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HomeMy WebLinkAbout072213_ca05C~i~s~:nt A~~t~d~ G~ ~RR{a~ ,~ ~~~F~~.s+~r~ ~~vvr~~~ ~'~~,IC ~~~,T~r ~4~,~„ t~~ 615 Sheridan Street o Port Townsend Q Wlfashington ~~ 98368 wv~riv.jeffersoncountypublichealth.prg ]~~FERS€~N C~I~N~~ B[]A-R'D flF G[)l~~VTY C~'~NIISSI~3N~RS -~k~GENL7A It~~~IJEST ~~ Board of G~unty Cor<mr~issioners Phillip '~+toriey, County Ad~~inistrator FR[3M: Jean Baldwin, Direct©r DACE: ~ ~..q ~ ~~ ~ ~ , ~~ ~ SI~B~ECT: Agenda Iterrt -Agency Agreement ~ Early Intervention Program ~EIP} 1363-79231 with Department of Social and Health Services; July d., 2013 - dune 30, 2f314, $36,623a0~# 5~'ATEM!EHT [gF ISS'LIiE: Jefferson County Public Health is requesting Board approval of the Agency agreement -Early Intervention Program {EIP) ##1363-79231 with Department of Social and Health Services;; Juiy 1, 2413 -June 30, 2414; X36,623.04 AitiALy5iSI5TRA~'EGIC GC3ALSIPF~Q'S and CC]H'S; Jefferson County Public Health has contracted with Department of Social & Hea#th Services, D#vision of Children & i=amity Services, tq provide Early Intenrentyen 5e~viees since ].990. This centract provides serv#ces to families referred by Chcldren's Administration, Child Protect'sve Services, for public health nurse interventions. Under thus agreement, DSHS contracts with JCPH to provide services for families that are at moderately low risk of abuse yr neglect. Services include direct services to fame#ies or link families to community resources to accomplish the folllowing goals; reduce risk by enhancing parenting skills and self- suff;ciency, reduce stress crn the family and enhance the health status of families and #inkages to health services, assessrrrent and identification of risk factors, education, information and referral and other public health serriees. F~'SCAL INIPAC~fCDST BEiV'EFIT AIV,~#LYSIS: The funding covers all program costs. There is no general fund support in this program. RECDMME~lDA7~flN. JCPH management request approval of the Agency agreement -Early InterventionProgram ~EIP~ #1363x79231 with Department of Social and Health Services; July 1, 2013 -June 34, 2414; $36,623.04 ..~--, REVIE~I''E BY r f .; - ~e ~ ~ I pt~p ~M~rley'C~ my Adm#nis~rat~r Tate .~ , CUMMUNIT'Y HEALTH RU~LIC HEALTI~ [NViRC~NMENTAI HFALTf-i bEVEL{7FIVlENTAI. D95A€iILdTIE$ WATER QUALITY MAIN: #3sOJ 385-9400 ALWAYS WORN4IHG FOR A SAFfR APIf) MAIN: (36q} 3$5-9444 FA7C: (36q# 3$5-9401 HEALTHIER COMMUNITY FAQ: {3F0) 379-4487 DSHS A~reerr~ent Number ~r~ w' ~/ p p n~ A ~+ n~ ^~ ~~U1M 1 f ~~~L~f~~lYl ML3~~~tY1~1Y~ 1~~3°~~2~1 ~~ Wrrshsngg ton S!a re L]LPR A'TL.SENT L7F ~at'~]r ~~'lt@T'Vetltian Pr{]t~Car~ (EIP] C3C-I y~ AC£ST~ RV This Prograrrl Agreemenf is by and between the State of Washington Department of Program Agreement Number 5ociai and Health Services Z1~SFiS] and the County identified laelow, and is issued in 4603- con~unction with a County and DSHS AgrEement on General Terms and Conditions, County Agreement Number which is incur orated b -reference. DSHS ADM€NiSTRATION DSHS I71VIS14N DSHS IND1=X NU'ME3ER DSHS CONTRACT CC3bE Childress Administration Division of Children and Family 1223 204805-63 ~eNIGeS DSHS CONTACT NA'iVIE AND TITLE DSHS CONTACT ADDRESS Dianne Thompson 1949 So. State 5t., NIS: N27-33Tacoma, WA 98405- l~e 'Iona! Contracts iVlana er D5H5 GC'~NTACT TE9_EF'HONE D5H5 GONTAGT FAX DSHS GC3NTACT E-1NA9L 253 983-6266 253 983-6433 thdi300 dshs.wa. av GaIJNTY NAME CC3UNTY ADDRESS 615 Sheridan St Jefferson County Port Townsend, VJA 98358- AGT NAME ' GC~I3NTY FEDERAL EMr'LOYER IDENTIFICATIC)NNUMBEB ~ N Danskin J Iia CdUNTY CONTACT TEI-EPHONE GrDUNTY CONTACT FAx COUNl'Y CONTACT E-~11AIL ~ ~ effersnn.wa.us danskin co. 36~~ 385.9420 360 385-9401 lS THE G{7'DNTY A SUBREGIPIENT FOR PURI'C~SES 'OF THIS PRC~~uRANf CFDA NUMBERS AGREEMENT? No _ - _ - - C3C,RAEuf AGREEPV}EN7 AMOUNT ~REEMENT END L3ATE PROGRAM AGREEMENT START RATE ~~ ~~ 2014 ~ ~ 623 04 07l0'l{2013 _ - -- lrXH1BITS. V11hen the boX below is marked with an X, the fallowing Exhibits are attached and are incorporated into this County Program Agreement by reference: ~ ~Exhiblts ('specify): ~xhitsit A -Data Securoty Requirernertts; Exhitait B-Statement of Work; ~xhitsit ~ - Program ~xh4t3tt ~- lrx~t Code ~'efirfntion; and ~~Exht7%t ~ ~ laud et ts ; ~R8 t~iremen Contract l''urpase: The purpose of these services is to control threats to child safety so children can remain safely in their while continuing to support families. These services at a rrsinurrium wilt: awn homes, Place the child and their safety as the center of focus for service delivery • Assess the child's safety to remain in the home on an ongoing basis Engage families in the focus to reduce safety threats Work to increase safe parenting skills; and wire immediate communication wwith the Children's Administration about safet threats to the child. P e ay their signatures below, the parties agree to the terms and conditions of this County Program Agreement and alP documents incorporated by reference. No other understandings or representations, oral or otherwise, regarding the sub}ect f this Program Agreerrlent shall tae deemed to exist or bind the parties. The parties signing below certify that they t er o mat are author`€~ed to si n this Pro rain A regiment. COUNTY SIGNraTUr~v(S} PRINTED NAMES) AND TITLE{S) DATE{S} SIGNED I .TUBE DSHS SIGNA PRINTED NAME AND TITLE BATE SIGNED Dianne E. Thompson, Contracts Manager DSHS Gentra9 Gorstrac! 5ervi~es 2fl4~CS EIF' Canty i5'3Q-13} _ „~ ~.~~~~ ~~ S`am' ~"a Page 1 Special ~"err~rs ar>ari Conditions Definitions. The words and phrases listed below, as used in this Contract, shall each have the fallowing definitions: a. "Abuse of Client" means the injury, sexual abuse or exploitation, negligent treatment or rnaltreatmert of a client by any person under circumstances which indicate that the client's health, welfare or safety is harmed thereby. b. `°Agency" means a public or private agency or other organization providing services to 17SHS clients. c. "Authorized" means approved by a CA social worked as evidenced by receipt of an SSPS Social Services notice or other written notice. d. "Authorized user~s)» means an individual or individuals with an authorized business requirement to access ®SF-1S Confidential Information. e_ "`Case°' means a family for which a risk of abuse or neglect has been determined and the #arnily is open to CA services. f. "CA" means Children's Administration, which is an Administration within pSHS. g. "CAS' ElR Liaison" means the CA staff person who is responsible for maintaining contact with the Contractor and coordinating ElP services in the region. h. `"CFWS' means Children and Family 1Nelfare Services.., a program under CA. i. "Child Abuse or hleglect" means the injury, sexual abuse, sexual exploitation, negligent treatment, or maltreatment of a child under circumstances, which indicate that the child's health, welfare, and safety is harmed. An abused. child is a child who has been subjected to child abuse or neglect. g `.'Client" means any child or adult who is authorized services by DSNS. k. °'Community Resources" means community supports and concrete services. I, "Community Resource ^irectory» means a list of local resource agencies ar individuals that provide supports for families. m. "Gommunity Supports" means services that are offered to families by corrlmunty providers that may include but are not lirrrited to: housing assistance, mental health services, public health services, alcohol and drug treatment, family and social support connections, financial assistance, domestic violence counseling and treatment, educational and employment assistance, parent education, legal services and' cultural and language assistance.. n, "Contract" means the entire written County 1'ragram Agreement between l~Sf~S and the Contractor, including any Exhibits, documents, and materials incorporated by reference. o. "Contractor" means the individual or entity performing services pursuant to this Contract and includes the Contractor`s owners, members, officers, directors, partners, employees, andlor agents, unless otherwise stated in this Contract. For purposes of any permitted Subcontract, "Contractor" includes any Subcontractor and its owners, members, officers, directors, partners, employees, andlor agents. p "Corpora1 Runishment"' means any act that wiUfuily inflicts or causes the infliction of physical pain on ~SHS Central Contract Seruices ~~~~ 2Q48C5 EIP County {5-3[7-13J Special Terms and Conditions a child. ~ "Coreective Aotion Plan" means a written plan approved by L~SidS which iden#ifies deficiencies in Contractor"s performance, describes the steps Contractor must take #o correct the deficiencies, and. sets forth tirnefra~mes within which such steps must be taken to return Contactor to compliance with the terms Qf the Contract. r. "`CPS'" means Child Protection Services, a program under CA. s ".CPS Intake" is the process designated to record all referral reports concerning instances of suspected child abuse and neglect, determine if the referral meets referral screening criteria and make a disposition concerning the referral. t. .`EFS ;" means the CA program tailed Early FamLly Support. Services. u. °E1P'° means Early Intervention Program. A program provided! by County 'Public Health ^e,partments, v. "Face to Face Contact" means an in-home visit or visit at an alternative Location with the referred family which is visual contact within the same room not to include any form of eleotronic contact,. e.g., telephone or camp~uter, with the exception of the use of such equipment as reasonable accommodation for a client with a d`esabLity. w. "FVS"' means Family Voluntary Services, a program under CA. x. "Hardened Password" means a string of at least eight characters containing at Least one aLphabe#ic character, at least one number and at least one special character such as an asterisk, ampersand or exeiamation point. y "KL3S" means Knowledge, I~ehavior, and Status which is the problem rating scale for outcomes within the dmaha System, ~. `°LEP" means Limited English Proficiency, and indicates an individual`s need for additional support and assistance in comprehending the English Language. aa, "pmaha System" is the corrrprehensive classification rating and outcorrte tool used for EFSS and E11~. The Qmaha. System consists of the Problem Classification Scheme, intervention Scheme, and. Problem Rating Scale for Outcomes. bb, '.