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Consent Agenda
Public Healt
JEFFERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
AGENDA REQUEST
TO: Board of County Commissioners
Mark Mc Cauley, County Administrator
FROM: Apple Martine, Public Health Director
Anna McEnery, DD & BH Coordinator
DATE:
SUBJECT: Agenda Item — School-to-Work — Direct Service, Program
Agreement with Department of Social and Health Services, the Division of
Vocational Rehabilitation; #DSHS-DVR-8500CC-63; in Jefferson County,
Washington; August 1, 2024 — September 30, 2025; Funding will be Fee
for Service; for the term of this agreement.
STATEMENT OF ISSUE:
Jefferson County Public Health, the Developmental Disabilities Division; is requesting Board approval of
the School to Work-Direct Service, Program Agreement with Department of Social and Health Services,
(DSHS); the Division of Vocational Rehabilitation (DVR); #DSHS-DVR-8500CC-63; in Jefferson County,
Washington; August 1, 2024- September 30, 2025; Funding will be Fee for Service; for the term of this
agreement.
ANALYSIS/STRATEGIC GOALS/PRO'S and CON'S:
This School to Work-Direct Service, Program Agreement will fund the development of new School-to-
Work Programs with DSHS - DVR; for services to transition students who experience
intellectual/developmental disabilities in every high school in Jefferson County, Washington.
School to Work means a seamless transition for students with intellectual/developmental disabilities
from school to adulthood; through employment services and connecting students to the necessary
resources for success.
The Jefferson County, Intellectual/Developmental Disabilities Advisory Board agrees that these are
essential and important services for our community.
Community Health Environmental Public Health
Developmental Disabilities 360-385-9444
360-385-9400 (f) 360-379-4487
360-385-9401 (f) Always working for a safer and healthier community
DD-24-037
FISCAL IMPACT/COST BENEFIT ANALYSIS :
This Program Agreement with the DSHS - DVR will be used to support the implementation of the new
School-to-Work Programs; in Jefferson County, Washington.
RECOMMENDATION:
Jefferson County Public Health, the Developmental Disabilities Division; is requesting Board approval
of the School to Work-Direct Service, Program Agreement with DSHS - DVR; #DSHS-DVR-8500CC-63;
in Jefferson County, Washington; August 1, 2024- September 30, 2025; Funding will be Fee for
Service; for the term of this agreement.
REVIEWED BY:
7/.7V/1/2f
Mark McCauley, C u ty Administrator Dat
Community Health Environmental Public Health
Developmental Disabilities 360-385-9444
360 385 9400 (f) 360-379-4487
360-385-9401 (f) Always working for a safer and healthier community
CONTRACT REVIEW FORM I Clear Form
(INSTRUCTIONS ARE ON THE NEXT PAGE)
CONTRACT WITH: DSHS-Division of Vocational Rehabilitation-(DVR) Contract No: DD-24-037
Contract For: School to Work Program Contract Term: August 1,2024-September 30,2025
COUNTY DEPARTMENT: Jefferson County Public Health-DD Program
Contact Person: Anna McEnery
Contact Phone: 360-385-9410
Contact email: amcenery@co.jefferson.wa.us
AMOUNT: Fee for Service PROCESS: ✓ Exempt from Bid Process
Revenue: _ Cooperative Purchase
Expenditure: _ Competitive Sealed Bid
Matching Funds Required: Small Works Roster
Sources(s) of Matching Funds _ Vendor List Bid
Fund# PH fund#127 RFP or RFQ
Munis Org/Obj #12768041 Other:
APPROVAL STEPS:STEP 1: DEPARTMENT CERTIFIES COMP WITH . 1 AND CHAPTER 42.23 RCW.
CERTIFIED: N/A; '■ Aug. 29,2024
Signature Date
STEP 2: DEPARTMENT CERTIFIES THE PERSON PROPOSED FOR CONTRACTING WITH THE
COUNTY (CONTRACTOR) HAS NOT BEEN DEBARRED BY ANY FEDERAL, STATE, OR LOCAL
AGENCY.
CERTIFIED: N/A:
rot-a- Aug. 29,2024
Signat re Date
STEP 3: RISK MANAGEMENT REVIEW(will be added electronically through Laserfiche):
Electronically approved by Risk Management on 8/29/2024.
STEP 4: PROSECUTING ATTORNEY REVIEW(will be added electronically through Laserfiche):
Electronically approved as to form by PAO on 8/29/2024.
State language -- cannot change
STEP 5: DEPARTMENT MAKES REVISIONS & RESUBMITS TO RISK MANAGEMENT AND
PROSECUTING ATTORNEY(IF REQUIRED).
STEP 6: CONTRACTOR SIGNS
STEP 7: SUBMIT TO BOCC FOR APPROVAL
1
DSHS Agreement Number
Washington State COUNTY PROGRAM AGREEMENT
Department of Social 2463-58391
7 &Health Services School-to-Work Direct Service
Transforming lives
Student Guide Method
This Program Agreement is by and between the State of Washington Administration or Division
Department of Social and Health Services (DSHS) and the County identified Agreement Number
below, and is issued in conjunction with a County and DSHS Agreement On County Agreement Number
General Terms and Conditions, which is incorporated by reference. DD-24-037
DSHS ADMINISTRATION DSHS DIVISION DSHS INDEX NUMBER DSHS CONTRACT CODE
Division of Vocational Division of Vocational 1223 8500CC-63
Rehabilitation Rehabilitation
DSHS CONTACT NAME AND TITLE DSHS CONTACT ADDRESS
Austin Diaz-Munoz 4565 7th Ave SE
Contracts Specialist
Lacey, WA 98503
DSHS CONTACT TELEPHONE DSHS CONTACT FAX DSHS CONTACT E-MAIL
(564) 200-2812 Click here to enter text. Austin.DiazMunoz@dshs.wa.gov
COUNTY NAME COUNTY ADDRESS
Jefferson County 615 Sheridan St
Port Townsend, WA 98368
COUNTY FEDERAL EMPLOYER IDENTIFICATION COUNTY CONTACT NAME
NUMBER Anna McEnery
COUNTY CONTACT TELEPHONE COUNTY CONTACT FAX COUNTY CONTACT E-MAIL
(360) 385-9410 (360) 385-9401 amcenery@co.jefferson.wa.us
IS THE COUNTY A SUBRECIPIENT FOR PURPOSES OF THIS PROGRAM ASSISTANCE LISTING NUMBERS
AGREEMENT?
No
PROGRAM AGREEMENT START DATE PROGRAM AGREEMENT END DATE MAXIMUM PROGRAM AGREEMENT AMOUNT
08/01/2024 09/30/2025 Fee For Service
EXHIBITS. When the box below is marked with an X, the following Exhibits are attached and are incorporated into this
County Program Agreement by reference:
® Exhibits (specify): Exhibit A - Data Security Requirements Exhibit B -Stuent Guide Instructions, Exhibit C -
Student Guide, Exhibit D -School-to-Work Student Data, Exhibit E - School-to-Work Success Story, Exhibit F -
School-to-Work Billing Checklist for Student Guide
❑ No Exhibits.
The terms and conditions of this Contract are an integration and representation of the final, entire and exclusive
understanding between the parties superseding and merging all previous agreements, writings, and communications, oral
or otherwise, regarding the subject matter of this Contract. The parties signing below represent that they have read and
understand this Contract, and have the authority to execute this Contract. This Contract shall be binding on DSHS only
upon signature by DSHS.
COUNTY SIGNATURE(S) PRINTED NAME(S)AND TITLE(S) DATE(S)SIGNED
Kate Dean, Chair
Board of County Commissioners
Jefferson County Washington
DSHS SIGNATURE PRINTED NAME AND TITLE DATE SIGNED
APPRO.D ORM ONLY:
/ � � for
08/29/2024
hilip C.Hun ucker, Date
Chief Civil Deputy Prosecuting Attorney
Jefferson County Washington
DSHS Central Contract Services
6017CF County Program Agreement(10-31-2017) Page 1
Special Terms and Conditions
1. Definitions
a. "Authorization for Purchase (AFP)" means the formal DVR fiscal document that officially identifies
and authorizes a DVR Contractor to deliver a specific service.
b. "CRP" or"Community Rehabilitation Program", means a provider which provides vocational
rehabilitation service to individuals with disabilities to enable those individuals to maximize their
opportunities for employment.
c. "Contractor" means Jefferson County.
d. "County" means the political subdivision of the State of Washington, named above, performing
services pursuant to this Program Agreement and includes the County's officers, employees, and
authorized agents.
e. "County Coordinator" means the official developmental disabilities program coordinator or their
designee.
f. "DDA" means the Developmental Disabilities Administration.
g. "DVR" means Department of Social and Health Services, Division of Vocational Rehabilitation.
h. "DVR Counselor(s)" means the Vocational Rehabilitation Counselor(s) assigned to the School-to-
Work Student through the DVR eligibility process.
i. "Extended Services" means ongoing support services and other appropriate services provided to
support a Student with a most significant disability in employment as a means to bridge
employment support between stabilization and long term services.
j. "Individual Plan for Employment (IPE)" means a DVR form that documents important decisions
about vocational rehabilitation services for a Student as defined in WAC 388-891-1115. The
decisions documented on the IPE include, but are not limited to:
(1) The employment outcome the Student plans to achieve;
(2) Each major step needed to accomplish the employment outcome;
(3) The Student's responsibilities in accomplishing each step of the plan;
(4) DVR's responsibilities in assisting the Student to accomplish each step of the plan;
(5) Vocational Rehabilitation (VR) services needed to complete each step; and
(6) Terms and conditions the Student and the DVR Counselor agree are required for continued
support from DVR.
k. "Intensive Training Services" means individualized, one-on-one job skills training and support
provided at the supported employment job site to enable a Student to:
(1) Attain Job Stabilization;
(2) Meet the employer's expected level of work productivity; and
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Special Terms and Conditions
(3) Transition to Long-Term Services provided by an entity other than DVR.
