HomeMy WebLinkAboutGrant Related - New Hope DV/SAV
June" 28, 2022
Board of Grant County Commissioners
PO Box 37
Ephrata, WA 98823
RE, gnature for Contra
ct #2263-43066
Dear Board of County Commissioners:
Please see attached contract for review and. s!t
gna ure.
Contractor: :DSHS
Term of Contrgct: 4.1,,202 . 2 to 3.31.20-25
Purpose'. The purpose of this Contract is to support. increased access to servi d
i e. ces an
supports for domestic violence survivors and. their dependentsv h, o have been i impacted
i
by the COVID-19 virus and the COVID-19 public health emergency, wi . . a n inteinton-Il a
ith
focus on Mitigating the spread of COVI.D-19 and *improving domestic vionce surviv I e ' ors,
access to healthcare,
Amount: $161,400
Suzi Fode is requestina vour signa
Wr AW t r n: the attached contract
Thank you for your consideration,
Suzi Fede, Director
Kids Hope and Nev Hope
DSHS Central Contract Services
3088CS FVPSA DV Health Supports and COVID Mitigation (4-15-2022) Page 1
DSHS Agreement Number
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ial
COUNTY PROGRAM AGREEMENT
2263-43066
71DJtV &epartment
Healthy
FVPSA DV Health Supports
Transforming lives
And COVID Mitigation
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
General Terms and Conditions, which is incorporated by reference.
Count Agreement Number
y g
DSHS ADMINISTRATION
DSHS DIVISION
DSHS INDEX NUMBER
DSHS CONTRACT CODE
Economic Services
Community Services Division
1221
3088CS-63
Administration
DSHS CONTACT NAME AND TITLE
DSHS CONTACT ADDRESS
Mette Earlywine
ESA CSD HQ
Program Manager
712 Pear Street SE
Olympia, WA 98501
DSHS CONTACT TELEPHONE
DSHS CONTACT FAX
DSHS CONTACT E-MAIL
360 790-8794
Click here to enter text.
earl me dshs.wa. ov
COUNTY NAME
COUNTY ADDRESS
Grant County
311 W. Third Ave.
New Hope Domestic Violence and Sexual
Moses Lake, WA 98837
Assault Sery
COUNTY FEDERAL EMPLOYER IDENTIFICATION
COUNTY CONTACT NAME
NUMBER
Suzi Fode
COUNTY CONTACT TELEPHONE
COUNTY CONTACT FAX
COUNTY CONTACT E-MAIL
509 764-8402
sfode rantcount a. ov
IS THE COUNTY A SUBRECIPIENT FOR PURPO7E'SOF THIS PROGRAM
CFDA NUMBERS
AGREEMENT?
93.671
Yes
PROGRAM AGREEMENT START DATE
PROGRAM AGREEMENT END DATE
MAXIMUM PROGRAM AGREEMENT AMOUNT
04/01/2022
1 03/31/2025
$161,400.00
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 — Statement of Work (SOW); Exhibit B — Program Requirements; Exhibit C —
InfoNet Data Requirements; Exhibit D — Budget
❑ 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 b DSHS.
COUNTY SIGNATURE(S)
PRINTED NAME(S) AND TITLE(S)
DATE(S) SIGNED
Danny E Stone, BOCC Chair
DSHS SIGNATURE
PRINTED NAME AND TITLE
DATE SIGNED
Shannon Williams, Contracts Officer
DSHS/ESA/Community Services Division
DSHS Central Contract Services
3088CS FVPSA DV Health Supports and COVID Mitigation (4-15-2022) Page 1
Special Terms and Conditions
1. Definitions Specific to Special Terms. The words and phrases listed below, as used in this Contract,
shall each have the following definitions:
a. "Advocacy" means that the client is involved with an advocate in individual or group sessions with a
primary focus of safety planning, empowerment, and education of the client through reinforcement
of the client's autonomy and self-determination. Advocacy also means speaking and acting for
change or justice with, or on behalf of, another person or cause. Advocacy is survivor -centered and
uses non -victim blaming methods that include:
(1) Identifying barriers and strategies to enhance, safety, including safety -planning.
(2) Clarifying and increasing awareness of the power and control associated with domestic violence
and the options one may have to obtain resources while staying safe.
(3) Supporting independent decision-making based on the unique needs and circumstances of
each individual.
b. "Advocate" means a trained staff person who works in a domestic violence program and provides
advocacy to clients.
c. "Child care" means the temporary care of a client's child or children by staff of the domestic
violence program at the program's location or another location where the client is receiving
confidential or individual services from the domestic violence program or is participating in activities
sponsored by the domestic violence program, other than employment, and so long as the client
remains on the premises.
d. "Children/Youth Activities" means age-appropriate activities other than children/youth advocacy,
such as recreational and educational activities.
e. "Children/Youth Advocacy" means age-appropriate supportive services that strives to assist
children/youth to express feelings about their exposure to domestic violence. It is an educational,
rather than a therapeutic service, and is focused on providing education about domestic violence,
safety planning, and developing or enhancing problem -solving skills. Advocacy can be provided on
an individual basis and in group settings.
f. "Client" means a victim of domestic violence who is accessing services at a domestic violence
program. A client may also be referred to as a survivor, service recipient, or resident.
g. "Community advocate" means a person employed or supervised by a domestic violence program
who is trained to provide ongoing assistance and advocacy for victims of domestic violence in
assessing and planning for safety needs, making appropriate social service, legal, and housing
referrals, providing community education, maintaining contacts necessary for prevention efforts,
and developing protocols for local systems coordination.
h. "Community -Based Domestic Violence Program" or "CBDVP" means an organization that provides,
as its primary purpose, assistance and advocacy for domestic violence victims. Domestic violence
assistance and advocacy includes crisis intervention, individual and group support, information and
referrals, and safety assessment and planning. Domestic violence assistance and advocacy may
also include, but is not limited to, provision of shelter; emergency transportation; self-help services;
culturally specific services; legal advocacy; economic advocacy; and accompaniment and advocacy
through medical, legal, immigration, human services, and financial assistance systems. CBDVPs
also provide community education and prevention efforts. Domestic violence programs that are
under the auspices of, or the direct supervision of, a court, law enforcement or prosecution agency,
or the child protective services section of the department as defined in RCW 26.44.020 are not
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Special Terms and Conditions
considered CBDVPs.
i. "Community Education" means information that is provided in community settings about domestic
violence and services related to victims of domestic violence. Community education activities
include: training, presentations, outreach to specific communities or geographic areas, community
events, and media events.
j. "Compliance Agreement" means a written plan approved by DSHS which identifies deficiencies in
Contractor's performance, describes the steps Contractor must take to correct the deficiencies, and
sets forth timeframes within which such steps must be taken to return Contractor to compliance with
the terms of the Contract.
k. "Confidential Communication" means all information, oral, written or nonverbal, that is transmitted
between a victim of domestic violence and an employee or volunteer of a domestic violence
program in the course of their relationship and in confidence, which means that the employee or
volunteer will not disclose the information to a third person unless authorized in writing by the
victim.