`Participation"" means family participation in one or more of the services outlined in the Family Service 1~Lan. cc. "Service plan" means a plan written with input from the ELP nurse and family to address family needs and strengths, behaviorally directed goals, specific interventions and community referrals. dd. "Staffing" means a formal or informa9 meeting, conducted by a CA social worker or CA staff member with one or more of the following persons; other CA staff, Contractor andlor other provider, consultants, parents or others, for the purpose of reviewing or discussing, or for making decisions concerning, a client or case. ee. „unique RJser ll~" means a string of characters that identifies a specific user and which, in conjunction with a password, passphrase or other mechanism,. authenticates a user to an information system. CSHS ~enlsai C4n]raca Se~vR~es Rage 3 ~[748C.5 ~kR County {5-34.33) Special Terrns and Conditions 2. [~a#a Security Requirements _ f=xhibit A. The Contractor shall protect, segregate, and dispgse of data from Children's Administration as described in Exhibit A, as required in the Section below entitled Secure ~llanagerrtent of Confidential Information. 3. Statement of Vllork - Exhit~it '~. The Contractor shall prgvide services and staff as described in the Statement of Work attached as Exhibit B. 4, program Requirements -~ Exhibit C, The Cgntractar shall comply with all program and other recluirernerats far prgviding services under this Contract, as stated in the Prggram Requirements attached as 1~xhibit C. 5, Exit Code pefinitiions ~ Exhibit D. The Cgntractar shall utilise the 'Exit Code Definitions when dgcurr~enting case clgsure with a family, attached as Exhibit D. ~. Eudget _ Exhitrit E, if Exhibit E- Budget is checked an page 1 of the Gantract, and Consideratign Section 8 indicates payment far either service based an actual casts qr in mgnthly payments then the Contractor's budget for ,providing services under this Contract is attached as Exhibit. E. l=ands rrtay be transferred between budget line items of the Cantractgr's E3udget subject tq the fallowing conditions: a, Transfer of funds up tq 1 fl°Ia of the budget line item must be requested in writing by the Contractor and may be made without amending this Gantract; b. Transfer of funds that exceeds ~{3°I~ of the budget line item shall require a written amendment tq this Contract rg igt to tk~e transfer of funds between budget line iterr~s. Secure [Management of Confidential Information The Contractor shall ensure that all Confidential Information (also referred to as Personal 1r3formation} as defined in the General Terms and Conditions Section 1, acquired under this contract is used only far the pravisign of services under this contract. and is handled woth the uttrrgst confidentiality as described in the General Terms and Conditions, Section ~, C~anfiderrtralify. In addition: a. Cgntractgrs Dave permission tq use mobile devices under this contract and shall ensure that mobile devices and data are accessed and protected as described in Exhi#~it A~ Qata Security Requirements. b. Failure to comply with applicable requirements may result in termination of thils contract. Consideration a. Maximum. Gantract Amount. The maximum amount of total corr~pensatign payable to the Cgntractgr far satisfactory performance of the work under this Gantract is 3~,f~23.0~#. b. Allocated Funds. Allgcatted funds not expended during th:e period ending on June 3c~, 2014 shall not be carried forward into the following fiscal year. c. tJendar Rate Increase. In the event of a legislatively mandated vendor rate increase far the services under this Gantract, the rates under this Contract shall be adjusted accordingly and incorporated into this Gantract as of the date the new rate becomes effective. d. Rate of Pa ment. I~SHS will pay Contractor as fgllaws: ~~) l3Sl~1S will pay Cgntractgr far actual casts related to services provided to CA referred families DSI-tS Centro.! C~n6ract Services Page 4 7.448CS E&P County (5-3fJ-13) Special Terms ar~d Candi#ions during the period of this Contract. B'slliryga The Contractor shalt submit the foliowint~ documents, prepared in the manner prescribed' by A~SF15, to invoice services performed under this Contract: i~SHS may choose to pay the Contractor for services under this Contract through Famlrink as an alternative method to the invoice billing process, described below. The Contractor shall be notified in writing of any change in the billing process, a. p,-1g~ v~~oECe. The Contractor shad subrrrit a rnonth4y invoice for services performed under this Contract on. State of '1,~Vasl'aington Invoice Voucher forms (Form A-1g}, prepared in the manner prescribed by DSF1S. ~1) The A-19 invoice shad state the amount of each cast or expense incurred by Contractor in the preceding calendar month that is based on the items listed in the Budget Exhibit. Costs ar expenses listed in the A-19 invoice must match the corresponding items Misted in the Budget Exhibit for costs or expenses that will be incurred by the Contractor. ~~} The cost or expense billed far each such item shall be charged against the total amount listed for that item in the Budget Exhibit. The currtulative dollar amount far each such item, for all invoices submitted by Contractor, shall not exceed the total dollar amount stated for that item in the budget Exhibit. (3} The A-1g invoice shall clearly ir4dicate that it is: "FtJR SERVICES RENDE~E[7 IN f'ERFC~R&NANCE UNQER ®SHS CONTRACT Nt7. 1363- 79~31 FaR TIDE h~l{]NTH CF , 20 {4} The A-13 invoice shall 'be submitted to: Kui Hug, Program Administrator Children's Administration Region 3 P,p. Box 45714 Qiympia, WA 98'544-5714 (5} The Contractor shall contact 1Cui Hug at {3~4} 725-5798 concerning billing questions. (~} The Contractor shall bill for each month of service on a separate A-19 invoice. The A-19 invoice shall state ttoe month services were provided. 10. payment. a. C4arns for payment must be received by DSHS no later than sixty (54} days from the date services were rendered.. b. pSHS willl male payment within thirty (34} days of receipt of a properPy completed invoice far services. c. DSl-1S may stop payment to the Contractor if reports required under this Contract are delinquent, i,e., not submitted within 14 days of the due date, ar incomplete. d. DS~iS may, at its safe discretion, withhold or deny payment claimed by the Contractor for services G'SH5 GEntra1 G~ntract 5e~+ices rage 5 2Ga8G5 SIP G~us?ty (5-~~'~~) Special fierms and Conditions rendered if Contractor fails to satisfactorily comply with any terra or condition afi the Contract. ~ 1. ~payrrtent only for Authar~ed Services ~5G~15 shall pay t~+e Contractor only for authorized services provided in accordance with this Cantract. if this Cantract is terminated for any reason, aSi-IS shall pay only for services authorized and provided through tt~e state of termination. 42. Funding Stiputations a. Information for f=ederal I~tandin ,The Contractor shall cooperate in supplying any information to Q5'M~ that.. may be needed to determine C5'~S or the client's eligibility for federal funding. b, Du licate Blllin .The Contractor must not bill other funding sources for services rendered under this Contract which would result in duplicate billing to different funding sources for the same service. furthermore, the Contractor shall ensure that no subcontractor twills any other funding sources for services rendered under this Cantract, which would result in duplicate biRling to different funding sources for the carne service. c. No !F~deral lviatch. The Contractor shale not use funds payable under this Contract as match toward federal funds without the prior written perrrrission of l7SHS. d, Supplanti~g. The Contractor st~al~l use these funds to supplement, not supplant the arrxaur~t of federal, state and local funds otherwise expended for services provided under this Contract. i3. Recovery of Fees far Nat~cacnpiiance In the event the Contractor b41s for services provided and is paid fees for services that ^SHS later finds were either {a} not delivered or (b) not delivered in accordance witG'1 applicable starsd'ards or the requirements of this Contract, DSf`-lS shall have the right to recover the fees far those services from the Contractor, and the Contractor shall fully coe~perate during the recovery process. 1~.. Overpaynnents 4n the event that ~7SHS establishes overpayments or erroneous payments made to the Contractor under this Contract, C~SI--IS may secure repayment, plus interest, if any, by requiring the pasting of a bond, assignment of deposit, or Borne otter form of security acceptable to DSNS. ~,~. Prohibition of 19se of Funds far irohbying activities The Contractor shal4 not use funds payable under the Contract far lobbying activities of arry nature. The Contractor certifies that no state or federal funds payable under this Cantract shall be paid to any person or orgac~izatiQn to influence, ar attempt to influence, either directly or indirectly, an officer or employee of any state ar federal agency, or an officer or member of any state ar federal legislative body or cornrnittee, regarding the award, amendment., madifica~tion, extension, ar renewal of a state ar federal contract or grant, ~+rty act by the Contractor i~n violation of this pro'tibition shall be grounds for termination of this Contract, at tt~e sole discretion of DSl~S, and shall subject Contractor to such monetary and other penalties as may be provided by IaGV. 1$, Investigations of Contractor ar Related Fersanne6 7St~S Ce~~tral Cantract Services Page ~ 2Q48 ;5 t=1P Caurty {5-30.13} Special ~err~s anti Conditions 1~SHS nnay, without prior notice, suspend the Contractor`s performance of the Contract if the Contractor, or any parkner, officer or director of the Contractor or a subcontractor, or any employee or volunteer of the Contractor or a subcontractor, is investigated by DSHS or a local, county, state or federal agency regarding any matter that, if ultimately established, could either, a, Result 'sn a conviction far violating a local, state or federal law, or b. In the sole judgment of DSHS, adversely affect the delivery of services under this Contract or the health, safety or welfare of DSHS clients.. ^SHS may also take other lesser action, including, but not limited to, disallowing the subject of the investigation, whether an employee, volunteer, or other person associated with the Contractor or a subcontractor,: from providing services, or from hawing contact with ~SHS clients, until the investigation is concluded and a final determination made by the investigating agency. 