I. "Job Foundation" —The Job Foundation and Value Based Payment Project is intended to engage
students earlier in targeted employment planning and connection; increase partnerships with school
staff to complete student's Job Foundation report with actionable next steps; and increase the
number of students completing transition programs with a job or secondary education connection.
(1) Job Foundation Report should include all information necessary for DVR Counselor to
complete the vocational assessment.
(2) Job Foundation process and comprehensive report may replace the need for a School-to-
Work Assessment.
(3) Additional assessment may be required and determined by the Student's Team should the
Job Foundation report not provide sufficient information to establish an employment goal for
the Student.
m. "Job Placement" means locating, securing, and placing a Student into competitive integrated
employment that is mutually agreed upon by the DVR Counselor, the Contractor, and the Student
or the Student's Team.
n. "Job Stabilization" means the DVR Student, the employer, the DVR Counselor and the Contractor
mutually agree that a Student placed in a Supported Employment position has demonstrated and
maintained satisfactory on-the-job performance and has the quantity and type of long-term
employment supports available from DVR extended services or other long term support providers
that are needed to maintain satisfactory on-the-job performance.
o. "Long Term Services" means ongoing support services provided by an entity other than DVR after
the Student attains employment and exits DVR School-to-Work services.
p. "Monthly Reports" means progress reports that are to be filled out on a monthly basis and shared
with the Student's Team to demonstrate progress towards employment and summarize monthly
work being done on behalf of the Student.
q. "School-to-Work" means a seamless transition for students with intellectual/developmental
disabilities from school to adulthood through employment services and connecting students to the
necessary resources for success.
r. "School to Work Assessment" means
(1) Identify a Student's unique work interests, abilities, and any competitive employment
barriers related to communication, mobility, work skills, work tolerance, self-direction
(cognition and learning), and interpersonal attitudes, skills, behavior, or self-care, etc.; and
(2) Identify the nature and extent of support(s) and accommodations needed for the Student to
obtain and maintain competitive integrated employment.
s. "Service Delivery Outcome Plan (SDOP)" is a written plan jointly developed by the Student, DVR,
DVR Counselor, and CRP representative for obtaining School-to-Work services. The details of the
agreement are tailored to the unique needs of the Student and documented.
t. "Service Delivery Outcome Report (SDOR)" is a required report completed by the Contractor
providing detailed documentation of how the Contractor met the expectations agreed upon in an
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Special Terms and Conditions
SDOP and this Contract for the services provided to a specific Student.
u. "Student" means a student with an intellectual/developmental disability age 20 to 21 who will be
exiting their final year of their high school transition program in the 2024-2025 academic year.
v. "Student Guide" means a guide designed for Students and/or parent(s)/guardians to house School-
to-Work related documentation, information, assessments, activity logs, and notes. This guide is a
Student's 'roadmap' to ensure key activities and milestones are completed and organized.
w. "Student's Team" means any combination of people, including, but not limited to; educators, CRPs,
the Student's Legal Representative or Guardian, County Staff, DVR Counselor(s) who support a
Student as they move towards Job Placement and Job Stabilization.
x. "Subcontractor" means a Community Rehabilitation Program that the Contractor has separately
chosen to perform all or a portion of the duties and obligation that the Contractor is obligated to
perform pursuant to this Contract.
2. Purpose. The purpose of this agreement is to provide School-To-Work services through collaboration
with the Contractor to provide employment related services to Students that will lead to community-
based jobs as they exit their high school transition program.
3. Period of Performance. The period of performance for this Contract shall begin August 1, 2024 and
end September 30, 2025.
4. General Requirements. The Contractor must perform the minimum expectations below in conducting
the services of this Contract:
a. Provide all services of this Contract in a manner and setting(s) that meet the requirements of
Washington State DSHS Administrative Policy 7.02.
b. Arrange and be responsible for all costs associated with communication interpreter services, as
needed, to provide disability-related access per the Americans with Disabilities Act (ADA) unless
the cost involved would cause an undue hardship (significant difficulty or expense) for the
Contractor. Determination of what constitutes an undue hardship will be made on a case-by-case
basis, relative to the Contractor's overall resources.
(1) If an undue hardship does exist, the DVR School-To-Work/Transition Program Manager or
their designated representative may authorize paying for interpreter services and/or
translation services apart from the contracted fee for service.
(2) Provide and be responsible for the cost of providing services through alternative formats,
methods, and languages, as needed, for Students who have Limited English Proficiency
(LEP) as per the Civil Rights Act of 1964.
c. Contractor is responsible for addressing cultural, language, and technological accessibility for all
Students to the best of their abilities when performing the services under this Contract.
d. Eligibility: Student must meet the following criteria:
(1) DDA-eligible.
(2) DVR-eligible.
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Special Terms and Conditions
(3) Intends to stay in school through their last year of their transition program.
(4) Student's last year of transition must be during the 2024-2025 academic year.
(5) Between ages 20-21.
(6) Have an Individualized Education Plan (IEP).
(7) Establish a DVR Individual Plan for Employment (IPE) with an employment goal that
requires Extended Services as needed and Long-Term Services in order to be achieved.
This requirement must be completed by the end of the School-to-Work Intake and
Assessment Phase per section 5, Statement of Work.
e. Meetings must be held in the format best suited for the Student. If all parties are not able to attend
meetings in person, use of telephone or video conferences is encouraged to complete the process
in a timely manner.
f. Contractor must keep all Students enrolled in School-to-Work through the duration of the Student's
last year of their transition program, regardless of outcome and/or Stabilization, unless Student
chooses to exit the program of their own volition or due to unforeseeable circumstances and is
mutually agreed upon by the Student's Team.
(1) Should a Student exit early for any reason, Contractor must document the departure in
Exhibit D — School-to-Work Student Data. See Section 6, Deliverables for further instruction.
g. Service Delivery Agreement: The Contractor's delivery of VR services specified in this agreement
will begin upon the completion and signing of the agreed upon SDOP.
h. Service Delivery Payment: The Contractor will be paid upon completion and submission of the
required documentation demonstrating completion of each of the three phases for each Student as
outlined in Section 5, Statement of Work.
i. Service Delivery Method: This Contract will offer two options for service delivery; the Student Guide
Method, or SDOR (and other required documentation) Method. The Contractor shall determine
which method of service delivery they will utilize for all Students throughout the duration of this
Contract and confirm with the DVR School-to-Work Transition Program Manager prior to execution
of this Contract. See Section 6, Deliverables for further instruction.
(1) Student Guide Method: The Contractor will provide and document all services in accordance
with the instructions outlined in the Student Guide. Should the Contractor choose this option,
Student Guides shall be provided by the DVR School-to-Work Transition Program Manager
or designated representative.
(2) SDOR (and other required documentation) Method: The Contractor will provide and
document all services through the utilization of the Service Delivery Outcome Report and
other required documentation. Should the Contractor choose this option, documents shall be
provided by the DVR Counselor assigned to each Student.
5. Statement of Work. The Contractor shall provide the services and staff, and otherwise do all things
necessary for or incidental to the performance of work, as set forth below:
Services shall be sorted into the following three phases:
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Special Terms and Conditions
School-to-Work Intake and Assessment Phase.
Job Placement Phase.
Employment Phase.
a. School-to-Work Intake and Assessment Phase. The intent of this phase is to bring the Student and
the Student's Team together to determine if enough information is available to establish an
employment goal, establish the employment goal, and build an individualized roadmap of the
Student's transition from their education to meaningful community employment. This shall be
accomplished through the following objectives:
(1) Intake
(a) At a minimum, the Contractor shall invite the Student, the Student's legal representative or
guardian (unless they are their own), the CRP, and the DVR Counselor together to:
i. Complete intake forms as needed, including the SDOP.
ii. The Student's Team determines if there is enough information to establish an
employment goal, or if additional assessment is needed to establish the employment
goal.
iii. The Student's Team shall outline how additional assessment will occur, including
additional meeting time.
(b) The employment goal is established and documented.
i. Determine what Job Seeker Tools are needed for the Student's employment goal.
(2) Assessment
(a) If applicable, review the Job Foundation report and determine if there is enough information
to establish an employment goal based on the following assessment criteria:
i. History of school attendance and reliability;
ii. Behavior support or potential strategies;
iii. Student Communication skills;
iv. Student learning preferences;
v. Student's personal hygiene;
vi. Potential job safety concerns;
vii. Student stamina/endurance;
viii. Student social skills;
ix. Demonstrated skills and task performance;
x. Transportation needs; and
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Special Terms and Conditions
xi. Work preferences and interests.