"Confidential Information" includes, but is not limited to, any information, advice, notes, reports,
statistical data, memoranda, working papers, records or the like, made or given during the
relationship between a victim of domestic violence and a domestic violence program, however
maintained. Confidential information includes personally identifying information (see definition
below) and other information that would personally identify a victim of domestic violence who seeks
or has received services from a domestic violence program.
m. "Crisis Hotline" or "Crisis Helpline" means a designated telephone line of the domestic violence
program that operates twenty-four (24) hours a day, three hundred sixty-five (365) days a year. A
hotline/helpline provides crisis intervention, safety planning, information, and referral services.
n. "Crisis Intervention" means services provided to an individual in crisis to stabilize an individual's
emotions, clarify issues, and provide support and assistance to help explore options for resolution
of the individual's immediate crisis and needs.
o. "Culturally Specific Supportive Services and Prevention Efforts" means services and prevention
efforts created by and for specific cultural populations that have been historically underserved or
unserved. Services and prevention efforts are typically designed by and with individuals from the
specific culture who are cognizant of the specific community generated risks and protective
characteristics and often utilize the language and settings familiar to the population served.
p. "Domestic Violence" means the infliction or threat of physical harm against an intimate partner, and
includes physical, sexual, and psychological abuse against the partner, and is a part of a pattern of
assaultive, coercive, and controlling behaviors directed at achieving compliance from or control over
that intimate partner. It may include, but is not limited to, a categorization of offenses, as defined in
RCW 10.99.020, committed by one intimate partner against another.
q. "Domestic Violence Program" means an agency, organization, or program with a primary purpose
and history of effective work in providing advocacy, safety assessment and planning, and self-help
services for domestic violence victims in a supportive environment, and includes, but is not limited
to, a CBDVP, emergency shelter, or domestic violence transitional housing program.
r. "Emergency Shelter" means a place of supportive services and safe, temporary lodging offered on
a twenty-four hour, seven-day per week basis to victims of domestic violence and their children.
Domestic violence programs may use hotels and motels for victims who need safe shelter, but the
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Special Terms and Conditions
domestic violence program must also have an emergency shelter that meets the requirements of
Washington Administrative Code (WAC) 388-061A. The mere act of making a referral to emergency
shelter is not itself considered provision of emergency shelter.
s. "Intimate Partner" means a person who is or was married, in a state registered domestic
partnership, or in an intimate or dating relationship with another person at the present or at some
time in the past. An intimate partner is also any person who has one or more children in common
with another person, regardless of whether they have been married, in a domestic partnership with
each other, or lived together at any time.
t. "Job Shadowing" means a work experience where an individual observes and learns about a job,
activity, or activities by walking through the work day as a shadow to a skilled and competent
employee. The experience is planned for and structured with the goal of observing behavior and
situations, engaging in interactive questions and answers, and experiencing the link between
learning and practice. Job shadowing may be anywhere from a few hours, to a day, week, or more,
depending on the job or activity.
u. "Legal Advocacy" means personal support and assistance with victims of domestic violence to
ensure their interests are represented and their rights upheld within the civil and criminal justice
systems, including administrative hearings. It includes educating and assisting victims in navigating
the justice systems; assisting victims in evaluating advantages and disadvantages of participating in
the legal processes; facilitating victims' access and participation in the legal systems; and
promoting victims' choices and rights to individuals within the legal systems.
V. "Legal Advocate" means a person employed by a domestic violence program or court system to
advocate for victims of domestic violence, within the civil and criminal legal systems and
administrative hearings, by attending court proceedings, assisting in document and case
preparation, and ensuring linkage with the community advocate.
W. "LEP" means Limited English Proficiency, and indicates an individual's need for additional support
and assistance in comprehending the English language.
X. "Live Training" means events that are held at a specific time and not prerecorded, where
participants have the opportunity to ask questions and hear the questions of others in real time.
Examples of live training include events that are in person, teleconferences, and interactive.
y. "Lodging Unit" means one or more rooms used for a victim of domestic violence including rooms
used for sleeping or sitting.
Z. "Match" means the Contractor's share of the contracted program costs. Match may either be "in-
kind" or "cash." Cash match includes actual cash spent by the Contractor to support the contracted
services such as non-federal money contributions from public agencies and private organizations or
individuals, such as donations. In-kind match includes the value of donated goods and services
used to support the contracted services. In-kind contributions can include such things as donations
of expendable equipment; office supplies; workspace; and the monetary value of time contributed
by professionals, technical personnel, and other skilled and unskilled labor (volunteer), so long as
the donated services provided are an integral part of the funded program. All match shall be
documented.
aa. "Personally Identifying Information" means individually identifying information for or about an
individual including information likely to disclose the location of a victim of domestic violence,
regardless of whether the information is encoded, encrypted, hashed, or otherwise protected,
including, but not limited to:
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(1) First and last name;
(2) Home or other physical address;
(3) Contact information (including postal, email or Internet protocol address or telephone or
facsimile number);
(4) Social security number;
(5) Driver's license number, passport number, or student identification number;
(6) Religious affiliation;
(7) Date of birth;
(8) Nine digit postal (ZIP) code;
(9) Physical appearance of;
(10) Case file or history; and
(11) Other information that would personally identify a victim of domestic violence who seeks
or has received services from a domestic violence program, or such other information which,
taken individually or together with other identifying information, could identify a particular
individual.
bb. "Prevention" means efforts that are designed to ultimately eradicate domestic violence through the
promotion of healthy, respectful, and nonviolent relationships. Successful domestic violence
prevention efforts address change at both the individual and community levels, and tailor messages
to diverse populations. Characteristics of promising prevention practices include working to
decrease risk factors for perpetration of abuse as well as victimization, while at the same time
promoting positive factors that protect individuals from perpetrating or experiencing abuse.
(1) Domestic violence prevention includes strategies, policies and programs that focus on at least
one (1) of the following:
(a) Increasing community dialogue about the root causes of intimate partner violence
(b) Shifting cultural norms
(c) Building skills for healthy relationships
(d) Promoting respectful and healthy relationship
(2) Examples of activities that are not considered prevention include:
(a) Community education as defined in this Contract;
(b) Transformative and restorative justice efforts;
(c) Single session or one-time activities, such as trainings, presentations, or events;
(d) Activities that focus on defining domestic violence, or teaching data, dynamics, and the
impacts of domestic violence;
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Special Terms and Conditions
(e) Providing information on how to access domestic violence services or how to help others in
accessing services;
(f) Support groups as defined in this Contract (support groups are considered a supportive
service); and
(g) Activities that focus on improving responsiveness to domestic violence survivors by
community members or system partners.
cc. "Resident" means a client of the domestic violence program who is residing in a shelter as defined
in this Contract.
dd. "Safety Planning" means a process of thinking through with the victim how to increase safety for
both the victim of domestic violence and any children of the victim. Safety planning addresses both
immediate and long term risks, barriers, or concerns regarding the victim and any dependent
children in the context of their communities and in relationship with the domestic violence
perpetrator. It is based on knowledge about the specific pattern of the domestic violence
perpetrator's tactics and the protective factors of the victim and any dependent children. Safety
planning can be done formally, informally, in writing or orally, or in any other conversational process
between the victim and advocate.
ee. "Secretary" means the department secretary or the secretary's designee.
ff. "Self -study" is a form of study in which one is, to a large extent, responsible for one's own
instruction. Examples of self -study include reading articles, books, academic journals, training
materials, engaging in online learning opportunities, and prerecorded webinars. Self -study content
must be current or have historical relevance to the domestic violence advocacy field.
gg. "Shelter" means temporary lodging and supportive services, offered by a CBDVP to victims of
domestic violence and their children.
hh. "Staff' means trained persons who are part of a domestic violence program and are paid or
volunteer to provide services to clients.
ii. "Subcontractor" means an individual or entity to perform all or a portion of the duties and obligations
that the Contractor is obligated to perform pursuant to this Contract. The Contractor shall have a
written subcontract for any service required by the contract that is performed for a fee by an entity
who is not an employee of the contracted program. Subcontracting for certain services may be
necessary for the Contractor, but in all cases shall require prior written approval by DSHS. Any
subcontractor shall meet the same contractual requirements as the Contractor.
ji. "Support Group" means interactive group sessions of two or more victims of domestic violence that
is facilitated by trained staff on a regular basis. Participants share experiences, offer mutual
support, and receive information and education around a specific topic of common interest.