14, Removal of lndivitluals from Perform9ng Services a. In the event that any of Contractor's er-nployees, subcontractors, or volunteers who provide services under this Contract do not meet qualifications required by this Contract or do not perform the services as required in this Contract, I~SHS may require that Contractor assure ~SHS that such individual will not provide services to 1DSHS clients under this Contract. b. ®SHS shall notify the Contractor of this decision verbally and in writing and the Contractor shall, within 24 hears, disallow that person from providing direct services to DSHS clients. Failure to do so may result in a Corrective Action Plan and possible suspension or termination of this Contract. 15. Compliance with Corrective Action Plan In the event that t~SHS identifies deficiencies in Contractor's performance under this Contract, aSHS may , at its. option, establish a Corrective Action Plan.. When presented with a Corrective Action Plan, Contractor agrees to undertake the actions specified in the plan within the tirneframes given to correct the deficiencies. Contractor's failure to do so shalil be grounds for termination of this Contract.. ~~, Insurance. For purposes of this Contract: a, aSHS certifies that it is self-insured under the State's self-insurance liability program, as provided by RCW 4.92.1 ~0, and shall pay for losses for which it is found liable. b. The Contractor certifies, by checking the appropriate box below, initialing to the left of the box selected, and signing this Contract, that: ,Tine Contractor is self-insured or insured through a risk pool and shall pay for losses ~~ for which it is found liable;. or ~] The Contractor maintains the types and amounts of insurance identified below and shall, prior to the execution of this Contract by 17SFlS, provide certificates of insurance to that effect to the ~SHS Contact on Page 1 of this Contract, (1) Cornrnerciai General Liability lnsuranc~ The Contractor shall maintain Commercial General Liability Insurance, or Business Liability Insurance, including coverage far bodily injury, property damage, and contractual iia'bility, with the following rr}inimum limits: each ©ccurrence - 1,130fl,CtC](l; General Aggregate - $2,{3t1a,QOt3. The policy shall include liability arising out of premises, operations, independent contractors, C]SS iS venirab Contract Ser+;ices rage 7 2~4~G5 F9~ County t5-~~-~~) Special Terms and. Condiilons products-completed operations, personal injury, advertising injury, and liability assumed under an insured contract. The State of Washington, Department of Social & Health Services {DSHS}, and elected and appainted officials, agents, and emplt~yees of the state, shall be named as additional insured. ~~} Business ,Automobile Liability Insurance !f a Contractor transports DSHS clients, the Contractor shall maintain a Business Autonnabile Policy on all vehicles used to transport clients, including vehicles hired by the Contractor or owned by the Contractor's employees, volunteers or others, with the following minimum limits: $1,000,000 per accident combined. snngle limit. The Contractor's carrier shall provide DSHS with. a waiver of subrogation or name DSHS as an additional insured. ~3} Professional le.iabilit ~lnsurance The Contractor shall maintain l~rofessianal Liability Insurance or Errors & ©missions insurance, including coverage for losses caused by errors and omissions, with the fallowing minimum limits: Each Occurrence - $1,000,000; Aggregate , $2,000,©0©.. ~~ Rescslutlan at plffierertces In the event of any differences between the parties on matters related to the interpretation and implementation of this Contract, the partses shall first attempt to resolve the difference informally between themselves at the local or regional. level, by following the regional conflict resolution process. If the parties are unable to resolve their difference as stated above, then either party may submit a request for dispute resolution as provided below, in the section titled "Disputes". A cagy of the regional conflict resal'ution process is available from the DSHS Contact person listed an Rage 1 of this Contract. fig, Qisputes a. Either Pally who has a dispute concerning this Contract may submit a written request for dispute resolution. The amount of any rate set by law, regulation, or ^SHS policy is not disputable. A party's written request for dispute resolution must include: (1} A statement identifying the issues} in dispute; and (2} Contractor's name, address and contract number. b. The request must be mailed to the following address within thirty X30} calendar days after the ,party could reasonably be expected to have knowledge of the issue, which is disputed. c. A copy of the current CA dispute resolution process is available at any time by written request. d. Pequests far dispute resolution ar far a copy of the current CA's dispute resolution process should be sent to: DSHSIChildren's Administration Attention Contracts Management lJnit ~.©. Scx 45710 Qlympia, WA 9f3504-5710 ;]~i~S Central Gan4rar~.la~ 13 ~~ sage 8 2(J4F). S E8r' County f.: ~ - ' ~ Specie! Terms ancf Conti%tions This dispute resolution process is the sale administrative remedy available under this Contract ~qg, Addressing Qiv@rsity In providing services to DSI--t$ clients under this Contract, the Contractor shall adhere to the principies of the CA Diversity Charter, whicts principies include but are not limited to the foblowing; Non-discrimination; Dxceptionai customer service; Diversified, individu~aiized, responsive and inclusive services; Services that meet the culturai acrd ethnic needs of clients; Ectuai ^pportunity for the workforce. To ensure compliance with the above requirement, tfre Contractor shall be famiPiar with the CA Diversity Charter, which can be accessed at http:llwwwl.dabs.wa.govlpdflpublicationsJ22-11 [l8.pdf 2,p. ~raam Considexatioms fn the event. that CA should need to inciude additional requirements relating to the services provided under this Contract, as part of CA's obligation to meet the requirements cf Sraam v. State of L~+lashin ton, the parties agree to negotiate in good faith the incorporation of such additional requirements in this Contract, either by an amerrdrnent to this Contract or by a revised contract that v,,roUld replace this Contract. ©S}~S CentraM Contract Services r~agc: 9 2L~48GS FOP County {5-3t1-13J exhibit A -Bata Security Requir+aments 1, pefinitions. The words and phrases listed below, as used in this Exhibit, shall each have the fallowing definitions: a. '`Authorized Users}„ means an individual or individuals with an authorized business requirement to access DSHS Confidential Inforn°ration. ~. "Hardened Password" means a string of at least eight characters containing at least one alphabetic character, at Yeast one number and at Least ane special character such as an asterisk, ampersand or exciarnation paint. c. "Unique User ID" means a string of characters that identifies a specific user and which, in conyunction with a password, passphrase or other mechanism, authenticates a user to an irlfarrnatian S]IStem. Data Transport. When transporting DSHS Confidential Information electronically, including via email, .. the Data will be protected by: a. Transporting the 'Data within the 4State Gavernnnental Network} SGN ar Contractor`s internal network, o r; b, Encrypting any data that will be i~n transit outside the SGIV or Contras#ar's internal network, This includes transit aver the public Internet. ~. pr©tection csf Data. The Contractor agrees to store Data an one ar rrsore of the following media and protect the Data as described: a, hard disk drives. Data st€~red on Local workstation hard disks. Access to the Data will be restricted tc~ Authorized Users) by requiring logon to the local workstation using a Unique User ID and Hardened Password or ether authentication mechanisms which provide equal or greater security, such as biometrics or smart cards. b. htetwark server disks. Data stored on hard disks mounted on network servers and made available through shared folders. Access to the Data will be restricted to Authorized Users through the use of access control lists which will grant access only after the Authorized User has authenticated to the network using. a Unique User lD and Hardened Password or other authentication mechanisms which provide equal or greater security, such as biometrics or srriar# cards. Data. an disks mounted to such servers must be located in an area which is accessible only to authorized personnel, with access controlled through use of a 'key, card key, combination lock, or comparable mechanism. For D5H5 Confidential Information stored on these disks, deteting unneeded Data is sufficient as long as the disks remain in a Secured Area and otherwise meet the requirements Misted in the above paragraph. Destruction of the Data as outlined in Section 5. Data Disposition may be deferred until fhe disks are retired, replaced, ar otherwise taken out of the Secured Area. p5H5 Central Contract Sen+mces Pale 10 Z(}48CS ~lP Gour+ty (~-3t3-'~~ c. ppticat discs (CDs or DVDs~ in focal workstation opticaP disc drives. Data provided by DSHS on optical discs which will be used an lanai workstation optical disc drives and which will not be transported out of a Secured Area. When not in use for the contracted purpose, such discs must be lacked in a drawer, Cabinet or other container to which only Authorized Users have the key, combination or mechanism required to access the contents of the container. Workstations w'hic'h access DSH'S pate on optical discs must be located in an area w~sch is accessible only to authorized personnel, with access controlled through use of a key, card key, combination lack, or comparable mechanism.. d, pptPcaP discs 4Cl']s or CD1fDsy in drives or jukeboxes attached to servers. Data provided by pSHS on optical discs which will be attached to network servers and which will not be transported out of a Secured Area. Access to Data on these discs will.. be restricted to Authorized Users through the use of access Control lists which wilt grant access only after the Authorized User has authenticated to the network using a Unique User 1D and Hardened Password or other authentication mechanisms which provide equal or greater security, such as biometrics ar smart cards. Data on discs attached to such.. servers must be located in an area which is accessible only to authorized persanne9, with access controlled through use of a key, card key, combine#ion lack, car comparable mechanism. e. paper c}vcuments. Ar1Y paper retards must be protected by staring the records in a Secured Area which is only accessibPe to authorized personnel. When not in use, suet records must be stored in a larked container, such as a file Cabinet, Pocking drawer, or safe, to which only authorized persons have access. f. Remote ,access. Access to and use of the Data aver the State Governmental Network ~SGP~!} ar Secure ACCess'~J1+'ashington (SAW} wiPl be controlled by D51-IS staff who will issue authentication credentials (e.g. a Unique User PD and l~lardened 'Password} to Authorized Users on Contractor staff. Contractor will notify DSHS staff immediately whenever an Authorized User in possession of such credentials is terminated ar otherwise leaves the employ of the Contractor, and whenever an Authorized User's duties change such that the Authorized User no longer requires access #o perform work for this Contract. g. C]ata storage on portable devices or media. ~1~ Except where otherwise specified P~erein„ DSNS Data shall not be stored !by the Contractor on portable devices or media unless specsficaily authorized within the terms and conditions of the Contract. If so authorized, the Data shal9 be given the fallowing pratettions: (a) Encrypt the Data with a key length of at least 128 bits (b) Control access to devices with a Unique User ID and Hardened Password or stranger authentication method such as a physical takers or biometrics. fit} Manually lack devices whenever they are 'left unattended and set devices to lock automatitaPly after a period of inactivity, if this feature is availatale. f~aximum period of inactivity is 2(] minutes. Physically Secure the portable deviCe~s~ andlar media by {d} Keeping them ir1 lacked storage when not in use Vie] t9sing check-infchetk-out procedures when they are shared, and ~~ faking frequent inventories ~SF15 Cenir~4 Con?~ac1 Services Page 'i 2ad~CS E§4' County {5-30.13} ~~} When being transported outside of a Secured Area, portable devices and media with DSHS Confidential Information must be under the physical control of Contractor staff with authorization to access the Data. (~3 Portable devices include, but are not limited to; smart phones, tablets, flash memory devices ~e,g. tJS6 flash drives.. personal media players}, portable hard disks, and laptoplnatebaokJnetbook computers if those computers may be transported outside of a Secured Area. (~} Portable media. includes, but is not limited to; optical media (e.g. CDs, DVDs}, magnetic media (e.g. floppy disks, tape}, or flast,i media ~e.g. CompactFlash, SD, MMC}. h. Data stored for backup purposes. (~} ®SHS data may be stored on portable media as part of a Contractor's existing, documented backup process far business continuity ar disaster recovery purposes. Such storage is authorized until such time as that media would be reused during the course of normal backup operatiansr if backup media is retired while DSHS Confidential Information still exists upon it, such media will be destroyed at that time in accordance with the disposition requirements in Section 5. Data Disposition ~~} DSHS Data may be stored on ncnrrportable media ~e.g. Storage Area Network drives, virtual media, etc.} as part of a Contractor's existing„ documented backup process far business continuity or disaster recovery purposes. if so, such med'aa will be protected as otherwise described in this exhibit. If this media is retired while DSHS Confidential Information still exists upon it, the data wilt be destroyed at that time in accordance with the disposition requirements in Section 5. Data Disposition. 4. Data Segregation. ~. DSHS Data must be segregated or otherwise distinguishable from nonyDSHS data. This is to ensure that when no longer needed by the Contractor, all DSHS Data can be identified for return or destruction. It also aids in determining wtRether l3SHS Data has or may have 'been compromised in the event of a security breach. As such„ one or mare of the following methods will be used for data segregation. b. DSHS Data will be kept an media ~e.g. hard disk, optical disc, tape, etc.} which will contain no non DSHS 'Data. Andlar, c DSHS Data will be stored in a logical container on electre~nic media, such as a partition or folder dedicated to DSHS Data. Andlar, d. DSHS pate will 'be stored in a database which will contain na non-DSHS da#a. Andfar, e. ®SHS Data will be stored within a database and will be distinguishable from non-DSH'S data by the value of a specific field ar fields within database records. f. When stored as physical paper documents, DSHS Data will be physically segregated from non- DSHS data in a drawer, folder, ar ether container. g, When it is not feasible yr practical to segregate C7SHS Data front non-DSHS data, then both the DSHS Data and the non-DSHS data with which it is commingled must be protected as described in this exhiblt. t35NS Cer!tra9 Cor+fract Services Age 12 104805 ~1T' Gounty [~°~~°~ 3] ~. ®ata ptspasitiia~n, When the contracted work has been completed or when no longer needed, except as Hated in ~-b above, Data shall be returned to DSI~S or destroyed. Media nn which Data may be stored and associated acceptable methods of destruction are as follows. '~]alta s Server or works Removalale me pflrlabie hard di Paper docume 9nfarmation Paper doc~ume requiring speci information} ~}ptical discs Magnetic tv~re~l ol~: _ Cation hard disks, or U'~lill be des~ro ed b : Using a ".wipe„ utility which will overwrite the Data at least three {3} times using either random or single die ~e.g. floppies, USB flash drives, sks} excluding ^ptical discs character data, ar Degaussing sufficiently to ensure that the Data cannot be reconstructed, or Ph sicall destro in the disk nts with sensitive or Confidential. Recycling through a contracted firm provided the contract with the recycler assures that the confidentialit of Data will be rotected. nts containing Confidential Inforrnatian a! handling (e.g. protected health ~?rsMsite shredding, pulping, or incineration e,g, CDs or DVDs) lneineration, shredding, or cornpletefiy defacing the readable surface with a coarse abrasive De cussing, incineratin or crosscut shreddin ~6, Notification of Compromise crr potential Cnmpr©mise. The compromise ar potential compromise of DSl~S shared Data must be reparted to the DSl~S Contact designated in the Contract within ane tt3 business day of discovery. if no DSHS Contact is designated 'in the Contract, then the notification must be repoded to the DSHS Privacy [7fficer at dshsprivacyaffioer~dshs,wa.gav. Contractor must. also take actions to mitigate the risk of loss and comply with any notification ar other requirements imposed by 4aw or DSI~S. ~, pate shared with ~ubcarrtractars. If DSHS Data provided under this Contract is to be shared with a subcontractar, the Contract with the subcantractor must include all of the data security previsions within this Contract and within any amendments, attachments, ar exhibits within this Contract. 'lf the Contractor cannot protect the !Data as articulated within this Contract, then the contract with the sub- Cantractor must be submitted to the DSHS Contact specified for this cantract far review and approval, D5~5 Cendral Cvs~t€aci services ~,~~~ ~~ 2L~48C5 E+~' {'.OU[11Y {5.3Q-33} ExH~~IT B ST~rTE~EN~ OF WAR~C Early Interver~tivra Program (1=1P} pR~AIVt~ATIQN C)P STATEMENT ~I^ W(7f~K 1. Intent of Services ~. Philosophical. Principals used in the Delivery of EIP Services 3, Client Eligi~biity and Referral for Services ~. Refers! Procedures ~. Service Coordination with CA fi, Dual Case Management with Another Agency 7. Family Centered Practice Model ~. Provision of Services a. Face to Pace Contact ~. Initial Screen c. Service Defvery d. Srief lnterventian Path e Assessrraent and Comprehensive Service Path f. Service Plan g. 9p-Day Reviews h. Exit from the EIF' Program i, Exit Summary 9. Reports 1 Q. l<'rogra~rn Irnpravemersts The Contractor shall ensure that services provided under this Contract at ail tunes meet the specifiaatians described in this Statement of 1lVork Exhibit. Intent of Services a. Early Intervention Services is a hams visiting nurse program which shal4 address health conditions, physical growth, child development, social-emotional health, caretakinglparenting, and borne safety issues for children served by CA. E1P nurses shall provide assessments, educatian]counseiing, care management, and linkage into community programs far identified concerns. b. The Contractor shall provide ElP services through direct services to families andlor by linking families to community resources to accomplish tk~e fallowing goals far families: ~1} Reduce risk of abuse or neglect of children in the hams; (2} Enhance parenting. skills, family and personal self-sufficiency, and family functioning. ~3} Reduce stress on the family; [~4} Reduce the likelihood of additional referrals to CPS; (b) ,Enhance the health and well being of children and' their families:; and (~} Facilitate linkages to health and camrnunity services. ~JS~1S ~.