(b) If there is enough information, Contractor must write an executive summary of the Job
Foundation report with recommendations of an employment goal; or
(c) If there is not enough information, Contractor must complete the School-to-Work
Assessment that addresses the above assessment criteria by locating, securing, and
placing the Student into a paid employment setting(s), or other realistic work setting(s), in
which the Student performs work for a specified period of time with the direct provision of
needed job supports and training.
b. Job Placement Phase. The intent of this phase is to provide the Student with the tools they will
need to find and secure meaningful community employment based on their employment goal. The
Contractor shall provide all services necessary to locate, secure, and place a Student into
competitive integrated employment that is mutually agreed upon by the Student's Team. Specific
placement expectations shall be outlined on the DVR SDOP for Job Placement and Intensive
Training.
Placements less than 10 hours: Job placement goals that are less than 10 hours per week shall be
approved in advance by the appropriate DVR Vocational Rehabilitation Supervisor in consultation
with the Student's Team.
(1) Job Seeker Tools
(a) Contractor shall create a resume and cover letter for the Student, or additional options per
the Student's needs such as videos, PowerPoint (or comparable applications), and/or
portfolios.
(b) Contractor may also develop other materials as it pertains to the Student's individualized
pathway to employment such as a letter of recommendation, create and/or update LinkedIn
page or other social media, etc.
(2) Job Offer
(a) If the Student received the job offer, Contractor must provide details of the job offer including
the following:
i. The Student's Employment Goal;
ii. Job Title;
iii. Start Date;
iv. Job Duties;
v. Expected Weekly Hours;
vi. Starting Wage;
vii. Location;
viii. Transportation Consideration;
ix. Benefits Package; and
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Special Terms and Conditions
x. Potential Training Services and Date/Additional Info.
(b) If the Student rejected the job offer, Contractor must provide the reason(s) why the Student
rejected the job offer.
i. Details must include the above-mentioned criteria or how the job did not meet their
individualized employment goal.
c. Employment Phase. The intent of this phase is to verify, stabilize, and maintain meaningful
community employment.
(1) Employment Verification
(a) Contractor shall submit one of the following methods of verification of employment after
Student's first day of employment.
A letter or other documentation agreed upon with DVR, signed by the employer, verifying
Student's first day of paid employment in a permanent, integrated, and competitive job; or
A copy of the Student's pay statement; or
Information from employer database systems indicating the Student's start date or wage;
and
Any additional details requested on the SDOP.
(2) Intensive Training Services
(a) Intensive job training expectations shall be outlined by the Student's Team. The Contractor
shall provide individualized, one-on-one job skills training and support at the supported
employment job site that will enable a Student to:
i. Achieve job stabilization in on-the-job performance, with job supports and services, and
a fading plan;
ii. Meet the employer's expected level of work productivity; and
iii. Transition to Extended Services as needed and Long-Term Services.
(3) Stabilization
(a) Stabilization is achieved when the Student's Team and their employer agree that the
Student has demonstrated and maintained satisfactory on-the-job performance and has
long-term supports in place.
(b) Job stabilization is determined for each Student in supported employment based on their
unique circumstances. The VR Counselor determines that the Student's work performance
is stabilized with input from the Student, employer and extended service provider when:
i. The Student has reached the agreed-upon goal for the number of weekly hours worked,
unless the Student and the VR Counselor agree that the job represents substantial and
suitable employment.
ii. The Student has reached a maximum level of on-the-job employment and meets
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Special Terms and Conditions
employer expectations.
iii. The supports available are adequate for the Student to maintain stable employment and
meet the employer's expected level of work productivity.
iv. The Student has long-term employment supports available or in process and is able to
transition to these services to maintain job stability.
(c) Once achieved, a Stabilization Report must be completed for the Student.
(4) Extended Services
(a) DVR shall provide Extended Services needed by the Student until DDA funds are available.
(b) Extended Services funded by DVR shall be outlined on the DVR Extended Support SDOP.
i. Maximum 26 hours per month at the hourly rate of $105.00
(A) If more than 26 hours per month are needed for a Student, the DVR Counselor must
document the requirement for more service hours and staff the case with their
supervisor to request an exception to this maximum.
(B) Exceptions may be made on a case-by-case basis and must be submitted and
approved by the DVR School-to-Work Transition Program Manager or designated
representative.
6. Deliverables. The Contractor shall demonstrate completion of activities for payment through the
following reporting methods. Submissions should be written in language that directly addresses the
Student and shall continue for 90 days beyond the Student's stabilization, or until DVR case closure.
The Contractor shall submit the required monthly summary to the assigned DVR Vocational
Rehabilitation Counselor for each Student who is served by this Contract.
a. Required for All Contractors: At a minimum, the Contractor shall submit the following deliverables to
demonstrate completion of the required services:
(1) Intake and Assessment Phase
(a) Intake — Signed SDOP & Roles and Responsibilities of the Student's Team.
i. Roles and Responsibilities of the Student's Team will include;
(A) Team member's role.
(B) Team member's contact information including name, email, and phone.
(C) Team member's responsibility to the Student.
(b) Assessment— Employment Goal is established, demonstrating how it was reached.
(2) Job Placement Phase
(a) Job Seeker Tools — Resume and Cover Letter (Video, PowerPoint, Portfolio,etc.).
(b) Job Offer— Documentation/Details of a Job Offer as stated in Section 5 —Statement of
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Special Terms and Conditions
Work.
(3) Stabilization Phase
(a) Employment Verification — Documentation/Details of a Job Start.as stated in Section 5 —
Statement of Work.
(b) Stabilization — Stabilization Report.as stated in Section 5 - Statement of Work.
(4) Data Sharing and Reporting - DVR is tracking the progress and success of the School-to-
Work program to ensure the program is available to all Students who meet eligibility
requirements across the state. In order to accomplish this, the Contractor must submit
Exhibit D — School-to-Work Student Data.
(a) Exhibit D incorporates the following required data elements:
i. Number of Students identified as eligible for School-to-Work in county or counties
served. If the Contractor coordinates services for more than one county, the Contractor
shall submit data for each county.
ii. Number of Students identified by race/ethnicity.
iii. Number of Students enrolled with DVR.
iv. Number of Students employed.
v. Number of Students who exited School-to-Work early.
vi. Reason for Student exiting early.
vii. Number of Students who exited School-to-Work/DVR employed and transferred into
Extended Services with DDA.
viii. Number of Students transferred into Adult Services or Job Placement with DVR.
(b) Exhibit D must be submitted a total of three (3) times to the DVR School-to-Work Transition
Program Manager throughout the course of the transition year following the below schedule
and with the appropriate tab completed:
i. The "July 1st, 2024" tab shall be submitted on July 1st
ii. The "December 31st, 2024" tab shall be submitted on December 31 st
iii. The "June 30th, 2025" tab shall be submitted on June 30tn
(c) If the above dates fall on a State-recognized holiday or weekend, Contractor may submit
Exhibit D on the nearest workday prior to the due date.
(5) Successful Job Outcome Report— DVR is tracking Student success within the School-to-
Work program. In order to accomplish this, the Contractor must submit the "Successful Job
Outcome Report" tab of Exhibit D — School-to-Work Student Data one (1) time for each
county the Contractor serves at the end of the transition year.
(a) The "Successful Job Outcome Report" tab incorporates the following required data
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Special Terms and Conditions
elements:
i. Name of Student;
ii. Name of Student's school district;
iii. Whether Job Placement was achieved;
iv. Whether Job Placement aligns with the Student's employment goal;
v. Name of the employer;
vi. Date of Student's first day of employment;
vii. Industry Student is working in;
viii. Student's job title;
ix. Expected weekly hours;
x. Student's hourly wage; and
xi. Student's benefits package, if applicable.
(6) Success Story— DVR shall share the progress and success of the School-to-Work program.
In order to accomplish this, the Contractor must submit Exhibit E —Success Story with a
DSHS Personal Information Release (DSHS 16-178) and DSHS Photo Release (DSHS 16-
235). Should the Contractor not have an individual Student success story, the Contractor
may submit a success story within their county that exhibits growth and/or success in
transition services for Students.
(a) Exhibit E incorporates the following:
i. The first name of the Student;
ii. The county the Student participated in School-to-Work;
iii. A minimum of two-hundred and fifty (250) words describing the Student's journey
through the School-to-Work program. This may include, but is not limited to;
(A) Job placements;
(B) Movement towards community employment;
(C) Personal challenges the Student was able to overcome;
(D) Getting connected to valuable community resources;
(b) Exhibit E must be submitted one (1) time per county served to the DVR School-to-Work
Transition Program Manager by the Contract end date.
(c) Contractor may reach out to the School-to-Work Transition Program Manager for additional
support with this exhibit.
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Special Terms and Conditions
b. Contractor-Chosen Deliverables: Contractor shall choose one of the below options for all Students
throughout the duration of this Contract as outlined in Section 4 — General Requirements.
(1) Student Guide
(a) The Contractor shall submit a copy of the Student Guide to the Student's Team at the end of
each month demonstrating the progress of the Student's transition year via completion of
the Monthly Progress Reports section.
(b) The Contractor shall submit an invoice to the DVR Counselor upon completion of each
payment point for each Student as demonstrated in the Student Guide, utilizing Exhibit F -
School-to-Work Billing Checklist for Student Guide, provided by the School-to-Work
Transition Program Manager or designated representative.
(c) Contractor shall submit a minimum of three (3) invoices for all payment points for each
Student.
