HomeMy WebLinkAboutParents for Parents JEFFERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
AGENDA REQUEST
TO: Board of County Commissioners
Mark McCauley, County Administrator
FROM: Barbara Carr
Juvenile Court Administrator
DATE: August 22,2022
SUBJECT: Parents for Parents Grant
STATEMENT OF ISSUE:
Agreement for amendment of Parents for Parents, additional funding to Juvenile Court Services needs to be
executed.
ANALYSIS:
This agreement reflects our intent to accept additional, one-time funding for fiscal year July 1, 2022 through
June 30, 2023. These funds fully support P4P matters, to wit: additional hours for the Parents 4 Parents
Coordinator, Alicia Reynolds (clerk hire), for the period of time identified in the Amendment.
FISCAL IMPACT:
This revenue will be included in my budget for 2023, and a 4th quarter supplemental request in the final
quarter of 2022 will include those funds received and expended.
RECOMMENDATION:
That the Board approve the agreement and sign 3 originals. A fully executed original will be returned to the
BOCC office upon final execution of AOC.
REVIEW D BY:
i
S7LT(ZZ-_—
ark McCaule , unty Administrator Date
r
T►
CHILDREN'S
HOME SOCIETY
..J Wn:Fr..q ron
Parents for Parents(P4P)Agreement
AMENDMENT
Between
CHILDREN'S HOME SOCIETY OF WASHINGTON
And
JEFFERSON COUNTY JUVENILE AND FAMILY COURT
This Amendment ("Amendment 1), modifies the agreement between Children's Home Society of
Washington (CHSW)and Jefferson County Juvenile and Family Court concerning the expansion of the
Parents 4 Parents agreement entered into 7/1/2022 as follows:
1. Funding& Financial Agreement is changed to: Due to additional funding received we will pay
Contractor an additional$15,000 for a total of$43,000.00.This one-time, limited funding will be
from September 1st, 2022-June 30th, 2023.
2. No other changes. All other terms and provisions of the contract remain in full force and effect
through the end of the amended period of the agreement.
CHILDREN'S HOME SOCIETY OF WASHINGTON JEFFERSON COUNTY
FAMILY COURT
Dave Newell Signature Heidi Eisenhour
air, Board of County Commissioner
President/CEO
Approved as form only:
- August 11,2022
Date Philip C. Hunsucker
Chief Civil Deputy Prosecuting
Attorney
/2) )\17
AGREEMENT BETWEEN
CHILDREN'S HOME SOCIETY OF WASHINGTON
AND
JEFFERSON COUNTY JUVENILE COURT 2021-2023
This Agreement, made by and between Children's Home Society of Washington, hereinafter
referred to as CHSW, and Jefferson County Juvenile Court, hereinafter referred to as the
Contractor, governs the provision of work, the collection of data and payment of authorized
services rendered.
Contractor:
Jefferson County Juvenile Court
1820 Jefferson St.
Port Townsend, WA 98368
TERMS AND CONDITIONS
Exhibits Incorporated by Reference:
In addition to the rights and obligations of the parties set forth below in this Agreement,the rights
and obligations of the parties to this Agreement shall be subject to, and governed by, the
following attached exhibits:
Exhibit A: Statement of Work
Exhibit B: Budget
Exhibit C: Parents for Parents Program Description
Exhibit D: Parents for Parents Parent Ally Qualifications
Exhibit E: Parent Ally Program Coordinator Job Description
IT IS MUTUALLY AGREED THAT:
Section A. Statement of Work
The Contractor will provide Parents for Parents services, as outlined in the attached Statement
of Work, Exhibit A.
Section B. Period of Performance
The period of performance governing this Agreement will be July I, 2021, through June 30,
2023.
1
Section C. Budget
CHSW will pay the Contractor up to $28,000 for those services described in the Statement of
Work, Exhibit A and according to the Budget, attached as Exhibit B, through funding CHSW
has received from the Washington State Office of Public Defense. Administrative fees for this
contract should not exceed ten percent of the contracted budget.