~'1116i3~ ~ORdfBCt .Je ~EC~S Page 14 2043CS EVr' County {5-3~-~3~ Z. philosophical Principles used in the i]eiivery p#'Eii'services a. individualized, tailored interventions b. Empowerment approaches; c. Comrnunity support building approach; d. Strengths perspective; e. Cultural carnpetence; #. Develop~'nentai appropriateness; and g. Outcome driven service puns. 3, Client ~ligibillty and Re#erral #ar Services a. Eli ibilit .Families are eligible for EIP services who meet the following criteria: (1} Have a child ages birth to six who has issues related to hislher: [a} I~iutrition; (b} Physical growth; ~C} Social-emotional health; {d} ~{ygiene; fie} Developmental patterns; ~~ Medical conditions; fig} Access to health care; [h} Attachment with caregiver; or ~i} !Risks for injuries from barns safety hazards.. DFt (2} Have a school aged Child or youth who 'has medical neglect er prot~6ems with chronic health conditions. Infants and y€~urag children under three are a# 'highest priority and should be served first whenever passible b. Ref~als_ EIP services are designed to be a cooperative service between CA and the contracted nurse. Bath CA and the El'P nurse shale work together to provide service delivery in a coordinated approach. All! 'EIP service plans should be developed in consultation with the GA social worker. Ali families must be referred' to 'Ell=' by a CA social worker. Families may be referred frarrr CPS, Family Voluntary Services, or Child and Family Welfare Services as fellows: 41} flr~en Child protective Services (CPS Gases: Includes children who have been investigated by GPS and are residing with their biological parent or legal caregiver. Referral can be made to RIP: ~7SH5 Eontral Contra~t 3t7-13 os Wage ~ 5 2+~a8CS Ckr' County (- 1 {a} CPS social worker has interviewed the family and has identified an issue relating to the child's health, growth, development, caretakinglparenting, or hams safety. (b} Families are opened far brief assessment and must be closed when the CPS social worker closes their case. The EIP tlurse links family to needed community resources and services. ~~} u en ~amilV Vofuntar~ 5erv~ce ~FVSy Cases: Includes children who are opened to FVS services and have an active service plan in place. ~a} i=~5 social worker has interviewed the family and has identified an issue relating to the child's health, growth, development, caretakinglparenting, ar hams safety. (b} The CA family's service plan iindicates a Baal related to the child's health, growth, development, caretakingfparenting, ar home safety and the family would benefit from having an Ell' nurse Name visitor to address these issues in the CA service plan. (c} Priority far EIP eligibility is given to child{ren} in home or returning to the home within 6(7 days. `~} ~nen Gh~ld_apd Famiiy Welfare Service fCFWS] Cases: includes children who are in relative placement, foster care, ar in-hams dependencies: ta) CFWS racial worker has interviewed the family and hats identified' an issue relating to the child's health, growth, development, parenting, or hams safety. (b) An EiP referral may be appropriate far a brief nurse consultation when the child enters foster care or out-of home placement and has an immediate health care management problem that requires health assessment, case caardnation, care management education, and, linkage into health care services. Vic} ,q child in out-af home p&acement and wha is being returned to a caregiver ar permanent placement within X60 days and has a health care management probfem. The borne visiting nurse is to provide health assessment, case coordination, caregiver care management education, and linkage into health care services,. (d} Priority far EIP eligibility 'is given to child{ren} in home or returning to the hams within ~a days. 4. deferral Procedures a, CA shall have sole responsibility far referring clients to the Contractor under Phis Contract. All referrals must be initiated in writing by CA. GA will not pay far any families served under this Contract wha were not referred by CA. b. CA shall submit a written EIP referra9 to the Contractor which will authorize services. c. The Canfractar shall adhere to the referral procedures set forth in the CA regianalllocai protocol. d. Referral review. ~~} The Contractor she'll review the IMP referral to ensure; (a} The referral meets the eligibility criteria and the family and has identified an issue relating to the child's health, growth, development, caretakinglparenting, or home safety concern that necessitates nursing interventions; (b} The reasons far requested EIP intervention are cleat' and are appropriate for nursing services; JSH~ GenEraV Cffntract Services Page ~~, 7[}bBCS FSr' Caur~ty t5-3t}°fi3l (c} Clients case numbers, clients names and dates of births, and client contact information are provided; and {d) Assigned CA socia6 worker names and contact information is provided. t2y if the referral does not have the above information or the information is unclear, the Contractor shall contact the referring CA social worker, or their agency 1s11~ program leads, or the CA ~I~' liaison to obtain the needed information. ~3} Upon receipt of the referral, the lP nurse shall telephone the referring CA social worker to inform them of their assignment to the case and discuss coordination of services for the family- Service Coordination with CA. The Contractor shall ensure that the assigned EIP nurse: a, Vllorks col4aboratively with the CA social worker to determine the ElP nurse's role in working with the needs of children in order to coordinate, but not overlap, service delivery; b. Reviews the GA's fareai~ly assessment, if services have warranted its development; and c. C3eve#ops a family assessment, if CA has not develflped ©ne. 17ua! Case llilanagernent with Ana#her Agency a. if the Contractor and another agency are performing case management services for the same family, the Contractor shall facilitate a staffng with the other agency to assure that the famiby's needs are met in a coordinated approach. b. The Contractor shall ensure services being provided under this Contract are not being charged to another funding source which would result in duplicate payment. ~. Farnity +Centered Practice GViotGe! "fhe Contractor shall provide services consistent with Solution used Casework, the family-centered practice model used by the Children's Administration, It shall be the Contractor's responsibility to obtain information on Solution 1~ased Casework team CA. Information about Solution D~ased Caseworl< is available at ktittp:lfwww.dshs.wa.aovlcalaboutlsbc.aso Provision of Services The Contractor shall deliver services as follows for CA refereed families: a. 1<ace to Face Contact. ~'he Contractor sha61: (t} Attempt to make initial contact with the family within three t3} working days of acceptance of the referral from CA. Initial contact may be via. a telephone contact or face to face contact. ~~} tlotify the CA social worker in writing within 1 fl working days if the family is unavailable or unwilling to meet with the Contractor for an initial face to face home visit... t~} Make, at a minimume~ d t Contra~to~ shall document o the 1=xt Summary the reasonsa attempt is not comp second attempt far a home visit was not completed- (4} Immediately notify the referring social worker and complete an Exit Summary if the family has r-noved from the service area and is not available for any face-to-face contact. p~~5 Cen4ra~ Centra~t 8~ e~v~}es Page. 17 2~3~8C5 EP C©ur?ty { - b. Initial Screen {~) The El'P nurse shall conduct an initial screening to determine the family ar child's: {a} health care needs, to include physical and develapmental health, racial-ernatit7r~al health, and dental health; and {b} Issues relating to home safety, basic needs, parenting skills, parental delays, and home environment. {~} Based on the initial screening, the SIP nurse, family, and CA racial worker will determine the service path for the family. The service path will be either a Srief Interventian Path ar an Assessment and Comprehensive Service Path. c_ Service beiivery {1 } Schedule services at the family's convenience and tailor to accommodate a family's work schedule whenever possib0e. {~} iVtake EIP nurses available to testify at court hearings when subpoenaed. When requested by CP+ staff, B'IP nurses shall participate in GA o=1P meetings, Child Protective Team {CPT} ar case staffings, and child fatality reviews for EIP involved farrtil%es. If l~lP nurses are not able to attend in person, the Contractor shall provide a written summary of the family's progress. (3} Length of Service. ~Ip services shall be provided only while the case fs span to CA. d, Brief Interventian Path {1} The 'Brief Interventian Path is a short-term Interventian designed to: {a} Provide health and develapmental assessments for the identified. child; fb) Assist the CA sacral. worker with case planning inforrnatian; {c} Connect the family with camrrrurrity services; and {d3 Provide brief and focused teaching and guidance irr areas identified in the screening process. {~} The Brief Intervention shall be completed within 9g days and an Bxt summary completed within 11) days of case closure. e, Assessrr4ent and Gamprehensive Senriee Path {1} A~ser~t. The Contractor shall work with the assigned CA social worker and family so that a complete family assessment is created that identifies or addresses the farniiy's: {a} Current protective factors; {b} Current strengths and successes of the family that can be built upon to address need; {c} Current safety