HomeMy WebLinkAbout080513_ca10f50N COL
Consent Agenda
JEFFERSON COUNTY PUBLIC HEALTH
e ?K 615 Sheridan Street o Port Townsend o Washington o 98368
www.jeffersoncountypublichealth.org
July 15, 2013
JEFFERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
AGENDA REQUEST
TO: Board of County Commissioners
Philip Morley, County Administrator
FROM: Jean Baldwin, Director
DATE: �U'ie4fI�
SUBJECT: Agenda Item — Grant Agreement with Thrive by Five for Home Visiting
Services; July 1, 2013 — June 30, 2014; $176,740
STATEMENT OF ISSUE:
Jefferson County Public Health requests Board approval of the continuation of the Bridge Partnership with
Thrive By Five for Home Visiting Services; July 1, 2013 — June 30, 2014; $176,740
ANALYSIS /STRATEGIC GOALS /PRO'S and CON'S:
This is the second year with JCPH as lead on this Thrive contract. JCPH has 14 years of participation in the
Nurse Family Partnership Program (NFP). This Home Visiting Services Agreement allows Jefferson and
Kitsap Public Health Departments to share Nurse family Partnership staff, training, supervision.
JCPH staff will work to create a strong regional team sharing expertise. Fiscal responsibility is also with
JCPH, a subcontract will be written to share the work and funding with KPHD. This regionalization approach
to providing services is a vision of possible regional services that may save County money and programs in
the future.
FISCAL IMPACT /COST BENEFIT ANALYSIS:
$87,500 of these funds is available for Jefferson County to continue this partnership and will allow JCPH to
serve additional families in 2013 -14. The program can be partially sustained by billing, Prop 1 funds; MH /CD
funding and Federal MCH dollars. KCHD will also receive $87,500 to continue their services in the NFP
program on the Kitsap Peninsula.
COMMUNITY HEALTH PUBLIC HEALTH ENVIRONMENTAL HEALTH
DEVELOPMENTAL DISABILITIES WATER QUALITY
MAIN: (360) 385 -9400 ALWAYS WORKING FOR A SAFER AND MAIN: (360) 385 -9444
FAX: (360) 385 -9401 HEALTHIER COMMUNITY FAX: (360) 379 -4487
Consent Agenda
RECOMMENDATION:
JCPH management request approval of the Grant Agreement with Thrive by Five; July 1, 2013 —
June 30, 2014; $176,740
(Routed to all Public Health Managers)
Date
-2b -cl
GRANT AGREEMENT
Washington Early Learning Fund, d/b /a Thrive by Five Washington ( "Thrive ") and Jefferson
County Public Health ( "Grantee ") hereby enter into this Agreement as of July 1, 2013 (the "Effective
Date ").
Grant Award Total: $176,740.00
Includes:
Service Funds: $175,000.00
Travel Stipend: $1,740.00
Grant ID:
127
Grant Term:
7/1/2013 to 6/30/2014
Tax ID Number:
133148295
Project Lead:
Ms. Yuko Umeda
Purpose:
Home Visiting Services Account
Federal Subrecipient:
No
1. Grant Award and Term. Thrive hereby awards a grant in the amount of $176,740.00 to
Grantee for the grant purposes described more fully in the approved proposal and budget
(referred to herein as the "Project "), and for which excerpts (Project Description, Logic Model,
and Budget) have been incorporated as Schedule A. Grant funds may not be expended, loaned,
pledged or transferred for reasons other than carrying out the Project. The term of this
Agreement ( "Term ") begins on the Effective Date, and the Grantee agrees to not incur any
expenses on the Project using Thrive funding prior to the Effective Date. The Term end date is
met when all funds have been expended and Project requirements met, or earlier in the event of
non - compliance.
2. Travel Stipend Funds. Included in the Grant Award Total is a Travel Stipend. Grantee agrees
that funds awarded for the Travel Stipend will be used solely for travel costs associated with
Grant Requirements outlined in Schedule B (Ld). Should any Travel Stipend funds be
unexpended after all requirements have been met, Grantee may request in writing that Stipend
funds be repurposed for the Project.