Support groups validate the experiences of victims, explore options, build on strengths, and respect
participants' rights to make their own decisions. A shelter or house meeting where, for example,
chores are discussed, and there is no advocacy provided, is not a support group.
kk. "Supportive Services" means assistance and advocacy for victims of domestic violence and their
children that are designed to meet the needs of victims and children and provided in accordance
with the service model defined in this chapter. Supportive services include, but are not limited to,
activities described in the definition of CBDVP.
II. "Underserved" or "Unserved Populations" means populations who face barriers in accessing and
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Special Terms and Conditions
using victim services, including populations underserved or unserved because of religion, sexual
orientation, or gender identity or expression, underserved or unserved racial and ethnic populations,
and populations underserved because of special needs including language barriers, disabilities,
immigration status, and age.
mm. "Victim" means an intimate partner who has been subjected to domestic violence.
2. Purpose. The purpose of this Contract is to:
The purpose of this Contract is to support increased access to services and supports for domestic
violence survivors and their dependents who have been impacted by the COVI D-19 virus and the
COVID-19 public health emergency, with an intentional focus on mitigating the spread of COVID-19
and improving domestic violence survivors' access to health care, as further described in the Contract
Statement of Work, Exhibit A. In performing the services, requirements and activities covered by this
Contract, the Contractor shall comply with all applicable requirements of the federal American Rescue
Plan Act of 2021, the Family Violence Prevention Services Act (FVPSA), 42 U.S.C. Title 42, Chapter
110, the 2021 Family Violence Prevention and Services Act American Rescue Plan COVI D-19 Testing,
Vaccines, and Mobile Health Units Access Supplemental Funding Program Instruction, the Uniform
Administrative Requirements, Costs Principles, and Audit Requirements for HHS Awards, and the
applicable provisions of chapter 70.123 RCW and WAC 388-61A.
3. Statutory or Administrative Rule Changes.
In the event that DSHS should need to incorporate statutory or administrative rule changes relating to
contract services and/or requirements, the parties agree to negotiate in good faith the incorporation of
such additional requirements in this Contract, either by an amendment to this Contract or by a revised
contract that would replace this Contract.
4. Statement of Work — Exhibit A. 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:
The Contractor shall ensure that services provided under this Contract at all times meet the
specifications in the Statement of Work, attached as Exhibit A. The Contractor's submittal in the
associated FVPSA DV Health Supports and COVID Mitigation Funds application, as approved by
DSHS for this Contract, is incorporated by reference in this Contract.
5. Program Requirements — Exhibit B
The Contractor shall ensure that all qualifications, performance expectations and program requirements
for services provided under this Contract at all times meet the specifications described in the Program
Requirements attached as Exhibit B.
6. InfoNet Data Requirements — Exhibit C
The Contractor shall comply with the requirements for entering mandatory data into the InfoNet data
collection system, as stated in the InfoNet Data Requirements attached as Exhibit C.
7. Budget— Exhibit D
a. Contractor's budget for providing services under this Contract during the term of the Contract for the
period of performance stated on page 1 of this Contract is attached as Exhibit D. This budget is
based on the Contractor's budget submittal in the associated FVPSA DV Health Supports and
COVID Mitigation Funds application, as approved by DSHS for this Contract. If the approved
budget includes equipment which was approved for purchase by the DSHS Program Manager for
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Special Terms and Conditions
this Contract, ownership of the equipment shall be retained by the Contractor.
b. With the exception of Indirect costs, transfer of funds between and among line item budget
categories of the approved Budget must be requested in writing by the Contractor if the cumulative
amount of these transfers exceeds or is expected to exceed $2,000. Budget adjustment requests
must be submitted in writing to the DSHS Program Manager on the Contract Budget Revision
Request form, and are subject to justification and negotiation. Approved budget revisions shall be
incorporated by reference into this Contract as Addendums to Budget Exhibit D and shall not
require separate amendments. Transfer of funds to the Indirect Cost line item prohibited.
c. Notwithstanding any provision of this Contract to the contrary, at any time during the period of
performance, DSHS may analyze Contract expenditures as a proportion of the Contract budget. If
DSHS determines, in its sole discretion, that the Contract funding is underutilized, DSHS, in its sole
discretion, may unilaterally modify the Contract to reduce the balance of the Contract budget.
8. Consideration.
a. Maximum Contract Amount. The maximum amount of total compensation payable to the
Contractor for satisfactory performance of the work under this Contract is the amount stated on
page 1 of this Contract under "Maximum Contract Amount".
b. Allotted Funds. Funds allotted are Supplemental Family Violence Prevention and Services Act
(FVPSA) Funds allocated to the Department of Health and Human Services in the federal American
Rescue Plan Act of 2021. The CFDA Number is 93.671.
c. Obligation and Liquidation of Funds. Contractor shall obligate all funds received under this Contract
by the Contract end date listed on Page 1 of this Contract. All obligated funds shall be liquidated no
later than thirty (30) days after the Contract end date listed on Page 1 of this Contract, without
exception.
d. Travel Expenses. Travel expenses incurred or paid by the Contractor shall be reimbursed at a rate
not to exceed the current state rate and in accordance with the State of Washington Office of
Financial Management Travel Regulations. Any out-of-state travel must be approved in advance by
the DSHS Contract Manager for this Contract. Travel expenses are included in the maximum
contract amount for this Contract. Current rates for travel may be accessed at:
https,.Hofm.wa.gov/accounting/administrative-accounting-resources/travel.
9. Billing and Payment.
a. The Contractor shall submit a monthly or bimonthly (every two months) invoice for services
performed under this Contract on State of Washington Invoice Voucher forms (Form A-19),
prepared in the manner prescribed by DSHS. Invoices shall not be submitted more frequently than
monthly.
b. The voucher shall be on pre-printed invoice forms provided to the Contractor by DSHS and shall
clearly indicate the contract number, invoice period, and the total reimbursement requested.
c. The invoice shall state the total amount of expenses incurred by the Contractor that is based on the
line items listed in the Budget Exhibit attached as Exhibit D. The invoice submittal shall include the
following
(1) A spreadsheet that includes the Contract budget by line item, amount requested for the invoice
by line item, contract -to -date expenditures by line item, and Contract balance by line item.
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(2) An Invoice Documentation worksheet for any salaries, benefits, subcontracted services, and
goods and services expenses the Contractor is charging to the Contract. Items that are eligible
for reimbursement will be those negotiated from the Contractor's application and as agreed to
by DSHS. Contractor shall not submit copies of expenditure source documentation unless
requested by DSHS.