or health risk factors; {d} Nafurai suppo~ systems, such as friends, family, community members, and groups; {e} physical health and racial-ematianal health care needs; f~3 Attainment of developrr~ental rnilestanes and physical growth; {g} Service andfar support needs of the children; and GSI+.S ~,entral Ccsntract Serv4ces ~,~~~ 18 ~peg~;,5 EIP Gc~unty t~-34-~~~ (h} Circumstances that led to the crisis, ~2} Ideni:ified Priorities. After the assessment is completed, ttte EIP nurse shah utilize the C3maha System for identified priorit%es. ~a} The E4P nurse shall identify the tc~p two to three Omaha problems that are cif priority far EIP interventions. (b} The ElP nurse shall' scare each selected Clmaha prablerri using the Krsowledge, Behavipr, and Status ('K8S} scoring system as defined by the Crr~aha System in conjunction with the CA K~S manual. Vic} The results of the Qrnaha scores shall be recorded on g(~ day reports and Exit summary reports. f, ~e,~.v,1Ce ptan, The ElP nurse may contribute to the CA service plan by assisting the social worker in the identification of: ~~ } The to,p twc~ to three Omaha priorities for the client, The nurse, in conjunction with the farrsily and CA social worker, shall develop specific behaviorally driven gaols and objectives that support the target areas identified through the family assessment process and supported by the pmaha priorities. (2} The client's individualized interventions designed to iincrease protective factors, decrease risk factors, and target child safety and well-being outcomes. The Contractor shall focus on the following: (a} Physical health;. (b} Wellness; (c) Social-emotional health; ~d} Nome safety; fie} CaretakingJparenting; and ~f} ^evelopmer~tal issues. ~3} Tl~e family's internal and external support networks and service providers and plans for utilization. ~, ~Q~d~y RtrV9E"WS t~} The Contractor shall cot~plete the ERP 3(~ lay Review form when providing services #a farr~ilies up to end beyond 9f~ days. The g0 t7aY Review form is f110-~79 and may be accessed at: tt :li:.dshs'+^d covltorms_J~forms.shtml (2} Contractor shall submit reports at 94 day service intervals ar when CA requires service reports for court proceedings. h_ Exit frt~rn the 1r1P Pragrarx~. ~~ he Contractor shall staff with CA to determine whether to close an ElP' case if one or mere of the following occurs: 4t} 1<amily refused service; ~2} Children removed from parentfcaregiver; C]SHS i ea7iral Gantrac~ 5erviGes Wage 19 2L~43~S Eke ~e~nty (5°36-13} (3} Family moved from contractor service area; (4j i=amity vvas referred to another prograrr~ or service that is rroore appropriate than the EiP intervention; ~5} CA is c6osing the case: or (~} Services were completed. i. Exit Summary [1} The Contractor shah complete the 'EiP Exit Summary art completion of services with families set-ved under the EIS Contract. The E4i~ Exit Summary farm is #10-475 and may be accessed at: http:~fwww dshs.wa.oovlforrrxslefarms.shtml ~~~ The Contractor shall submit the Exit 5urrimary to the CA social worker within 14 working days of case closure. 9 Reports a. Written reports must be submitted by secure entail to the C]SHS contacts identified below, The DSHS Secure E-mail UserGuide is available at http:Ifwww.dshs.wa.govlcalpartnersfintra.aso b. The Cantractor shall submit the following monthly reports, in a format ,prescribed by CAA as instructed below, unless specified differently in the regional protocol: E1P Contractor Reports Submit to: _ i flue Qate Ell' fulonthly l~epo~ 9 electroniic copy to the l=fl? C.4 By the 15 of the month regional 'fiaisan far services provided in panne: lCui l-fug, F'resgram Admirtistratar the previous month Email: kui,hug@dshs,rwa.gov 1 electronic copy to the EIP CA headquarters liaison Lori VanClifford Lori. vane! ifford dshs.wa.g av 9Q aay Review Exit Summary 1 copy of each to the assigned CA sc+cial worker fay the 15", of the monYl7 for services provided in the previous month Ar~nuai {Contract period} roll- up repoCt to include: ~, # of referrals ~ # of unduplicated children served ~ # of unduplicated families cases} served of families (cases} exited from ElP for: • ## offamilies-Provider unabfe to make contact # of families-Provider rietermined famii +~does pSHS Central Contract 5~:rvdces 2448051=~f Cour7ry {a°3[7-13p 'i efectranic cagy to the Elf' CA reg'r©nal liaison (as above} 1 efectranic cDpy to the EIP headquarters liaison has above) Ey the 15"~ of the month of July each year of contract. Page 24 not need. Ell' ^ # of farrrilies - Family refused services ^ # of families -Farrtily was referred to another program within CA # of families -Service were completed • # of families -Provider referred'~IP case back to CPS as higher risk of farr+ilies - re-referra9 and accepted for investigation o # of cases with another CPS referral received while family was participating in i=4P c~ # of families enrolled in community resource and referral services ~, # of families enrolled in Family ~ngagernent Services ~, 7f total # of families, what °/° improved KSS scores in caretaking and parenting n~xF+r 4'ir71B c. L3~1-~5 may stop payment to the Contractor if rep€~rts required under this Contract are delinquent or incomplete• d. p,dditionai data aSHS may request additional measurable service and outcome data far services provided. In the event DSl~1S so requests, DS~1S commits to work with the Contractor to develop data elements. If so requested,. the Contractor agrees to provide data collection in a manner prescribed by DSHS. 14, program Improvements The Contractor agrees to collaborate with CA to develop and implement program changes. which may ir~c{ude: a standardized assessment tool, performartce rrreasures, and service standards. pSHS Central Corstract Services fx~ge 21 20~+8CS E!P County (5°3[9-33) ExHIaIT c pRd~GRA~ REC~UIR~IVI~N7S Early lnterver~fivn Proc~rarn (ElP) pRryp;,Nl~ATI®N +DF PR~GRA~JI REQtrJIREtVIE1V`TS 1. Quaiificatian Requirements 2. Licensing or Statutory Requirements ~ 'R+equired ~.icense in Goody 'Standing ~. Degree Requirements ~. Staff and Sut~tontractar Training ~. Annual EIP Provider ll+leetings ~. Rvaluatiorr of Contractar $. Background Checks 9_ Heaith ar~d Safety of aSFIS Clients 1€~, Corporate Punishment Prohibited 11. 5making Prohibited in Presence of Client Children and Foster ~6outh 1 ~. Na Transportation of GSi-IS Ciients 1 ~. Culturally Relevant Services 14. Interpretation anA~d ~ianal~ Re uirements 1 ~. Can#identiality - q 16. Retards a, Claent Retards b. Administrative Records c. Personnel and Subtantractar Records 17. Auditing and N4arLitaring 18. pperatirrg Procedures 19. QfFice of the Family and Children's Ombudsman The Contractor shall ensure that all qualifications for empls~yees, volunteers„ or sul3cantractars, performance expects#ians and program requirements far services provided under this Carrtract at alI times meet the specifications described in this Program Requirement Exhikait. puai'rflcatian Requuremerits a. `The Contractor shall ensure that employees, subcon#ractors, andlor volun#eers providing services to pSKS clients under this Contract have the following minirnurrr qualifications;. ~1~ l~alds a current license to practice as a registered nurse by the State of Washingtarr; ~~~ I-~as a mirbimum of two years working with children ands farr~ilies; and (3} bias experience providing a have visitation model of service delivery. C)R ~~~ ~Ias can7pleted a Bachelor of Nursing Prograrrr and currently is serving as a Public Fleaith Nurse in a l~acal Health .9ursdiction. b. Excep#ions far Required Staff Oualificatians ~SuS CenSral Contract S~rv>ces Page 22 2rJ4~C5 tVP Cor~niy {5 3a-13~ if the preferred candidate does not rr~ee# the requirements for the minimum hon7e visiting experience, the Contractor sha11 request an exception toy submitting the following information to the CA headquarters program manager for EtP: (1 } Documentation of the individual's credentials and work experiences; (~) Documentation of related coursework, conferences, and other trainingr ~~) f~easons why applicant was chasers; 44} How the Corstractar pkans to supervise the applicant; (5} Training plan; anti (S} Position description far which the exception is being requested. pSHSIChi1dren's Administration Attention: EiP Program Manager pQ Sox 4571 g C~iympia, WA 9850-a71 Q ~. Licensing Qr Statutory Requirerr~ents a. The Contractor shat4 meet or exceed all minimum licensing or certification requirements or other requirements as required by statute. b. When licensing, certification, or other statutory requirements differ from contract requirements, the Corstractar shall meet whichever requirement. imposes the higher standard. Any variance from such requirements shall require a licensing waiver from the issuing agency. 