HomeMy WebLinkAbout081913_ca03Consent Agenda
JEFFERSON COUNTY PUBLIc HEALTH
615 Sheridan Street o Port Townsend o Washington o 98368i
www.,jeffersoncouintyPLblicheaRh.org
July 26, 2013
];a 114
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TO: Board of County Commissioners
Philip Morley, County Administrator
FROM: lean Baldwin, Director
'710 3
DATE: CA e t f, r 1 �
SUBJECT: Agenda Item - Implementation Agreement with Nurse Family
Partnership for Nurse Home Visitation; July 1, 2013 - June 30, 2016;
$6,028
STATEMENT OF ISSUE:
Jefferson County Public Health, Community Health, requests Board approval of the Implementation
Agreement with Nurse Family Partnership for Nurse Home Visitation; July 1, 2013 - June 30, 2016; 6,028
ANALYSIS STRATEGIC gOALL ZPRO'S and .CON'S:
Jefferson County Public Health uses the Nurse-Family Partnership (NFP) program to provide primary
prevention services targeted to high risk pregnant women and infants. NFP is an evidence-based program,
which has demonstrated the ability to improve short and long term outcomes for both the parent and the
child in areas such as health, school readiness, reduced child abuse/neglect, criminality, and lower
substance abuse. Extensive analysis has demonstrated a high rate of return on investing in this program.
ongoing quality assurance and monitoring from the Denver National Service Office and fidelity to the model
leads to confidence that similar results will be seen in the local population as in the national trials. The NFP
national service office in Denver contracts with local agencies to provide this ongoing quality assurance
through: ongoing web based data collection, analysis, and reporting. Additionally we receive professional
and site development, policy and program support on site with NFP national staff every year.
Due to the small population size and 25-family caseload in each county we have negotiated with the NFP
national office for a shared contract with Mason County. The usual contract fee is based on a minimum
caseload of 100 families. This shared contract allows small counties such as Jefferson to participate in the
highest quality evidence based prevention at a reasonable cost.
COMMUNITY HEALTH ENMOININ-rAL HEALTH
DEVEI.OPMENTAL 016ABlUTIES PUBLIC HEALTH MEWATER QUAI. ff'Y
M�M (360)'385 -9400 ALWAYS WOMING FOR A SAFER AND MAK: (31601) 385-9444
FAX: (360) 3859401 HEALTHIER COMMUNITY F (360) 379-4487
Consent Agenda
FISCAL JL4PACj/CO$T BENEFIT ANALYSIS:
The contract amendment is funded by Proposition 1.
RECOMMENQATIQN'.
JCPH management request approval of the Implementation Agreement with Nurse Family Partnership for
Nurse Home Visitation; July 1, 2013 — June 30, 2016; $6,028
7161�-3
r����ty Adminisbikor Date
This Agreement ("Agreement"), for the period July 1, 2013, through June 30, 21016, is by
and between Jefferson County, a political subdivision of the State of Washington
('Agency") and Nurse-Family Partnership, a Colorado nonprofit corporation ("NFP")
(together, the "Parties"),
RECITALS:
A. The Parties understand and agree that the Nurse-Family Partnershipe) Program (the
"Program"') is an evidence-based program developed on the basis of randomized
controlled trial research to yield certain benefits for low-income, first-time mothers
and their children ("Program Benefits").
B. The Parties understand and agree that Program Benefits can be described generally
as helping low-income, first-time mothers develop behaviors that enable them to
have healthier pregnancies, be better parents, have emotionally and physically
healthier children, and attain greater economic self-sufficiency.
C. The Parties understand and agree that Program implementation by Agency must be
based upon key parameters ("Model Elements") identified through research and
refined based upon the Program's experience since 1997 and attached to this
Agreement as Exhibit A, Nurse-Family Partnership Model Elements.
ID, Agency desires and intends to implement the Program to serve low-income, first-time
mothers in the geographic area it serves and to be known to the public as Nurse-
Family Partnership.
E. NFP desires and intends to guide and support the Program implementation process
in order to help Agency obtain Program Benefits for the mothers and children that
Agency serves.
F. Accordingly, the Parties wish to enter into this Agreement in order to memorialize the
mechanisms and means by which Agency shall implement the Program and NFP
shall support such implementation. The Parties intend to remain in a contractual
relationship for the period described in Section V herein and thereafter, so long as
funding is available to both of the Parties for this purpose,
_AAA6119
In consideration of the foregoing recitals, which are incorporated herein, and for other
good and valuable consideration, the receipt and adequacy of which are hereby
acknowledged, the Parties agree as follows:
11111MEM
A, Agreement-Specific Definitions. In addition to terms defined above and
elsewhere in this Agreement, the following terms shall have the meanings set
forth below:
jeffersonco—WA—NFPAgrmt—Exp20l6O630—FinaI (2).docx
"ETO TW means the Efforts to OutcomeST11 software system that NFP makes
1. available to Agency, into which designated, NFP-approved Agency personnel
enter data collected about Clients and the Program, and from which the
Parties can obtain reports to help manage and evaluate program
implementation and results.
Z
"INTO Website" means the Internet URL through which designated, NFP-
approved Agency personnel can access the ETO to enter data and obtain
certain reports and other services. ETO software is secured against
unauthorized use by VeriSign@ 128-bit Security Encryption, the industry
standard in Internet site protection. Authorized access to the ETO Website
can only be provided by NFP
3, "Administrator" means a person with fiscal and quality oversight, operational
coordination responsibilities, and/or evaluation responsibility for the
Program's management.
4. "Client" means a low-income, first-time mother who is enrolled in the Program
implemented by Agency.
5. "Effective Date" means the date first noted above and upon which this
Agreement becomes effective.
6. "Fidelity to the Model" means implementing the Program in a manner
consistent with the Model Elements and therefore maximizing the likelihood
of achieving results comparable to those measured in research.
7. Visit-to-Visit Guidelines" means a written guide or guides for how a Nurse
Home Visitor schedules and conducts visits with Clients during their
participation in the Program.
8. "Location" means the work address of a Program Supervisor.
9. "Program Supervisor" means a person who supervises up to eight Nurse
Home Visitors who implement the Program on behalf of Agency.
10, "Research- means any activity, including program evaluation and/or quality
improvement activities, (i) that would, according to Federal regulations,
require review by an Institutional Review Board ("IRB"), or (ii) that could be
expected to yield generalizable knowledge that could be shared publicly with
the professional, academic, and/or lay communities.
