory
improvement.
(d) Outline a timeline for the completion of the Performance Improvement Plan by
the Contractor.
(2) DCYF will monitor at least monthly the Contractor's progress according to the timeline,
action steps and indicators described in the Performance Improvement Plan, with the
option of conducting on-site visits if necessary.
(3) If satisfactory improvement in the specific area(s) indicated in the Plan is met by the
Contractor within the timeline for completion of the Plan, DCYF will transition the
Contractor off Quality Review Status, and DCYF will provide the Contractor written notice
of this transition.
(4) If satisfactory improvement in the specific area(s) indicated in the Plan within the timeline
for completion of the Plan is not met by the Contractor, DCYF may transition the
Contractor out of Quality Review Status into Non-Compliant Status, and DCYF will
provide the Contractor written notice of this transition.
6. Non-Compliant Status and Non-Compliant Courses of Action
a. Non-Compliant Status: If DCYF transitions the Contractor to Non-Compliant Status, the
Contractor shall participate in the steps outlined below, within 14 days of written notification from
DCYF, or within an extended, alternate timeline with written approved by DCYF:
(1) Participate in Non-Compliant Status meeting(s) with DCYF staff to:
(a) Review the Contractor's Quality Review and Performance Plan and discuss
progress made and barriers encountered during the Plan's implementation
including technical assistance and/or other supports designated to be made
available to the Contractor by DCYF.
(b) Identify and review the Contractor's contractual requirements and areas of
contractual non-compliance.
(c) Discuss Non-Compliant Courses of Action.
b. Non-Compliant Course(s) of Action. Within 14 days of the last Non-Compliant Status meeting
DCYF will issue the Contractor a written Non-Compliant Course(s) of Action. The written Non-
Compliant Course(s) of Action shall include one or more of the four Non-Compliant Course(s) of
action listed below:
(1) Continuation of Performance Plan: DCYF may propose to modify and/or extend the
Contractor's Performance Plan for up to an additional 3-month period to meet specific
area(s) cited in need of improvement.
(2) Suspension of Payment: DCYF may suspend payment of all or part of Contract funds
until satisfactory contract compliance is met.
(3) Reduction in Maximum Contract Total: DCYF may amend this contract to reduce the
Contractor's maximum contract total:
(a) To reflect the amended Implementation Plan scope negotiated between DCYF
and the Contractor based on Contractor's cost per family served and other
related factors and,
Contract Number: 26-1141 Printed Date: 9/2/2025 Page 4 of 5
(b) If feasible and in compliance with HVSA and DCYF funding requirements,
contractual requirements, and approval processes, including Home Visiting
Model Developer program requirements.
(4) Early Contract Termination: DCYF may terminate this contract prior to the end of the
Term if satisfactory contract compliance is not met by the Contractor in the
implementation of Contractor's Implementation Improvement Plan, and/or if the
Contractor is not able to or is not cooperative in development and implementation of the
Implementation Improvement Plan.
(5) Notice: The written Non-Compliant Course(s) of Action shall become effective a minimum
of 30 days after the delivery of the written Non-Compliant Course(s) of Action to
Contractor.
Contract Number: 26-1141 Printed Date: 9/2/2025 Page 5 of 5
WASHINGTON STATE DCYF Contract Number: 26-1141
Department of Contract Maximum: $446,836.63
41'. Children, Youth, and Families
From-To:07/01/2025-07/31/2026
Attachment 4 - Data Collection, Reporting and HVSA Aligned
Measures
Attachment: Data Collection, Reporting and HVSA Aligned Measures
1. Data Sharing
a. Required elements of the Data Sharing Agreement (DSA) with the Department of Health (DOH): The
Contractor will work with DOH to establish data sharing agreements according to the timelines set
forth within Exhibit A, Statement of Work. The data sharing agreement shall outline specifications of
the data use and data sharing to implement required reporting, evaluation and quality assurance or
improvement activities. The data sharing agreement shall minimally:
(1) Allow DOH access to client and program data as outlined below in section 4.0.
(2) When parental consent is provided,
(a) Share with and allow DOH access to confidential information listed in Table 3 below;
(b) Allow DOH to share confidential information with DCYF; and
(c) Allow DOH to share confidential information with other Washington State agencies,
including, but not limited to, the Office of Research and Data Analysis (RDA) housed
within DSHS to conduct administrative match from families in Home Visiting and Child
Protective Services (CPS) programs.
b. National Service Office Permissions for data sharing:
(1) DCYF will work with NFP National Service Office to secure an approved template for NFP
programs to authorize the national service office to share data with DOH. The Contractor shall
send authorization by July 31, 2025 using the approved template to the NFP National Service
Office in coordination with the NSO.
