HomeMy WebLinkAbout081015_ca04615 Sheridan Street
Port Townsend, WA 98368
www. JeffersonCountyPublicHealth.org
Consent Agenda
July 23, 2015
JEFFERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
AGENDA REQUEST
DATE:
SUBJECT: Agenda Item — Washington Early Learning Fund, d /b /a Thrive
Washington for Home Visiting Services; July 1, 2015 — June
30, 2016; $175,000
STATEMENT OF ISSUE:
Jefferson County Public Health is requesting Board approval for Thrive Washington funding
of Home Visiting Services; July 1, 2015 — June 30, 2016; $175,000
ANALYSIS I STRATEGIC GOALS:
This agreement funds the visiting nurse services Jefferson County Public Health has
provided, based on efficacy studies conducted by Nurse Family Partnership (NFP), and in
keeping with NFP model requirements, to support families in an effort to alleviate the effects
of poverty, single parenthood, parental unemployment or underemployment, parental
disability, education attainment, and family engagement in child welfare on child
development. This is the fourth year JCPH has participated in the Thrive Washington Home
Visiting Services grant. The grant allows JCPH community nursing staff to make home visits,
and supports Kitsap County, via subcontracting.
FISCAL IMPACT:
$87,500 of these funds is available for Jefferson County to continue this partnership and will
allow JCPH to serve additional families in 2015 -16. 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.
RECOMMENDATION:
JCPH management requests approval of the Washington Early Learning Fund, d /b /a Thrive
Washington for Home Visiting Services; July 1, 2015 — June 30, 2016
REVS W BY: ,,-
e
"Morley, ma unt ,Adm ni t for Date
Community Health Environmental Health
Developmental Disabilities Water Quality
360- 385 -9400 360- 385 -9444
360- 385 -9401 (f) Always working for a safer and healthier community (f) 360- 379 -4487
CA
INDEPENDENT CONTRACTOR AGREEMENT
Washington Early Learning Fund, d/b/a Thrive Washington ("Thrive") and Jefferson County
Public Health ("Contractor") hereby enter into this Agreement as of July 1, 2015 (the "Effective
Date").
Maximum Contract Total: $175,000
Contract ID:
Contract Term:
Tax ID Number:
DUNS#:
Project Lead:
Purpose:
347
July 1, 2015 to June 30, 2016
133148295
184826790
Ms. Yuko Umeda
Home Visiting Services Account
1. Services. Contractor shall perform all services listed in the approved proposal and budget (referred
to herein as the "Project"), and for which excerpts (Implementation Plan and Budget) have been
incorporated as Seti tee A�
2. Payment. Thrive will reimburse Contractor for actual expenditures incurred each month,
according to the terms provided in - Schedule B, provided that Contractor performs the services.
Monthly expenditures will be reported Using the online reporting system. Payment is based on the
assumption that state and private funds are available to Thrive for disbursement to the Contractor
and have been expended and Project requirements met, or earlier in the event of non-compliance.
In the event that state funds are not available to Thrive, Thrive reserves the right to amend the
payment terms and the amount of the Maximum Contract Total. The term of this Agreement
("Term") begins on the Effective Date, and the Contractor agrees to not incur any expenses on the
Project using Thrive funding prior to the Effective Date. The Term end date is June 30, 2016 or
earlier in the event of non-compliance.
3. Payment Information. Conti-actor agrees to provide Thrive with all information necessary to
correctly issue such payments, including but not limited to bank name, routing I'lUrnber, aCCOUnt
number, and account. type. If (".7ontractor fails to provide such information in response to Thrive's
written request, then Thrive may withhold payments to Contractor until Contractor provides such
information.
4. Independent Contractor. In executing the Project, Contractor will act as an independent
contractor and not as an employee or agent of Thrive. This Agreement does not create an agency,
partnership, joint venture, franchise, or employment relationship between the parties. Contractor
has no authority to obligate Thrive. Thrive will not be liable for any of Contractor's expenses,
except as expressly stated in Schedule B. Thrive will not make deductions from any amounts
payable to Contractor for taxes. Contractor will be responsible for and will pay all taxes related to
the receipt of payments from Thrive.
1. Budget. Contractor further agrees that funds provided under this Agreement will be expended as
specifically itemized line by line in the Budget provided in Schedule A, and that transfers within
expense categories of the budget in excess of 10% of the award amount will not be made unless
approved by Thrive.