CHSW will pay the Contractor up to an additional $2500 for start-up related expenses through a
contract CHSW has received funding from the Washington State Administrative Office of the
Courts. This funding is time-limited and the Contractor needs to invoice CHSW by September
30, 2021.
Section D. Current/Future Support
CHSW is funded through a contract from the Washington State Office of Public Defense. This
Agreement is subject to continuing funding from the Washington State Office of Public Defense.
In the event funding is withdrawn, reduced or limited in any way after the effective date of this
Agreement and prior to the normal completion, CHSW may unilaterally terminate this
Agreement or may reduce its scope and budget.
Section E. Reports/Invoices/Documentation
Invoices
The Contractor will submit quarterly invoices to CHSW no more frequently than monthly and at
least quarterly.
Invoices should be emailed to CHSW Accounts Payable—COAccountingchs-wa.org
Reports
Once the program has hosted their first Dependency 101 class, the Contractor will submit the
following to CHSW within 20 days following the end of each month:
• Parents for Parents monthly online data report, internet link provided by CHSW
Payment is conditional on meeting the requirements of the Statement of Work, Exhibit A and
receipt of completed monthly data report. Payment will be made thirty (30) days after receipt of
the invoice form.
The Contractor will provide CHSW with documentation of all services provided by the
Contractor related to this Agreement, upon request.
During the Agreement period and following its termination, the Contractor, and any
subcontractors resulting from this Agreement, shall follow accounting procedures and shall
maintain books, records, documents, and other evidence in the performance of this Agreement.
2
The Contractor will retain all books, records, documents, and other materials relevant to the
provision of services under this Agreement for a period of seven (7) years from the date of final
payment. Any person authorized by CHSW shall have full access to and the right to inspect
excerpts, audit or examine any of these records at all reasonable times for a period of seven (7)
years.
Section F. Audit Requirements
The Contractor is required to complete an annual independent audit that meets generally accepted
accounting standards and OMB Circular A-133, if applicable. A copy of the audit will be
available to CHSW, upon request.
Section G. Nondiscrimination/Confidentiality
The Contractor certifies that all goods to be furnished and/or services to be rendered within this
Agreement, including employment, will be provided to people without discrimination because
of a person's race, color, gender, religion, sexual orientation, disability, marital status, national
origin, age, veteran status or any other characteristic protected by law.
The Contractor will respect the rights of consumers at all times and ensure the confidentiality of
tl-J consumer information in accordance with all applicable confidentiality statutes, laws, and
regulations. All consumer records will be maintained in a secure, locked file.
Section H. Compliance with the Health Insurance Portability Accountability Act
Waived.
Section I. Contractor Status
In providing services under this Agreement, the Contractor is an independent agent, and neither
it nor its officers, agents or employees are employees of Children's Home Society of Washington
for any purposes and will not be held up as such. The Contractor will be responsible for all
federal and/or state tax, industrial insurance, and Social Security liability that may result from
the performance of and compensation for these services.
Section J. Criminal History
Waived
Section K. Licenses/Registrations/Accreditation
The Contractor will comply with all applicable local, state, and federal licensing, accreditation
and registration requirements and standards, necessary for the performance of this Agreement.
Section L. Subcontracting
3
The Contractor shall not enter into subcontracts for any of the work contemplated under this
Agreement without obtaining prior written approval of CHSW.
Section M. Insurance
By the date of execution of this Agreement, the Contractor shall procure and maintain for the
duration of the Agreement, insurance against claims for injuries to persons or damages to
property, which may arise from, or in connection with, the performance of this Agreement. The
Contractor shall pay the cost of such insurance. The Contractor shall provide a Certificate of
Insurance to CHSW or evidence of self-insurance, naming CHSW as additional insured.
Minimum limits of insurance shall be at least:
• General Liability: $1 Million combined single limit per occurrence by bodily injury, personal
injury, and property damage, and for those policies with aggregate limits, a $2 Million
aggregate limit.