11. "Team" means a half- to full-time Program Supervisor and up to eight (8)
Nurse Home Visitors who report to the Program Supervisor.
B. "Proprietary Property" means all of (i) the Program, including facilitators and
handouts, (ii) the Model Elements, (iii) the name "Nurse-Family Partnership" and
the acronym "NFP" when used in connection with the NFP Logo and the goodwill
associated therewith, (iv) all NFP Community Website and RTC website content,
and (v) the copyrighted materials and other materials used in the Program as of
the date hereof that would be designated as protectable intellectual property
under applicable law, including, but not limited to, all modifications, additions,
updates, and derivative works thereof and all of the rights of NFP and its
licensors associated with this property. Proprietary Property shall also include,
individually and collectively, all ideas, concepts, designs, methods, inventions,
modifications, improvements, new uses, and discoveries which are conceived
and/or made in the performance of the responsibilities stated under this
Agreement by one or more of Agency, NFP, or its licensors, whether or not they
are incorporated into the Program or the Proprietary Property. NFP and its
licensors reserve the right to modify the Proprietary Property from time to time in
accordance with the data, research and current modalities of delivery of the
JeffersonCo—WA._NFPAgrmt—Exp20l6O630_FinaI (2),docx
Program and for any other reason NFP or its licensors, in their sole and absolute
discretion, deem appropriate, NFP will provide Agency with reasonable notice of
those modifications. NFP and its licensors shall retain ownership and all rights to
all proprietary Property, whether modified or not by Agency.
C, General Application. Unless a clear contrary intention appears, words used with
initial - capitalized letters shall have the meanings set forth in this Agreement, and
(i) the singular includes the plural and vice versa, (ii) reference to any document
means such document as amended, from time to time, (iii) "include" or "including"
means including without limiting the generality of any description preceding such
term, and (iv) the term "or" is not exclusive.
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X NFP grants to Agency a non-exclusive limited right and license to use the
Proprietary Property for the purpose of carrying out Agency's obligations under
this Agreement in the geographic area within which Agency Nurse Home Visitors
serve Clients. NFP reserves the right to modify the Proprietary Property from
time to time in accordance with the data, research and current modalities of
delivery of the Program. NFP will provide reasonable notice of those
modifications as set forth in the Implementation Agreement. NFP shall retain
ownership and all of the rights to any Proprietary Property, whether modified or
not by any Agency. In any event, all software and FTC Website content,
excluding Agency's and other agencies' data, shall remain the sole property of
NFP.
B. NFP will provide support to help Agency implement the Program as described in
Exhibit B, Nurse-Family Partnership Support for an Agency.
C. NFP shall submit invoices to Agency for services provided to Agency, listing a
date of provision, a description of each such service, and amounts based upon
the fee schedule provided in Exhibit C, Fees for Nurse-Family Partnership
Services.
D. NFP may, from time to time, request that Agency collect additional data and/or
participate in Research initiated by NFP and intended to improve the NFP model
or implementation of the model. NFP may provide the public with information
about Agency's NFP-related Research, publications and presentations.
E. NFP, independently or jointly with Agency, may publish or present NFP-related
information or Program results in research reports, books, book chapters, peer-
reviewed journal articles, and at academic or professional conferences, always
giving due credit to the Parties Involved and recognizing the rights of the
individuals doing the work.
F, NFP understands that pursuant to this Agreement, NFP and its employees may
have access to patients' Protected Health Information (THY) and Agency's
business information. NFP acknowledges that this information has a high level of
confidentiality, and NFP and its employees agree to keep all information made
available to its employees confidential and not to disclose this information. NFP
will instruct its employees/staff /affiliates to follow Agency's policies regarding
jeffersonCo-WkNFPAgrmt—Exp20l6O630—FinaI (2),docx
patient and business confidentiality, Further, NFP acknowledges that Agency is
bound by law to have written agreements with its business partners who may
have access to patient information requiring compliance with the Health
insurance Portability and Accountability Act of 1;996 (HIPAA) and the rules and
regulations promulgated thereunder. Accordingly, NFP warrants and represents
that NFP is in compliance with HIPAA and all relevant federal statutes, rules,
regulations, and applicable interpretive rulings promulgated under HIPAA, or will
become compliant to regulations and requirements effective at future dates
according to the applicable timetables, Exhibit D, HIPAA Business Associate
Addendum, is hereby incorporated in this Agreement. Failure by NFP to comply
with this provision and the provisions of Exhibit D, HIPAA Business Associate
Addendum, shall result in immediate and automatic termination of this
Agreement without penalty or cost to Agency. NFP will cooperate with any
Agency program(s) instituted in the future to bring Agency into compliance with
HIPAA.
AGENCY OBLIGATIONS
A. Agency will make best efforts to implement the Program with Fidelity to the
Model and will undertake the steps described in Exhibit E, Agency
Responsibilities, in order to do so.
B. Agency will take all appropriate steps to maintain client confidentiality and obtain
any necessary written client consents for data analysis or disclosure of protected
health 'information, in accordance with applicable federal and state laws,
including, but not limited to, authorizations, data use agreements, business
associate agreements, as necessary.
C. Agency assumes responsibility for knowledge of and compliance with the State
Nurse Practice Act of its state, state laws, regulations, and licensing
requirements pertaining to nursing practice and state laws and regulations
pertaining to mandatory reporting.
D. Agency will ensure that nurses whom it employs to implement that Program are
able to provide care to clients in a manner consistent with the NFP Visit-to-Visit
Guidelines.
E. When requested by NFP, Agency will make reasonable efforts to collect
additional data and/or participate in Research intended to improve the NFP
model or implementation of the model.
F. In order to avoid becoming involved in Research that conflicts with implementing
the Program with Fidelity to the Model, Agency will request NFP's permission
prior to participating in any Research that is (1) initiated by a party other than
NFP and (2) that involves Program staff or explicitly targets the families that are
enrolled in the Program. NFP will review and approve or disapprove Agency's
request for participation in such Research on a timely basis and will not
unreasonably withhold such approval.
G. Agency will inform NFP of Agency proposals to publish or present NFP-related
information in research reports, books, book chapters, peer-reviewed journal
9effersonCO_WA_NFPAgrmt_Exp2Dl6O630—FinaI (2).docx
articles, and at academic or professional conferences. Results of the Program
herein outlined may be published by Agency, or jointly by Agency and NFP,
always giving due credit to the Parties involved and recognizing the rights of the
individuals doing the work,
H. Agency is authorized to reproduce certain published materials specified below
and used in the implementation of the Program so long as (1) this Agreement is
in effect, (2) Agency uses the reproductions solely for Program implementation,
and (3) Agency does not sell or otherwise distribute the reproductions to any third
party not involved in Agency's implementation of the Program.