3. Disbursement. Thrive will disburse the funds to Grantee according to the terms provided in
Schedule B, provided that Grantee performs the services and expends the awarded funds as
described in the Project and in a timeframe that is aligned with the payment schedule in Schedule
B. Payment is based on the assumption that project state and private revenue commitments to
Thrive have been maintained, and that such funds are available to Thrive for disbursement to the
Grantee. In the event that revenue commitments are not available to Thrive, Thrive reserves the
right to amend the payment terms and the amount of the Grant Award Total. Thrive will monitor
expenditures on a quarterly basis and reserves the right to amend the Payment Schedule if funds
are not expended in accordance with the Project budget and in a timeframe that is aligned with
the Payment Schedule.
4. Grantee's Tax Status. Grantee represents that it is either 1) a tax- exempt organization described
in Section 501(c)(3) of the Code or 2) a governmental entity described in Section 170(c)(1) of
the Code, and that it is not either 1) a "private foundation" as defined in Section 509(a) of the
Code, or 2) a Type III supporting organization as described in Section 509(a)(3)(C) of the Code
(other than a "functionally integrated" Type III supporting organization as defined in
Section 4943(f)(5)(B) of the Code). if Grantee is described in Section 501(c)(3) of the Code,
then Grantee has submitted to Thrive a determination letter of tax exemption issued by the
Internal Revenue Service, and represents that such letter has not been revoked or modified.
Grantee agrees to notify Thrive immediately of any changes in its tax status during the term of
the grant.
5. Use of Grant Funds. Grantee agrees to use the grant funds solely for the Project in accordance
with the proposal and budget submitted to Thrive, and that such funds will be used exclusively
for charitable purposes as described in Section 501(c)(3) of the Internal Revenue Code of 1986,
as amended (the "Code "). Grantee agrees not to use any portion of the grant funds to participate
in any political campaign on behalf of or in opposition to any candidate for public office, to
make grants to individuals on a nonobjective basis, or for any non - charitable purpose. No portion
of this grant is earmarked for use in carrying on propaganda or otherwise attempting to influence
legislation. Grantee agrees not to use any portion of the grant funds to participate in any political
campaign on behalf of or in opposition to any candidate for public office. Grantee will promptly
return to Thrive any portion of grant funds unexpended or uncommitted at the end of the Grant
Term, or used for purposes or in a manner than those described in the Project.
6. Budget. Grantee further agrees that funds will be expended as specifically itemized line by line
in the Budget provided in Schedule A, and that transfers within lines of the budget in excess of
10% of the award amount will not be made unless approved by Thrive.
7. Reporting and Other Grant Requirements. Grantee agrees to submit program and expense
reports, as well as all perform all other grant requirements outlined in Schedule B, on or before
the dates indicated therein. Thrive 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 Thrive with respect to the Project. Use of any data by Thrive
will be restricted exclusively to charitable purposes.
8. Data Collection and Evaluation. Thrive will conduct research and evaluation regarding the
projects funded through its grants program. Grantee agrees to participate in these evaluation
efforts and will fulfill the data collection and reporting requirements specified in Schedule C,
Evaluation Requirements. It will be the obligation of Thrive representatives, contractors, and
Grantee to provide protections and assurances regarding the confidentiality of data, samples of
work (in any media format) and /or interview comments provided by participants. Grantee also
agrees to provide Thrive with the results of any independent or self - directed evaluation or
research undertaken with respect to the Project.
9. Control of Grant Funds. Grantee acknowledges and represents that it is accepting this grant for
its own account and not as an agent for any other organization, and will exercise supervision and
oversight over the use of all grant funds to ensure that the terms of this Agreement are met.
10. Subcontracts. In the event that any portion of the grant funds will be paid to subcontractors,
contractors, or subgrantees to assist in the completion of the project without Thrive's prior
knowledge, Grantee agrees to notify Thrive in writing at GrantsManagerOThrivebvFivewa.or
or other such person as designated by Thrive. Grantee acknowledges that Thrive: (a) does not
2
approve the selection of any of Grantee subcontractors, contractors, or subgrantees and (b) will
not oversee the activities or use of grant funds by any such parties. Grantee remains responsible
for ensuring that any subcontractors, contractors, or subgrantees uses grant funds consistently
with the terms and conditions of this Grant Agreement and the Proposal. Neither Grantee nor
Grantee subcontractors may state to investors, media or the general public that Thrive supports
the activities of any subcontractor.
11. Recordkeeping. Grantee agrees to keep records in an easily read form sufficient to account for
all receipts and expenditures of grant funds. These records of grant funds as well as supporting
documentation will be archived by Grantee's office for at least six (6) years after the end of the
Grant Term. Grantee agrees to make such books, records, and supporting documentation
available to Thrive for inspection, if requested.