• Professional Liability, Errors, and Omissions coverage: $3 Million
• Automobile Liability: If automobiles are used in the performance of this Agreement, a
minimum of$1 Million combined single limit per accident for bodily injury and property
damage is required.
• Workers' Compensation: Statutory requirements of the State of Washington.
• Employee Dishonesty Coverage in the amount of this Agreement.
Section N. Hold Harmless/Indemnification
Each party to this Agreement shall protect, defend, indemnify, and hold harmless the other party,
their officers, employees and agents from any and all costs, claims,judgments, and/or awards of
damages, arising out of or in any way resulting from the negligent acts or omissions of the
indemnifying party, its officers, employees, and/or agents. Each party agrees that its obligations
under this subparagraph extend to any claim, demand, and/or cause of action brought by, or on
behalf of, any of its employees or agents. For this purpose, each party by mutual negotiation,
hereby waives, as respects the other party only, any immunity that would otherwise be available
against such claims under the Industrial Insurance provisions of Title 51 RCW. In the event
either party incurs any judgment, award, and/or cost arising therefrom including attorney's fees
to enforce the provisions of this article, all such fees, expenses, and costs shall be recoverable
from the other party.
Section O. Federal Programs
Contractor represents and warrants that Contractor has not been excluded from federal programs.
Contractor will immediately notify CHSW if Contractor becomes excluded from any federal
program or is subject to proceedings that may lead to exclusion. Exclusions from any federal
program are a basis for immediate termination of this Agreement.
4
Section P. Governing Law
The Contractor is required to comply with all applicable local, state and federal laws and
regulations. Breach of this provision shall be grounds for termination of this Agreement.
This Agreement and the right and obligations of the parties shall be governed by the laws of the
State of Washington. The Contractor is required to comply with all applicable local, state and
federal laws and regulations. Breach of this provision shall be grounds for termination of this
Agreement. Venue shall be King County, Washington.
Section Q. Agreement Modifications
This Agreement contains all the terms and conditions agreed upon by the parties. No other
understanding,oral or otherwise, regarding the subject matter of this Agreement shall be deemed
to exist or to bind any of the parties hereto.
This Agreement shall be subject to the written approval of the President/CEO of CHSW and the
approved delegate of the Contractor. Only the President/CEO or his delegate shall have the
expressed, implied, or apparent authority to alter, amend, modify, or waive any clause or
condition of this Agreement. Changes are not effective or binding, unless made in writing and
signed by the President/CEO or his delegate and the approved delegate of the Contractor.
Section R. Notification of Significant Changes
The Contractor will notify CHSW in writing of changes in key personnel or problems, which
have significant impact on Contractor activities.
Section S. Severability
If any part, term, or provision of this Agreement is held by a court to be illegal, the validity of
the remaining portions shall not be affected, and the rights and obligations of the parties shall be
construed and enforced as if the Agreement did not contain the invalid portion. If it should appear
that any part, term, or provision conflicts with statutes, then that part, term, or provision shall be
deemed inoperative, and this Agreement shall be modified to such statutory provision.
Section T. Corrective Action
The Contractor is required to meet the terms and conditions of this Agreement. Should an
Agreement violation or a performance deficiency be identified by CHSW, the Contractor will
receive a written notice for corrective action unless CHSW determines termination is appropriate.
The Contractor must submit a corrective action plan within thirty (30) days from the written
notice from CHSW. In the case of a material breach, however, CHSW may require an immediate
corrective action plan and its implementation in lieu of termination.
5
CHSW will approve or disapprove the Contractor's corrective action plan in writing within
fourteen (14) days of receipt of the plan. If approved, the Contractor will be required to
implement the plan and ensure correction of the deficiency. If the Contractor does not correct the
deficiency, submit a corrective action plan within thirty (30) days, or CHSW deems the plan
unsatisfactory, CHSW will take the necessary action. Such action may include, but is not limited
to, reduction in Contractor payment or termination in whole or in part of the Agreement. All
corrective action correspondence shall be delivered by certified mail, return receipt requested.