1 . The published materials covered by this authorization are delivered to Nurse
Home Visitors as part of the Nurse-Family Partnership Home Visitor
education materials in sets referred to as follows:
a) Pregnancy Facilitators and Handouts
b), Infancy Facilitators and Handouts
c) Toddler Facilitators and Handouts
2. The handouts bear notices indicating copyright by any of the following:
a) University of Colorado
b) University of Colorado Health Sciences Center
c) University of Colorado at Denver and Health Sciences Center
d) Nurse-Family Partnership
3. NFP has the right to grant permission to reproduce materials specified above
and that bear the University copyright notice under the terms of a
Memorandum of Understanding (WOU") dated March 31,, 2003„ between the
University of Colorado Health Sciences Center, now known as University of
Colorado at Denver and Health Sciences Center, and NFP, The MOU gives
NFP an exclusive, perpetual, royalty-free right and license to use copyrighted
materials and other materials used in the Program for the purpose of
implementing the Program to serve low-income, first-time mothers and their
families.
4. The corresponding Spanish-language versions of these materials are also
covered by this authorization.
5. Agency may not authorize any other entity to reproduce the materials without
prior written permission from NFP.
Agency understands and agrees that all Proprietary Property is owned
exclusively by NFP �sestlhe rulinitprty htherein, Agency shall Proprietary Property solely for the purpose of
carrying out Agency's obligations under this Agreement and shall not modify any
Proprietary Property without the prior express written permission of NFP.
Agency shall protect all Proprietary Property that belongs to NFP or its licensors,
Agency shall not duplicate and shall prohibit distribution of or access to Visit-to-
Visit Guidelines and the ETO to any individual or organization not party to the
implementation, administration, and operation of the Program, except as
authorized by this Agreement. Agency shall not change or alter the ETO
jeffersc)nCo—WA.-NFPAgrmt-Exp20l6O630—FinaI (2).docx
software, and shall allow only trained, NFP-authorized users to access the ETC)
Website. If a person leaves Agency's employ, Agency shall retrieve all
Proprietary Property that the person may have in his or her possession.
IV. FEES AND PAYMENT
A. Fees associated with NFP services in support of an implementing agency are as
follows:
Initial Education Services. NFP provides initial Nurse-Family Partnership
education for nurse home visitors, Program Supervisors, and Agency
Administrators. This fee applies once for each individual nurse home visitor,
nurse supervisor, and administrator at an agency. Fees are due upon
completion of the face-to-face session.
a) Nurse Home Visitor Initial Education Tuition, Education for nurse home
visitors (NHV) consists of one face-to-face education unit supported by
distance education components. All Program Supervisors who have
never taken NHV Education or who completed it more than two years
prior to being promoted to Supervisor are required to attend NHV
Education as well as Supervisor Education.
b) Supervisor Initial Education Tuition, For Program Supervisors, education
consists of Nurse Home Visitor Initial Education plus two face-to-face
education units supported by distance education components and nurse
consultation.
c) Annual Supervisor Education. Program Supervisors are required to
attend a three day face-to-face session held annually in Denver. There is
no tuition or registration fee.
d) Agency Administrator Initial Education Tuition. A two day face-to-face
session in Denver (in development).
e) Nurse-Family Partnership Education Materials Fee, Contributes toward
the cost of the following materials :
(1) Nurse-Family Partnership Orientation Materials
(2) Set of Prenatal, Infancy and Toddler Guidelines
(3,) A series of additional nursing practice and program management
resources tied to implementation of Nurse-Family Partnership.
2, implementation Support Services. Fees are due on the Effective Date and
each anniversary thereof and are based on the number of Program
Supervisor Positions (the greater of (1) the number of individuals with
supervisory responsibility at the agency or (2) the number of supervisor FTEs
that are required to be implementing the model with fidelity (at least one per
eight nurse home visitors). Fees are as follows:
a) Program Support. The Parties have agreed that for purposes of this fee,
the,5FTE Supervisor in place at Agency and the .5FTE Supervisor at
Jeffersonco__WkNFPAgrmt—Exp20l6O630_FinaI (2).docx
Mason County at the time of the Effective date will be treated as one
Supervisor.
Fees are per Program Supervisor Position per year and contribute to
covering costs associated with the following'.
(1) Data system (ETO) operation and use, Program Quality System, and
Reporting.
(2) Ongoing Nurse-Family Partnership nurse home visitor, supervisor,
and administrator education; resource library; conference calls; web
forums; Nurse-Family Partnership Community resources; and
updating of Nurse-Family Partnership Education and Visit-to-Visit
Guidelines and supporting materials.
(3) Marketing and Communications consultation and support, including
marketing and community outreach materials (brochures, posters,
Client Referral Kits (with wallet cards, counter display, posters and
other program information); health fair bags, and nurse recruitment
packets. The agency, however, is responsible for printing, stamping or
affixing labels with their local contact information to the majority of
these materials, Client Referral Kits are customized /printed at no
additional charge to the agency. Also provided are the NFP marketing
and communications resources and guidance and a copy of the NFP
Public Awareness Video, as well as updates and regular monthly
communications from the NFP National Service Office.
(4) policy and Government Affairs, including advocacy and educational
work at federal and state levels.
b) Nurse Consultation. The fee is per Program Supervisor Position per year.
The full fee is charged for the first Program Supervisor Position at a
geographic location and a reduced fee is charged for each additional
Program Supervisor Position at that same location. The fees contribute to
covering, costs associated with a Nurse-Family Partnership Nurse
Consultant providing the following support to Program Supervisors:
(1) Helping each Program Supervisor develop an annual plan for
implementation.
(2) Monitoring reports based on each Program Supervisor and her/his
team's activity and performance.
(3) Ongoing email support for each Program Supervisor and periodic
regular calls with each Program Supervisor.
(4) Periodic visits to each Program Supervisor with potential travel with
each Program Supervisor and/or selected nurse home visitors.
(5) Clinical and supervisory coaching and consultation with each Program
Supervisor.
c) Program Supervisor Expansion or Replacement Fee. A one-time fixed
fee is charged for extra support when a new Program Supervisor Position
is added or a vacant position is filled.