2. Reporting and Other Contract Requirements. Contractor agrees to submit Project and expense
reports, as well as perform all other requirements outlined in Schedule 13, on or before the dates
indicated therein. Thrive reserves the right to aggregate, disaggregate, analyze, reproduce, and/or
disseminate the data provided in Project Reports, Financial Activity Reports, or any other reports
submitted to Thrive with respect to the Project.
3. Data Collection and Evaluation. Thrive will conduct research and evaluation regarding the
projects funded through its home visiting program. Contractor agrees to participate in these
evaluation efforts and will fulfill the data collection and reporting requirements specified in
Schedule C, Data Collection and Evaluation Requirements. It will be the obligation of Thrive
representatives, Contractor, and other contractors to provide protections and assurances regarding
the confidentiality of data, samples of work (in any media format) and /or interview comments
provided by participants. Contractor also agrees to provide Thrive with the results of any
independent or self- directed evaluation or research undertaken with respect to the Project.
4. Subcontracting. Neither the Contractor nor any Subcontractor slaa,ll enter into subcontracts for
any of the wort( c:oraternplated under this Contract without obtaining prior written approval of
Thrive and DEL. All subcontracts must be in writing and in effect before Subcontractor services
begin. "Subcontractor" shall mean one who is not employed by the Contractor, but who is
performing all or part of those services under this Contract under a separate contract with the
Contractor. The terms "Subcontractor" and "Subcontractors" mean Subcontractors in any tier. In
no event shall the existence of the subcontract operate to release or reduce the liability of the
Contractor to Thrive and DEL for any breach in the performance of the Contractor's duties. The
Contractor is responsible to Thrive and DEL for the performance and monitoring of the
Subcontractor to ensure compliance with the terms, conditions, assurances, and certifications of
this Contract. This clause does not include contracts of employment between the Contractor and
personnel assigned to work under this Contract.
5. Recordkeeping. Contractor agrees to keep records in an easily read form sufficient to account for
all receipts and expenditures of contract funds. These records, as well as supporting
documentation, will be archived by Contractor's office for at least six (6) years after the end of the
Term. Contractor agrees to make such books, records, and supporting documentation available to
Thrive for inspection, if requested.
6. Confidentiality. Contractor 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. Contractor will not disclose confidential information to any third party, and will not use
any contidenthal information other than as nccess'ary for- Contractor to per form its obligations rrnder
this Aga Berne nt. l "his Section will not apply to information (a) that was known to Contractor before
Thrive's disclosure, or information that becomes publicly available through no fault of Contractor;
or (b) that Contractor can demonstrate was independently developed or received by Contractor
with no breach of any duty owed by a third party to Thrive independent of this Agreement.
Contractor may disclose confidential information as required by applicable law, legal process or
any order of a court or other governmental authority, but Contractor 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 applicab�le law.
7. Intellectual Property. Contractor 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 'S „glaedulc B. Contractor 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
2
shall contain an attribution of ownership.
8. Third -Party Rights. Contractor 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.
9. Monitoring and Non - Compliance. Throughout the course of the Term, Thrive will monitor
compliance with contract requirements (Schq ule 13), progress toward completion of the
Implementation Plan (SchedeaL_ ), and performance as outlined in Schedule -l). If Thrive (a)
encounters non - compliance with the terms outlined in the Agreement on the part of Contractor, or
(b) is not satisfied, in its sole discretion, with the quality of Contractor's work, Thrive will follow
to make a reasonable attempt to assist Contractor with technical assistance to resolve issues that
impede quality and compliance. In the event that compliance and /or quality issues are not resolved
through standard technical assistance, Contractor will be engaged in corrective action through
Implementation Improvement processes, as outlined in Schedule 1). Failure to meet the corrective
actions can result in Non - Compliance Courses of Action, as outlined in Schedules D.
10. Early Termination. Thrive may terminate the contract prior to the end of the Term if satisfactory
compliance is not reached after reasonable efforts have been made to restore compliance, as
outlined in ' Schedule 1 . In the case of such early termination, Contractor is required to immediately
repay the fll amount of any funds which Contractor did not spend as of the date of the notice of
termination, and Thrive shall have no further obligation to distribute any funds to Contractor.
11. 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 or
authority, or employment status of Project l ea�d(s) during the Tern, "Thrive requires that
Contractor notify Thrive staff within 30 days of the change.