Section U. Termination of Agreement
Either party may resolve to discontinue this Agreement with thirty (30) days written notification
to the other party.
CHSW will pay for all services rendered up to the time of notification of termination of this
Agreement, less prior interim payments, if any. Upon payment of such sums, CHSW shall be
discharged from all liability to the Contractor hereunder, and this Agreement shall be considered
terminated unless extended in writing by mutual agreement between the parties.
Section W. Addresses for Official Communication
Marlena Torres Barbara Carr
Chief Operating Officer Administrator
Children's Home Society of Washington Jefferson County Juvenile Court
P.O. Box 15190 1820 Jefferson St.
Seattle, WA 98115-0190 Port Townsend, WA 98368
In witness thereof, Children's Home Society of Washington and the Contractor have signed this
Agreement.
6
CHILDREN'S HOME SOCIETY CONT P OR
OF WASHINGTON
Mar ena Torres Bar Wra
Chief Operating Officer Administr tor /
741y A/ 1.5
Date Date
Kate Dean, Chair
Jefferson County BOCC
V772 /
Date
Philip C. iltinsucker
Civil Deputy
Jefferson County Prosecutor
August 18, 2021
Date
7
EXHIBIT A:
STATEMENT OF WORK
Parents for Parents Program
July 1, 2021, through June 30, 2023
The Contractor will:
1) Serve as the host of the Parents for Parents program (P4P), as summarized in Exhibit C;
2) Partner with local stakeholders and CHSW to ensure the Parents for Parents program is
consistent with program components listed on the Model Fidelity Checklist and the
program design in the Parents for Parents Start-Up Guide, provided by CHSW;
3) Partner with CHSW to prepare program site for implementation including host, stakeholder
and parent identification;
4) Attend and invite stakeholders and parents to an on-site program model orientation session;
D5) Identify and/or hire program supervisor;
6) Identify parents who will work with the program and hire one parent to serve as the
coordinator of the program (exhibit D and E);
7) Ensure the program's needs are met including office space, computer, supplies, etc.;
8) Provide for accessible meeting space and equipment for the Dependency 101 classes and
other Parents for Parents meetings;
9) Offer Dependency 101 classes and other Parents for Parents meetings to Jefferson County
dependency-involved parents- class materials and dependency information may be brought
to Jefferson County's parents at court or offered through a technology platform;
10)Provide travel and accommodation expenses for program staff including, at a minimum, the
P4P Coordinator and Supervisor to attend a two-day core program training in Port Angeles,
Washington or at a nearby program;
11)Ensure program data is collected. Share trends and analysis of program data to CHSW as
requested;
12)Schedule a site visit with CHSW staff to observe program and assess model fidelity
approximately one year from the start of the program;
8
13)Provide for the liability insurance of the P4P Coordinator and Parent Allies;
14)Work with CHSW to discuss any rural considerations needed in order to ensure quality
outreach of services/support to dependency-involved parents in Jefferson County; and
15)Support funding efforts by CHSW on behalf of the Parents for Parents program, in addition
to seeking additional funding streams, in order to support the ongoing needs of the program.
CHSW will:
1) Provide technical assistance in assessing and preparing program site readiness including host,
stakeholder and parent identification;
2) Provide on-site program orientation for stakeholders and parents;
3) Facilitate a two-day training in Port Angeles or at another nearby location for program staff
(Supervisor, P4P Coordinator and additional Parent Allies if applicable). This will include
core program training for staff and the opportunity to shadow an existing program and their
staff at a Dependency 101 class and at shelter care and dependency court hearings;
4) Provide on-site support and technical assistance at first Dependency 101 class;
5) Provide on-going technical assistance and consultation during program implementation;
6) Visit site to observe and assess if program meets the fidelity requirements;
7) Provide information and support to stakeholders in the seeking of funding for the program;
and
8) Provide leadership in seeking increased funding for the Parents for Parents program.
9
EXHIBIT B:
BUDGET
July 1, 2021 - June 30, 2023
Funds may be allocated as shown in the budget below, there may be up to 10% variation to
accommodate local program needs.