(3) Upon request by the DSHS Program Manager for this Contract, Contractor shall attach, or
submit, copies of all source documentation for expenditures claimed on invoice vouchers
submitted for payment, in the manner requested by DSHS.
d. The cost or expense billed for each such line item shall be charged against the total amount listed
for that line item in Exhibit D. The cumulative dollar amount for each such line item, for all invoices
submitted by the Contractor, shall not exceed the total dollar amount stated for that line item in the
Budget Exhibit, except as provided in Special Terms and Conditions, Section 7 Budget — Exhibit D,
Subsection b., above.
e. Original A-19 invoice vouchers shall be submitted electronically to the DSHS Contact Name listed
on page 1 of this Contract. The Contractor shall contact the DSHS Contact Name listed on page 1
of this Contract concerning billing questions.
f. Claims for payment submitted by the Contractor shall be paid by DSHS if received by DSHS no
later than sixty (60) days from the date services were rendered; EXCEPT, the final invoice for
services performed under this Contract shall be submitted to DSHS no later than thirty (30) days
after the Contract end date listed on page 1 of this Contract, without exception.
g. DSHS will not be obligated to pay for services submitted more than three (3) months after the
calendar month in which the services were performed.
h. DSHS shall make payment within thirty (30) days of receipt of a properly completed invoice for
services.
i. Contractor certifies that work performed under this Contract does not duplicate any work to be
charged against any other Contract, subcontract, private grant or other state or federal funding
source.
j. DSHS may stop payment to the Contractor if reports, activities, or other documentation required
under this Contract are delinquent, i.e., not submitted within ten (10) days of the due date, or are
incomplete.
k. DSHS may, at its sole discretion, withhold or deny payment claimed by the Contractor for services
rendered if Contractor fails to satisfactorily comply with any term or condition of the Contract.
10. Meals and Refreshments — Limitations
With the exception of food purchased by the Contractor for residents of the Contractor's emergency
domestic violence sheltering service, any meals or refreshments provided by the Contractor, as part of
the contracted services provided, are subject to limitations under the RCW and state and federal
regulations as to (1) the circumstances under which they may be provided and claimed as an expense
under the Contract, and as to (2) the amount of that cost that may be claimed for reimbursement from
DSHS under the Contract.
a. Meals, refreshments, or food services provided by the Contractor in connection with services
provided under the Contract must be an integral part of the service or activity provided by the
Contractor and must advance or support the purpose of the Contract for which the services are
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Special Terms and Conditions
provided.
b. The cost of any meals provided by the Contractor in connection with the services provided under
this Contract must meet the published requirements and guidelines of the Office of Financial
Management (OFM) applicable to Washington State employees, in order for DSHS to reimburse the
Contractor for such costs. In the event such costs exceed the amounts allowable by OFM, DSHS
will reimburse the Contractor up to, but not to exceed, the amount otherwise allowable by OFM.
(1) OFM requirements for reimbursement for meals with meetings may be found at:
http://www.ofm.wa.gov/policv/70.15.htm.
(2) OFM rates for reimbursement may be found at: https://ofm.wa.gov/accounting/administrative-
acco u nti ng -resp u rces/trave I .
11. Payment Only for Authorized Services
DSHS shall pay the Contractor only for authorized services provided in accordance with this
Contract. If this Contract is terminated for any reason, DSHS shall pay only for services authorized and
provided through the date of termination.
12. Funding Stipulations
a. Duplicate BillincL The Contractor must not bill other funding sources for services rendered under
this Contract which would result in duplicate billing to different funding sources for the same
service. Furthermore, the Contractor shall ensure that no subcontractor bills any other funding
sources for services rendered under this Contract, which would result in duplicate billing to different
funding sources for the same service.
b. Match. Match is not required for the Supplemental FVPSA funds allocated in the American Rescue
Plan Act of 2021.
13. Recovery of Fees for Noncompliance
In the event the Contractor bills for services provided and is paid fees for services that DSHS later finds
were either a) not delivered b) unallowable, or c) not delivered in accordance with applicable standards
or the requirements of this Contract, DSHS shall have the right to recover the fees for those services
from the Contractor, and the Contractor shall fully cooperate during the recovery process.
14. Overpayments and Assertion of Lien
In the event that DSHS establishes overpayments or erroneous payments made to the Contractor
under this Contract, DSHS may secure repayment, plus interest, if any, through the filing of a lien
against the Contractor's real property, or by requiring the posting of a bond, assignment of deposit, or
some other form of security acceptable to DSHS.
15. Administrative and National Policy Requirements
Awards issued under this funding opportunity are subject to 45 CFR Part 75 - Uniform Administrative
Requirements, Cost Principles, and Audit Requirements for HHS Awards currently in effect or
implemented during the period of award, other Department regulations and policies in effect at the time
of award, and applicable statutory provisions. The Code of Federal Regulations (CFR) is available at
www.ecfr.gov. Unless otherwise noted in this section, administrative and national policy requirements
that are applicable to discretionary grants are available at: www.acf.hhs.gov/administrative-and-
national-policy-requirements
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An application funded with the release of federal funds through a grant award does not constitute or
imply compliance with federal regulations. Funded organizations are responsible for ensuring that their
activities comply with all applicable federal regulations.
16. HHS Grants Policy Statement
The HHS Grants Policy Statement (HHS GPS) is HHS's single policy guide for discretionary grants and
cooperative agreements. ACF grant awards are subject to the requirements of the HHS GPS, which
covers basic grants processes, standard terms and conditions, and points of contact, as well as
important agency -specific requirements. The general terms and conditions in the HHS GPS will apply
as indicated unless there are statutory, regulatory, or award -specific requirements to the contrary that
are specified in the Notice of Award. The HHS GPS is available at
https://www.hhs.gov/sites/default/files/grants/grants/policies-requiations/hhscgpsl 07.pdf
17. Restrictions on Lobbying
a. In general, as a matter of federal law, federal funds awarded may not be used by the Contractor, or
any Subcontractor at any tier, either directly or indirectly, to support or oppose the enactment,
repeal, modification, or adoption of any law, regulation, or policy at any level of government. See 18
U.S.C. 1913. (There may be exceptions if an applicable federal statute specifically authorizes
certain activities that otherwise would be barred by law.)
b. Another federal law generally prohibits federal funds awarded from being used by the Contractor, or
any Subcontractor at any tier, to pay any person to influence (or attempt to influence) a federal
agency, a Member of Congress, or Congress (or an official or employee of any of them) with
respect to the awarding of a federal grant or cooperative agreement, subgrant, contract,
subcontract, or loan, or with respect to actions such as renewing, extending, or modifying any such
award. See 31 U.S.C. 1352. Certain exceptions to this law apply, including an exception that
applies to Indian tribes and tribal organizations.
c. Should any question arise as to whether a particular use of federal funds by a Contractor (or
Subcontractor) would or might fall within the scope of these prohibitions, the Contractor is to contact
DSHS for guidance, and may not proceed without the express prior written approval of DSHS.