12. Confidentiality. Grantee will hold in strictest confidence any non - public information that Thrive
designates as being confidential during the term of this Agreement and for six (6) years
thereafter. Grantee will not disclose confidential information to any third party, and will not use
any confidential information other than as necessary for Grantee to perform its obligations under
this Agreement. This Section will not apply to information (a) that was known to Grantee before
Thrive's disclosure, or information that becomes publicly available through no fault of Grantee;
or (b) that Grantee can demonstrate was independently developed or received by Grantee with no
breach of any duty owed by a third party to Thrive independent of this Agreement. Grantee may
disclose confidential information as required by applicable law, legal process or any order of a
court or other governmental authority, but Grantee will give Thrive notice reasonably sufficient
to allow Thrive to have an opportunity to object to such disclosure in advance, unless providing
such notice would violate applicable law.
13. Intellectual Property. Grantee shall retain all copyrights and other intellectual property rights to
written work produced as a result of this award, including but not limited to work product listed
in Schedule B. Grantee grants to Thrive a nonexclusive, irrevocable, perpetual, and royalty -free
license to access, reproduce, publish, copy, alter or otherwise use such written work, for any
purpose consistent with Thrive's continuing status as an organization described in Section
501(c)(3) of the Code. Project materials may be reproduced (but not morphed, amended, revised,
or redesigned) by any other party, on a worldwide, non - exclusive basis and without fee in
connection with their own educational or program purposes, but may not be used in connection
with sales or distribution for profit. The owner must approve any use of project materials not
specifically permitted under this provision, in advance and in writing. As appropriate, all
materials shall contain an attribution of ownership.
14. Tbird -Party Rights. Grantee warrants that written work product produced under the terms of
this Agreement will not infringe, misappropriate, or violate the rights of any third party, or
incorporate or be derived from the intellectual property of any third party, without Thrive's prior
written consent.
15. Quality of Work and Non - Compliance. Quality of work and compliance with the terms
outlined in the Agreement will be monitored throughout the course of the funding period using
the methods described in Schedule B. If Thrive is (a) not satisfied, in its sole discretion, with the
quality of the Grantee's work or (b) encounters non - compliance with the terms outlined in the
Agreement on the part of the Grantee, Thrive will make a reasonable attempt to assist the
F
Grantee with technical assistance and quality assurance activities to resolve issues that impede
quality and compliance. In the event that compliance issues cannot be resolved, the Grantee will
be engaged in a probationary process as described in Schedule D.
16. Early Termination. Thrive may terminate the contract prior to the end of the Grant Term if
satisfactory compliance is not reached after reasonable efforts have been made to restore
compliance, as outlined in Schedule D. In the case of Early Termination, Grantee is required to
immediately repay the full amount of any grant funds which were unspent as of the date of the
notice of termination, and Thrive shall have no further obligation to distribute any unpaid portion
of the Grant to Grantee.
17. Change in Key Personnel. The success of the approved Project is largely contingent on the
Project Lead(s) identified in the proposal. Should there be any material change in job description,
level of authority, or employment status of Project Lead(s) during the grant term, Thrive requires
that Grantee notify Thrive staff within 30 days of the change.
18. Nondiscrimination. Contractor must maintain non - discriminatory policies with regard to race,
color, age, gender, marital status, sexual orientation, political ideology, age, creed, religion,
heritage, ancestry, national origin or sensory, mental, or physical ability throughout the Term.
19. Indemnification. As a condition to this Agreement, Grantee agrees to indemnify, defend and
hold Thrive harmless and against any and all liability, loss, and expense (including reasonable
attorneys' fees) or claims for injury or damages arising out or resulting from, or that are alleged
to arise out of or result from, negligent actions or omissions by Grantee or any of the Grantee's
officers, agents, employees, subcontractors, contractors, or subgrantees with respect to the
Agreement. Further, no provision of this Agreement shall inure in any way to the benefit of any
third -party so as to constitute such party as a third -party beneficiary of the Agreement or any one
or more of the terms hereof or otherwise give rise to any cause of action in any person or entity
not a party hereto.
20. Grant Announcements; Public Reports and Use of Thrive Name and Logo. Thrive will
include information on this grant in Thrive's periodic public reports and may make information
about this grant public at any time on its web page and as part of press releases, public reports,
speeches, newsletters, and other public documents. If Grantee wishes to issue a press release or
report announcing this grant, or otherwise use Thrive's name or logo, please
contactGrantsManagerrci thrivewa.org at least two weeks before the desired announcement or
publication date. Grantee agrees to obtain advance approval from Thrive of the press release and
the date of release, or of any other use of Thrive's name or logo. Thrive requests an opportunity
to review and comment on subsequent press releases or reports that are directly related to the
grant.