Parent Ally Compensation $18,000
(Including Parent Coordinator& Program support stipends)
Clinical Supervision $2,400
Program Expenses (supplies, food, meeting costs, etc.) $1,200
Administration (not to exceed 10%) $2,400
Carryforward Balance from Fiscal Year 19-21 $4,000
Total $28,000
July 1, 2021 —September 30,2021
Washington State Administrative Office of the Court Start-Up Funding $2500
Total Contract Funding $30,500
15
II
EXHIBIT C
PARENTS FOR PARENTS PROGRAM
Summarized Program Description
Parents for Parents is an early engagement, parent mentoring and education program that promotes
the safe and timely reunification of children with their parents, or an alternative permanency
outcome when reunification is not a viable goal and supports the preservation of families with in-
home dependency cases. The program serves families, who are in the dependency system within
Washington State, and services are initiated when a child has been removed from his or her home
by Child Protective Services. Parents receive information and support to navigate the dependency
system and, whenever possible,to safely reunify with their child(ren), as well as to understand and
provide their child(ren) with resources to promote their optimal development.
Services are provided by Parent Allies, who are parents who have successfully navigated the child
welfare system. Services include:
1) Outreach and support to parents at all dependency-related hearings, beginning with the
shelter care hearing;
2) Maintaining and distributing updated information about community resources and
services that can assist families in the dependency system;
3) A Dependency 101 class that educates parents about the dependency system they must
navigate in order to have their children returned, empowers them with tools and
resources they need to be successful with their case plan, and provides information that
helps them understand and support the needs of their children,
4) A curriculum-based Dependency 201 class that provides ongoing support to parents
throughout their dependency case. This includes building a support network, training
on life skills and accessing resources. (Note:Not all counties are operating Dependency
201 at this time)
5) Individual peer support to help parents involved with the child welfare system,
including telephone/electronic support.
Stakeholders meet regularly in Advisory Committee meetings to discuss the local program,trouble
shoot problems, identify ways to optimize its success within their local community, identify
resources to share with parents, etc.
15
EXHIBIT D
P4P PARENT ALLY QUALIFICATIONS
• Dependency case has been closed;
• Satisfactory background check clearance and no criminal infractions since the case has
been closed;
• Accepts responsibility for issues that brought their child(ren) into care
• Demonstrated continuing attention to positive and healthy life style (e.g., active in
recovery, mental health, strong social support, etc.);
• Mentally and emotionally stable;
• Time/capacity to meet the hours and needs of the program;
• Ability to maintain confidentiality;
• Ability to work independently and as a team player;
• Ability to respect cultural diversity;
• Motivated; able to follow directions, ask questions and learn assigned tasks;
• Effective oral and written communication skills; legible penmanship;
• Positive attitude;
• Ability to maintain good working relationships with courts, stakeholders and the
community;
• Respectful and considerate;
• Dependable;
• Solution-oriented versus problem-oriented;
• Noted willingness to help others succeed;
• Ability to maintain objectivity and professionalism;
• Ability to be detail orientated;
• Appropriate communication skills, and
• Able to accept supervision and coaching.
15
EXHIBIT E
PARENT ALLY PARENTS FOR PARENTS PROGRAM COORDINATOR
JOB DESCRIPTION
Summary Description — In collaboration with the P4P Program Supervisor, the Parent Ally P4P
Program Coordinator is responsible for the overall functioning of the Parents for Parents program.
S/he is the primary "public face" for Parent Allies in his/her respective community, ensures that
the Parents for Parents program reflects the high standards and values of Parent Ally work, and
ensures that the Parents for Parents program is coordinated with other Parent Ally work in the
community.
1) P4PP Staffing
• Collaborate with the P4P Program Supervisor to recruit, engage, train and monitor the
Parent Ally Program Supports.
• Collaborate with the P4P Program Supervisor in decisions and actions related to the
temporary or permanent termination of Parent Ally Program Supports, if and as needed.