(2) SDOR (and other required documentation)
(a) The Contractor shall submit a copy of the SDOR and other required documentation to the
DVR Counselor at the end of each month demonstrating the progress of the Student's
transition year.
(b) The Contractor shall submit an invoice to the DVR Counselor upon completion of each
payment point for each Student as demonstrated in the SDOR.
(c) Contractor shall submit a minimum of three (3) Service Delivery Outcome Reports for all
payment points for each Student.
7. Monitoring.
a. The Department of Social and Health Services, Division of Vocational Rehabilitation is required to
maintain a contract administration system which ensures that Contractors perform in accordance
with the terms, conditions, and specifications of their Contracts. DVR manages and monitors its
contracts through conducted risk assessments and monitoring plans. Authority to conduct such
reviews is provided by Title 2 of the Code of Federal Regulations (CFR), 34 CFR 80.36, OFM
SAAM Policy 16.20.55, DSHS Administrative Policies No. 13.11 and 19.50.30.
b. Program Progress: DVR School-to-Work Transition Program Manager shall work with the
Contractor to plan quarterly meetings that may include Contractors, CRP service providers, DVR
staff and DDA representatives. The gathering of partners will allow discussion of the program
process and encourage methods to improve effectiveness of services.
DVR School-to-Work Transition Program Manager or designee shall be responsible for arranging
the time, place, and specific agenda items for these meetings in coordination with the Contractor.
(1) Contractor shall invite DVR partners to attend local County-initiated service provider
meetings. DVR partners may include local DVR Counselors, supervisors, and School-to-
Work staff.
c. Student Progress: DVR School-to-Work Regional Transition Program Specialist shall work with
Counties to plan meetings no less than semi-annually which shall include Contractors, to allow
discussion of student progress and support methods to ensure Students are receiving adequate
services to obtain employment.
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8. Subcontractors.
a. All subcontractors utilized by the Contractor in delivery of direct services described in this
agreement shall hold a current DVR Community Rehabilitation Program (CRP) contract in which
they provide the following services:
(1) Community-Based Assessments; and
(2) CRP Job Placement; and
(3) CRP Intensive Training Services.
b. Subcontracts
(1) Copies of proposed subcontracts between the Contractor and subcontracted CRPs shall be
provided to DVR School-to-Work Transition Program Manager for approval or modification
prior to the start date of this agreement; OR
(2) Within seven (7) calendar days of start date of the subcontract if its execution is after the
start date of this agreement.
9. Consideration. Total consideration payable to Contractor for satisfactory performance of the work
under this Contract is up to a maximum of$14,000 per Student. This is a comprehensive rate for each
service and takes into account the administrative costs associated with operating the program as well
as the actual costs of each service, and shall be based on the following:
a. School-to-Work Intake and Assessment Phase —A total payment of$5,000 per Student shall be
paid to the Contractor when the individual Student has completed the following activities:
(1) Intake Meeting: Paid upon receipt of an invoice and a written report in the Student Guide or
the Service Delivery Outcome Report. The total billable amount for this activity is $3,000 per
Student.
(2) Assessment: Paid upon receipt of an invoice and a written report in the Student Guide or the
Service Delivery Outcome Report. The total billable amount for this activity is $2,000 per
Student.
b. Job Placement Phase—A total payment of$3,000 per Student shall be paid to the Contractor when
the individual Student has completed the following activities:
(1) Job Seeker Tools: Paid upon receipt of an invoice and a written report in the Student Guide
or the Service Delivery Outcome Report. The total billable amount for this activity is $1,000
per Student.
(2) Job Offer: Paid upon receipt of an invoice and a written report in the Student Guide or the
Service Delivery Outcome Report. The total billable amount for this activity is $2,000 per
Student. A job offer is payable once upon receipt of the offer regardless of whether or not
the Student accepts the job offer.
(3) If a Student with a placement goal of 10 hours per week or more accepts a placement for
less than 10 hours per week, an exception for payment may be granted with approval of the
appropriate DVR Supervisor. This approval shall be in consultation with the team including
the Student, Student's Family (as applicable), DVR Counselor, CRP, and County staff.
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c. Employment Phase —A total payment of$6,000 per Student shall be paid to the Contractor when
the individual Student has completed the following activities:
(1) Employment Verification: Paid upon receipt of an invoice and a written report in the Student
Guide or the Service Delivery Outcome Report. The total billable amount for this activity is
$1,000 per Student.
(2) Job Stabilization: Paid upon receipt of an invoice and a written report in the Student Guide
or the Service Delivery Outcome Report. The total billable amount for this activity is $5,000
per Student.
10. Billing and Payment
a. The Contractor shall submit no less than three (3) separate original invoices to the assigned DVR
Vocational Rehabilitation Counselor for each Student who is successfully served by this Agreement.
(1) At a minimum, one invoice per phase as outlined in Section 5, Statement of Work.
(2) Invoices may only be submitted to DVR upon the successful completion of an activity
outlined in the SDOP.
(3) Student Guide Option: Contractor must submit a copy of the School-to-Work Billing
Checklist for Student Guide with the invoice for payment.
b. Payment shall be considered timely if made by DSHS within thirty (30) days after receipt and
acceptance by the designated DVR VR Counselor of the properly completed invoice. Payment shall
be sent to the address designated by the Contractor on page one (1) of this Agreement.
c. DSHS may at its sole discretion, withhold payment claimed by the Contractor for services rendered
if the Contractor fails to satisfactory comply with any term or condition of this Agreement.
11. Insurance - Self-Insured
a. DSHS certifies that it is self-insured under the State's self-insurance liability program, as provided
by RCW 4.92.130, and shall pay for losses for which it is found liable.
b. The Contractor certifies, by checking the appropriate box below, initialing to the left of the box
selected, and signing this Agreement, that:
(1) ❑ The Contractor is self-insured or insured through a risk pool and shall pay for losses for
which it is found liable; or
(2) I I The Contractor maintains the types and amounts of insurance identified below and shall,
prior to the execution of this Agreement by DSHS, provide certificates of insurance to that
effect to the DSHS contact on page one of this Agreement.
Commercial General Liability Insurance (CGL) —to include coverage for bodily injury, property
damage, and contractual liability, with the following minimum limits: Each Occurrence - $1,000,000;
General Aggregate - $2,000,000. The policy shall include liability arising out of premises,
operations, independent contractors, products-completed operations, personal injury, advertising
injury, and liability assumed under an insured contract. The State of Washington, DSHS, its elected
and appointed officials, agents, and employees shall be named as additional insureds.
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12. Investigations of Contractor or Related Personnel
a. DSHS may, without prior notice, suspend the Contractor's performance of the Contract if the
Contractor, or any partner, officer or director of the Contractor, or a subcontractor, or any employee
or volunteer of the Contractor or a subcontractor, is investigated by DSHS or a local, county, state
or federal agency regarding any matter that, if ultimately established, could either:
(1) Result in a conviction for violating a local, state or federal law.
(2) In the sole judgment of DSHS, adversely affect the delivery of services under this Contract
or the health, safety or welfare of DSHS Students.
b. DSHS may also take other lesser action, including, but not limited to, disallowing a staff member,
employee, or other individual associated with the Contractor or a subcontractor, from providing
services, or from having contact with DSHS Students, until the investigation is concluded and a final
determination made by the investigating agency if inconclusive or unsubstantiated.
13. Removal of Individuals from Performing Services
a. In the event that any of the Contractor's employees, subcontractors, or volunteers who provide
services under this Contract do not meet qualifications required by this Contract or do not perform
the services as required in this Contract, DSHS may require that Contractor remove such individual
from providing services to DSHS Students under this Contract.
b. DSHS shall notify the Contractor of this decision verbally and in writing and the Contractor shall,
within 24 hours, remove that individual from providing direct services to DSHS Students. Failure to
do so may result in a Corrective Action Plan.
14. Compliance with Corrective Action Plan
In the event that DSHS identifies deficiencies in Contractor's performance under this Contract, DSHS
may establish a Corrective Action Plan When presented with a Corrective Action Plan, Contractor
agrees to undertake the actions specified in the plan within the timeframes given to correct the
deficiencies. Contractor's failure to do so shall be grounds for termination of this Contract.
15. Order of Precedence in DVR Process
In the event of any inconsistency or conflict between the Terms and Conditions of this Contract and the
DVR Service Delivery Outcome Plan (SDOP) and the Authorization for Purchase (AFP), the
inconsistency or conflict shall be resolved by giving precedence this contract in its entirety. Terms or
conditions that are more restrictive, specific, or particular than those contained in this contract shall not
be construed as being inconsistent or in conflict.
16. Disputes
When a dispute arises over an issue concerning the terms of this Contract, the following process is
used to address the dispute:
a. The Contractor and DVR shall attempt to resolve the dispute through informal means between the
Contractor and the assigned DVR Counselor. For those contracts where a DVR Counselor is not
assigned, the Contractor shall attempt to resolve the dispute with the contact person identified on
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the first page of the contract.
b. If the Contractor is not satisfied with the outcome of the resolution with the DVR Counselor or
DSHS contact person, the Contractor may submit a request for review of the disputed issue, in
writing, for review within thirty (30) business days of the outcome to:
DVR Director
DSHS/DVR
PO Box 45340
Olympia WA 98504-5340
c. The Director may appoint a designee to review the disputed issue.
d. A request for dispute resolution shall include:
(1) Name of the requester.