21. Insurance. Grantee will obtain, and provide proof of, insurance coverage as set out in this
section. The intent of the required insurance is to protect Thrive should there be any claims,
suits, actions, costs, damages or expenses arising from any negligent or intentional act or
omission of Grantee, or agents thereof, in carrying out the Project. Grantee will obtain insurance
coverage, which will be maintained in full force and effect during the Grant Term, as follows:
a. Commercial General Liability Insurance. Obtain a Commercial General Liability
Insurance Policy, including contractual liability, in adequate quantity to protect against
legal liability arising out of Project - related activities but no less than $1,000,000 per
occurrence.
b. Automobile Liability. In the event that Project - related activities involve the use of
vehicles, whether or not owned by Grantee, automobile liability insurance will be
required. The minimum limit for automobile liability is $1,000,000 per occurrence, using
a Combined Single Limit for bodily injury and property damage. The parties agree and
acknowledge that a non owned and hired policy is acceptable as the Grantee has no
vehicles in its possession.
c. Maintenance of Insurance. Grantee will maintain the coverage described in Section 21 (a)
and (b) above through either (i) its participation in a self- insurance program established
pursuant to RCW 48.62, or (ii) an insurance company /ies authorized to do business
within the State of Washington, and will name Thrive, its agents and employees as
additional insureds under the insurance policy /ies. All policies must be primary to any
other valid and collectible insurance. Grantee will instruct the insurers or self - insurance
program to give Thrive thirty (30) calendar days' advance notice of any insurance
cancellation.
d. Certificate of Insurance. Grantee will submit to Thrive within forty five (45) calendar
days of the Effective Date, a certificate of insurance that reflects the coverage and limits
described in Section 21 (a) and (b). Grantee will provide a renewal certificate as
necessary to document compliance with this Section 21 during the Grant Period.
e. Industrial Insurance Coverage. To the extent required by law, Grantee will comply with
the provisions of Title 51 RCW, Industrial Insurance.
22. Compliance with Laws. Grantee will comply with all applicable federal, state, and local laws,
rules, and regulations (including, without limitation, the Americans with Disabilities Act (ADA)
of 1990, codified at 28 CFR Part 35, nondiscrimination laws and regulations, and licensing,
accreditation and registration requirements and standards) in carrying out the Project.
23. Conflict of Interest. Notwithstanding any determination by the Executive Ethics Board or other
tribunal, Thrive may, in its sole discretion, by written notice to Grantee terminate this Grant
Agreement if it is found after due notice and examination by Thrive that there is a violation of
the Ethics in Public Service Act, Chapter 42.52 RCW or any similar statute involving Grantee
and activities performed pursuant to the Agreement.
24. Disputes. Except as otherwise provided in this Grant Agreement, when a bona fide dispute arises
between the parties and it cannot be resolved through discussion and negotiation, either party
may request a dispute hearing. The parties will select a dispute resolution team to resolve the
dispute. The team will consist of a representative appointed by Thrive, a representative appointed
by Grantee and a third party agreed to be appointed by both parties. The team will attempt, by
majority vote, to resolve the dispute. This dispute process will precede any action in ajudicial or
quasi - judicial tribunal. In the event of a lawsuit involving this Grant Agreement, venue will be
C7
proper only in King County, Washington. Grantee acknowledges the jurisdiction of the courts of
the State of Washington in this matter.
25. Waiver of Default. Waiver of any default shall not be deemed to be a waiver of any subsequent
default by Thrive. Waiver or breach of any provision of the Agreement shall not be deemed to be
a waiver of any other or subsequent breach and shall not be construed to be a modification of the
terms of the Agreement unless stated to be such in writing, signed by an authorized
representative of Thrive and attached to the original Agreement.
26. Amendment; Assignment. This Grant Agreement may be amended or modified only by a
mutual written agreement of the parties. Neither this Grant Agreement, nor any claim arising
under this Grant Agreement, may be transferred or assigned by Thrive or Grantee without prior
written consent of the other party.