3. Required License in Gaoci Standing. a. if the Contractor or any of the Contractor"s staff are required to be licensed to provide any of the services under this Contract, the required license must be in good standing at all times during the term of the Contract. b. In the event that a required license is suspended, or if any limitations or restrictions are placed on the license, tl~e Contractor shalt notify the L7Si~S Contact person listed on Page 1 of this Contract C~egree Requirements. The Contractor shall ensure That any degrees required of the Contractor or the Contractor's staff under this Contract, or by s#atute, shall meet the following requirements before the Contractor shall provide services under this Contract: a. The degree ~ the ec ~ ent ~ theodegree,~cessful completion of a required course of instruction undertaken by b. The degree must be awarded by a public ar private ~-year or 2-year college, university,. community college, trade ar vocational school, or other institution of higher education in the l~nited States that is accredited by the Council for Higher Education Accreditation (CHEA) or an accreditation organizatian recognized by the Council far Nigher Education Accreditatiors, or by one cif the fallowing regional accreditation boards far the l.lnited States: (1 } MSA - Diddle States Association uSfi~ Central Can4ract 5e€uices 2p4~3C5 ~Ir Cnus~ty 45-s~•~3} Page 23 ~~} i~IWCCU _ Northwest Commission on Colleges and Universities ~~} ~gCA - North Central Association of Colleges and Schools ~,~} NEASC -New England Association of Schools and Colleges ~~} SA,CS -Southern Association of Colleges and Schools t~} WASC -Western Association of Schools and Colleges c. if the degree has Yaeen awarded by a tribal college, university, community college, trade or vocational school, it rrtust be accredited 'by one of the above regional accreditation boards or other accreditation organization recogn1zed by the American V'ndian Higher Education Consortium, which may be accessed at: www.aihec.org. d, if the degree has b'eer' awarded by a foreign educational institution outside of the United States, it must be qualified in the country in which it is located to provide the course of instruction leading to that degree, and must be accredited by an accreditation organization recognized as such in the country in which it is located or recognized by the Council for Higher Education Accreditation. The Council for Higher Education Accreditation (CHEA} is located at acne Dupont Circle NW, Suite ~1p, Washingfon, ®C ~Og3~V1 f35 and may be accessed at: vk+wvr.chea.org. e. Failure to comply with the degree requirements of this section shall be grounds for termination of this Contract. ~. Staff and Sut~contractor Training. a. C)ralaYstern The Contractor shall ensure that all direct service staff have completed the ameba Training. The pmaha training can tae obtained througi~ King County Health i7epartment or the Tacoma~Pierce County t#ealth i~epartment. Training is to be paid by the Contractor through the allotted Contract dollars. hnanelated Re~ortef Trainin {1} The Contractor shall ensure that all current employees and volunteers, who are mandated reporters or who have access to children, read andlor view the materials in CA's Mandated Reporter Toolkit within 3a days of the effective date of a first time CA Contract and annually thereafter; and that all newly hired employees and volunteers who are mandated reporters or who have access to children read andlor view the materials. in the Mandated Reporter Toolkit within two ~~} weeks of initial employment. After reading and reviewing the materials, each employee shall sign and date a statement acknowledging his or her duty to report child maltreatment and affirming that he or she understands when and how to report suspected' child abuse or neglect, The Contractor shall retain the signed statement in each individual's personnel file. (2} The Contractor shall either obtain a copy of the Mandated Reporter Toolkit from USHS, or access tt~e Mandated Reporter Toolkit online at the following address: #~ttp:flv,r~w.cishs.wa ~ovlcalsafetylabuseR~t.a~~a72 ~. l<1P Provider Atieetings It is expected under this Contract that, at a minimum, one Contractor representative shall attend any I]Sr18 C~str~6 Contract Senr4ces Page 24 20~1SCS ~1P GaunEy (5•?D-13} scheduled CA's ~1P provider meetings. I~vatuation ~~ Contcactdr a. !~SNS may evaluate the Gantractor's perFormance during the terra of the Cantract.. Areas of review may include, but are not limited to, the following: (~} } Reports required under' this contract are complete and submitted in a timely manner; ~2} Families are referred to appropriate community resources; and ~~} Ells direct service staff participate in all ~1P program meetings and trainings as required by CA. b. if the Contractor fails to meet any of the performance measures, ~SHS may terminate this Contract. 8. ~ac~gr-~sund checks a. This requirement appi~ies to any employees, volunteers and subcontractors who may have unsupervised access to children seared under this Cantract. b, This requirement does not apply to currently licensed faster parents who are affiliated with the Contractor. Licensed foster parents are subject to the criminal history background provisions associated with obtaining and maintainincg a current foster license. c. The Contractor shah ensure a criminal history background check pursuant to 'RCW 43.43.32„ 43,43.834, RCW 43.2QA.71g and INAC 388-46 has been completed through DSHS for all current employees, volunteers, and subcontractors, and that a crirnina!'history background check shah tae initiated far al4 prospective employees, volunteers and subcontractors who may have unsupervised access to children served under this contract.. d. The Contractor shad assist in obtaining additional state or national criminal history andlor child abuselneglect history, if requested by DSl-t5. e. The Contractor shall ensure that no employee, volunteer or subcontractor, including those provisionally hired pursuant to RCW 43.43.8320'}, has unsupervised access to children served under this contract, until a fulN and satisfactory background check is completed and documentation,. qualifying the individual for unsupervised access, is returned to the Contractor. g, Hea6th anal Sa#ety of pSY~S Cti~ents In the delivery of services under this Contract, children's health, safety and well-being shad'1 always be the first concern of the Contractor. a, if the Contractor determines that there are additional hea9th and safety concerns, suspected substance abuse, or ether presenting problems which were not stated in the CA referral, the Contractor shall immediately report this information to the referring CA social worker and, if appropriate to CPS Intake. The Contractor shall follow such verbal notification by written notification within 24 hours to the CA social worker and to C!='S Intake. b. Contractors are mandated reporters under Chapter 2ti.44.g3(t RCW. The Contractor shall immediately report all instances of suspected child abuse grad neglect to (1 }Child Protective Services (CPS} Rntake and {2} the referring CA social worker. The Contractor shall follow verbal notification by written notification within ~~ hears to the CA social worker and to CIS Intake. c, CPS Intake shali~ make the determination of whether the referral constitutes era allegation ofi child DSHS Cenirai Ganira~t~© 3)es f'a~e 25 2(1ASCS ~kP G~unty 4 -. ,abuse or neglect that shall be accepted far investigation, as a possible licensing compliance issue, or as a matter of °`information only" d. UVritten notification required by the Contractor shall include notification by fax ar by e-mail. iCla, Carparal Punishrr~ent Preshi~aited Corpora4 punishment of children in the Department's care or custody is prohibited. Corporal punishment is any act which willfully inflicts or causes the infliction of physical pain on a child. The Contractor, and the Contractor's agents and emploYees~ shall not administer corporal punishment to chi6dren served under this Contract. .1 ,1. Srxsoking prahiblted in !Presence of Clfient Children and Faster Youth Smoking in the presence of client chiidren is prohibited including, but not limited to whenever there is direct contact with client children under age ~ 8 and foster youth ~ 8 to 21 years of age, such as talking with. a child or accos~panying a child, even when in a public place where smoking may otherwise be permitted. 1 ~. No Transportation of [~SHS Clients.. The Contractor shall not provide transportation to DSHS clients under this Contract 'f 3. Cult~uralty Relevant Services The Contractor shall provide appropriate, accessible, and culturally relevant services to clients and their far~nilies. Service delivery shall be culturally competent and responsive to each client's cultural beliefs and values, ethnic norms, language needs, and individual differences. Contractors are encouraged to employ a diverse workforce that reflects the diversity of their clientele and the community. The Contractor she#1 have a written recruitment policy which demonstrates that the Contractor is an equal opportunity employer. 14. Interpretation and. Translation a. The Contractor shall provide Limited English Proficient ~LtYI'} clients with certified or otherwise qualified interpreters and translated documents. b. The Contractor shall provide deaf, deaf-blind, or hard of hearing clients witl`~ the services of a certified sign language interpreter. c. Interpreter and translation services shall be provided at no cast to the client. Ail interpreter and translation casts shall be the financial responsibility of the Contractor. These costs are included in the contracted rate. d. I~xtraardinary costs, which create an undue hardship for the Contractor in providing interpretation andlor translation services to an individual client, may be reviewed and addressed far supplemental reimbursement by the CA regional Administrator ar designee an a case by case basis. ~~. eonfldentiality -- Additiar~al Requirements This Contract imposes the following additional requirements to the section titled Cc~r~frdentralify, set forth as one a# the General Terms and Conditions of this Contract: a. Ccynsent b Mnar. The Contractor shall not use, publish, transfer, sell or otherwise disclose any Confidential Information of a miner except as provided by law or with the prier written consent of the I3Sf+S Centra9 Ga~iraci ~Qrvices Page 26 2G48G5 ~~F Gca~antY (5-34.73] minor's parent, legal representative or guardian. If a child' is a dependent of Washington State, then prior written consent must be obtained from ®S~iS. b. Encr ted EmaM1l -Acc€~u~t• The Contractor shall use an encrypted email account for electronic submissions which contain Confidential, and Personal Informationv as defined in the General Terms and Conditions. Information regarding encrypted email accounts can be obtained at CA's vo+ebsite, located at: httg:Ilwww dshs wa.govlcalpartnerslir~fro.as~. 