12. Equipment Purchase, Maintenance, and Ownership. The Contractor agrees that any
del r:•eciarble equipment purchased, in whole: or in part,, with (: "ontract funds at a cost. of $1,000 per
item or niore, is upon its purchase, the property of Thrive and will be used only for the Project,
The Contractor agrees to establish and maintain transaiction doc.nments (purchase requisitions,
packing slips, invoices, receipts) and maintenance records of equipment purchased with Contract
funds. The Contractor shall be responsible for any loss or damage to property of Thrive
that results from the negligence of the Contractor or that results from the failure on the
part of the Contractor to maintain and administer that property in accordance with sound
management practices. In the case of Early Termination, the Contractor agrees that all such
equipment will be returned to Thrive unless otherwise agreed upon in writing by the Contractor
and Thrive.
13. 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.
14. Warranties, Contractor warrants that Contractor has full power and authority to enter into this
Agreement and has the right to perform the Project in accordance with this Agreenient.
15. Indemnification. As a condition to this Agreement, Contractor 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 Contractor or any of Contractor's
officers, agents, employees, subcontractors, contractors, or grantees with respect to this
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
9
or more of the terms hereof or otherwise give rise to any cause of action in any person or entity
not a party hereto.
16. Project Announcements, Public Reports and Use of Thrive and DEL Name and Logo. Thrive
and the DEL may include information on this Project in their periodic public reports and may make
information about this Project public at any time in their web pages and as part of press releases,
public reports, speeches, newsletters, and other public documents related to the Project. If
Contractor wishes to issue a press release or public report announcing this Agreement, or otherwise
use Thrive's, name or logo for purposes related to the Project, Contractor must contact Thrive's
Director of Grants and Program Innovation at least two weeks before the desired announcement
or publication date to obtain advanced approval. Contractor should also include the name and logo
of DEL in such media related to the Project and shall be responsible for obtaining advanced
approval from DEL. Thrive requests an opportunity to review and comment on subsequent press
releases or reports that are directly related to this Agreement and the Project.
17. Insurance. Contractor 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
Contractor, or agents, subcontractors, or grantees thereof, in carrying out the Project. Contractor
will obtain insurance coverage, which will be maintained in full force and effect throughout the
Term, as follows:
a. C'oairn rcial General liability lilsurance. 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. r utotnobile Lia!2 lam. In the event that Project - related activities involve the use of vehicles,
whether or not owned by Contractor, 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 if Contractor has no vehicles in its possession.
c. Maintenance of Insurance. Contractor will maintain the coverage described in Section 21 (a)
and (b) above through either (i) its p ',articipation in a self- insurance program established
pursuant to RCW 48.62, or (ii) an insurance cornpanyhes 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. Contractor 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. Contractor 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). Contractor will provide a renewal certificate as necessary to document
compliance with this Section 21 during the Term.
e. Industrial Insurance Cova�ra , e,,. To the extent required by law, Contractor will comply with the
provisions of Title 51 RCW, Industrial Insurance.
18. Compliance with Laws. Contractor 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.
19. Conflict of Interest. Notwithstanding any determination by the Executive Ethics Board or other
tribunal, Thrive may, in its sole discretion, by written notice to Contractor terminate this
Agreement if it is found after due notice and examination by Thrive that there is a violation of the
4
Ethics in Public Service Act, Chapter 42.52 RCW or any similar statute involving Contractor or
any activities performed pursuant to the Agreement.
20. Disputes. Except as otherwise provided in this 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
Contractor, 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 a judicial or
quasi-judicial tribunal. In the event of a lawsuit involving this Agreement, venue will be proper
only in King County, Washington. Contractor acknowledges the jurisdiction of the courts of the
State of Washington in this matter.
21. 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.
22. Amendment; Assignment. This Agreement may be amended or modified only by a mutual
written agreement of the parties. Neither this Agreement, nor any claim arising under this
Agreement, may be transferred or assigned by Thrive or Contractor without prior written consent
of the other party.
23. Unilateral Contract Changes. The Contractor acknowledges that Thrive may correct
typographic errors, numbering errors or other minor grammar or punctuation error without the
need to amend the agreement. The Contractor shall be notified when any correction take place
and will be provided with a corrected copy of the contract.
24. Entire Agreement; Governing Law; Severability. This 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 Agreement.
The provisions of this 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.
25. Review by Thrive. Contractor will permit representatives of Thrive to visit Contractor's premises
and review Contractor'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 expenditures
related to this Agreement.
26. 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 Washington is the Bill & Melinda Gates
Foundation's grantee and that you are a subgrantee of Washington Early Learning Fund for the
Project.