27. Entire Agreement; Governing Law; Severability. This Grant Agreement constitutes the entire
agreement and supersedes any prior oral or written agreements or communications between the
parties regarding its subject matter. The laws of Washington State shall govern this Grant
Agreement. The provisions of this Grant Agreement are severable so that if any term or
provision is found for any reason to be invalid, illegal, or unenforceable, such finding shall not
affect the validity, construction, or enforceability of any remaining term or provision.
28. Grant Review. Grantee will permit representatives of Thrive to visit Grantee's premises and
review Grantee's activities with respect to the Project, and will permit Thrive, at its own
expense, to conduct an independent financial and /or programmatic audit of the expenditure of
this grant.
29. Subgrants and Subcontracts. Your organization has been selected to participate in the Project
through the formal HVSA review process. You may not make any statement or otherwise imply
to donors, investors, media, or the general public that you are a direct grantee of the Bill&
Melinda Gates Foundation. You may state that Thrive by Five Washington is the Bill& Melinda
Gates Foundation's grantee and that you are a subgrantee of Washington Early Learning Fund
for the Project.
30. Notices. All legal notices under this Agreement shall be addressed as follows:
Thrive: Grants Manager
Thrive by Five Washington
1218 Third Avenue, Suite 800
Seattle, WA 98101
Grantee: Ms. Jean Baldwin, Director JCPH
Jefferson County Public Health
615 Sheridan
Port Townsend, WA 98368
This Agreement must be signed by an authorized officer of Grantee prior to issuance of the grant
funds. Grantee may keep a copy of this Grant Agreement as signed for its records.
3
WASHINGTON EARLY LEARNING FUND Jefferson County Public Health
d /b /a THRIVE BY FIVE WASHINGTON
By: Nina Auerbach,
Title: President and CEO
Date:
By: John Austin
Title: Chair
Date:
r lefferaon i 12,1) 12
Co. prosecutors
David Alvarez, Chief Civil D A
7
SCHEDULE A: PROJECT OVERVIEW
1. Project Description
Jefferson County Public Health (JCPH), Kitsap Public Health District (KPHD) and Port Gamble
S'Klallam Tribe (PGST) collaborated to form the NFP Bridge Partnership. The NFP Bridge
Partnership allows for the sustainability of Nurse Partnership Program (NFP) in the regional
area of the Kitsap and Olympic Peninsulas. NFP outcomes include improving pregnancy
outcomes, improving child health and development and improving economic self - sufficiency of
the low- income first -time pregnant women who are the target population of the program. The
NFP program guidelines are followed, and nurse home visitors (NHVs) trained in the NFP model
meet with clients from early to mid - pregnancy until the child's second birthday. The NFP Bridge
Partnership's whole program consists of two- .5 NHVs from KPHD, one- .5 FTE NHV from
PGST, and two NHVs (1.0 and .5 FTE) and one -.8 FTE Nurse supervisor from JCPH. The
whole program serves 77 unduplicated mothers, their children and families. HVSA funding
provides for 2.0 FTE NHVs and .08 FTE Nurse supervisor who will serve 50 unduplicated first -
time mothers, their children and families.
Home Visiting Model: NFP
Target Population: low
income, first -time
pregnant women
Target Geographic Area:
Jefferson and Kitsap
Counties
Staffing: .08 Nurse
Supervisor, 1.0 FTE
NHV(Jefferson), 2 -5 FTE
(Kitsap)
Home Visiting
Curriculum Used: NFP
Visit guidelines PIPE
parenting education
Funding Sources:
Medicaid, Jefferson
County MH /CD tax, KPHD
Local Capacity
Development Funds,
Healthy Start Kitsap
(5016)
Data System(s): Efforts
to Outcomes (ETO),
Nightingale Notes, and
Kansas Information
Public Health System
(KIPH5)
1.1: Maintain existing staff
2: Training
2.1: NFP program staff will
Participate in initial and
ongoing training, education,
and coaching as required by
NFP NSO
2.2: NFP program staff will
Participate in other training,
education, and coaching as
required for grants, funders,
and specific population needs.
3. Outreach /Reauitment
• 3.1: Existing caseloads will
be maintained
• 3.2: Maintain well
established referral base
1.1: Maintain existing staff: 2 FTE Nurse
Home Visitor (NHVs); .Og FTE Supervisor
2.1: NFP Supervisor and NHVS will
Participate in DANCE education when
scheduled.