(2) Contractor's name, full address, phone number, and email.
(3) Contract number.
(4) Description of the issue in dispute.
(5) A statement describing the requester's position on the issue in dispute, including any
documentation that supports this position.
(6) Steps already taken to resolve the dispute.
e. The reviewer may request additional supporting documentation from either party to assist in
reaching a fair resolution.
f. The Director shall issue a written decision to the Contractor within thirty (30) business days of
receipt of all information relevant to the issue.
g. The dispute resolution process described above is the sole administrative remedy available under
this Contract.
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Exhibit A — Data Security Requirements
1. Definitions. The words and phrases listed below, as used in this Exhibit, shall each have the following
definitions:
a. "AES" means the Advanced Encryption Standard, a specification of Federal Information Processing
Standards Publications for the encryption of electronic data issued by the National Institute of
Standards and Technology (http://nvlpubs.nist.gov/nistpubs/FIPS/NIST.FIPS.197.pdf).
b. "Authorized Users(s)" means an individual or individuals with a business need to access DSHS
Confidential Information, and who has or have been authorized to do so.
c. "Business Associate Agreement" means an agreement between DSHS and a contractor who is
receiving Data covered under the Privacy and Security Rules of the Health Insurance Portability
and Accountability Act of 1996. The agreement establishes permitted and required uses and
disclosures of protected health information (PHI) in accordance with HIPAA requirements and
provides obligations for business associates to safeguard the information.
d. "Category 4 Data" is data that is confidential and requires special handling due to statutes or
regulations that require especially strict protection of the data and from which especially serious
consequences may arise in the event of any compromise of such data. Data classified as Category
4 includes but is not limited to data protected by: the Health Insurance Portability and Accountability
Act (HIPAA), Pub. L. 104-191 as amended by the Health Information Technology for Economic and
Clinical Health Act of 2009 (HITECH), 45 CFR Parts 160 and 164; the Family Educational Rights
and Privacy Act (FERPA), 20 U.S.C. §1232g; 34 CFR Part 99; Internal Revenue Service
Publication 1075 (https://www.irs.gov/pub/irs-pdf/p1075.pdf); Substance Abuse and Mental Health
Services Administration regulations on Confidentiality of Alcohol and Drug Abuse Patient Records,
42 CFR Part 2; and/or Criminal Justice Information Services, 28 CFR Part 20.
e. "Cloud" means data storage on servers hosted by an entity other than the Contractor and on a
network outside the control of the Contractor. Physical storage of data in the cloud typically spans
multiple servers and often multiple locations. Cloud storage can be divided between consumer
grade storage for personal files and enterprise grade for companies and governmental entities.
Examples of consumer grade storage would include iTunes, Dropbox, Box.com, and many other
entities. Enterprise cloud vendors include Microsoft Azure, Amazon Web Services, and Rackspace.
f. "Encrypt" means to encode Confidential Information into a format that can only be read by those
possessing a "key"; a password, digital certificate or other mechanism available only to authorized
users. Encryption must use a key length of at least 256 bits for symmetric keys, or 2048 bits for
asymmetric keys. When a symmetric key is used, the Advanced Encryption Standard (AES) must
be used if available.
g. "FedRAMP" means the Federal Risk and Authorization Management Program (see
www.fedramp.gov), which is an assessment and authorization process that federal government
agencies have been directed to use to ensure security is in place when accessing Cloud computing
products and services.
h. "Hardened Password" means a string of at least eight characters containing at least three of the
following four character classes: Uppercase alphabetic, lowercase alphabetic, numeral, and special
characters such as an asterisk, ampersand, or exclamation point.
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i. "Mobile Device" means a computing device, typically smaller than a notebook, which runs a mobile
operating system, such as iOS, Android, or Windows Phone. Mobile Devices include smart phones,
most tablets, and other form factors.
j. "Multi-factor Authentication" means controlling access to computers and other IT resources by
requiring two or more pieces of evidence that the user is who they claim to be. These pieces of
evidence consist of something the user knows, such as a password or PIN; something the user has
such as a key card, smart card, or physical token; and something the user is, a biometric identifier
such as a fingerprint, facial scan, or retinal scan. "PIN" means a personal identification number, a
series of numbers which act as a password for a device. Since PINs are typically only four to six
characters, PINs are usually used in conjunction with another factor of authentication, such as a
fingerprint.
k. "Portable Device" means any computing device with a small form factor, designed to be transported
from place to place. Portable devices are primarily battery powered devices with base computing
resources in the form of a processor, memory, storage, and network access. Examples include, but
are not limited to, mobile phones, tablets, and laptops. Mobile Device is a subset of Portable
Device.
I. "Portable Media" means any machine readable media that may routinely be stored or moved
independently of computing devices. Examples include magnetic tapes, optical discs (CDs or
DVDs), flash memory (thumb drive) devices, external hard drives, and internal hard drives that have
been removed from a computing device.
m. "Secure Area" means an area to which only authorized representatives of the entity possessing the
Confidential Information have access, and access is controlled through use of a key, card key,
combination lock, or comparable mechanism. Secure Areas may include buildings, rooms or
locked storage containers (such as a filing cabinet or desk drawer) within a room, as long as access
to the Confidential Information is not available to unauthorized personnel. In otherwise Secure
Areas, such as an office with restricted access, the Data must be secured in such a way as to
prevent access by non-authorized staff such as janitorial or facility security staff, when authorized
Contractor staff are not present to ensure that non-authorized staff cannot access it.
n. "Trusted Network" means a network operated and maintained by the Contractor, which includes
security controls sufficient to protect DSHS Data on that network. Controls would include a firewall
between any other networks, access control lists on networking devices such as routers and
switches, and other such mechanisms which protect the confidentiality, integrity, and availability of
the Data.
o. "Unique User ID" means a string of characters that identifies a specific user and which, in
conjunction with a password, passphrase or other mechanism, authenticates a user to an
information system.
2. Authority. The security requirements described in this document reflect the applicable requirements of
Standard 141.10 ( :tps://ocio.wa.gov/poiiL ) of the Office of the Chief Information Officer for the state
of Washington, and of the DSHS Information Security Policy and Standards Manual. Reference
material related to these requirements can be found here: https://www.dshs.wa.gov/ffa/keepinq-dshs-
client-information-private-and-secure, which is a site developed by the DSHS Information Security
Office and hosted by DSHS Central Contracts and Legal Services.
3. Administrative Controls. The Contractor must have the following controls in place:
a. A documented security policy governing the secure use of its computer network and systems, and
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which defines sanctions that may be applied to Contractor staff for violating that policy.
b. If the Data shared under this agreement is classified as Category 4, the Contractor must be aware
of and compliant with the applicable legal or regulatory requirements for that Category 4 Data.
c. If Confidential Information shared under this agreement is classified as Category 4, the Contractor
must have a documented risk assessment for the system(s) housing the Category 4 Data.
4. Authorization, Authentication, and Access. In order to ensure that access to the Data is limited to
authorized staff, the Contractor must:
a. Have documented policies and procedures governing access to systems with the shared Data.
b. Restrict access through administrative, physical, and technical controls to authorized staff.
c. Ensure that user accounts are unique and that any given user account logon ID and password
combination is known only to the one employee to whom that account is assigned. For purposes of
non-repudiation, it must always be possible to determine which employee performed a given action
on a system housing the Data based solely on the logon ID used to perform the action.
d. Ensure that only authorized users are capable of accessing the Data.
e. Ensure that an employee's access to the Data is removed immediately:
(1) Upon suspected compromise of the user credentials.
(2) When their employment, or the contract under which the Data is made available to them, is
terminated.
(3) When they no longer need access to the Data to fulfill the requirements of the contract.
f. Have a process to periodically review and verify that only authorized users have access to systems
containing DSHS Confidential Information.
g. When accessing the Data from within the Contractor's network (the Data stays within the
Contractor's network at all times), enforce password and logon requirements for users within the
Contractor's network, including:
(1) A minimum length of 8 characters, and containing at least three of the following character
classes: uppercase letters, lowercase letters, numerals, and special characters such as an
asterisk, ampersand, or exclamation point.
(2) That a password does not contain a user's name, logon ID, or any form of their full name.
(3) That a password does not consist of a single dictionary word. A password may be formed as a
passphrase which consists of multiple dictionary words.
(4) That passwords are significantly different from the previous four passwords. Passwords that
increment by simply adding a number are not considered significantly different.
h. When accessing Confidential Information from an external location (the Data will traverse the
Internet or otherwise travel outside the Contractor's network), mitigate risk and enforce password
and logon requirements for users by employing measures including:
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(1) Ensuring mitigations applied to the system don't allow end-user modification.
(2) Not allowing the use of dial-up connections.
(3) Using industry standard protocols and solutions for remote access. Examples would include
RADIUS and Citrix.
(4) Encrypting all remote access traffic from the external workstation to Trusted Network or to a
component within the Trusted Network. The traffic must be encrypted at all times while
traversing any network, including the Internet, which is not a Trusted Network.
(5) Ensuring that the remote access system prompts for re-authentication or performs automated
session termination after no more than 30 minutes of inactivity.