27. Notices. All legal notices under this Agreement shall be addressed as follows:
Thrive: Priti Mody -Pan, Director of Grants and Program Innovation
Thrive Washington
1111 Third Avenue, Suite 210
Seattle, WA 98101
5
Contractor:
Ms. Jean Baldwin, Director
Jefferson County Public Health
615 Sheridan Street
Port Townsend, WA 98368
This Agreement must be signed by an authorized officer of Contractor prior to any payment of funds
under this Agreement. Contractor may keep a copy of this Agreement as signed for its records.
WASHINGTON EARLY LEARNING FUND
d /b /a THRIVE WASHINGTON
By: Sam Whiting
Title: President and CEO
Date:
Jefferson County Public Health
By: Ms. Jean Baldwin
Title: Director
Date:
Approved form on
4 / ks
Je Mon cry.. Prow Ut a
David Alvarez, Clnlef IDP A
0
SCHEDULE A: IMPLEMENTATION PLAN AND BUDGET
1. IMPLEMENTATION PLAN
a. STAFFING
1) PLAN: Contractor agrees to hire and maintain staffing appropriate to serve the
proposed number of children and families, as outlined in the plan below:
2) MODEL FIDELITY: Contractor agrees that staff will be hired in fidelity to Nurse -
Family Partnership (NFP) model requirements as outlined below:
o Supervisors are registered nurses with a minimum of a Bachelor's degree
in nursing.
7
b. TRAINING
1) PLAN: Contractor agrees that all home visitor and supervisory staff are trained
according to model requirements.
2) MODEL FIDELITY: Contractor agrees that training will be completed in fidelity to
Nurse - Family Partnership (NFP) model requirements as outlined below:
a) Supervisors complete core educational requirements and additional supervisory
units on an annual basis.
b) Nurse Home Visitors complete core educational sessions required by NFP NSO.
c. RECRUITMENT AND ENROLLMENT
1) PLAN: Contractor agrees to:
a) Recruit families from the following prioritized communities:
i. Rural
ii. American Indian /Alaskan Native Non - Hispanic
b) Reach and maintain enrollment of 40 Proposed Families Served.
c) Ensure respective staff build and maintain the caseloads in accordance to model
requirements.
2) MODEL FIDELITY: Contractor agrees that enrollment will be maintained in fidelity to
Nurse - Family Partnership (NFP) model requirements as outlined below:
a) A full -time Nurse Home Visitor will carry a caseload of no more than 25 active
clients.
G0
d. HOME VISITS
1) PLAN: Contractor agrees to administer an average of
a) 2 home visits per month to enrolled families, for a total of between 480 and 960
annually.
2) MODEL FIDELITY: Contractor agrees that home visits will be administered in
fidelity to the Nurse - Family Partnership (NFP) model requirements as outlined
below:
a) Client is visited throughout her pregnancy and the first 2 years of her child's life.
e. SUPERVISION
1) PLAN: Contractor agrees that:
a) Supervisor will provide 3 hours of supervision to each home visitor per month.
b) Supervisor will administer 4 hours case conferencing, group supervision, or staff
meetings per month.
2) MODEL FIDELITY: Contractor agrees that supervision will be administered in
fidelity to the Nurse - Family Partnership (NFP) model requirements as outlined
below:
a) A full -time nurse supervisor provides supervision to no more than 8 individual
home visitors and one hour of reflective supervision per week per home visitor.
f. SCREENINGS
1) PLAN: Contractor agrees to administer
screenings with the frequency outlined
below:
Demographic: Intake
Wi thin 2 months ...... _ _....
hs of 1st Visit
m....._.
Maternal Health Assessment
_..
Within 2 months of Ist Visit ......
-
Use of Government & Community Services mmmmmmmmIT
months;
Within 2 months of: 1st Visit; 12 l8
months
_
Health Habits
� Within 2 months of- 4th visit; 36 weeks
runt
. _. _.__
Relationship Assessment: r e nacy
Within months of. 3rd-4th visit
Edinbourgh Postnatal Depression Scale or Patient
Within 2 months of. 36 wks preg; 1 -8 weeks post -
Health Questionnaire - 9
partum; months
12 mo ..,..,._ m..........
,...._ .. ,e. _. m .....
ant Birth
1 st postpartum visit
Within 2 months of __. _m
AS Q (ASQ 3 )
Within 2 months of, 4 months , 14 months
__.. ...
AS -SE
Q
Within 2 months of: 6 Months; 18 months
m....�.