18. Business/Financial Assessment
a. The Contractor authorizes DSHS to obtain a financial assessment and/or credit report of the
Contractor's corporation and/or business, and of the principal owner(s) of the corporation and/or
business, at any time prior to or during the term of this Contract. A "principal owner" includes
person(s) or organization(s) with a 25% or more ownership interest in the business.
b. DSHS may deny, suspend, terminate, or refuse to renew or extend a Contract if, in the judgment of
DSHS, the Contractor or any partner or managerial employee of the Contractor, or an owner of 50%
or more of the Contractor entity, or an owner who exercises control over the Contractor's daily
operations:
(1) Has a credit history which could adversely affect the Contractor's ability to perform the
Contract;
(2) Has failed to meet a financial obligation as the obligation fell due in the normal course of
business; or
(3) Has filed for bankruptcy, reorganization, or receivership within five (5) years of the start date of
the Contract.
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19. Compliance Agreement
In the event that DSHS identifies deficiencies in Contractor's performance under this Contract, DSHS
may, at its option, establish a Compliance Agreement. When presented with a Compliance Agreement,
Contractor agrees to undertake the actions specified in the Agreement within the timeframe given to
correct the deficiencies. Contractor's failure to do so shall be grounds for termination of this Contract.
20. 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 staff or
employee or volunteer of the Contractor or a subcontractor, is investigated by DSHS or a local,
state or federal agency regarding any matter that, if ultimately established, could either:
(1) Result in a conviction for violating local, state or federal law, or
(2) In the sole judgment of DSHS, adversely affect the delivery of services under this Contractor
the health, safety or welfare of clients being served by this Contract.
b. DSHS may also take other lesser action, including, but not limited to, disallowing a staff member,
employee, or other person associated with the Contractor or a subcontractor from providing
services, or from having contact with clients being served by this Contract, until the investigation is
concluded and a final determination made by the investigating agency.
21. Insurance.
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:
F-1 The Contractor is self-insured or insured through a risk pool and shall pay for losses
for which it is found liable; or
F-1 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.
22. Disputes
a. Either party who has a dispute concerning this Contract may submit a written request for dispute
resolution. The amount of any rate set by law, regulation, or DSHS policy is not disputable. A
party's written request for dispute resolution must include:
(1) A statement identifying the issue(s) in dispute; and
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(2) The Contractor's name, address, and contract number.
b. The request must be mailed to the following address within thirty (30) calendar days after the party
could reasonably be expected to have knowledge of the issue which is disputed.
c. A copy of the current DSHS dispute resolution process is available at any time by written request.
d. Requests for dispute resolution or for a copy of the current DSHS dispute resolution process should
be sent to:
Department of Social and Health Services
Attention: Domestic Violence Unit
PO Box 45470
Olympia, WA 98504-5440
e. This dispute resolution process is the sole administrative remedy available under this Contract.
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EXHIBIT A
STATEMENT OF WORK
FVPSA DV Health Supports and COVID Mitigation Funding
April 1, 2022— March 31, 2025
Contractor shall provide the following services and activities as described in this Statement of Work.
Services and activities shall be provided as described in the Contractor's FVPSA DV Health Supports and
COVID Mitigation Funding application, as approved by DSHS, which is incorporated into this Contract by
reference.
In performing the services, requirements and activities covered by this Contract, the Contractor shall comply
with all applicable requirements of
• the federal American Rescue Plan Act of 2021,
• the Family Violence Prevention Services Act (FVPSA), 42 U.S.C. Title 42, Chapter 1101
• the 2021 Family Violence Prevention and Services Act American Rescue Plan COVI D-19 Testing,
Vaccines, and Mobile Health Units Access Supplemental Funding Program Instruction,
• the Uniform Administrative Requirements, Costs Principles, and Audit Requirements for HHS Awards,
and the applicable provisions of chapter 70.123 RCW and WAC 388-61A.
Contractor shall:
1. Provide COVID testing kits for staff and program participants as needed, consistent with local, state
and federal public health guidance.
2. Provide information and referral about testing, vaccines, and boosters to program participants
upon request, consistent with local, state and federal public health guidance.
3. Provide the services listed below, in accordance with the Contractor's approved application.
a. Financial assistance. If any of the services below involve providing emergency financial assistance
or housing assistance to domestic violence survivors, such financial and housing assistance shall
be paid directly to the vendor. FVPSA funds may not be provided directly to a program participant.
b. Ineligible costs. The following are ineligible costs under this Contract:
(1) Direct payments to survivors.
(2) Construction costs.
(3) Renovation costs.
(4) Purchase of single items with a purchase price more than $5,000.
DV Health Supports
Activities and services to improve access to health care for DV survivors and their dependents.
c. Facilitate access to health care and/or behavioral health care through transportation, childcare
supports or other financial supports so survivors and their children can seek and receive health care
services related to COVID mitigation. Healthcare access services may include, but are not limited
to:
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(1) assistance with enrolling in a healthcare plan,
(2) establishing a primary care provider,
(3) providing health education, and
(4) providing interpreters, translating materials, and developing and distributing linguistically specific
and/or culturally appropriate materials.
COVID-19 Mitigation
Testing, vaccines, and other activities to mitigate the spread or impact of COVID-19.
d. Provide safe, voluntary access to testing for staff and program participants onsite at a
Contractor's facility or other location(s) that are safe and accessible for domestic violence survivors
and their dependents.
e. Provide safe, voluntary access to vaccines for staff and program participants onsite at a
Contractor's facility or other location(s) that are safe and accessible for DV survivors and their
dependents.
f. Facilitate access to testing and vaccines through transportation, childcare supports or other
financial supports for survivors and their children to seek and obtain COVID testing, vaccines and
boosters. Additional testing and vaccines access services may include, but are not limited to:
(1) providing health education, and
(2) providing interpreters, translating materials, and developing and distributing linguistically specific
and/or culturally appropriate materials related to COVI D-19 testing, vaccines and mitigation
strateg ies.
Workforce Development, Retention and Resilience
g. Support continuity of domestic violence services by sustaining an advocacy workforce to
prevent, prepare for, and respond to the needs of domestic violence survivors impacted by the
COVI D-19 public health emergency. Such expenses may include, but are not limited to:
(1) behavioral health supports for DV program staff and volunteers,
(2) hiring bonuses and retention payments,
(3) compensation and benefits improvements,
(4) childcare supports, transportation subsidies, and other fringe or personal benefits.
Hiring bonuses, retention payments, and fringe or personal benefits must be eligible under federal
regulations, made available to all eligible positions regardless of whether the position is supported
with federal funds, and included in the Contractor's written compensation policies which are
approved by the Contractor's board of directors or governing authority for government entities and
tribes.
h. Increase staffing as necessary to implement this supplemental funding, support access to testing
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and vaccines, and support coordination with local health care partnerships.
i. Hire culturally -competent and linguistically -appropriate providers and staff to carry out DV health
supports and COVI D mitigation activities.
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PROGRAM REQUIREMENTS
FVPSA DV Health Supports and COVID Mitigation Funding
April 1, 2022 — March 31, 2025
The Contractor shall comply with all program and other requirements for providing services under this
Contract, as set forth below.
1. Acknowledgement of Federal Funding
Family Violence Prevention
& Services State Grants
Amount obligated by this action:
$161,400.00
Federal Award Date:
10/25/2021
Federal Award Period:
10/1/2020 — 09/30/2025
Federal Award Identification Number (FAIN):
2202WAFTC6
Total Amount of the Federal Award to Washington State
Department of Social and Health Services:
$ 714849366.00
Awarding Official:
Department of Health and Human Services,
Administration for Children &Families
Catalog of Federal Domestic Assistance (CFDA) Number:
93.671
This subaward may not be used for research and development purposes.