2.2: NFP Supervisor will participate in
• monthly Supervisor Community of
Practice call,
• quarterly in- person Supervisor
Community of Practice meetings,
• the annual National Education
Symposium in Denver 5/14
• monthly individual consultation calls
with state nurse consultant
• quarterly NFP Tribal Community of
Practice calls
3.1: Each FTE NHV will maintain a
caseload of 22 to 25 clients
3.2: NFP Supervisor will
• coordinate a written plan for
cultivating relationships with referral
sources and communitypartners. Plan
will include in- person contacts,
community presentations, follow -up
visits, letters and/or calls
• monitor effectiveness of plan by using
ETD data on enrollment by referral
Measure 1
Nurse home visitors and
supervisors are registered nurses
with a minimum of a Bachelor's
degree in nursing.
Measure 2
Nurse home visitors and nurse
supervisors complete core
educational sessions required by
the NFP National Service Office
and deliver the intervention with
fidelity to the NFP Made].
Measure 3
Client meets low- income criteria
at intake as defined by program.
Measure 4
Client is enrolled in the program
early in her pregnancy and
receives her first home visit by no
later than the end of the 28th
week of pregnancy.
Measure 5
Client is visited throughout her
pregnancy and the first two years
of her child's life in accordance
with the current NFP Guidelines.
"The Logic Model may be revised throughout the Continuous Quality Improvement Process
10
4: Home Visits
Measure 6
• 4.1: Prmidehomevisits
4.1: 50 clients
A fulbtime nurse home visitor
for first time, low- income
• will be enrolled by 28 weeks of
carries a caseload of no more
pregnant women, mothers
pregnancy and 50 %will be enrolled
than 25 active clients.
and infants
by 15 weeks of pregnancy
• 4.2: Meet NFP goals on
• will receive 1 -3 home visits /month
Measure 7
frequency of visits and
according to the NFP standard and /or
Afull -time nurse supervisor
content of visits
flexible visit guidelines
provides supervision to no more
than eight individual NHVS.
4.2 The team's quarterly data on
• completed to expected visit ratio will
Measure
meet the national goals of:
Nurse home visitors and nurse
80% in Pregnancy
supervisors coiled data as
60 in Infancy
specified by the NFP National
60% in Toddler
Service Office and use NFP
• content coverage in the Maternal Role
reports to guide their practice,
Domain to meet national goals of:
assess and guide program
Pregnancy: 23 -25%
implementation, inform clinical
Infancy: 45 -50%
supervision, enhance program
Toddler: 40 -45%
quality and demonstrate program
fidelity.
5: Supervision
• 5.1: NHVS will receive
5.1 Supervisor will
reflective supervision
• provide individual, 60" reflective
supervision sessions for each NHV 3
times per month
• facilitate two— 1.5 to 2 hour reflective
case conferences each month
6: Continuous quality
Improvement
6.1: Supervisors and nurse
6.1 Supervisor
home visitors will review and
• will review ETO quarterly reports with
utilize team data to improve
NHVS and State Nurse Consultant
delivery of NFP program
(SNC),
• create Annual Plan with SNC
• and SNC will review Annual Plan
quarterly
"The Logic Model may be revised throughout the Continuous Quality Improvement Process
10
3. Budget
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11
SCHEDULE B: GRANTEE REQUIREMENTS AND PAYMENT SCHEDULE
1. Grantee Requirements
a. Individualized Assessments: Grantee will administer individualized assessments of
participant families, and services will be provided in accordance with those individual
assessments.
b. Voluntary Services: Services will be provided to clients only on a voluntary basis.
c. Priority Participants: Priority will be given to serve eligible participants who:
• Have low incomes;
• Are pregnant women who are under 21;
• Have a history of child abuse and neglect or have had interactions with child
welfare services;
• Have a history of substance abuse or need substance abuse treatment;
• Are users of tobacco products in the home;
• Have, or have children with, low student achievement;
• Have children with developmental delays or disabilities;
• And /or are in families that include individuals who are serving or have formerly
served in the armed forces, including such families that have members of the
armed forces who have multiple deployments outside of the United States.
d. Capacity Assessment: Grantee will develop and submit a Capacity Assessment detailing
community and organizational readiness and capacity for implementation of home
visiting services with fidelity (prior to the contract period). Materials provided in the
Capacity Assessment will be used to inform the Agreement.
e. Logic Model: Grantee will develop and continuously refine a Logic Model to guide
program implementation.
E Implementation Improvement Plan: Grantee will collaborate with Thrive and Thrive
Consultants to develop, submit, refine and utilize for reporting and Continuous Quality
Improvement (CQI) an Implementation Improvement Plan.
g. Annual Orientation Webinar: Grantee will participate in an annual orientation webinar
providing any updates on requirements associated with HVSA funding. The webinar will
be held on July 15, 2013.
h. HVSA Trainings: Grantee will participate in two full -day trainings.