2. Data Collection Process and Schedule
a. The Contractor shall collect all of the data outlined in section 4 of this attachment for all enrolled
participants according to the guidelines and requirements outlined in the HVSA Data Requirements
web page (https://www.dcyf.wa.gov/services/child-dev-support-providers/home-visitinq/data-
collection). The Contractor shall record data in the model specific database within five (5) business
days of data collection. The Contractor shall provide data as outlined in the Data Sharing Agreement
executed with DOH. Data will be provided to the Department of Health directly from National Service
Office on a monthly basis.
3. Parental Consent
a. The Contractor will make every effort to seek Parental Consent to share confidential information with
DOH during the contract period; the Contractor shall seek this consent from all newly enrolled
participants within the first three home visits. Consent form(s) are available on the Home Visiting
page at DCYF.wa.gov.
b. Parental Consents for voluntary services and confidential data sharing may be combined.
c. Participants who do not provide consent to share confidential information remain eligible to receive
home visiting services. Non-confidential program data reporting is still required for these participants.
d. For those participants who consent to share confidential information, the Contractor shall send to
DOH the list of participants by client ID and their consent status (e.g., Yes or No) on at least a
monthly basis and no later than 6 business days after the close of the prior month. For those
participants who consent to share confidential data, Contractor will enter confidential data in Flo.
Contract Number: 26-1141 Printed Date: 9/2/2025 Page 1 of 9
e. The Contractor will maintain consent forms on file for all participants enrolled in home visiting services
in both physical files and electronically in model data system, if applicable. Upon request, the
Contractor will provide to DCYF a copy of the consent form used.
4. HVSA Aligned Performance Measures
a. HVSA Aligned Measures: As outlined in statement of work, the Contractor will collect data for all
enrolled HVSA families that meets model requirements and the DCYF definitions outlined in Tables 1
through 5 below. These measures may be revised per Federal guidance, with updated requirements
mutually agreed upon for implementation one quarter following Federal changes. Department of
Health will work with the Contractor to review data collection and reporting to support Contractor
quality assurance.
(1) HVSA Aligned Measures: System and Program Performance Indicators: The Contractor shall
collect and share data for all measures for participating caregivers and children as outlined in
Table 1.
(2) Enrollment and Service Utilization: The Contractor shall collect and share data on all enrollment
and service utilization measures outlined for participating caregivers and children.
(3) Demographic Information: The Contractor shall collect and share data for all demographic
information outlined for participating caregivers and children.
(4) Performance Based Contracting Measures: The Contractor shall review data reports from DOH
to substantiate Performance Based Contracting Measures as described in Table 4.
(5) HVSA Definitions: Table 5 presents definitions of measures related to Performance Based
Contracting.
Contract Number: 26-1141 Printed Date: 9/2/2025 Page 2 of 9
WASHINGTON STATE DCYF Contract Number: 26-1141
Department of Contract Maximum: $446,836.63
.14 Children, Youth, and Families
From-To:07/01/2025-07/31/2026
Table 1 HVSA: System and Program Performance Indicators
Timeline for Data Share with HVSA MIECHV
Measure Definition Numerator/Denominator Collection LIAs Aligned Measure
Measure
HVSA Aligned Measures: All Contractors shall report on the following eight(8) measures
Percent of infants (among Number of enrolled children Collect between 6
mothers who enrolled QA reports,
1. Breastfeedingprenatally) breastfed any amount at 6 months of age and
who were Annual Yes Yes
breastfed any amount at 6 months/ Number of enrolled before 12 months of reports
months of age children age 6-12 months age
Number of primary
Percent of enrolled caregivers with at least one
primary caregivers who PHQ-9 screening completed
are screened for within 3 months of delivery if Collect within 3 Quarterly
depression using a enrolled prenatally or within months of Dashboards,
3 months of enrollment if QA reports,
2. Depression validated tool within 3 enrollment or 3
Screening months of enrollment if enrolled post delivery / months postnatally Performanc Yes Yes
Number of primary e Payments,
enrolled post-delivery or caregivers enrolled for at (for those enrolled Annual
within 3 months after while pregnant)
delivery if enrolled least 3 months if enrolled reports
prenatally post-delivery, or at least 3
months after delivery if
enrolled prenatally
Percent of enrolled Number of children enrolled
children who received the who received the last Collect well child QA reports,