Infant Health .. .n ........re
Ca �
nonths; 12 months; 18
months;
Within 1 month of. 6
months
_
Demographic: dates
_
Within 2 months of. 12 months; 18 months
p sessment: Infancy w_._. _
Relationship
2 months of: 12 months
Within _ .. _ µµµµw
2) MODEL FIDELITY: Contractor agrees that screenings will be administered in
fidelity to the Nurse - Family Partnership
(NFP) model requirements as outlined
below:
a) Screenings are completed within the
first 4 home visits.
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1.
BUDGET
Ole la
„
ORGANIZATION TYPE: NFP
07101/15-
Period: 06130/16
Award for
XYZ GRANT I
CONTRACT
Line Item
CommentslJustification
lines txlowl.ine Item
(List individual posit ions, types of oxpenses on lines beloweach line heading. Farmulas
ilem) aule naorvll.:ndy pa Xap wi.u.
F.
Personnel $71,590.91
. .._. . _.� _.
......
Salaries and Wages (Salaries and wag <:e fnr (individual
0- ildrLJAPUMD YI9Xg86'i9 M10 I�4011e, 111110
'..
NFP Nurse $40,796,31
�__......__._ _
.675 FTE x 60,438.98
�.�..
....,NFP S,..__...
upennsor $1890,32
1,
397,04
162 FTE x �3._��. „_
benefits $18,904.28
35 E18e _.
B.
Staff Recruitment, Training, Retention, etc. $0.00
C.
_. T ravel . $0.00
�..�. . � ...._
D.
E .] -Went Purchase, rent, maintenance $0.00
upplles (Postage, Println Publication, etc.
_ mm
f .
Occu anc Rent, utilities, etc.) $0.00
Contracted /Professional Services
G.
, suiting, Printin , etc. $87,500.00
Su contrac on ..
_p
_. .
Kitsa Count Health District $87,500.00
Y ........
1,0 FT' x $64,395,5 S1a88 °7r Benefits
H.
Evaluatlon Stipend ...
ti send - T!±Ve mandatory trainirreas $0.00
J.
s if included above $15,909.09
Indirect �... g ..........
_.... har es if not lnclum_mm m. -..
$15, 909, 09
K.
TOTAL $175,,000.00
11
SCHEDULE B: CONTRACTOR REQUIREMENTS AND PAYMENT SCHEDULE
1. Contractor Requirements
a. Individualized Assessments. Contractor 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 address the needs of families to
alleviate the effect on child development of factors such as:
• Poverty,
• Single parenthood,
• Parental unemployment or underemployment,
• Parental disability, or
• Parental lack of high school diploma
• Family engagement in child welfare
d. Capacity Assessment. Contractor will develop and submit an Annual Capacity
Assessment detailing community and organizational readiness and capacity for
implementation of home visiting services with fidelity (prior to the Term). Materials
provided in the Annual Capacity Assessment will be used to inform the Agreement.
e. Implementation Plan. Contractor will develop an Implementation Plan to guide
Project implementation (prior to the Term).
f. Annual Orientation Webinar. Contractor will participate in an annual orientation
webinar providing any updates on requirements associated with HVSA funding. The
webinar will be held on July 22, 2015 at 2:OOpm.
g. HVSA Trainings. Contractor will participate in two full -day trainings about HVSA
contractual and reporting requirements on the following dates:
h. HVSA Training 1: November 5, 2015
i. HVSA Training 2: April 14, 2016
j. Technical Assistance and Coaching Calls. Contractor will participate in monthly
one -hour Technical Assistance and coaching calls with Thrive Implementation Hub,
and if requested DEL staff for continuous quality improvement and quality assurance.
k. Site Visits. Contractor will cooperate with up to eight (8) scheduled site visits
conducted for contract compliance, reporting requirements, organizational due
diligence, HVSA evaluation, quality implementation technical assistance, and
continuous quality improvement.