• Create and maintain a system for recording and reporting on Parent Ally Program Supports'
training, services provided, and compensated hours worked. Track unpaid volunteer time
related to the Parents for Parents program.
• Create and maintain a system for accounting and distribution of stipends for Parent Ally
Program Supports and for payment for other program expenses.
• Collaborate with the P4P Program Supervisor to observe and assess the work of the Parent
Ally Program Supports. Provide additional coaching and support as needed.
• Participate in weekly supervision to discuss pertinent details regarding the program and to
process issues that surface in the course of their work that may interfere with their work
and/or personal well-being.
2) Advisory Committee
• Serve as leader and facilitator of the Advisory Committee.
• Work with Advisory Committee members to plan for and schedule presentations by
representatives of all systems at Dependency 101 classes.
• Collaborate with the P4P Program Supervisor to create the agenda for the meetings of the
P4P Advisory Committee.
• Send out meeting reminders to all Advisory Committee members in a timely manner.
• Work with Advisory Committee members to identify and troubleshoot issues that surface
in the implementation of Parents for Parents. Discuss work of the Parent Allies from the
perspective of the Advisory Committee members.
• Ensure that minutes are taken at each meeting and distributed in a timely manner. Maintain
a record of attendance and minutes from all meetings.
• Follow through on agreements made at Advisory Committee meetings.
15
3) Dependency Hearings
• Collaborate with court personnel to identify strategies for accessing the court docket in
order to identify and reach out to parents attending Shelter Care Hearings and subsequent
dependency hearings.
• Ensure that all Shelter Care Hearings and subsequent dependency hearings are covered by
the Parent Ally P4P Coordinator and/or other Parent Ally Program Supports.
• Ensure that accurate contact and demographic information is collected on all parents with
whom outreach is made.
• Invite all parents with whom outreach is made to attend a Dependency 101 class.
• Provide parents with written materials about resources that can assist them in their case.
• Provide for telephone follow up to parents who have signed up for the class, ideally once
a week prior to the class and then one day immediately prior to the class.
4) Dependency 101 Class
• Ensure that each Dependency 101 class is covered by a Parent Ally facilitator, a
representative from each system, and additional Parent Ally Program Supports, as needed.
• Update Dependency 101 curriculum, as needed.
• Ensure that all handouts for Dependency 101 classes are updated, developed and available
for each meeting. Ensure that folders and surveys are properly numbered.
• Maintain a system for ensuring that snacks and other required materials are available for
all Dependency 101 meetings.
• Work with Parent Ally Program Supports, court personnel and other system stakeholders
to recruit and sign people up for the Dependency 101 classes.
• Complete tracking sheets for each parent at the class,whose tracking sheet has not yet been
completed.
• Ensure all pre/post surveys are completed and collected.
5) Client data
• Create and maintain a database on all parents served, including:
• names and contact information;
■ demographic information;
• assistance needs, and
• records of contacts with parents, including telephone contacts, attendance at
Dependency 101 class, input from pre-and-post Dependency 101 and 201 surveys, and
all other P4P services received.
6) Resource Bank
• Maintain sufficient supply of printed information on resources to be accessed by families.
• Ensure that folders for Dependency 101 class are accurately completed and available in
sufficient supply for all classes.
7) Community
15
• Make/coordinate Parent Ally presentations at child welfare forums, conferences, trainings,
etc., as approved by P4P Supervisor and after ensuring main program components of this
contract are met.
• Coordinate Parents for Parents work with other Parent Ally work in the community,
when/if applicable, as approved by the P4P Supervisor and after ensuring other program
components of this contract are met.
8) Reunification Day Celebrations
• If all the core components of the program are met, program staff may participate in the
planning committee and event to strengthen the Parents for Parents program visibility,
recruitment efforts and continued stakeholder buy-in.
T,.
I
WASHINGTON COUNTIES RISK POOL
2558 R.W.Johnson Road SW.Suite 106
•z.