(6) Ensuring use of Multi-factor Authentication to connect from the external end point to the internal
end point.
i. Passwords or PIN codes may meet a lesser standard if used in conjunction with another
authentication mechanism, such as a biometric (fingerprint, face recognition, iris scan) or token
(software, hardware, smart card, etc.) in that case:
(1) The PIN or password must be at least 5 letters or numbers when used in conjunction with at
least one other authentication factor
(2) Must not be comprised of all the same letter or number (11111, 22222, aaaaa, would not be
acceptable)
(3) Must not contain a "run" of three or more consecutive numbers (12398, 98743 would not be
acceptable)
j. If the contract specifically allows for the storage of Confidential Information on a Mobile Device,
passcodes used on the device must:
(1) Be a minimum of six alphanumeric characters.
(2) Contain at least three unique character classes (upper case, lower case, letter, number).
(3) Not contain more than a three consecutive character run. Passcodes consisting of 12345, or
abcdl2 would not be acceptable.
k. Render the device unusable after a maximum of 10 failed logon attempts.
5. Protection of Data. The Contractor agrees to store Data on one or more of the following media and
protect the Data as described:
a. Hard disk drives. For Data stored on local workstation hard disks, access to the Data will be
restricted to Authorized User(s) by requiring logon to the local workstation using a Unique User ID
and Hardened Password or other authentication mechanisms which provide equal or greater
security, such as biometrics or smart cards.
b. Network server disks. For Data stored on hard disks mounted on network servers and made
available through shared folders, access to the Data will be restricted to Authorized Users through
the use of access control lists which will grant access only after the Authorized User has
authenticated to the network using a Unique User ID and Hardened Password or other
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Special Terms and Conditions
authentication mechanisms which provide equal or greater security, such as biometrics or smart
cards. Data on disks mounted to such servers must be located in an area which is accessible only
to authorized personnel, with access controlled through use of a key, card key, combination lock, or
comparable mechanism.
For DSHS Confidential Information stored on these disks, deleting unneeded Data is sufficient as
long as the disks remain in a Secure Area and otherwise meet the requirements listed in the above
paragraph. Destruction of the Data, as outlined below in Section 8 Data Disposition, may be
deferred until the disks are retired, replaced, or otherwise taken out of the Secure Area.
c. Optical discs (CDs or DVDs) in local workstation optical disc drives. Data provided by DSHS
on optical discs which will be used in local workstation optical disc drives and which will not be
transported out of a Secure Area. When not in use for the contracted purpose, such discs must be
Stored in a Secure Area. Workstations which access DSHS Data on optical discs must be located
in an area which is accessible only to authorized personnel, with access controlled through use of a
key, card key, combination lock, or comparable mechanism.
d. Optical discs (CDs or DVDs) in drives or jukeboxes attached to servers. Data provided by
DSHS on optical discs which will be attached to network servers and which will not be transported
out of a Secure Area. Access to Data on these discs will be restricted to Authorized Users through
the use of access control lists which will grant access only after the Authorized User has
authenticated to the network using a Unique User ID and Hardened Password or other
authentication mechanisms which provide equal or greater security, such as biometrics or smart
cards. Data on discs attached to such servers must be located in an area which is accessible only
to authorized personnel, with access controlled through use of a key, card key, combination lock, or
comparable mechanism.
e. Paper documents. Any paper records must be protected by storing the records in a Secure Area
which is only accessible to authorized personnel. When not in use, such records must be stored in
a Secure Area.
f. Remote Access. Access to and use of the Data over the State Governmental Network (SGN) or
Secure Access Washington (SAW) will be controlled by DSHS staff who will issue authentication
credentials (e.g. a Unique User ID and Hardened Password) to Authorized Users on Contractor's
staff. Contractor will notify DSHS staff immediately whenever an Authorized User in possession of
such credentials is terminated or otherwise leaves the employ of the Contractor, and whenever an
Authorized User's duties change such that the Authorized User no longer requires access to
perform work for this Contract.
g. Data storage on portable devices or media.
(1) Except where otherwise specified herein, DSHS Data shall not be stored by the Contractor on
portable devices or media unless specifically authorized within the terms and conditions of the
Contract. If so authorized, the Data shall be given the following protections:
(a) Encrypt the Data.
(b) Control access to devices with a Unique User ID and Hardened Password or stronger
authentication method such as a physical token or biometrics.
(c) Manually lock devices whenever they are left unattended and set devices to lock
automatically after a period of inactivity, if this feature is available. Maximum period of
inactivity is 20 minutes.
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(d) Apply administrative and physical security controls to Portable Devices and Portable Media
by:
i. Keeping them in a Secure Area when not in use,
ii. Using check-in/check-out procedures when they are shared, and
iii. Taking frequent inventories.
(2) When being transported outside of a Secure Area, Portable Devices and Portable Media with
DSHS Confidential Information must be under the physical control of Contractor staff with
authorization to access the Data, even if the Data is encrypted.
h. Data stored for backup purposes.
(1) DSHS Confidential Information may be stored on Portable Media as part of a Contractor's
existing, documented backup process for business continuity or disaster recovery purposes.
Such storage is authorized until such time as that media would be reused during the course of
normal backup operations. If backup media is retired while DSHS Confidential Information still
exists upon it, such media will be destroyed at that time in accordance with the disposition
requirements below in Section 8 Data Disposition.
(2) Data may be stored on non-portable media (e.g. Storage Area Network drives, virtual media,
etc.) as part of a Contractor's existing, documented backup process for business continuity or
disaster recovery purposes. If so, such media will be protected as otherwise described in this
exhibit. If this media is retired while DSHS Confidential Information still exists upon it, the data
will be destroyed at that time in accordance with the disposition requirements below in Section 8
Data Disposition.
i. Cloud storage. DSHS Confidential Information requires protections equal to or greater than those
specified elsewhere within this exhibit. Cloud storage of Data is problematic as neither DSHS nor
the Contractor has control of the environment in which the Data is stored. For this reason:
(1) DSHS Data will not be stored in any consumer grade Cloud solution, unless all of the following
conditions are met:
(a) Contractor has written procedures in place governing use of the Cloud storage and
Contractor attests in writing that all such procedures will be uniformly followed.
(b) The Data will be Encrypted while within the Contractor network.
(c) The Data will remain Encrypted during transmission to the Cloud.
(d) The Data will remain Encrypted at all times while residing within the Cloud storage solution.
(e) The Contractor will possess a decryption key for the Data, and the decryption key will be
possessed only by the Contractor and/or DSHS.
(f) The Data will not be downloaded to non-authorized systems, meaning systems that are not
on either the DSHS or Contractor networks.
(g) The Data will not be decrypted until downloaded onto a computer within the control of an
Authorized User and within either the DSHS or Contractor's network.
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(2) Data will not be stored on an Enterprise Cloud storage solution unless either:
(a) The Cloud storage provider is treated as any other Sub-Contractor, and agrees in writing to
all of the requirements within this exhibit; or,
(b) The Cloud storage solution used is FedRAMP certified.
(3) If the Data includes protected health information covered by the Health Insurance Portability and
Accountability Act (HIPAA), the Cloud provider must sign a Business Associate Agreement prior
to Data being stored in their Cloud solution.
6. System Protection. To prevent compromise of systems which contain DSHS Data or through which
that Data passes:
a. Systems containing DSHS Data must have all security patches or hotfixes applied within 3 months
of being made available.
b. The Contractor will have a method of ensuring that the requisite patches and hotfixes have been
applied within the required timeframes.
c. Systems containing DSHS Data shall have an Anti-Malware application, if available, installed.
d. Anti-Malware software shall be kept up to date. The product, its anti-virus engine, and any malware
database the system uses, will be no more than one update behind current.
7. Data Segregation.
a. DSHS Data must be segregated or otherwise distinguishable from non-DSHS data. This is to
ensure that when no longer needed by the Contractor, all DSHS Data can be identified for return or
destruction. It also aids in determining whether DSHS Data has or may have been compromised in
the event of a security breach. As such, one or more of the following methods will be used for data
segregation.
(1) DSHS Data will be kept on media (e.g. hard disk, optical disc, tape, etc.) which will contain no
non-DSHS Data. And/or,
(2) DSHS Data will be stored in a logical container on electronic media, such as a partition or folder
dedicated to DSHS Data. And/or,
(3) DSHS Data will be stored in a database which will contain no non-DSHS data. And/or,
(4) DSHS Data will be stored within a database and will be distinguishable from non-DSHS data by
the value of a specific field or fields within database records.
(5) When stored as physical paper documents, DSHS Data will be physically segregated from non-
DSHS data in a drawer, folder, or other container.
b. When it is not feasible or practical to segregate DSHS Data from non-DSHS data, then both the
DSHS Data and the non-DSHS data with which it is commingled must be protected as described in
this exhibit.
8. Data Disposition. When the contracted work has been completed or when the Data is no longer
needed, except as noted above in Section 5.b, Data shall be returned to DSHS or destroyed. Media on
which Data may be stored and associated acceptable methods of destruction are as follows:
DSHS Central Contract Services
6017CF County Program Agreement(10-31-2017) Page 23
Special Terms and Conditions
Data stored on: Will be destroyed by:
Server or workstation hard disks, or Using a "wipe" utility which will overwrite the Data at
least three (3) times using either random or single
Removable media (e.g. floppies, USB flash drives, character data, or
portable hard disks) excluding optical discs
Degaussing sufficiently to ensure that the Data
cannot be reconstructed, or
Physically destroying the disk
Paper documents with sensitive or Confidential Recycling through a contracted firm, provided the
Information contract with the recycler assures that the
confidentiality of Data will be protected.