• HVSA Training 1: November 6, 2013
• HVSA Training 2: March 13, 2014
i. Technical Assistance Coaching Calls: Grantee will participate in monthly 1.5 hour
Technical Assistance calls with Thrive staff and Thrive Consultants for Continuous
Quality Improvement.
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j. Site Visits: Grantee will cooperate with up to eight (8) scheduled site visits conducted for
grant compliance, organizational due diligence, HVSA evaluation, quality
implementation technical assistance, and continuous quality improvement.
k. Quarterly Program Reports: Grantee will submit four (4) program reports online no
later than the dates outlined below in the Payment Schedule. Program reports will
include, but are not limited to, the following information:
• Participant Demographics
• Implementation Progress on the Logic Model
• Implementation Reflection
• An Updated Logic Model
• Select Fidelity Measures
• Select Constructs and Benchmarks
• Progress on Implementation Improvement Plans
Thrive will notify the Grantee in writing or orally within thirty (30) working days of
errors or omissions in the Program Reports and any corrections that need to be made by
the Grantee and the expected timeline to submit the correction to Thrive.
I. Monthly Enrollment Numbers: Grantee will submit monthly Enrollment Numbers
Reports online no later than the dates outlined below in the Payment Schedule. Monthly
Enrollment Reports will include the number of childen, parents /caregivers, and families
enrolled for the previously completed month.
m. Quarterly Financial Activity Reports: Grantee will submit four (4) Financial Activity
Reports online no later than the dates outlined below in the Payment Schedule. Expense
reports will include, but are not limited to, cumulative expenditures incurred to date
compared to line items identified in the budget in Schedule A, section 3.
n. Standard Line Item Reports: Grantee will submit monthly Standard Line Item Reports
online no later than the dates outlined below in the Payment Schedule. Standard Line
Item Reports will include monthly expenditures for the Personnel and Occupancy budget
line items for the previously completed month.
o. Additional Requirements: Grantee will maintain and make available to Thrive, if
requested, documentation demonstrating accomplishments of the Grant Agreement. Such
documentation may include, but is not limited to:
• Services Provided, Service Dates, and Number of Service Hours
• Data Collection and Assessments by Participants
• Completed Evaluation Tools
• Attendance Sheets
• Service Logs
• Demographic Information of Participants
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2. Payment Schedule
The Payment Schedule below is based on the assumption thatstate and private revenue commitments
to Thrive have been maintained, and that such funds are available to Thrive for disbursement to the
Grantee. in the event that revenue commitments are not available to Thrive, Thrive reserves the
right to amend the payment terms and the amount of the Grant Award Total.
-Site Visits TBD
NA •.
NA
HVSA Orientation Webinar
July 15, 2013
NA
August 2013
$44,185.00
Signed Grant Agreement
August I, 2013
NA
Monthly Enrollment Numbers and
August 21, 2013
July 1-31,2013
Standard Line Item Report
Monthly Enrollment Numbers and
September 21, 2013
August 1 -31, 2013
Standard Line Item Report
November 2013
$44,185.00
Monthly Enrollment Numbers and
October 21, 2013
September 1 -30, 2013
Standard Line Item Report
Program Report and Expense Report
October 31, 2013
July 1, 2013-
41
September 30, 2013
HVSA Training I
November 6, 2013
NA
Monthly Enrollment Numbers and
November 21, 2013
October 1 -31, 20t3
Standard Line Item Report
February 2014
$44,185.00
Monthly Enrollment Numbers and
Standard Line Item Report
December 21, 2013
November 1 -30, 2013
Monthly Enrollment Numbers and
January 21, 2014
December 1 -31, 2013
Standard Line Item Report
Program Report and Expense Report
January 31,2014
October 1, 2013-
42
December 31 2013
Monthly Enrollment Numbers and
February 21, 2014
January 1 -31, 2014
Standard Line Item Report
May 2014
$44,185.00
Participation in HVSA Training 2
March 13, 2014
NA
Monthly Enrollment Numbers and
Standard Line Item Report
March 21, 2014
February 1 -28, 2014
Monthly Enrollment Numbers and
April 21, 2014
March 1 -31, 2014
Standard Line Item Report
Program Report and Expense Report
April 30, 2014
January 1, 2014-
#3
March 31 2014
Monthly Enrollment Numbers and
May 21, 2014
April 1 -30, 2014
Standard Line Item Report
Monthly Enrollment Numbers and
June 21, 2014
May 1 -31, 2014
Standard Line Item Report
NA
NA
Monthly Enrollment Numbers and
July 21, 2014
June 1 -30, 2014
Standard Line Item Report
Program Report and Expense Report
..