Tumwater.Washington 98512-6103
Created by Counties for Counties
August 2, 2021
Children's Home Society of WA
RE: Notice to Certificate of Membership Holder
Member County: Jefferson County
Effective Dates: October 1, 2020 —September 30, 2021
Dear Certificate Holder:
The Member County listed above and on the attached Certificate of Membership is a
member of the Washington Counties Risk Pool (WCRP), a group of Washington
counties that have come together under an interlocal agreement as permitted under
RCW 48.62 to group self-insure for liability coverage.
The WCRP and its participating members group purchase re-insurance and excess
liability insurance, and the self-insured retention of the WCRP is completely self-funded
by the membership. The WCRP is not an insurance company and therefore cannot
name other entities, organizations, or individuals as an "additional insured."
However, the WCRP and its reinsurers provide contractual coverage to its members and
will extend protection to those parties that the Member County has contractually agreed
to indemnify. Coverage is subject to all the terms, conditions, exclusions, definitions,
and limits of liability in the current WCRP Memorandum of Liability Coverage document.
We hope that this satisfies the requirement that Jefferson County name your
organization as an additional insured.
Sincerely,
P/d1G--
Derek C. Bryan, Executive Director
Washington Counties Risk Pool
Phone(3601 292-4500 • Fax (360)292-4501
Email: info@wcrp.wa.gov • Website: www.wcrp.info
+ 9
CERTIFICATE OF MEMBERSHIP IN THE WASHINGTON COUNTIES RISK POOL
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE
CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE JOINT SELF-INSURANCE
LIABILITY COVERAGE AFFORDED BY THE WASHINGTON COUNTIES RISK POOL
MEMBER COUNTY: Liability Coverage Afforded by the:
Jefferson County,Washington Washington Counties Risk Pool
Attn:Mark McCauley,County Admin&Risk Manager 2558 R W Johnson Rd SW,Suite 106
PO Box 1220 Tumwater,WA 98512-6103
Port Townsend,WA 98368
Jefferson County(the"County")is a member of the Washington Counties Risk Pool(the"Pool"),as authorized by RCW 48.62.031,
and the County is covered by the Pool's Joint Self-Insurance Liability Program. The Pool's Joint Self-Insurance Liability Program was
created by interlocal cooperative agreement amongst the Pool's member counties to share risks by`jointly,self-insuring"certain third-
party liabilities. The Pool is NOT an insurance company. Claims that are covered under a Memorandum of Liability Coverage
("MLC")from the Pool and were submitted under Chapter 4.96 RCW("Actions against political subdivisions, municipal and quasi-
municipal corporations")against the County,its employees,officers,volunteers and agents and/or actions in connection with or
incidental to the performance of an agreement/contract which the County and/or its officers,employees or volunteers are found to be
liable for will be paid by the Pool and/or the County.
MLC NUMBER: 20202021 RISKPOOL-JFCO
MLC EFFECTIVE DATE: October 1,2020
MLC EXPIRATION DATE: October 1,2021
LIMITS OF LIABLITY EACH OCCURRENCE
BI AND PD COMBINED: $10,000,000
TYPES OF LIABILITY
COVERAGE AFFORDED: General Liability
Including: Bodily Injury
Personal Injury
Property Damage
Errors and Omissions/Professional
Advertising Injury
Automobile Liability
DESCRIPTION OF OPERATIONS/LOCATION/A FHICLE CANCELLATION
SHOULD THE ABOVE DESCRIBED MLC BE CANCELLED
Agreement to provide Parents for Parents Services BEFORE THE EXPIRATION DATE THEREOF,THE ISSUER
WILL ENDEAVOR TO PROVIDE THIRTY(30)DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER,BUT FAILURE TO
MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION NOR
LIABILITY OF ANY KIND UPON THE ISSUER OR ITS AGENTS
During the MLC Period 10/1/20 - 10/1/21 OR REPRESENTATIVES.
CERTIFICATE HOLDER: ISSUE DATE:
August 2,2021
Children's Home Society of Washington
Claims Specialist