B. Prices are subject to change in accordance with Section IV E below,
C. All fees are based upon NFPs standard terms of invoicing and payment, as
follows:
JeffersonCo—WA_NFPAgrmLExp20l6O630—FinaI (2),docx
1 - Program Support and Nurse Consultation Fees are invoiced on the Effective
Date and each anniversary thereof to cover each ensuing year and are due in
30 days. No special reporting or documentation is provided with the
invoice(s).
2. Education Fees are invoiced when individuals attend in-person education
sessions. No special reporting or documentation is provided with the
invoice(s).
3, Program Supervisor Expansion or Replacement Fees are invoiced when the
new supervisor is hired. No special reporting or documentation is provided
with the invoice(s).
D. NFP shall invoice, without limitation, for services provided to Agency based upon
the fee schedule set forth in Exhibit C, Fees for Nurse-Family Partnership
Services. NFP reserves the right to change the fees set forth in Exhibit C during
the term of this Agreement but not more often than annually. NFP will notify
Agency at least one year prior to any such change becoming effective.
E. Invoices will be sent to:
Jefferson County Health Department - WA
615 Sheridan
Port Townsend, WA 98368
Attention: Accounts Payable
Telephone: (360) 379-9475
Email: sreynolds@cojefferson.wa.us
F. Agency will send payments, identifying the NFP invoice, within 30 days of invoice
to: Nurse-Family Partnership
Attention, Accounts Receivable
I goo Grant Street, S u ite 400
Denver, co 80203
A. Term of Agreement, This Agreement shall remain in full force and effect through
June 30, 2016, unless it is terminated by mutual agreement of the Parties or as
otherwise provided below.
B. Term Extension. Upon July 01, 2016 and each anniversary of that date, this
Agreement shall automatically extend for an additional year unless either party
has provided not less than sixty (60) days' notice to the other of its intention to
terminate the Agreement on the upcoming anniversary date.
C. Early Termination, The Parties agree that they intend to and will engage in
mutual efforts to keep this Agreement in force. Recognizing, however, that
circumstances beyond the control of the Parties may compel one Party to desire
termination before completion of the term or an extension thereof, either Agency
jeffersonCO_WA._NFPAgrmt—Exp2ol6O630—FinaI (2),docx
or NFP may terminate this Agreement at any time Iby giving the other party
written notice of not less than sixty (60) days.
D. Default. A party shall be in default under this Agreement if a party (i) breaches a
material provision of this Agreement, which breach is not cured to the non-
breaching party's reasonable satisfaction within thirty (30) days of written notice
given to the breaching party by the non-breaching party or (6) the bankruptcy of a
party.
L Remedies upon Default. The Parties shall use commercially reasonable efforts
to take steps necessary to cause the breaching party to cure the applicable
default. if such default is not cured to the reasonable satisfaction of the other
party, and both of the Parties do not agree to terminate this Agreement, the
Parties shall proceed in accordance with the dispute resolution, process set forth
in Section V1,
F, Effect of Termination.
1 . If this Agreement is terminated by notice of one party to the other, Agency will
pay NFP for all work performed up to the date of termination and all non
cancelable obligations incurred in accordance with this Agreement. Payment
shall be due within thirty (30) days of termination.
2. If this Agreement is terminated through the dispute resolution process, the
rights and obligations of each of the Parties upon termination shall be spelled
out in the dispute resolution process.
3. Upon termination of this Agreement, regardless of the timing, cause, or
mechanism of such termination:
a) Agency will no longer have access to ETO or the ETO Website;
b) All software and ETO Website content, excluding data which has been
collected by Agency in the course of implementing the Program, shall
remain the sole property of NFP;
c) NFP may retain a record of all data which has been collected by Agency
in the course of implementing the Program and may use that data and
reports derived from it to evaluate the overall progress in national
replication of the Program;
d) Agency and INFP will continue to comply with all relevant state, federal
laws and all other provisions of this Agreement with respect to
maintaining Client confidentiality;
e) All materials in Agency's possession that utilize the Nurse-Family
Partnership 1090, tag line, or other protected marks must be returned to
NFP or destroyed;
f) All copies of Proprietary Property that have been provided to Agency by
NFP or that have come into Agency's possession from other sources
must be returned to NFP or destroyed; and
g) Agency will cease to implement the Program and will cease to represent
that it is implementing the Program.
Vt. DISPUTE RESOLUTION. If a dispute arises relating to this Agreement, the Parties
shall attempt to resolve that dispute at the lowest possible level. If the dispute cannot
be resolved at that level, the dispute shall be elevated to the Director, Program
Development, of NFP and the Program Supervisor. If these persons cannot resolve
the dispute, it shall be elevated to the next organizational level of NFP and Agency. If
Jefferson CO-WA-NFPAgrm_ Exp2Ol6O630-FinaI (2).docx
the dispute is not resolved through the foregoing process within a reasonable period
of time, not to exceed any period of time that could reasonably be deemed to have a
detrimental impact on the implementation of the Program by Agency, either party
may initiate dispute resolution through any avenue permitted in law or in equity.
1/11, LIABILITY.
X Each party hereto agrees to be responsible and assume liability for its own
wrongful or negligent acts or omissions, or those of its officers, agents or
employees to the full extent allowed by law.
B. No liability hereunder shall result to a party by reason of delay in performance
caused by force majeure, that is, circumstances beyond the reasonable control of
the party.
Vill. ASSIGNMENT; SUBCONTRACTING. Except as provided herein, this
Agreement, and the rights and obligations hereunder, is not assignable or
transferable by either party without the prior written consent of the other party.
Without limiting the previous sentence, Agency shall not have the right to engage or
utilize the services of any subcontractor to perform any of Agency's services
hereunder without the prior written consent of NFP.
IX. MISCELLANEOUS PROVISIONS,
A. Consents. Whenever a Party's consent or approval is required under this
Agreement, such consent or approval shall not be unreasonably withheld. If
consent or approval is required by an employee of a Party, the Party who
employs such employee shall cause the employee to give or withhold such
consent or approval in accordance with this Paragraph. If no response is
received by the requesting Party within ten business days after delivery of the
applicable request, consent shall be deemed given.