3. Well Child last recommended well recommended well child visit visit data at
Visit child visit based on the based on AAP schedule/ minimum once per Annual Yes Yes
American Academy of Number of children enrolled month reports
Pediatrics (AAP) schedule _ in home visiting
Percent of enrolled Number of children with at
children with at least one least one investigated case Report parental
4. Child investigated case of Annual
Maltreatment maltreatment following of maltreatment since consent within first reports Yes Yes
enrollment within the enrollment/ Number of 3 home visits
reporting period children enrolled
Percent of enrolled Number of primary
primary caregivers who caregivers with an Collect at least
5. Parent-Child receive an observation of assessment completed once during the QA reports,
Interaction caregiver-child interaction using validated tool for the reporting year, Annual Yes Yes
using a validated tool and age range/ Number of ideally spaced reports
demonstrate positive primary caregivers with a every 12 months
parenting behaviors child who has reached an
Contract Number: 26-1141 Printed Date: 9/2/2025 Page 3 of 9
Table 1 HVSA: System and Program Performance Indicators
Timeline for Data Share with HVSA MIECHV
Measure Definition Numerator/Denominator Collection LIAs Aligned Measure
Measure
including behaviors that age appropriate for
promote attachment and assessment
child development
Percent of enrolled Number of enrolled children
6. Earlychildren with a family with a family member who
Collect data at least
member who reported that reported that during a typical QA reports,
Language and once during each
Literacyduring a typical week s/he week s/he read/told Annual Yes Yes
read, told stories, and/or stories/sang songs with child reporting period for reports
Activities each enrolled child
sang songs with their child every day/ Number of
every day enrolled children
Percent of enrolled Number of enrolled children
children with at least one with at least one ASQ-3
7. Developmental screening for screening within the AAP Collect for children QA reports,
Screening developmental delays with defined age/ Number of at 10, 18 and 24 Annual Yes Yes
a validated tool according children enrolled who are months of age] reports
to the AAP-defined age eligible for an ASQ-3
groups screening _ _
Percent of enrolled
Number of primary
primary caregivers who caregivers with an IPV Collect screening
are screened for intimate data for all primary QA reports,
8. IPV Screening partner violence (IPV) screen within 6 months of caregivers within 6 Annual Yes Yes
enrollment/ number of
within 6 months of primary caregivers enrolled months of Reports
enrollment using a enrollment
for at least 6 months
validated tool
Contract Number: 26-1141 Printed Date: 9/2/2025 Page 4 of 9
Table 2: HVSA: Enrollment and Service Utilization
Data Element Definition Timing of Data Collection
1. Enrollment Date Date of the first home visit during which the family voluntarily consents to Record at time of enrollment
participate and signs a written participant agreement
2. Funding Code - MIECHV Record at time of enrollment
- TANF
- 502
- GFS
3. Exit Date Date family exited the program Record at time of exit
4. Exit Reason Reason family exited the program, may include: Record at time of exit
- Completion —specific to each model
-Withdrawn —Client requests to leave program before graduation
- Transfer—Client transferred to another site or model
- Lost to Follow-up- Unable to contact client and complete a home visit for
more than 90 days
- Began/Returned to Work
- Began/Returned to School
5. Home Visit Date Date of each home visit that meets model criteria Record after each home visit
6. Home Visit Type - In-person Record after each home visit
-Video
- Phone
7. Home Visit Duration Length of visit (minutes) Record after each home visit
8. Encounter Date Date of each bi-directional engagement with families via in-person, email, Record after each encounter
text, phone, or other with minimal or no model content _
9. Encounter Type - In-person Record after each encounter
- E-mail
-Text
- Phone
- Other(e.g., porch drop-off with interaction)
10. Encounter Duration Length of encounter(minutes) Record after each encounter
Contract Number:26-1141 Printed Date: 9/2/2025 Page 5 of 9
Table 3: Demographic Information
Measure Definition Eligibility Timing of Data Collection
1. Caregiver Gender - Female All enrolled caregivers Collect at enrollment
- Male
- Non-binary
2. Child Gender - Female All enrolled children Collect at enrollment or after birth
- Male of the child (if enrolled prenatally)
- Non-binary
3. Caregiver Age Age of enrolled caregivers All enrolled caregivers Collect at enrollment
4. Child Due Date Expected due date Children enrolled Collect at enrollment
prenatally
5. Child DOB Date of birth for enrolled child All enrolled children Collect at enrollment or after birth
of the child (if enrolled prenatally)
6. Caregiver Ethnicity - Hispanic or Latino All enrolled caregivers Collect at enrollment