In the event a correction is required to the Acknowledgement of Federal Funding, an administrative
change will be processed. A change to the Acknowledgement of Federal Funding will not affect your
budget or scope of work and notice will be provided.
2. Requirements
The Contractor shall comply with all program and other requirements under this Contract as set forth
below:
a. Contractor shall provide all services in a way that enhances, and does not compromise the safety of
the victims being served.
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b. Contractor shall maintain confidentiality of communication and records for any individual provided
direct services funded by this Contract.
c. Contractor is prohibited from charging clients for services provided under this Contract.
d. Contractor shall not use funds payable under this Contract to provide perpetrator treatment services
for people who have caused harm.
e. Contractor shall not make any direct payment of contract funds to any individual provided services
under this Contract.
f. Contractor shall not use an income eligibility standard for individuals seeking services under this
Contract. Services shall be provided to victims being served without regard to income.
g. Contractor shall refrain from engaging in activities that compromise the safety of victims or their
children including, but not limited to, mediation, couples counseling, family counseling or any other
manner of joint victim -offender counseling, mandatory counseling for victims, requiring that victims
participate in criminal proceedings, supporting policies or engaging in practices that impose
restrictive conditions (e.g., attend counseling, or seek an order of protection) on the victim in order
to receive services or when the victim requests that an order of protection be rescinded or
modified.
3. Training and Qualifications
a. Domestic Violence Staff and Supervisors: Initial, continuing education, and supervisor training of
Contractor staff is critically important. In addition, quality supervision is an integral component for
the provision of excellent advocacy and in supporting staff. Advocates and advocate supervisors
must be able to demonstrate an understanding of the nature and scope of domestic violence as
defined, as well as the historical and societal attitudes in which domestic violence is rooted.
b. Training must be current and relevant to the provision of empowerment -based advocacy. The
Contractor should also strive to ensure that staff incorporate training on services to marginalized
and underserved populations as part of each advocate's annual continuing education. The
Contractor shall ensure that all staff (paid and volunteers) and staff supervisors, meet the following
minimum training and experience requirements prior to staff providing supportive services.
(1) Staff and volunteers providing supportive services and supervisors of staff must obtain a
minimum of twenty (20) hours of initial basic training that covers at least the following topics and
skills:
(a) Theory and implementation of empowerment -based advocacy.
(b) The history of the domestic violence movement.
(c) Active listening skills.
(d) Legal, medical, social service, and systems advocacy.
(e) Anti -oppression and cultural competency theory and practice.
(f) Confidentiality and ethics.
(g) Safety planning skills and barriers to safety.
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(h) Planning, clarifying issues and options, and crisis intervention.
(i) Providing services and advocacy to individuals from marginalized and underserved
populations.
(j) Policies and procedures of the domestic violence program.
(2) Initial training must be completed prior to providing supportive services to clients and/or their
dependent children.
(3) The recommended format for initial training is live and in-person group sessions. Structured
job -shadowing and self -study may be included as part of the overall initial training. All
Contractor in-house training must be based on a training plan that covers one or more of the
required initial training topics.
(4) Staff and volunteers providing supportive services and staff supervisors must also obtain an
annual minimum of twenty (20) hours of continuing education training beginning in the state
fiscal year after they completed their initial training, and each state fiscal year thereafter.
(a) A minimum of ten (10) hours must be live training on topics specifically focused on serving
victims of domestic violence and their children.
(b) The remaining ten (10) hours of training may be satisfied through self -study on topics
specifically focused on serving victims of domestic violence and their children.
(5) Within six (6) months of being hired as an advocate supervisor and for each year thereafter,
supervisors must obtain a minimum of five (5) hours of training on supervision. Supervision
training can be counted toward the twenty (20) hours of annual continuing education training
hours.
(6) Contractor staff who do not provide supportive services to clients or their dependent children are
not required to obtain initial and continuing education training as described in this
Contract. Examples of staff that are included in this category are individuals providing child care
assistance as defined in this Contract, and bookkeeping and accounting staff. It is
recommended, however, that staff who come into contact with clients of the domestic violence
program and their dependent children, but who do not provide supportive services, receive
training on the following:
(a) Confidentiality.
(b) Relevant policies and procedures of the domestic violence program.
(c) Mandated reporting of child abuse/neglect as required by RCW 26.44, Abuse of Children.
(7) Supervisors of staff providing supportive services to domestic violence clients shall meet the
following minimum experience and training requirements prior to being hired as a supervisor:
(a) Two (2) years of experience providing advocacy to victims of domestic violence within a
domestic violence program. Domestic violence program means an agency that provides
advocacy for domestic violence clients in a safe, supportive environment as defined in RCW
70.123.
(b) Fifty (50) hours of training on domestic violence issues and advocacy within three (3) years
prior to being hired as a supervisor.
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(8) Initial and continuing education training received by staff and supervisors of staff providing direct
services to victims of domestic violence must be entered in the Staff Training section of
InfoNet.
4. Evaluation of Contractor
DSHS may evaluate the Contractor's performance during the term of the Contract. Areas of review
may include, but are not limited to, the following:
a. Effectiveness of services;
b. Timeliness of services provided;
c. Adherence to contract terms; and
d. Compliance with federal and state statutes.
5. Mandated Reporting of Child Abuse or Neglect
a. The Contractor shall ensure that all current staff who are mandated reporters or who have access
to children read and/or view the materials in the Department of Children, Youth and Families
Mandated Reporter Toolkit within thirty (30) days of the effective date of a first time DSHS Contract
and annually thereafter; and that all newly hired staff who are mandated reporters or who have
access to children read and/or view the materials in the Mandated Reporter Toolkit within two (2)
weeks of initial employment. After reading and/or reviewing the materials, staff shall sign and date a
statement acknowledging their duty to report child abuse or neglect and affirming that they
understand when and how to report suspected child abuse or neglect. The Contractor shall retain
the signed statement in the staff personnel file.
b. The Contractor shall either obtain a copy of the Mandated Reporter Toolkit from DSHS, or access
the Mandated Reporter Toolkit online at: https://www.dcyf.wa.gov/safety/mandated-reporter.
6. Child Passenger Restraint Requirements
The Contractor shall at all times comply, and shall ensure that all employees, volunteers and
subcontractors at all times comply, with the child passenger restraint requirements of RCW 46.61.687
when transporting children or providing transportation to children served under this Contract. RCW
46.61.687 may be accessed at: http://apr)s.leg.wa.gov/RCW/default.aspx?cite=46.61.687.
Current child passenger restraint requirements may also be accessed on the Washington State Traffic
Safety Commission's website at: https://wtsc.wa.qov.
7. Interpreter Services
a. The Contractor shall provide Limited English Proficient (LEP) clients with certified or otherwise
qualified interpreters and translated documents. The Contractor may use a non -certified interpreter
when a certified interpreter is not available, provided that the interpreter is qualified to act as an.
interpreter for the specific service recipient, and the interpreter does not represent a real or
perceived conflict of interest. Family members of the service recipient shall not be used as
interpreters.
b. The Contractor shall provide Deaf, Deaf -Blind, or hard of hearing clients with the services of
certified or otherwise qualified interpreters. The Contractor may use a non -certified interpreter when
a certified interpreter is not available, provided that the interpreter is qualified to act as an
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interpreter for the specific service recipient, and the interpreter does not represent a real or
perceived conflict of interest. Family members of the service recipient shall not be used as
interpreters.
c. Interpreter and translation services shall be provided at no cost to the client. All interpreter and
translation costs shall be the financial responsibility of the Contractor.