1. Monthly Financial Line Item Reports. Contractor will submit monthly Financial
Line Item Reports online no later than the dates outlined below in the Payment
Schedule. Monthly Financial Line Item Reports will include actual expenditures
incurred for the month for each expense category in the proposed budget. Contractor
will be reimbursed for the expenses reported in the Monthly Financial Line Item Report
unless otherwise approved.
m. Quarterly Project Reports. Contractor will submit four (4) Project reports online no
later than the dates outlined below in the Payment Schedule. Reports shall include,
but are not limited to:
1. Participant Demographics
2. Implementation Progress
12
3. Implementation Reflection
4. Select Fidelity Measures
n. Monthly Enrollment Numbers. Contractor 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 children, female and male
parents /caregivers, and families enrolled for the previously completed month, the
number of new family enrollments during the month, the number of l"1111ilies that
completed the program; the number offianlilies that exited the program; and the number
of home visits administered.
o. One Month Transaction Detail (General Ledger Activity) Upon request, Contractor
will provide one month of General Ledger detail for Substantiation Testing.
p. Quarterly Financial Activity Reports. Contractor will submit four (4) Financial
Activity Reports online no later than the dates outlined below in the Payment Schedule.
Financial Activity Reports will include cumulative expenditures incurred for the
quarter compared to line items identified in the budget in Schedule A, section 2.
q. Model Standing. All contractors must retain affiliate in good standing status and/ or
active, ready to implement status, throughout the entire Term as described in Schedule
D. Contract Monitoring, Implcinentation linprovennenl Status, Non - Compliant Status,
and Non- Comphant Courses of Action. 1. Contract Monitoring. b. Model Standing for
Evidence -Based Home Visiting Projects.
r. Additional Requirements. Contractor will maintain and make available to Thrive, if
requested, documentation demonstrating accomplishments of the 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
• Attendance Sheets
• Service Logs
• Demographic Information of Participants
13
2. Payment and Reporting Schedule. The Payment Schedule below is bused on the
assumption that state and private revenue commitments to Thrive have been maintained,
and that such funds are available to Thrive for disbursement to the Contractor. 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 Contract Total.
Requirement
Due Date
Reporting Period
Payment Date
Amount
Technical Assistanc e
._.._.�. .
Monthly
..._ -�
NA
NA
NA
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July 22 2015
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SCHEDULE C: DATA COLLECTION AND EVALUATION REQUIREMENTS
1. Background and Overview: As a recipient of Home Visiting Services Account (FfVSA) funding
for the Project, the Contractor is required to collect data at the client and program level
required by home visiting program models. The Washington State Department of Early
Lcarniiig (DEL) li,,is established contractual agreements with Data beepers Technology, LIX
(VisitTracker) for Parents as Teachers (PAT) prograins, and Nurse -Fainily Partnership (N]"I')
National Service office, for N17P programs, to send the Contractors de-identified client and
program level PAT and N F P Project data directly to the Washington State
Department of Health (DOH), the DEL-specified Project Data Lead. DEL anticipates
entering into contractual agreement with Parents as Teachers National
Office for data associated with the Athena Penelope data system. DOH
s h a I I b e responsible for the receipt, secure storage and processing of the de-identified client
and program level data. D 0 H will provide de-identified data sets to DEL for quality assurance
and systems level Continuous Quality Improvement (CQI) purposes. Additionally, DOH will
provide Thrive program level summary /aggregated data reports to be used collaboratively
with national and state model leads in developing continumis quality improvement plans. No
individual, client-level data is released for this purpose. Project related data will be retained
for three years after completion of the Project for reporting purlioses only said then destroyed.
For Project auditing purposes and with data sharing agreements, DOH may share de- identified
client and prograrn level data with the Department of Early Learning.
2. Data Management: Contractor shall fully participate in timely and accurate data
collection, data entry, and daita maintenance effbrts related to entering client and program level
data required by home visiting program model.
3. Quality Assurance and Continuous Quality Improvement: The Contractor is required to
participate in CQI and Quality Assurance processes with Thrive, DEL and DOH:
a. For data quality assurance purposes, the Contractor shall maintain a data
sharing agreement with DOH.
b. The Contractor shall participate in ongoing training associated with the data management
offered by Thrive, DEL and/or DOH.
c. The Contractor shall work with staff from Thrive in establishing local CQI teams and
processes in support of CQI activities related to Project data.
4. Data Storage and Safe Guards: DOH shall ensure the client and program level data shall
be fully protected and compliant under HIJIAA regulzations. DO]] shall ensure data will be
maintained on secure servers and computers requiring password access for staff'whose duties
specifically require access to the data in the performance of their assigned duties. DO�H is
required to protect data from unauthorized physical and clectrotiie ac�c�css by adopting and
implementing effective protection measures and safeguards for hard disk drives, network
server disks, optical disks, paper documents, remote access to workstations, portable devices.
All data transfers with confidential information to/frorn DOH shall be made via Secure File
Transfer Protocol (SFTP) with login and hardened password security.