Paper documents containing Confidential Information On-site shredding, pulping, or incineration
requiring special handling (e.g. protected health
information)
Optical discs (e.g. CDs or DVDs) Incineration, shredding, or completely defacing the
readable surface with a coarse abrasive
Magnetic tape Degaussing, incinerating or crosscut shredding
9. Notification of Compromise or Potential Compromise. The compromise or potential compromise of
DSHS shared Data must be reported to the DSHS Contact designated in the Contract within one (1)
business day of discovery. If no DSHS Contact is designated in the Contract, then the notification must
be reported to the DSHS Privacy Officer at dshsprivacyofficer@dshs.wa.gov. Contractor must also
take actions to mitigate the risk of loss and comply with any notification or other requirements imposed
by law or DSHS.
10. Data shared with Subcontractors. If DSHS Data provided under this Contract is to be shared with a
subcontractor, the Contract with the subcontractor must include all of the data security provisions within
this Contract and within any amendments, attachments, or exhibits within this Contract. If the
Contractor cannot protect the Data as articulated within this Contract, then the contract with the sub-
Contractor must be submitted to the DSHS Contact specified for this contract for review and approval.
DSHS Central Contract Services
6017CF County Program Agreement(10-31-2017) Page 24
Exhibit B:School-to-Work Student Guide Instructions
The following is a billing guide for the Contractor as they work with students by following the pages
of the Student Guide.As the following sections are completed,the Contractor will use Exhibit F:
School-to-Work Billing Checklist for Student Guide, provided to the Contractor by DVR.
These instructions will support guidance to School-to-Work contractors as they work with students
who are participating in School-to-Work.To begin the process of School-to-Work and to review the
School-to-Work Student Guide, schedule a School-to-Work Intake and Assessment meeting with
the Student and the Student's Team. During this meeting,the School-to-Work Student Guide will be
shared with the student,going through the process of School-to-Work and what the student should
expect in their final year of Transition.
Billing Instructions:
1. Bill$3,000 for the School-to-Work Intake Meeting once the following pages are complete:
• Team Building Meeting and Information
• Team Contracts, Roles, and Responsibilities
2. Bill$2,000 for Assessment once the following pages are complete:
Assessment pages may include the following pages being completed, as applicable for the student,
as each student may get to their employment goal in their own way. If a Job Foundation Report was
enough for the student to set their employment goal, no additional assessment may be needed. If
the Job Foundation Report was not enough, an assessment may still be needed. Or, a student did
not go through Job Foundation and an assessment is needed no matter what to get to an
employment goal.The student and the student's team will work together to determine this.The
main goal for this section is to get to an employment goal and the next steps for the student:
• Job Foundation Report page with yes and no questions
• Job Foundation Executive Summary and Job Recommendation
• School-to-Work Assessment
• Job Goal
• Next Steps and Team Actions
3. Bill$1,000 for the Job Seeker Tools once the following pages are complete:
• Job Seeker Tools(both required tools are complete and shared with the student and DVR)
4. Bill$2,000 for the Job Offer once the following page is complete:
• Job Offer Details on the page titled"You were offered the job!Way to go!"
5. Bill$1,000 for Employment Verification once the following page is complete:
• Form is completed on the page titled"Congratulations,you are employed!"
6. Bill$5,000 for Stabilization once the following pages are complete:
• Your Supports on the Job
• Job Stabilization Report
Please note there are additional pages in the Student Guide that do not affect the above
payments and are intended to support the student.They are as follows:
• Helpful Resources (no actions needed for the student)
• Other Helpful Contacts(to be filled out only as applicable or helpful for the student)
• Optional Documents (to be filled out only as applicable or helpful for the student)
• Monthly Progress Reports(these are required to be completed and shared with the
student's team monthly)
4'�es�t��0�^n 5:5:t
Departmentolsocial Division of Vocational Rehabilitation
7 &Health Services
Transforming fives Exhibit E: School-to-Work Success Story
Name of Student (optional) Month and Year Reporting County
Describe the student's journey and success* in school to work:
* Success may be, for example: Job Placements, movement towards community employment,
personal challenges the student was able to overcome, or getting connected to valuable
community resources.
250 words minimum or summary with a link to a video.
Exhibit E must be submitted one (1) time per county served to the DVR School-to-Work
Transition Program Manager by June 30th
This form is not valid without the following signed documents:
• DVR's Personal Information Release form:
DSHS 16-178, Personal Information Release (wa.gov); and
• DSHS's Photo Release form: DSHS 16-235, Photo Release (wa.gov).
Exhibit E: School-to-Work Success Story Page 1 of 1
DSHS 16-278 (05/2024)
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TABLE OF CONTENTS
Contents
TABLE OF CONTENTS 2
WELCOME 3
SCHOOL-TO-WORK PHASES 4
PHASE 1: Intake and Assessment 5
TEAM BUILDING MEETING AND INFORMATION 6
TEAM CONTACTS, ROLES,AND RESPONSIBILITIES 7
ASSESSMENT(S) 8
JOB FOUNDATION REPORT 9
JOB FOUNDATION EXECUTIVE SUMMARY and JOB RECOMMENDATION 10
SCHOOL-TO-WORK ASSESSMENT 11
JOB GOAL 13
NEXT STEPS AND TEAM ACTIONS 14
PHASE 2:Job Placement 15
JOB SEEKER TOOLS 16
YOU WERE OFFERED THE JOB! WAY TO GO! 17
PHASE 3: Employment 18
CONGRATULATIONS,YOU ARE EMPLOYED! 19
YOUR SUPPORTS ON THE JOB 20
JOB STABILIZATION REPORT 21
HELPFUL RESOURCES 22
OTHER HELPFUL CONTACTS 23
OPTIONAL DOCUMENTS 24
MONTHLY PROGRESS REPORTS 25
NOTES 26
THANK YOU! 27
DVRSchoolToWork@dshs.wa.gov
W E LCO M E
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The School-to-Work Program is designed to assist students in finding a job before they
exit school in June. Students enrolled in the program
will work directly with a supported employment
•
agency that will collaborate with them, their
parents)/guardian, school district staff, County
a,a
Developmental Disabilities programs, the Division
of Vocational Rehabilitation, and the
Developmental Disabilities Administration.
0110000....""*"-'
This School-to-Work Student Guide is
designed for students and/or parent(s)/guardians
to house program related documentation,
assessments, activity logs, notes and so much more! 11
This guide will be a student's 'roadmap' to ensure key activities and milestones have been
completed and organized effectively. This tool will support students in keeping important
information in one place, and it will also be a great resource to bring to collaboration meetings
that occur with support partners and agencies.
DVRSchoolToWork@dshs.wa.gov
SCHOOL-TO-WORK PHASES
0
INTAKE and ASSESSMENT PHASE
This phase includes bringing a team together that
will support and guide you through the School-to-
i 0*
Work program. Key intake and assessment
F
activities will take place to ensure a positive
experience for you.
0
JOB PLACEMENT PHASE re
This phase includes conducting and capturing important ." 4gii '
A ,s t
job placement activities like employment goals, site visits, f
job interviews, and more.
0
"` EMPLOYMENT PHASE
, ‘101.01 'Si_ ‘ .. -
` r, This phase serves as an exciting step to complete and
it f 4
4, capture all employment stabilization information like
employment verification information, completion of
0 ,i
. 1st day of work confirmation, and much more!
DVRSchoolToWork@dshs.wa.gov
PHASE 1 : Intake and Assessment
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Items to include in this section are:
• Team Building Meeting and Information
• Team Contacts, Roles, and Responsibilities
• Job Foundation Report and/or School-to-Work Assessment
• Job Goal
• Next Steps and Team Actions
DVRSchoolToWork@dshs.wa.gov
TEAM BUILDING MEETING
AND INFORMATION
Team Building Meeting Date:
Agenda for Meeting:
1. Introductions/Overview of Services/Strengths and Challenges
2. Job Foundation Review/Assessment Needs
3. Job Goal is Established
Name Role/Agency
DVRSchoolToWork@dshs.wa.gov
TEAM CONTACTS, ROLES, AND RESPONSIBILITIES
Team Member Role Team Member Team Member Responsibility to
Contact Information You
Name: Show Up,Speak Up and Share!
You are the driver of your services and
You, the Student (most Email: without your voice,the team is not able
important person on to support you with your goals.
team) Phone: Work with your team to get a job.
Services are person-centered and
individualized
Name:
Supports you in partnership with
Your Parent or Guardian Email: school,county,and state departments
to acquire employment.
Phone:
Name:
Employment Provider: Coordinate getting resources,training,
Your Job Coach Email: and supports needed for you to get a
job before you leave school in June.
Phone:
Name: Coordinate with schools,counties,and
other state departments to help you get
Your Vocational Email: a job. Provide job coach funding.This
could be the Division of Vocational
Rehabilitation Counselor Rehabilitation(DVR), Department of
Phone: Services for the Bling(DSB),or Tribal
Vocational rehabilitation(TVR)
Name:
School-to-Work contractor entity
Your County Program Email: providing local support for you to
find a job.
Phone:
Name:
Your School Teacher Connects you or your parent or
and/or School Staff Email: guardian(s)with community,county,
and resources for School-to-Work.
Phone:
Name:
Lead role who edits this School-to-Work
Main Keeper of Your Email: Student Guide monthly and shares the
Student Guide most current copy with each person
listed above at the end of the month.