- Not Hispanic or Latino _
7. Caregiver Race -American Indian or Alaska Native All enrolled caregivers Collect at enrollment
-Asian
- Black or African American
- Native Hawaiian or Pacific Islander
-White
- More than one race
8. Child Ethnicity - Hispanic or Latino All enrolled children Collect at enrollment or after birth
- Not Hispanic or Latino of the child (if enrolled prenatally)
9. Child Race -American Indian or Alaska Native All enrolled children Collect at enrollment or after birth
-Asian of the child (if enrolled prenatally)
- Black or African American
- Native Hawaiian or Pacific Islander
-White
- More than one race
10. Caregiver Marital Status - Never married (excluding not married but All enrolled caregivers Collect enrollment, and annually
living together thereafter, and when any change
- Married in status is noted
- Not married but living together
- Separated/divorced/widowed
11. Caregiver Education -Enrolled in middle school All enrolled caregivers Collect at enrollment and
-Enrolled in high school annually thereafter, and when
-High school diploma any change in status is noted
-GED
-Less than high school diploma not
enrolled
-Training certificate program
-Associates degree
-Some college
-Bachelor's degree or higher
-Other
Contract Number: 26-1141 Printed Date: 9/2/2025 Page 6 of 9
Table 3: Demographic Information
Measure Definition Eligibility Timing of Data Collection
12. Caregiver Employment -Employed>=30 hours a week All enrolled caregivers Collect at enrollment and
-Employed <30 hours a week annually thereafter, and when
-Unemployed any change in status is noted
13. Caregiver Housing Status -Not homeless: Owns or shares own All enrolled caregivers Collect at enrollment and
home, condominium or apartment annually thereafter, and when
-Not homeless: Rents or shares own home change in status is noted
or apartment
-Not homeless: Lives in public housing
-Not homeless: Lives with parent or family
member
-Not homeless: Some other arrangement
-Homeless: Sharing housing
-Homeless: Living in an emergency or
transitional shelter
-Homeless. Some other arrangement
14. Primary language in -English All enrolled caregivers Collect at enrollment
household -Spanish
-Other (specify)
15. Household Income Total income from all household members All enrolled households Collect at enrollment and
from all sources, including TANF benefits annually thereafter
16. Number of Household Total number of residents within the All enrolled households Collect at enrollment and
Members Dependent on household that rely on reported household annually thereafter
Income income. May include enrolled participants
and other household members.
17. Pregnant Enrolled guardian is pregnant during the All enrolled caregivers Collect due date and DOB for all
report period (Yes/No) children
18. Caregiver Health Insurance - Medicaid or CHIP All enrolled caregivers Collect at enrollment and at
Status - No insurance coverage minimum every six months
- Private or other thereafter, and when any change
- Tri-Care in status is noted
19. Child Health Insurance Status - Medicaid or CHIP All enrolled children Collect at enrollment or after birth
- No insurance coverage of the child (if enrolled prenatally)
- Private or other and every six months thereafter,
-Tri-Care and when any change in status is
noted
20. Child's Usual Source of -Doctor's/Nurse Practitioner's Office All enrolled children Collect at enrollment or after birth
Medical Care -Hospital Emergency Room of the child (if enrolled prenatally)
-Hospital Outpatient and annually thereafter, and
-Federally Qualified Health Center when any change in status is
-Retail Store or Minute Clinic noted
-Other
Contract Number: 26-1141 Printed Date: 9/2/2025 Page 7 of 9
Table 3: Demographic Information
Measure Definition _ Eligibility Timing of Data Collection
21. Child's Usual Source of -Yes: Has a usual source of dental care All enrolled children Collect at enrollment or after birth
Dental Care -No: Does not have a usual source of of the child (if enrolled prenatally)
dental care and annually thereafter, and
when any change in status is
noted
22. Residential Zip Code Zip code for family residence All enrolled families Collect at enrollment and when
family moves
23. Additional Confidential Parent Full Name All enrolled children Collect at enrollment or after birth
Demographics required for Parent Date of Birth of the child (if enrolled prenatally)
consenting participants Parent Address
Child Full Name
Child Provider One Number
Table 4: Performance Based Contracting Measures
Measure Definition Milestone Criteria
Enrollment Percent of Maximum Service Capacity filled during Performance Milestone: Active Enrollment* is at least 85% of
(Active Enrollment*) the quarter, as measured by the average of the Maximum Service Capacity for the reporting quarter, with the
number of participants actively enrolled* on the last calculation limited to prenatal families and families with
day of each of Month 1, Month 2 and Month 3 of the children up to and including 60 months of age.