16
SCHEDULE D: CONTRACT MONITORING, IMPLEMENTATION IMPROVEMENT
STATUS, NON - COMPLIANT STATUS AND NON - COMPLIANT COURSES OF
ACTION.
1. Contract Monitoring. Thrive will monitor Contractor compliance with the general terms and
conditions of this contract, contract requirements, model standing, implementation progress,
enrollment performance and financial activity through review of the following, though not
limited to; Contractor monthly financial and enrollment reports, general ledger transaction
detail, quarterly financial and Implementation Plan progress reports, meetings with Contractor,
and site visit(s) with Contractor.
a. Compliance with Contract Requirements. The Contractor will ensure all Contractor
Requirements, as outlined in Schedule B, section 1, are met and submitted. Failure to
comply with, or submit timely and complete materials related to Contract Requirements
may result in withheld or delayed payments as described and indicated in the Schedule B,
Section 2. Payment Schedule.
b. Model Standing for Home Visiting Programs. All Contractors funded to implement a
home visiting must retain affiliate in good standing and /or active ready to implement status
throughout the Term of the contract. If the home visiting model developer withdraws or
revokes the Contractors affiliate in good standing and /or active ready to implement status,
prior to the contract Term end date, Thrive in coordination with DEL will conduct a joint
due diligence review of the loss of the Contractor's affiliate in good standing and /or active
ready to implement status, and then Thrive may, upon written notification to the
Contractor, terminate this Contract in whole or in part.
c. Implementation Progress. Thrive will review quarterly progress toward completion of
the Contractor's Implementation Plan and conduct quarterly budget monitoring activities
outlined in Schedule A. Implementation Plan and Budget, (Schedule A.). Plan and Model
Fidelity progress will be reviewed with respect to the following Schedule A. 1.
Implementation Plan categories: a. Staffing, b. Training, c. Recruitment and Enrollment,
d. llonic Visits,, e. Supervision, f. Screenings,, and financial activity related to 2. Budget.
Delay in meeting two or more Schedule A. 1. cal;egory areas and /or non - coral ,)fiance related
to financial activity during a quarter, will result in Contractor's transition to
Implementation Improvement Status
d. Enrollment Performance
1) Thrive will review Contractor enrollment performance for the following measure:
Percentage of Families Enrolled to Proposed Families Served. For purposes of this
section only: minimally, Percentage of Families enrollment is defined as an enrolled
family receiving at least one home visit, or other home visiting model developer
approved contact, by an approved home visitor, during a calendar month. This
definition does not supersede or relieve the Contractor from complying with specific
home visiting model developer guidelines, standards and /or fidelity measures set for
enrollment and /or Schedule A. 1. c. Recruitment and Enrollment, and d. Home Visits
categories Plan and /or Model fidelity areas specified in Schedule A.
2) The Contractor shall maintain at least 80% enrollment of the Proposed Families Served
in Schedule A. 1. c. Recruitment and Enrollment, during the term of the contract.
Enrollment numbers will be reviewed on a monthly basis.
17
a) If the Contractor's enrollment of Proposed Families Served in A. 1. c. Recruitment
and Enrollment, is between 70 % -79 %, for two or more consecutive months, the
Contractor will receive written notification of their low enrollment status and a
follow -up call to discuss barriers and strategies for increasing enrollment.
Contractors that maintain an enrollment of less than 79% of Proposed Families
Served for an additional two months after receiving written notification of their low
enrollment status, and follow -up call, will be transitioned to Implementation
Improvement Status for additional contract monitoring focused on supporting
improvement in Contractors enrollment.
b) If the Contractor's enrollment of Proposed Families Served in A. 1. c. Recruitment
and Enrollment, is below 70 %, for two or more consecutive months, the Contractor
will be transitioned to Implementation Improvement Status for additional contract
monitoring focused on supporting improvement in Contractors enrollment.