Jul 31, 2014
April 1, 2014-
r. -_- an 'm n
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SCHEDULE C: EVALUATION REQUIREMENTS
1. Evaluation Design. Thrive is in the process of designing a new evaluation framework.
Implementation of this framework will occur following the selection of an evaluation group
responsible for carrying out the new evaluation framework. Selection of this group is intended to
be completed by September 2013. The design of the new evaluation framework is guided by the
following objectives:
a. Increase the capacity of the HVSA Grantees to effectively use data to guide program CQI
b. Inform relevant HVSA evaluation efforts underway, including, but not limited to Data
Benchmarks, the State CQI plan, reporting to private funders, and Thrives strategic
measures reporting
c. Develop data measures to sustain and build the capacity of the HVSA that is aligned with
advancing the Washington state Early Learning Plan
2. Data Transition and Protections. The new evaluation framework will be phased in over time,
gradually replacing the existing framework. During this transition:
a. Data safeguards, protocols, and security measures will remain in place to ensure data
collected from Grantee continues to be confidential, de- identified
b. Transfer and use of data will be in compliance with all HIPAA requirements, as well as
meet the contractual requirements of program models and individual Grantees
In addition, de- identified client data will be retained for 6 years after completion of this Agreement
and then destroyed.
3. Evaluation Activities. In addition to participating in activities that support the evaluation
framework, Grantees will continue to participate in evaluation activities for all families served
under through HVSA program funds. These requirements include, but are not limited to:
a. Executing a data- sharing agreement with the evaluation group.
b. Meeting data collection pass- through requirements described in Federally approved
Washington State Data Benchmarks Plan; including but not limited to:
• Participating in data collection and training activities
• Collecting specified data elements
• Implementing data collection processes and reporting
4. Timeline: It is anticipated that Grantees will begin working with the newly designated
evaluation group in the last quarter of 2013. In the meantime, Thrive may have particular
requests of Grantees that are consistent with objectives stated in Section 2 above. Initial activities
carried out by the evaluation group will include a meeting with Thrive and Grantees to discuss
issues related to data security and storage, use of data, and data sharing agreements, and existing
evaluation capacity.
5. Revisions to Schedule C: When a new evaluation design has been developed, Thrive will
disseminate an amendment to the Schedule C defined herein providing a clear description of
revised evaluation requirements. The amendment must be executed by both parties.
15
SCHEDULE D: PROBATION PROCEDURES FOR NON - COMPLIANCE
In the event that the Grantee is deemed "non- compliant," Thrive will follow the procedures outlined
below:
1. Notice of Probation: Thrive will issue a written Notice of Probation (Notice) to the Grantee.
Probationary status means that Grantee is vulnerable to Suspension of Payment if corrective
action is not taken within the specific timeframe outlined in the Notice. Such notification will be
sent a minimum of thirty (30) days prior to the effective date. The Notice of Probation will:
a. Cite and describe the specific issue(s) of non - compliance.
b. Describe a protocol for corrective action.
c. Outline a required timeline for corrective action.
In order to regain active Grantee status, the Grantee must correct the non - compliance issue to the
satisfaction of HVSA within the timeframe stipulated in the Notice (or an amended timeframe as
agreed upon between Grantee and Thrive).
2. Suspension of Payment: If Grantee fails to satisfactorily correct the non - compliance issues cited
in the Notice within timeframe cited in the Notice, Thrive may suspend payment of funds until
satisfactory contract compliance is met. Grantee will be informed in writing a minimum of thirty
(30) days prior to the effective date of such action.
3. Suspension of Payment Appeal: Grantee is entitled to appeal Suspension of Payment within ten
(10) days of receiving the suspension notice. HVSA will review the case within fifteen (15) days
of receipt of the appeal and schedule a date to hear the appeal within thirty (30) days of receipt of
the notice of appeal. HVSA will notify the Grantee in writing of the appeal decision within ten
(10) days of the appeal hearing.
4. Early Termination: Repeated probation or Suspension of Payment may result in Early
Termination (Grant Agreement, clause 15).
16