quarter divided by the Maximum Service Capacity
(total number of possible families)
Family Retention — Number of participants who are engaged" in the Per Client Milestone: Number of participants who remain
12 months program for 12 months after enrollment engaged* in the program for 12 months after enrollment, as
indicated by receiving a visit on a date between 30 days
before and 30 days after the 12-month anniversary of their
enrollment date and not exited prior to 12 months.
Per Client Milestone: Number of participants meeting the
retention criteria and reporting 2 demographic characteristics
related to early exits described in Table 5 below.
Family Retention— Number of participants who are engaged* in the Per Client Milestone: Number of participants who remain
18 months program for 18 months after enrollment engaged* in the program for 18 months after enrollment, as
indicated by receiving a visit on a date between 30 days
before and 30 days after the 18-month anniversary date of
their enrollment date and not exited prior to 18 months.
Per Client Milestone: Number of participants meeting the
retention criteria and reporting 2 demographic characteristics
related to early exits described in Table 5 below.
Depression Screening Number of participating primary caregivers who are Per Client Milestone: Number of eligible caregivers who
screened for depression using an approved, receive a depression screening during the contract year
validated tool within 3 months postpartum (if enrolled according to this definition
prenatally) or 3 months after enrollment (if enrolled
postnatally)
Contract Number: 26-1141 Printed Date: 9/2/2025 Page 8 of 9
Table 4: Performance Based Contracting Measures
Measure Definition Milestone Criteria
Depression Referral Number of participating primary caregivers who Per Client Milestone. Number of primary caregivers who
screened positive for depression and were referred to screen positive for depression who were referred or
or connected with appropriate services. A Contractor connected to appropriate services during the contract year
can receive this award only once per participant over
the years.
Healthy Birthweight - Number of participants who give birth to an infant of Per Client Milestone: Number of participants who give birth to
Participant Outcomes healthy birthweight during the contract year using the an infant of healthy birthweight during the contract year using
definition below in Table 5. the definition below in Table 5.
Per Client Milestone: Number of participants with at least one
identified HBW criteria for additional support detailed in Table
5 who gives birth to an infant of healthy birthweight during
the year.
*Designation of"active enrollment" and "engaged" may shift depending on extenuating circumstances (e.g., COVID-19 pandemic). Upon formal
announcement by DCYF, active enrollment or engagement may be limited to documentation of a received visit or the definition of active and engaged may
expand to include encounters (bi-directional engagement with family via in-person, email, text or phone).
Table 5 HVSA Definitions Impacting Based Contracting Measures
Demographic Characteristics Related to Early Exit
The characteristics listed below have been identified as related to early exits in research and among the FY18 HVSA participants. This list is not all-
inclusive and subject to change during the contract year.
• Teenage (<20) at enrollment
• Less than high school education (among non-teens) at enrollment
• Homelessness (on the street or living in a group home or shelter or some other arrangement), reported any time during service
• Participating on TANF, reported any time during service
• Not residing with a romantic partner(single, divorced, widowed), reported any time during service
Healthy Birthweight(HBW) HBW Criteria for Additional Support (Characteristics of Mother*)
Infant birthweight is: • Black/African American
• greater than or equal 2500g • American Indian or Alaska Native
and • 35 years or older at enrollment
• less than 4500g • Used alcohol anytime while pregnant
• Used drugs anytime while pregnant (marijuana, cocaine, or other drugs)
• Smoked at enrollment
• Homelessness (on the street or living in a group home or shelter or some other arrangement),
reported any time during service
*The characteristics listed above were identified as correlated with birthweights below 2500g or above
4500g based on analysis of birthweights of infants born to HVSA participants in 2017 and 2018.
Contract Number: 26-1141 Printed Date: 9/2/2025 Page 9 of 9