B. Notices, All notices and other communications that are required or permitted to
be given to the Parties under this Agreement shall be sufficient in all respects if
given in writing and delivered by overnight courier or certified mail, postage
prepaid, return receipt requested, to the receiving party at the following address:
For NFP:
Original to:
Nurse-Family Partnership
1900 Grant Street, Suite400
Denver, CO 80203
Attention: Chief Executive Officer
Telephone: 303-327-4274
Facsimile: 303-327-42610
Email:
Tom,Jenkins@NurseFami)yPartnership.org
JeffersonCo,_WA_NFPAgrmt—Exp20l6O630—FinaI (2),docx
With a copy to:
Nurse-Family Partnership
1900 Grant Street, Suite400
Denver, CO 80203
Attention: Legal Affairs Manager
Telephone: 303-327-4271
Facsimile: 303-327-42,60
Email:
Elizabeth. Jasper @NurseFamilyPartnership.org
For Agency:
Original to:
Jefferson County Public Health
615 Sheridan Street
port Townsend, WA 98368
Attention: Jean Baldwin
Telephone 360-385-9408
Facsimile: 360-385-9401
Email' jbaldwin@co.jefferson.wa.us
Jefferson County Public Health
615 Sheridan Street
Port Townsend, WA 98368
Attention'. Cathy Avery
Telephone: 360-385-9438
Facsimile,- 360-385-9401
Email'. caveryQco.jefferson.wa.us
or to such other address as such party may have given to the other by notice
pursuant to this Paragraph. Notice shall be deemed given on the delivery or
refusal date, as specified on the return receipt in the case of certified mail or on
the tracking report in the case of overnight courier.
C. Binding Upon Successors and Assigns, This Agreement, and all covenants,
terms, provisions, and agreements contained herein, shall be binding upon and
shall inure to the benefit of the Parties' respective successors and permitted
assigns.
D. Waivers. No covenant, term, or condition, or the breach thereof, shall be
deemed waived, except by written, consent of the party against whom the waiver
is claimed; and any waiver of the breach of any covenant, term, or condition shall
not be deemed to be a waiver of any preceding, or succeeding breach of the
same or any other covenant, term, or condition.
E. Responsibility for Debts and Obligations, Neither party shall be responsible
either directly or indirectly for any of the debts or obligations of the other party
except as provided under this Agreement.
F. No Third Party Beneficiary. This Agreement does not create any third party
beneficiary rights in any person or entity.
& Authority to Contract, The undersigned individuals represent that they are fully
authorized to execute this Agreement on behalf of the respective Parties and
make all representations, warranties and covenants set forth herein. The Parties
represent and warrant that the execution, delivery, and performance of this
Agreement have been duly authorized by all necessary corporate actions of the
Parties and do not violate any laws or any provisions of any agreement to which
the Parties are bound.
H. No Joint Venture, Nothing contained in this Agreement shall be deemed or
construed as Creating a joint venture or partnership among the Parties. No party
shall have the power to control the activities or operations of another party and
their status is, and at all times shall continue to be, that of independent
contractors with respect to each other. No party shall hold itself out as having
authority or relationship in contravention of this Paragraph.
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Attorneys' Fees. if a party shall commence any action or proceeding against
another party in order to enforce the provisions of this Agreement, or to recover
damages as a result of the alleged breach of any of the provisions of this
Agreement, the prevailing party shall be entitled to recover all reasonable costs
in connection therewith, including reasonable attorneys' fees.
I. Further Assurances. The Parties shall cooperate fully with each other and
execute such further instruments, documents, and agreements, and shall give
such further written assurances, as may be reasonably requested by another
party to better evidence and reflect the transactions described herein and
contemplated hereby, and to carry into effect the intent and purposes of this
Agreement.
K Entire Agreement. This Agreement (together with Exhibits hereto, which are
hereby incorporated by this reference) constitutes the entire agreement between
the Parties relating to the subject matter hereof and supersedes all prior or
contemporaneous agreements, whether written or oral, among themselves or
their agents and representatives relating to the subject hereof. This Agreement
may be altered, amended, or revoked only by an instrument in writing signed by
all the Parties hereto.
Severability. If any term or provision of this Agreement shall, to any extent, be
determined to be invalid or unenforceable by a court or body of competent
jurisdiction, the remainder of this Agreement shall not be affected thereby, and
each term and provision of this Agreement shall be valid and enforceable to the
fullest extent permitted by law.
M. Applicable Law. This Agreement shall be governed by and construed according
to the internal laws of the State of Colorado. By execution of this Agreement,
each party submits and irrevocably waives any objection to in personarn jurisdic-
tion in the State of Colorado and the forum and convenience of the state and
federal courts thereof,
N, Survival, The terms and conditions of this Agreement shall survive the expiration
or termination of this Agreement to the full extent necessary for their enforcement
and for the protection of the party in whose favor they operate.
0. Counterparts and Facsimile Signatures. This Agreement may be executed in two
or more counterparts, each of which shall be deemed an original and all of which,
taken together, shall constitute one agreement. A facsimile signature to this
Agreement shall be deemed an original and binding upon the party against whom
enforcement is sought.
Jeff ersonCO._WA__N FPAgrmt_Exp201 60630—Final (2).docx
IN WITNESS WHEREOF, the Parties hereto have caused this Agreement to be
executed as of the date set forth herein by their duly authorized representatives.
For NFP:
Nurse-Family Partnership
By:
Wallace P. Dunlap, (;NeT Planning &
Administrative officer
Fama
For Agency,
Jefferson County
Bw
[Type in Name, Title]
Date:
proved as o Ifornmn on
i efferson �unty Pro utors office
David Alvarez, Q'ief civil DPA
JeffersonCo-WA _NFPAgrmt—Exp20l60630—Fin aI (2).docx
Y PARTNERSHIP MODEL ELEMENTS
When the Program is implemented in accordance with these Model Elements, the
Parties can reasonably have a high level of confidence that results will be comparable to
those measured in research. Conversely, if implementation does not incorporate these
Model Elements, results may be different from research results.
Element 1 Client participates voluntarily in the Nurse- Family Partnership program.
Element 2 Client is a first-time mother.
Element 3 Client meets low- income criteria at intake.
Element 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.
Element 5 Client is visited one to one, one Nurse Home Visitor to one first-time
mother/ family.
Element 6 Client is visited in her home.
Element 7 Client is visited throughout her pregnancy and the first two years of her
child's life in accordance with the current Nurse-Family Partnership Guidelines.
Element 8 Nurse Home Visitors and Nursing Supervisors are registered professional
nurses with a minimum of a Baccalaureate degree in nursing.