8. Confidentiality
In addition to the General Terms and Conditions of this Contract regarding Confidentiality, the
Contractor shall ensure that it maintains confidentiality of all client communications and information —
verbal, written, and electronic — to include personally identifying information of the client, unless the
Contractor has express written authority to release information, or as otherwise provided by
law. Contractor shall ensure that it complies with the privilege and confidentiality provisions of RCW
5.60.060(8) (a -b), RCW 70.123, and RCW 5.60.060(7)(a -b).
In order to ensure the safety of adult, youth, and child victims of sexual assault, domestic violence, and
dating violence, and their families, FVPSA-funded programs must establish and implement policies and
protocols for maintaining the confidentiality of records pertaining to any individual provided with
services.
FVPSA-funded programs cannot disclose any personal identifiable information (PII) collected in
connection with services; reveal PH without informed, written, reasonably time-limited consent; or
require a victim to provide consent as a condition of eligibility for services (45 CFR 1370.4(a)(1 — 3)).
Additionally, consent to release PH shall be given by an unemancipated minor and the minor's parent or
guardian, or in the case of an individual with a guardian, it shall be given by the individual's guardian
(45 CFR 1370.4 (b)).
9. Reporting and Record -Keeping
a. The Contractor must collect and maintain data that measure the performance and effectiveness of
work done under this contract.
b. The Contractor shall enter non -personally identifiable client demographic, service and compliance
data required by state and federal fund sources in the InfoNet data collection system. Mandatory
demographic and service data elements are listed in Exhibit C, and shall be entered in accordance
with the data reporting guidance to be provided by DSHS. The Contractor shall maintain
documentation and records that support the data reported in InfoNet.
c. Client demographic and service data shall be entered into, and updated in, InfoNet at least
quarterly. Contractor shall generate InfoNet reports at least quarterly on all clients receiving
services for the previous quarter(s), review the entered data for accuracy, and correct any errors.
Report data shall be due in InfoNet within 15 days of the end of the preceding quarter.
(1) For clients served during the period of this Contract, all demographic, service and compliance
data shall be entered into InfoNet no later thirty (30) days after the Contract end date listed on
page 1 of this Contract.
d. The Contractor shall establish and maintain written procedures for the security of InfoNet use at its
site(s). Procedures shall include:
(1) Only authorized staff are provided access to the InfoNet data and files.
(2) Staff are informed of the need for security and confidentiality of data and files maintained in or
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available through the InfoNet system.
(3) That the Contractor shall notify the DSHS Program Manager for this Contract when an
employee is no longer authorized to access the InfoNet system.
e. Contractor shall also submit semi-annual narrative reports on Contract activities. The report form
will be provided to the Contractor by the DSHS Program Manager.
f. FVPSA Specific Data Reporting. As a condition of receiving federal FVPSA DV Health Supports
and COVI D Mitigation Funding as part of this Contract, Contractor shall collect and report the
following by September 30, 2022, September 30, 2023, September 30, 2024 and April 30, 2025:
(1) Annual program expenditure report to be provided by the DSHS Program Manager named on
page 1 of this Contract.
(2) Written responses to FVPSA grant narrative questions to be provided by the DSHS Program
Manager.
10. Cost Allocation
The Contractor shall maintain a current written cost allocation plan. This plan must clearly and
completely describe the methodology used to determine what portion of shared costs will be allocated
to each funding source being billed for such costs.
11. Client Records
a. Contractor shall maintain a written file for clients who are served pursuant to this Contract. At a
minimum, files shall:
(1) Include an intake that clearly demonstrates each client's eligibility for Contract services.
(2) Be brief in documenting the supportive services provided to the client if written documentation of
services is also maintained in the client file. Service documentation must be entered into
InfoNet.
(3) Document only sufficient information to identify the service provided, and not include any
references to client feelings, emotional or psychological assessments, diagnoses, or similar
subjective observations or judgments. Documentation shall not include any direct quotes from
the client.
(4) Include copies of all required releases and client notices.
b. Where supportive services are provided to child/youth of clients, the Contractor shall:
(1) Document in InfoNet the supportive services provided for each child/youth. Written
documentation shall not be included in the file of the parent/guardian.
(2) Be brief in documenting the supportive services provided to the child/youth if written
documentation of services is also maintained in the file of the child/youth. Service
documentation must be entered into InfoNet.
(3) Document only sufficient information to identify the service provided, and not include any
references to the child/youth's feelings, emotional or psychological assessments, diagnoses, or
similar subjective observations or judgments. Documentation shall not include any direct quotes
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from the child/youth.
12. Administrative Records
In addition to any other provisions of this Contract governing maintenance of records, the Contractor
shall retain the following administrative records:
a. Documentation that funds received under this Contract were used only for the purposes and
services allowed by the Contract. Funds received under this Contract shall be clearly distinguished
and accounted for distinctly from other contracts, grants, or other funding sources.
b. Fiscal records that substantiate all costs charged to DSHS under this Contract. Contractor shall
maintain appropriate accounting and auditing procedures to ensure proper documentation, fiscal
control, proper management, and efficient disbursement of Contract funds, and in accordance with
applicable provisions of OMB Uniform Guidance.
c. Documentation of all audits, license reviews, contract monitoring reports, and corrective action
reports and action taken.
d. Copies of all subcontracts or other agreements for subcontracted services and the provider's
qualifications for the service to be performed.
e. Copy of the Certificate of Insurance for each subcontractor, if required.
f. Contractor shall also retain the following protected group data:
(1) A list of current staff by position (not names) that includes date of birth, gender, and identified
protected group status, including race, Vietnam Era Veteran, Disabled Veteran, and person of
disability.
(2) Data from clients that includes age, gender, and race/ethnicity.
(3) When collecting protected group data, the Contractor shall inform staff and clients that:
(a) Furnishing the information is entirely voluntary; and
(b) The refusal to furnish the data shall not have adverse effects or denial of services.
13. Personnel Records
Contractor shall maintain a personnel record(s) for each staff, paid and volunteer, that includes at least
the following:
a. Application for employment or resume.
b. Criminal history background check verification.
c. Current job description.
d. If applicable, a signed and dated statement acknowledging the duty to report child abuse/neglect.
14. Operating Policies and Procedures
In addition to any other provisions of this Contract governing maintenance of records, the Contractor
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shall have written policies and procedures covering the following issues:
a. Confidentiality and protection of client records and communication.
b. Nondiscrimination relating to staff, clients, and provision of services.
c. The provision of bilingual and interpreter services to clients.
d. Responding to subpoenas and warrants.
e. Reporting of child abuse as legally mandated.
f. Client access to their files.
g. Grievance procedure for clients.
h. Prohibiting harassment of service recipients based on race, sexual orientation, gender identity (or
expression), religion, and national origin, and procedures for addressing violations.
L Emergency procedures for fire, disaster, first aid, medical and police intervention.
j. Security of InfoNet system by users and the agency.
k. Records retention.
I. Accounting procedures.
m. Personnel policies and procedures.
n.. Administrative policies and procedures.