2. Implementation Improvement Status. Contractors transitioned to Implementation
Improvement Status are required to participate in the steps outlined in a. -c. below within 30
days of written notification by Thrive, or within an extended, alternate timeline approved by
Thrive:
a. Completion of Self- Assessment: Contractor will complete a Self - Assessment provided by
Thrive which may address, though is not limited to the following: compliance with contract
requirements, model fidelity, implementation progress, financial activity, and /or
enrollment performance in need of improvement.
b. Participation in Implementation Improvement Meeting: Contractor will participate in
an Implementation Improvement meeting with Thrive staff. The purpose of the meeting is
discuss the Self - Assessment; gather information and feedback from the Contractor; share
and review Thrive data; other available program data; and other information related to areas
in need of improvement which may be used to inform the development of an
Implementation Improvement Plan. The Contractor shall participate in additional meetings
in collaboration with Thrive to develop the Contractors Implementation Improvement Plan.
c. Development of an Implementation Improvement Plain: Thrive shall issue a written
Implementation Impr°ovement Plan (Plan) to the Contractor within 30 days of the last
Implementation Improvement Meeting. The Plan shall:
1) cite and describe the Contractor's specific area(s) in need of improvement, including,
though not limited to: compliance with contract requirements, model fidelity,
implementation progress, financial activity, and /or enrollment perfornivince in aced of
improvement. For the specified area(s) in need of irnprovcment, the Plan shall provide
metrics or benchmarks to serve as indicators of satisfactory improvement.
2) identify corrective action items and /or steps the Contractor shall comply with to address
cited areas in need of improvement. The plan shall also identify technical assistance
and /or other supports designated to be made available to the Contractor by Thrive to
assist the Contractor in achieving satisfactory improvement.
3) outline a timeline for the completion of the Implen'rentation Improvement Plan by the
Contractor.
d. If satisfactory improvement in the specific area(s) indicated in Plan is met by the
Contractor, within the timeline for coa�npletion of the Plan, the Contractor shall be
transitioned out of Implementation Improvement Status. Thrive will provide the
18
Contractor written notice of this transition once it has determined satisfactory improvement
has been met following the timeline for completion of the Plan.
e. If satisfactory irnprovernent in the specific area(s) indicated in Plan, within the timeline for
completion of the Plan, is not met by the Contractor, the Contractor shall be transitioned
out of Implementation Improvement Status to Non-Compliant Status. Thrive will provide
the Contractor written notice of this transition once it has determined satisfactory
improvement has not been met following the timeline for the completion of the Plan.
3. Non-Compliant Status: Contractors transitioned to Non-Compliant Status are required to
participate in the steps outlined in a. and b. below, within 14 days of written notification from
Thrive, or within an extended, alternate timeline, approved by Thrive:
a. The Contractor shall participate in a Non-Corrililiant Status meeting with Thrive staff to:
1) review the Contractor's Implenientation Improvement Plan and discuss progress that
was made and barriers that were encountered during the Plan's implementation,
including technical assistance and/or other supports designated to be made available to
the Contractor by Thrive.
2) identify and review Contractor's contractual requirements and areas of contractual non-
compliance
3) discuss Non-Compliant Courses of Action
b. After completing the Non-Compliant Status meeting, and any additional Non-Compliant
Status follow-up meetings with the Contractor to gather information or feedback, Thrive,
in coordination with DEL, and DSHS, will issue the Contractor a written Non-Compliant
Course(s) of Action within 14 days of the last Non-Compliant Status meeting date.
4. Non-Compliant Course(s) of Action. The written Non-Compliant Course(s) of Action issued
by Thrive shall include one or more of the four Non-Compliant Course(s) of action below:
a. Continuation of Implementation Improvement Plan. Thrive may propose to modify
and/or extend the Contractor's Implementation Improvement Plan for up to an additional
3 month period to meet specific area(s) cited in need of improvement.
b. Suspension of Payment: Thrive may suspend payment of all or part of Contract funds
until satisfactory contract compliance is met.
c. Reduction in Maximum Contract Total. Thrive may amend this contract to reduce the
Contractor's maximum contract total:
1) to reflect the amended Implementation Plan scope negotiated between Thrive and the
Contractor based on Contractor's cost per family served and other related I'actors, and,
2) if feasible and in conil)Hance with funding requirements, contractual requirements, and
approval processes, including Horne Visiting Model Developer program requirements.
d. Early Contract 1'erinination. Thrive may terminate this contract prior to the end of the
Term if satisi'actory contract compliance is not rnet by the Contractor in the implementation
of the Contractor's Implementation Improvement Plan, and/or if the Contractor is not able
to, or is not cooperative in development and implementation of the Implementation
Improvement Plan.
c. Notice. The written Non-Compliant Course(s) of Action shall become effective a minimum
of 30 days after the delivery of the written Non-Compliant Course(s) of Action to the
Contractor, except as identified in La., I.b. 4.b., 4.cii., and 4.d., of this schedule and as
provided for elsewhere in the Independent Contractor Agreement boilerplate and/or other
schedules attached to this contract.
19
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