Element 9 Nurse Home Visitors and Nursing Supervisors complete educational
sessions required by NFP NSO and deliver the intervention with fidelity to the NFP
Model.
Element Io Nurse Home Visitors, using professional knowledge, judgment and skill,
apply the Nurse-Family Partnership Visit-to-Visit Guidelines individualizing them to the
strengths and challenges of each family and apportioning time across defined program
domains.
Element 11 Nurse Home Visitors apply the theoretical frameworks that underpin the
program, emphasizing Self-Efficacy, Human Ecology and Attachment theories, through
current clinical methods
Element 12 A full time Nurse Home Visitor carries a case load of no more than 25
active clients.
Element 13 A full-time Nursing Supervisor provides supervision to no more than 8
individual Nurse Home Visitors
Element 14 Nursing Supervisors provide Nurse Home Visitors clinical supervision
with reflection, demonstrate integration of the theories, and facilitate professional
development essential to the Nurse Home Visitor role through specific supervisory
JeffersonCO—WkNFPAgrmt_Exp2Ol6O630_FinaI (2).docx
activities including 1:1 clinical supervision, case conferences, team meetings and field
supervision.
Element 15 Nurse Home Visitor and Supervisors collect data as specified by the NFP
N and use NFP Reports to guide their practice, assess and guide program
implementation, inform clinical supervision, enhance program quality, and demonstrate
program fidelity.
Element 16 purse - Family Partnership Implementing Agency is located in and
operated by an organization known in the community for being a successful provider of
prevention services to low-income families.
Element 17 Nurse-Family Partnership Implementing Agency convenes a long-term
Community Advisory Board that meets at least quarterly to promote a community
support system to the program and to promote program quality and sustainability.
Element 18 Adequate support and structure shall be in place to support Nurse Home
Visitors and Nursing Supervisors to implement the program and to assure that data is
accurately entered into the data base in a timely manner.
JeffersonCo—WkNFPAgrmt—Exp20l6O630—FinaI (2).docx
EXHIBIT B. IVURSI - FAIUIii_Y PARTNERSHIP SUPPORT FOR AN AGENCY'
To help Agency implement the Program with Fidelity to the Model, NFP provides the
following support to Agency:
l NFP provides support to help Agency prepare to implement the Program including:
A. Materials to help Agency:.
I . Maintain Agency's work space;
2. Maintain telecommunications and computer capabilities;
3. Recruit, hire, and retain Program Supervisors, Nurse Home Visitors, and
administrative support staff;
4. Maintain and improve a network of sources who may refer low- income, first -
time mothers to Agency;
5. Facilitate enrollment of Clients,;
5. Maintain and improve a network of social services that can provide support
to Agency's Clients;
', Work with media;
8. inform the community and 'build support for Agency, the Program,. and
Program Benefits;
g. Establish and maintain strong, stable, and sustainable funding for Agency
operations.
B. An ETO users' manual, which provides instructions describing what data must be
collected for ETO by Agency staff, how that data must be entered into ETCH, and
how reports can be obtained. NFP may modify the ETC users' manual from time
to time and will provide Agency with updated versions on a timely basis.
C. Access to an Internet -based discussion forum with other entities that are
implementing the Program.
®, A visit to Agency by a member of NFP staff to offer direct consultation on
Program implementation.
ll, NFP provides ongoing support to Agency via telephone and email during Program
implementation and operation, including;
A. Consultation with respect to topics such as human resources, developing
community support, keeping interested constituencies informed about progress
and results, planning and implementing expansion, and sustaining and
increasing funding;
E, Clinical consultation for Program Supervisors and Nurse Home Visitors;
C. Consultation regarding data collection„ entry, management, and interpretation.
C. On-site consultation as is mutually deemed necessary and appropriate.
III. NFP provides a description of education programs, bath required and optional, and a
schedule of upcoming education events and locations. NFP may modify the specific
names, descriptions, and content of education programs, as well as their schedule
and locations from time to time and will inform Agency of such modifications on a
timely basis.
IV. NFP provides education to Program Supervisors and Nurse Home Visitors at dates
and locations to be determined by NFP. Education will cover the following topics;
A. The Program, Program Benefits, and Model Elements;
S. Use of ETO, including data collection, entry, management„ and interpretation;
JeffersonCO WA_NFPAgrmt_Ex'p2Ol6O630 —Fina9 (2),d u
C. implementation of the Program using the NFP Visit-to-Visit Guidelines and
associated tools and materials;
D. Knowledge and skills needed by the NFP Program Supervisor-, and
E. Other aspects of the Program that NFP believes are warranted for successful
Program implementation by the staff at Agency.
V, NFP provides Visit-to-Visit Guidelines and other materials to help Program
Supervisors and Nurse Home Visitors implement the Program with Fidelity to the
Model Elements. NFP may modify the Visit-to-Visit Guidelines from time to time and
will provide Agency with updated versions on a timely basis.
Vt. NFP provides support for Agency's use of ETO, including:
A. Monitoring the Agency's data collection and entry activity and quality and
providing feedback to Agency as appropriate-,
S. Maintaining and supporting ETO software;
C. Upgrading ETO software when deemed necessary by NFP; and
D, Technical assistance via telephone or e-mail to support Agency's use of ETO.
vii, NFP provides implementation reports and evaluation reports at such times as NFP
deems commercially reasonable and necessary to meet the needs of Agency and
entities to which Agency may be obligated to provide such information, Subject to
applicable federal and state laws, if any, such reports cover:
A. Agency activity, Reports designed primarily for Program Supervisors and Nurse
Home Visitors to help them manage Nurse Home Visitor activity.
B. Quality improvement. Reports aimed to help Agency improve Fidelity to the
Model including reports designed (i) to assist Program Supervisors and Nurse
Home Visitors identify and prioritize actions for improving Program outcomes,
and (ii) to help NFP staff assess how Agencies are performing with respect to
Fidelity to the Model.
c. Program outcomes, Reports designed to help Program Supervisors and funding
decision makers assess the effectiveness of the Program as applied to Agency's
particular circumstances.
D. These reports are available on a pre-defined schedule or from the ETO Website
on demand. NFP may modify the Program Reports from time to time.
Vill. NFP will provide art work and color and usage guidelines to help Agency develop
and produce communications materials that properly use the NFP trademark, logo,
tag lines, and other copyrighted or otherwise protected language, images, and
materials controlled by NFP.