Phone:
Name:
Other Person on Your Email:
Team
Phone:
DVRSchoolToWork@dshs.wa.gov
ASSESSMENT(S )
JOB FOUNDATION REPORT AND/OR SCHOOL-TO-WORK ASSESSMENT
Your job coach will collect information about your strengths, skills,and support needed for success on
the job.This information will be gathered through school, home, and community work-related activities,
as well as conversations and observations with those supporting your School-to-Work journey.
Assessment includes the following areas:
• History of school attendance and reliability
• Behavior support or strategies likely to be needed
• Student's communication skills.
• Student's learning preferences
• Student's personal hygiene
4
• Potential job safety issues �` � ">
• Student's stamina/endurance
• Student's social skills
�. .
• Demonstrated skills and task performance
• Transportation needs
• Work preferences and interests
GO TO THE NEXT PAGE TO DETERMINE THE NEXT STEP.
DVRSchoolToWork@dshs.wa.gov 8
JOB FOUNDATION REPORT
What is the purpose of Job Foundation?The purpose is to engage, connect, and plan
earlier for students in their second to last year of school through discovery and the
completion of the Job Foundation Report that includes actionable next steps for
employment.
Answer the following questions:
Is the Job Foundation Report complete?
YES NO n
Final Report sent to Student and to DVR Counselor?
YES n NO n Date Sent:
If no, complete a School-to-Work Assessment.
At this point, do you feel you have a job goal in mind?
YES n NO n
If yes, have your job coach complete the next page, the Job Foundation Executive
Summary and Job Recommendation.
If no, complete a School-to-Work Assessment and come back together with your
team to establish a job goal.
*Team meeting date to discuss results of assessment:
DVRSchoolToWork@dshs.wa.gov
...........................
JOB FOUNDATION EXECUTIVE SUMMARY
and JOB RECOMMENDATION
Add Job Foundation Executive Summary here:
Add Job Recommendation based on what was learned through the Job
Foundation Process here:
DVRSchoolToWork@dshs.wa.gov
10
SCHOOL-TO-WORK ASSESSMENT
It has been determined that a School-to-Work Assessment is needed to learn more about what you would
like to do for a job. This will help you determine your job goal! Your job coach will collect information about
your strengths, skills, and supports needed for success on the job. The following information will be based
on your school, home, and community work-related activities, interviews with you, your family, school
staff, others who are familiar with you, and your job coach observations.
1. Summary of Assessment Areas
a. History of school attendance and reliability:
b. Behavior support or strategies likely to be needed:
c. Communicationskills:
d. Learning preferences:
e. Personal hygiene:
f. Potential job safety issues:
g. Stamina/endurance:
DVRSchoolToWork@dshs.wa.gov
h. Socialskills:
i. Demonstrated skills and task performance:
j. Transportation needs:
k. Work preferences and interests:
2. Recommendations
a. Skills and interests:
b. Desired work environment:
c. Desired schedule:
d. Ability to travel to and from work within a reasonable length of time:
3. Accommodations and Necessary Supports
DVRSchoolToWork@dshs.wa.gov
JOB GOAL
Name:
Date:
Goal:
•
_(3), Congratulations! You are on your way to being employed!
DVRSchootToWork@dshs.wa.gov 13
NEXT STEPS AND TEAM ACTIONS
Task Who When
=4TIP: More tasks may be added throughout your School-to-Work year, or even be
=
removed as tasks if they are not something you want to explore any longer.
DVRSchoolToWork@dshs.wa.gov
14
1
PHASE 2: Job Placement
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Items to include in this section are:
• Job Seeker Tools
• Job Offer Details
DVRSchoolToWork@dshs.wa.gov
JOB SEEKER TOOLS
Follow the instructions below to attach documents or paste links to digital materials on the next
few pages. Items may include online portfolios, cover letters, video resumes, letters of
recommendation, Linkedln pages, and more.
Resume or Media Resume (Required)
(Video, PowerPoint, Portfolio, etc.)
Sent to Student and DVR Counselor:nYes❑No Date sent:
Cover Letter (Required)
Sent to Student and DVR Counselor: ❑Yes❑No Date sent:
Employer Letter of Recommendation (optional)
Sent to Student and DVR Counselor:❑Yes nNo Date sent:
Linkedln page (optional)
Sent to Student and DVR Counselor: ❑Yes❑No Date sent:
DVRSchootToWork@dshs.wa.gov
16
YOU WERE OFFERED THE JOB !
WAY TO GO !
JOB OFFER DETAILS:
Did you accept this offer? YES
NO
If yes, please complete the section below.
If no, please explain:
Job Goal:
Employer:
Job Title:
Start Date:
Job Duties:
Expected Weekly Hours:
Starting Wage:
Location:
Transportation Considerations:
Benefits Package:
Potential Training Services and Date/Additional Info:
DVRSchoolToWork@dshs.wa.gov 17
PHASE 3: Employment
CONGRATS, YOU HAVE A JOB !
Items to include in this section are:
• Job Verification
• Your Supports on the Job
• Job Stabilization Report
1 WAR
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18
CONGRATULATIONS, YOU ARE EMPLOYED !
Now what?
Please work with your job coach to complete the form below:
The following is to be filled out by the contractor.
EMPLOYEE'S NAME EMPLOYER'S NAME
EMPLOYEE'S JOB TITLE EMPLOYER'S ADDRESS
DATE EMPLOYEE STARTED WORK
Is this a new job?[]No []Yes
AVERAGE HOURS PER WEEK RATE OF PAY OR SALARY(HOURLY, DAILY OR PIECE RATE)
Pay frequency: [aily Weekly Every two weeks [Two times a month []Monthly
Tips No Yes; if yes, how often and how much?
Commissions No [] Yes; if yes, how often and how much?
Bonuses - No — Yes; if yes, how often and how much?
Overtime - No Yes; if yes, how often and how much?
Work schedule (include exact times when possible):
MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY SUNDAY
Is Health Insurance available?[]Yes No
1. If yes, is employee enrolled in the health plan? Yes []No
a) When does the coverage begin?
b) What is the employee's portion of premiums?
CONTRACTOR/REPRESENTATIVE'S PRINTED NAME AND TITLE DATE
DVRSchootToWork@dshs.wa.gov
YOUR SUPPORTS ON THE JOB
The strengths you bring to the job!
How you will become stable on the job (your fading plan):
Additional training, services, and supports could include:
4"` D_ The support you receive on the job from the beginning will be shared with you and your
0 team in the monthly notes at the end of this guide.
DVRSchoolToWork@dshs.wa.gov
JOB STABILIZATION REPORT
You are considered stable on the job when:
a. Your placement hours are met (unless you and your team agree the job represents
suitable employment)
b. Your DVR Counselor, your job coach, and your employer agrees that you meet your
employer's expectations (this is verified by your job coach)
c. And you are ready for long term support
But first...
Did you meet your expected goal? YES_ NO_
Was your starting wage what you wanted? YES_ NO_
Does the job location meet your expected needs? YES NO
Anything else you want to add about your job?
Job Stabilization Summary:
Detail and summarize how the placement hours were met (or if the job represents suitable
employment)
DVRSchoolToWork@dshs.wa.gov
Detail and summarize how it has been agreed that the employer's expectations have been
r for
met. Please provide descriptions and details as to how stabilization occurred o the e
employer's expectations to be met.
Detail and summarize how long-term supports are set up and will occur.
DVRSchoolToWork@dshs.wa.gov
HELPFUL RESOURCES
4,410. DEVELOPMENTAL DISABILITIES ADMINISTRATION (DDA)
.11111 • Website:www.dshs.wa.gov/dda
'111 11.
vo IP, • DDA Eligibility Information:www.dshs.wa.gov/dda/consumers-and-
families/eligibility
`ii DIVISION OF VOCATIONAL REHABILITATION (DVR)
. NI NI : • Website:www.dshs.wa.gov/dvr
. ■ . .
• Phone: 1-800-637-5627
SOCIAL SECURITY ADMINISTRATION
• Website:wwwssa.gov
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• Phone: 1-800-772-1213 e F----
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23
OTHER HELPFUL CONTACTS
Name:
Phone:
Email:
Other:
Name:
Phone:
Email:
Other:
Name:
Phone:
Email:
Other:
DVRSchootToWork@dshs.wa.gov 24
11-21"11:s.,
OPTIONAL DOCUMENTS I ._
10
MEM
❑Copy of Food Handlers Card
Sent to Student and DVR Counselor: Yes ❑ No Date:
CI Copy of Current CPR and/or First Aid
Sent to Student and DVR Counselor: Yes ❑ No ❑ Date:
❑*Other:
Sent to Student and DVR Counselor: Yes No ❑ Date:
❑ *Other:
Sent to Student and DVR Counselor: Yes n No n Date:
*Ideas of other items to include could be a person-centered plan, other
certifications, and other job-related documents.
Tip: This page may or may not be applicable. Students are encouraged to include(D_
4 documents that are focused on their future and employment after school.
DVRSchootToWork@dshs.wa.gov 25
MONTHLY PROGRESS REPORTS
May
June
July
August
September
DVRSchoolToWork@dshs.wa.gov 26
October
November
December
January
February
March
April
May
June
July
August
September
NOTES
DVRSchoolToWork@dshs.wa.gov 29
T H ANK YOU !
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