1i;. Recarcls Client Records The Contractor shall maintain individual client records and shall promptly submit to DSHS a copy of such records upon request. At a minimum, individual client records must include: (1} CA intake Referral Summary Report; (2} Additional referral inforrrdation, if applicable; (3} Client Assessment; (~} Client Screenings; (5} Family Service Plan;., (~} Q Day Reviews; (~} Exit Summary; ($) Kl3S scores and supporting documentation; {g) Contacts with the family to include: date of contact, names} of rnember(s} present, and charting notes; and (tl~} Contacts with CA social worker and service providers. b. Administrative Records The Contactor shall retain the following administrative records: (1 } Community Resource Directory that lists: name of agency, address, telephone nuamber, description of available resources and supports for families; (2} lvlonthly reports; (3} Fiscal records tt~Sat shall substantiate costs charged to t~SHS under this contract; (4) Audits, license review, contract monitoring and corrective actions required and action taken; (~} Documentation of ail audits, license reviews, contract monitoring reports, and corrective action reports and actions taken. Qocumentation of all costs associated with service provided Under this Contract; (~) Recruitment policy which demonstrates that Contractor is an equal opportunity employer; DSHS ~enlra6 Conx~act Seavsces Page 27 ~~u~SCS SIP Co€~nty [5.3b-~3? 4~} personnel policy reflecting CA policy requirerrtents re `"Smoking Prohibited in Presence of Client Children and Poster Youth"', as stated above in Section 11; 48} A copy of any subcontract or other agreement for subcontracted services and the provider`s ~uaiiflCatii]ns; 4g} Capy of the Certificate of Insurance far each subcontractor; and 41 ~}} Protected group data: 4a} A iist of current staff by position that addresses date of birth, sex, and identified protected group status, including race, Vietnam Pro Veteran, Cisabled' Veteran, and person of disability. 4b} A list of all clients served that addresses date of birth, sex, and race. When collecfing protected groups data, fhe ~Confracfor shall inform staff acrd clients that {7} fhe furnlshing o f fhe information is entirely voJr~nfary; {2j fhe refusal fo furnish the data shall not have adverse effects. c_ Personnel and Subcontractor Records The Contractor shall retain the following records on 41 }ail of Contractor's staff and errrpioyees, whether full-time or part-time, 42} volunteers, and 43} any subcontractor's staff and employees who may haute contact with C~SHS clients in performing duties or providing services under this Contract; (1} C35F1S criminal history background check approval; 42} Any other crirr~inal history background checks; 4~} Current licenses} ar certification4s} to practice in the state of lNashington andfor in the state in which services are provided, as applicable; 44} Proof of degree4s}, if required, and transcripts frorrr College or other school awarding any degrees} required under this Contract for service provision; (5} ~pocun~entation of academic history and credentials, as applicable; [~} Ilwrraployment and experience history; 4T} .dob description; 4g} p,nnual performance evaluations; (g} Training retards, as applicable; 41 ~) l~aurs worked and payment records; 411} Staff training log; 412) Signed statements to adhere to confidentiality of client information; 41 ~} Signed statements acknowledging duty to report child maltreatment; and 414} Copy of each signed subcontract or other agreement far any subcontractors. 45H5 venfr~i Contact Seeai~es ~a~e 28 2U48L`~ EIP Goundy (~-38.13} ~?. Audwting and Montnrir+g a. if the of ther a~ud tlrepart to he~1~SH5 Contact 4 steel anuPage pleof thiseContrac nntractor shall forward a copy ~. 1f federal or state audit exceptions are grade relating to this Contract, the Contractor must reimburse the amount of the audit exception, and any other casts including, but not limited to, audit fees, court costs, and penalty assessments. c. The Contractor shall be financlally responsible for any overpayments by !bSM1-151CA to the Contractor.. The Contractor shall be financially responsible for any audit disallowances resulting from a faders! or state audit which resulted from an action, omission or failure to act on the park of the Contractor. d. CS!H5 may schedule monitoring visits with the Contractor to evaluate performance of the program. The Contractor shall p~rnvlde at no further cost to l~SI~S reasonable access to ail program-related' records and materials, including financial records in support of billings, and records of staff andlor subcontractor tune. 'y g, Qperating Praced~rres a, In collaboration with CA, the Contractor shall develop written operating procedures, which set forth procedures for the day-today operation and conduct of activities under this Contract. Such procedures must kae in accord and consistent with, and shall not conflict with, the provisions of this Contract. The written operating procedures shall address; ~~} Referral process steps; (2} Comrnunicatian links [contact persons}; {3} Case updating requirements; (~}} Case termination and extension procedures; (~} Scheduling process; (~} Training collaboration, if any; (7} Report anal feedback process; ($} 1<rriergency procedures. b. The Contractor shall submit a copy of the written operating procedures to the C]SHS Contact identified nn IPage ~ of this Contract. c. The Contractor and CA shall each retain a copy of the written operating procedures. 19, Office caf the 1=amlly ant! Ch'rtdren's Qrrslaudsmar} ae The Contractor shall release records relating to services provided to youth that are dependent under Chapter ~ 3.34 RC1N to the UFC4. The Contractor can release records for dependent youth under Chapter ~ 3.34 without the consent of a dependent youth s parent or guardian or the youth if the youth is under the age of t 3 years, unless law otherwise specifically prohibits such release. b. The Contractor shall notify the CA headquarters 'Program Manager when the (~1=CU rnal4es a request for records. k~S~iS Centra9 Contract 5erv€ces Page ~g 2~~48GS E1P County (5-3~-13} ExH~erT v ~ac~e 1 of 2. exit Code ~3ef9nitons Early Farnily 5up{aaart and Early 1r3#erventior~ exit Summary Cede DefiinitiQns Cede - ' Qefiraitiart 1a. Family Engagement The family Chas engaged ~n an ain services with a pravider and has identified and ,Assessment Services gaa#s and priorities far services. The family has engaged in ir7terventians ar Completed services outlined in the service plan to address risl4 factors far child abuse and ne iect and su art Tamil siren the and rotective factors. ~ b. Car,nmunity Resource The family has initiated community services. and ReferraV Cam feted - 2. Initial Screening Visit The family engaged in the initial screening visit with the pravider and declined Only further services either directly ar by agreeing to services and then failing to show far a ointments. 3. Participated in Services but did not complete SeNice p#an due ta: a. Change in 3a. The farm#y engages in services to a level the pravider believes will benefit Circumstance the family to some degree, but further services are discontinued due to change in circumstances. b. Refused Farm y his reached the service limit and is not longer e! 4a. Famil' to other c services. ~tb,t3a ail' S_erVICeS S.AI# sere ~6,19r~abl 7.~ir~abl~ 3b. The family engages in services to a ieve6 that the pravider believes the children will benefit to some degree from the changes that will occur, 'but the family refuses to further engage in services prior to addressing all rusklprotective factors far child abuse and neglect.. The provider MI.JST write the activities the family participated in an the exit summary,) The family continues to participate in services and is no longer eligible for ~'FFSS services. ib#e for services. yr has transferred ammunity 4a. The Fami4y has transferred to other carrrmunity services.. per comrn~snity are available. 4b. The communit does not have a ro ria~ to serv+ces fior the Tamil ~ lined d declines to pravider contacts farnii b hone ar in erson and the farm# ec ices artiei ate in services. Ito locate family ~ The pravider is not able to physically locate the address or the family at the address rovided. to contact Family does live at the identified address but the pravider is not able to contact the family tlnraugh at feast 2 attempted home visits; and phone calls andlor letters. ~ - g DSFiS Gesstrak Gon[ract Services Page 3a 2~4AC5 E1P Gaunty (5-3~-t3J EXHIBIT D pace 2 of 2 Services nat needed $ Family was cantacted in person and is already engaged in carnmunity services . that address the allegatians, thus services would be d~rplicative and would not be necessary. 8a. 5elf Report ga. Client self reported, unable to verify gb. 1/erificatian Sb. Provider verified other service invalverr~ent received Returned to CP5 due g _ ~__. Prior to contact with the family CPS receives additiarta'l information accepts the . to high level of risk case far investigation ar after further discussion with CA results in accepted investigation. ' FSS Qn1 E v CPS referral. N - additional referral is made to CPS ~ r ev 1p. Assigned far investigatian and the crie is accepted fa irlVestigatlan EFSS C1nt Participated in Family na longer in EFSS service area and cannot receive services. ~ ~. Services then family waved. Child Placed in out ~ 2 Chrid has been placed in out of home care through a dependency or caurk . of borne care intervention D5HS G~e~traY Cpnrract ~~ruices Page 31 2a4~C5 f=3P Cos~nty (5-3t}-i3} Exhibit E BU~GI~~T Early Ir~terventiQ~r Pr~g~~m ~EIF} a~ly 1, 2fl13 ~ Jane 34, 21:114 AG7lVIT"Y (riot iir~ited to the iter~ts ~elr~w3 F~~ec~Se aGIC~ fi30tlZatBS f0 tale ~?UC~C,~EI SECfI[)I7 aS Pe Ce`t~t E~ud ~t RequeS~ fOr FY'14 ne~C~~d`. - I#ERSQIdI~IE~- ~1an'leS: 39©/0 ~ 33,Qg3.S7 Denis Lang©is O $ °/ II X16 `P fringe TRAVEL ~iternze} $ ~ (?f}'0C1 LQpG1NG ~1t~n't4ZB~ P€R ~7fE~'I ~i#ern1~e~ ~ OTHER CIRECT C{pSTS Egtaipmen# lees Includes ~~trricuia} Supp ~ ~. ~ 100.~(l Pra~essicnal servECes ~ C~tk~ter (t~se as many lines as needed} ~ TpTAL DIRECT CHARGES - $3,294 INDIRECT CHARGES (see artachmenf S use as many limes as needed} ~~,329.4 T®TAt- 1N171RECT CHARGES $3,329 GRA~1D T1gTAL _ _ _ 36,623 *TraF~el: yliEea~e f~rr hr~me visits DSHS Central Canfraet Services Page 32 2f}4$CS E9f' County (5.34-133