IX. From time to time, NFP may engage either internal or external auditors to evaluate
the performance of the Agency. Agency will cooperate fully with any quality audit
that is undertaken by or on behalf of NFP.
jeffersonCo—WA—NFPAgrmLExp20l6O630_Fina' (2).d0CX
EXHIBI ES
NFP fees for services provided under this Agreement will be as follows, subject to change in
accordance with Section IV D:
initial NFP Education Fee (Invoiced u on com Nation
of the face-to-face session
Price Effective Date End Date
Unit Price
Unit of Measure
711/2013 6/30/2014
$4,069.00
One time per NHV or Supervisor
7/1/2014 6/3012015
$4,06
7/1/2015 6130/2016
$4,272.00
Su Orvisc" Education Fee (invoiced ugon completion f the first face -to -face session)
initial NFP Pro ram
End Date ..
Unit Price Unit of Measure
Price Effective Date
14
$734.00 One time per Supervisor
71112013
71112014 613012015
$734.00
711/2015 6130/2016
$771.00
Administrator Education Fee (Invoked upon completion of the first face-to-face session)
FP A enc
Price Effective Date End Date
Unit Price Unit of Measure
71112013 613012014
$480-00 One time per Administrator
71112014 6/3012015
$480.00
71112015 613012016
$504.00
NFP Educational Materials Fee (invoiced won comp_Ietion of the face-t o-face NHV Education session )
initial
Price Effective Date End Date
Unit Price Unit of Measure
$517.00 One time per NHV Trainee
71112013 613012014
7/112014 613012015 $517.00
71112015 613012016 $543,00
Annual Pro ram Su port Fee (Invoiced annually
on the Price Effective Date
Price Effective Date End Date Unit Pace Unit of Measure
Per Program Supervisor Position
71112013 per Year
7/1/2014
71112015 $3,699-00 1
Annual Nurse Consultation . Fee for Each First Program Supervisor at a Location
(invoiced annually on the Price Effective Date)
Price 'Effective Dale End Date,
Unit Price Unit of Measure
7/1/2013 6130/2014 $4 224.00 Per Program Supervisor Position
71112014 613012015 $4,224.00 per Year
71112015 6130/2016 $4,436,00
Nurse Consultation Fee for Each Additional Program Supervisor at a Location
Annual
(invoiced annually on the Price Effective Date)
Price Effective Date End Date
Unit Price Unit of Measure
711/2013 6/3012014 $5,066.00 Per Program Supervisor Position
711/2014 613012015 $5,068-00 per Year
711015 6130/2016 $5,321.00 '
Pro ram Su ervisor Ex ansion or Replacement Fee (Invoiced at the time of hire)
Price Effective Date End Date
'unit Price Unit of Measure
71112013 6/30/2014 764 00 5ne time per Expansion or Replace—rr
W$2,9O2,00
71112014 6/3W $21764M Program Supervisor
per Year
M/2015
jeffersonCo–WkNFPAgrmLExp2016o630–FinaI (2).docx
EXHIBIT Nan h 11PrAA BUSINEss As OCIATE ADDENDUM
The U.5 Department of Health and Human ,Services has issued final regulations,
pursuant to the Health Insurance Portability and Accountability Act of 1996
("HIPAA"), governing the privacy of individually identifiable health information. See
45 CFR Parka 160 and 164 (the "HIPAA Privacy Rule "), The Agency, as a `Covered
Entity " as defined by HIPAA, its a provider of heath care, a health plan, or otherwise
has possession, custody or control of health care information or records..
"Protected health information" ( "PHI'") means individually identifiable health
information including all information, data, documentation and records, including but
not limited to demographic, medical, and financial information that relates to the 'past,
present, or future physical or mental health or condition on an individual; the
provision of health care to an individual or payment for health care provided to an
individual and that identifies the individual or which Agency believes could be used
to identify the individual.
A. "Electronic protected health information" means PHI that is transmitted by
electronic media or maintained in electronic media.
B. "Security incident" means the attempted or successful unauthorized access, use,
disclosure, modification„ or destruction of information or interference with system
operations in an information system.
III. NF'P is considered a Business Associate of Agency, as NFP either; (A) performs
certain functions on 'behalf of or for Agency that may involve the use or disclosure of
protected individually identifiable health information by Agency to NFP, or the
creation or receipt of PHI by NFP on behalf of Agency; or (B) provides legal,
actuarial, accounting, consulting, data aggregation, management, administrative,
accreditation, financial or social services for Agency involving the disclosure of PHI,
IV. NFP agrees that all PHI obtained as a result of this Agreement shall be kept
confidential by NFP, its agents, employees, successors and assigns as required by
HIPAA law and regulations and by this Agreement and addendum.
V. NFP agrees to use or disclose PHI solely (A) for meeting its obligations under this
,Agreement, or (B) as required by law, rule or regulation or as otherwise permitted
under this Agreement of the HIPAA Privacy Rule.
Vl. The parties acknowledge that data that may be (but is not with certainty) PHI is
collected during the term of this Agreement for NFP "s reporting and evaluation of (a)
Agency's implementation of the Program, (b) comparison of Agency's
implementation of the Program with implementation by other entities, and (c) regional
and national patterns and trends in Program implementation. Returning this data is
not feasible. Therefore, NFP shall extend the protections of this Agreement to such
data and/or PHI and limit further uses and disclosures of such data and /or PHI to
those set out in this agreement for so long as NFP maintains such data and /or PHI.
If it becomes necessary for NFP to use the data and /or PHI in any manner other than
what is contemplated in this Agreement, NFP agrees to consult with and obtain the
permission of the Agency.
VII. In the course of providing the services to Agency under the terms of this agreement,
NFP will be enabling the Prevention Research Center for Family and Child Health
(`°PRG')„ an organization which is park of the University of Colorado at Denver and
Health Sciences Center, to access data that may be PHI for the purposes of
research, analysis, and reporting. NFP will ensure that PRC and its employees and
NFP °s agents, employees, subcontractors or others to whom it provides PHI received
e ferson o—WA_N PAgrmt_ xp20l6o6 O_F'inaI (2).doex
by or created by NFP on behalf of Agency agree to the same restrictions and
conditions that apply to NFP with respect to such information. NFP also agrees to
take all reasonable steps to ensure that its employees', agents' or subcontractors'
actions or omissions do not cause NFP to breach the terms of this Addendum. NFP
will use all appropriate safeguards to prevent the use or disclosure of PHI other than
pursuant to the terms and conditions of this Agreement and Addendum.
Vlll. NFP shall, within three () days of becoming aware of any use or disclosure of
PHI, other than as permitted by this contract and Addendum, report such disclosure
in writing to Agency.
IX. NFP shall make available such information in its possession which is required for
Agency to provide an accounting of disclosures in accordance with 45 CFR 1164.52&
In the event that a request for accounting is made directly to NFP, NFP shall forward
such request to Agency within two (2) days of such receipt. NFP shall implement an
appropriate record keeping process to enable it to comply with the requirements of
this provision. NFP shall maintain data on all disclosures of PHI for which accounting
is required by 45 CFR 164.528 for at least six (6) years after the date of the last such
disclosure.
X. NFP shall make PHI available to Agency upon request in accordance with 45 CFR
164,524.
Xl. NFP shall male PHI available to Agency upon request for amendment and shall
incorporate any amendments to PHI in accordance with 45 CFR 164.526.
X11. NFP shall make its internal practices, books, and records relating to the use and
disclosure of PHI received from or created or received by NFP on behalf of Agency
available to the Secretary of the US. DHHS for purposes of determining Agency's
compliance with the HIPAA Privacy Rule.
ill. Compliance with Security Regulations: In addition to the other provisions of this
Addendum, if NFP creates„ receives, maintains, or transmits electronic PHI on
Agency's behalf, NFP shall.
A. implement administrative, physical, and technical safeguards that reasonably
and appropriately protect the confidentiality, integrity, and availability of the
electronic protected health information that it creates, receives, maintains, or
transmits on behalf of Agency;
B3 Ensure that any agent, including a subcontractor, to whom it provides such
information agrees to implement reasonable and appropriate safeguards to
protect it; and
C. Report to Agency any security incident of which it becomes aware..
XIV. NFP agrees to indemnify and hold Agency harmless from and against all liability
and co=sts, including attorneys' fees, created by a breach of this Addendum by NFP,
its agents„ employees or subcontractors„ without regard to any limitation or exclusion
of damages provision otherwise set forth in the Agreement.
XV,Notwithstanding any other provision of the Agreement, Agency shall have the right to
terminate the Agreement immediately if Agency determines that NFP has violated
any material term of this Exhibit D.
Jefferson ca—" VkNFPAgrmt- xp 0l6O630_FinaI (2).docx
NSIBILITIES
To ensure that the Nurse-Family Partnership Program is implemented with Fidelity to
the Model, Agency will undertake the following actions during initial implementation
and ongoing operation:
1. Agency will:
A. Maintain an appropriate work space for staff who are to implement the
Program',
B, Maintain appropriate telecommunications and computer capabilities for
staff;
C Recruit, hire, and retain Program Supervisors, Nurse Home Visitors, and
administrative support staff"
D. Maintain and improve a network of referral sources who may refer low-
income, first-time mothers to Agency;
E. Enroll clients that meet the criteria specified in the Model Elements.
F, Maintain and improve a network of social services that can provide
support to Agency's Clients;
G, Work with media to ensure timely and accurate communication to the
public about the Program and its implementation by Agency;
H, Inform the community and build support for Agency, the Program, and
Program Benefits;
I. Establish and maintain strong, s table, and sustainable funding for Agency
operations.
J. Utilize NFP's Internet-based discussion forum to share learning with other
entities that are implementing the Program.
11. Agency will keep NFP informed of implementation issues that arise.
III. Agency will ensure that all Program Supervisors, nurses, and administrative staff
attend, participate in, and/or complete education programs required by NFP, do so
on a timely basis, and, upon completion, demonstrate a level of competence deemed
satisfactory by NFP,
IV. Agency will ensure that no Nurse Home Visitor is assigned a case load or makes
a Client visit (except in the company of an NFP-educated Nurse Home Visitor) until
after she/he has completed education on the Program, Program Benefits, Model
Elements, use of the ETC, and implementation of the Program for mothers who are
pregnant.
V. Agency will implement the Program in accordance with Visit-to-Visit Guidelines
including, Nurse Home
X Ensure enrollment of 23 to 25 first-time mothers per full -time
Visitor within nine months of beginning implementation and make best efforts to
maintain that level of enrollment on an ongoing basis;
& Ensure that each full-time Nurse Home Visitor carries a caseload of not
more than 25 active families;
C, Maintain the established visit schedule; and
D, Ensure that the essential Program content as described in the Visit-to-
Visit Guidelines is covered with Clients by Nurse Home Visitors.
JeffersonCo-W/+ _NFPAgrmLExp20l6O630_FinaI (2).docx
VI, Agency will ensure the availability of appropriate, fully functioning computer
systems and software at Agency for use of ETO and for communication with NFP by
email.
V11 Agency will ensure that Program Supervisors and Nurse Home Visitors (a) collect
required data on client visits and enter it in ETO completely and accurately within
one week of each client visit and (b) enter any other data for ETO completely and
accurately on or before the last day of each calendar month, taking all appropriate
steps to maintain client confidentiality and obtain any necessary written permissions
or agreements for data analysis or disclosure of protected health information, in
accordance with HIPAA (Health Insurance Portability and Accountability Act of 1996)
regulations, including, but not limited to, authorizations, data use agreements,
business associate agreements, as necessary. Failure of Agency to comply with any
applicable provision of HIPAA will constitute a breach of this Agreement.
VIII. Agency will ensure that Program Supervisors:
X Aim to develop a supportive relationship with the Nurse Home Visitors
she/he supervises;
B. Meet one-on-one with each Nurse Home Visitor at least weekly to provide
clinical supervision using reflection, preferably in person but by telephone where
travel constraints limit nurse or Program Supervisor mobility;
C. Run activity reports and quality improvement reports from the ETO
Website on a timely basis (typically monthly); use such reports to assess areas
where systems, organizational, or operational changes are needed in order to
enhance the overall quality of program operations; and develop and implement action
plans based on such assessments.
IX Agency will develop a Community Advisory Board with diverse representation
(for example, health, mental health, education, criminal justice, youth, business,
social services, faith-based leaders, other prominent community organization
leaders) to ensure broad-based community support for Agency's implementation of
the Program.
X. NFP will periodically assess the extent to which Agency is implementing the
Program with Fidelity to the Model. When such assessment indicates, opportunities for
Agency to improve its results by strengthening Fidelity to the Model, NFP staff will meet
with Agency supervision and mutually develop a plan to do so
Jeffersonco__WkNFPAgrmt_ Exp20l6O630—FinaI (2),docx