15. Auditing and Monitoring
a. Auditing
(1) Single Audit Act Compliance. If the Contractor is a subrecipient and expends $750,000 or more
in federal awards from any and/or all sources in any fiscal year, the Contractor shall procure and
pay for a single audit or aprogram-specific audit for that fiscal year. Upon completion of each
audit, the Contractor shall:
(a) Submit to the DSHS contact person the data collection form and reporting package specified
in 2 CFR Part 200, Subpart F, reports required by the program -specific audit guide (if
applicable), and a copy of any management letters issued by the auditor;
(b) Follow-up and develop corrective action for all audit findings in accordance with 2 CFR Part
200, Subpart F; prepare a "Summary Schedule of Prior Audit Findings" reporting the status
of all audit findings included in the prior audit's schedule of findings and questioned costs.
(2) Overpayments. If it is determined by DSHS, or during the course of a required audit, that the
Contractor has been paid unallowable costs under this or any Program Agreement, DSHS may
require the Contractor to reimburse DSHS in accordance with 2 CFR Part 200.
b. Monitoring
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(1) DSHS may schedule on-site monitoring visits with the Contractor to evaluate compliance with
the terms of this Contract and the performance of the program. The Contractor shall provide at
no further cost to DSHS, reasonable access to all program -related records and materials, staff
and/or subcontractor time, and any other documents or information necessary in order to
evaluate contract and program compliance.
(2) DSHS may also conduct an investigation if it receives information that the Contractor is out of
compliance with its Contract in accordance with WAC 388-61A.
ADDITIONAL FEDERAL FUNDING REQUIREMENTS
16. Applicability of Part 200 Uniform Requirements
a. The Uniform Administrative Requirements, Cost Principles, and Audit Requirements in 2 C.F.R.
Part 200, as adopted and supplemented by HHS in 2 C.F.R. Part 300 [apply to this Award from
HHS.
b. Record retention and access: Records pertinent to the award that the recipient (and any
subrecipient ("subgrantee") at any tier) must retain -- typically for a period of 3 years from the date
of submission of the final expenditure report (SF 425), unless a different retention period applies --
and to which the recipient (and any subrecipient ("subgrantee") at any tier) must provide access,
include performance measurement information, in addition to the financial records, supporting
documents, statistical records, and other pertinent records indicated at 2 C.F.R. 200.333.
17. Compliance with Family Violence and Prevention Services Act (FVPSA) Program Final Rule
In performance of the services, requirements, and activities set forth herein, the Contractor shall comply
with all applicable federal requirements of the Family Violence and Prevention Services Act (FVPSA)
Program Final Rule as posted at https://www.ecfr.gov/cgi-bin/text-
idx?S I D=42070a8b5269075caf6c6e7ac5d 1 a234&mc=true&node=pt45.5.1370&rg n=d iv5.
18. Federal Funds Expenditure
Federal funds awarded under this Contract must be expended for the purposes which they were
awarded and within the time period allotted.
19. Funding Restrictions
The Departments of Labor, Health and Human Services, and Education, and Related Agencies
Appropriations Act, 2021, and Consolidated Appropriations Act, 2021, (Division H, Title 11, Sec. 202),
limit the salary amount that may be awarded and charged to ACF grants and cooperative agreements.
Award funds issued under this announcement may not be used to pay the salary of an individual at a
rate in excess of Executive Level II. The Executive Level II salary of the "Rates of Pay for the Executive
Schedule" is $199,300. This amount reflects an individual's base salary exclusive of fringe benefits and
any income that an individual may be permitted to earn outside of the duties of the applicant
organization. This salary limitation also applies to subawards and subGrants under an ACF grant or
cooperative agreement. https://www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/salary-
tables/pdf/2021 /EX. pdf.
20. Computer Networks
Contractor understands and agrees that it cannot use any federal funds to maintain or establish a
computer network unless such network blocks the viewing, downloading, and exchanging of
pornography.
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21. Disallowed Costs
The Contractor is responsible for any audit exceptions or disallowed costs incurred by its own
organization or that of its Subcontractors.
22. Non -Discrimination Legal Requirements for Recipients of Federal Financial Assistance
Contractor must administer the project in compliance with federal civil rights laws that prohibit
discrimination on the basis of race, color, national origin, disability, age and, in some circumstances,
religion, conscience, and sex (including gender identity, sexual orientation, and pregnancy). This
includes taking reasonable steps to provide meaningful access to persons with limited English
proficiency and providing programs that are accessible to and usable by persons with disabilities. The
HHS Office for Civil Rights provides guidance on complying with civil rights laws enforced by HHS. See
https://www.hhs.gov/civil-rights/for-providers/provider-obligations/index.html.
HHS funded health and education programs must be administered in an environment free of sexual
harassment, see https://www.hhs.gov/civil-rights/for-individuals/sex-discrimination/index.html
For guidance on administering your project in compliance with applicable federal religious
nondiscrimination laws and applicable federal conscience protection and associated anti -discrimination
laws, see https://www.hhs.gov/conscience/conscience-protections/index.htmi and
https://www.hhs.gov/conscience/religious-freedom/index.html
23. Services to Limited English Proficient (LEP) Persons
The Contractor is required to take reasonable steps to ensure that the Contract project provides
meaningful access to persons with limited English proficiency. For guidance on meeting your legal
obligation to take reasonable steps to ensure meaningful access to your programs or activities by
limited English proficient individuals, see https://www.hhs.gov/civil-rights/for-individuals/special-
topics/limited-english-proficiency/fact-sheet-guidance/index.html and https://www.lep.gov.
Contractors are encouraged to consider the need for language services for persons with limited English
proficiency both in developing their programs and budgets and in conducting their programs and
activities. Reasonable costs associated with providing meaningful access for individuals with limited
English proficiency are considered allowable program costs.
24. General appropriations -law restrictions on the use of federal funds
The Contractor, and any Subcontractor at any tier, must comply with all applicable restrictions on the
use of federal funds set out in federal appropriations statutes. Pertinent restrictions, including from
various "general provisions" in the Consolidated Appropriations Act, 2018, are set out at
https:Homp.gov/funding/Explore/FY18Appropriations Restrictions. htm and are incorporated by reference
here.
Should a question arise as to whether a particular use of federal funds by a contractor (or a
subcontractor) would or might fall within the scope of an appropriations -law restriction, the recipient is
to contact DSHS for guidance, and may not proceed without the express prior written approval of
DSHS.
25. Human Trafficking Provisions
These awards are subject to the requirements of Section 106(g) of the "Trafficking Victims Protection
Act of 2000" (22 U.S.C.7104). The full text of this requirement is found at
http://www.acf.hhs.gov/.grants/award-term-and-condition-for-trafficking-in-persons.
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26. Noncompetitive procurement contracts over $250,000
No American Rescue Plan Supplemental FVPSA Funds will be used to use a noncompetitive approach
in any procurement contract that would exceed the Simplified Acquisition Threshold (currently,
$250,000). This condition applies to agreements that, for the purposes of federal grants administration,
would be considered a procurement "contract" (and therefore does not consider a subaward).
27. Posting Federally Funded Disclaimer Language on Documents
In accordance with Section 505 of Public Law 115-31, the Consolidated Appropriations Act of 2017 is
applicable to the mandatory grant programs. "When issuing statements, press releases, requests for
proposals, bid solicitations and other documents describing projects or programs funded in whole or in
part with Federal money, all recipients receiving Federal funds included in this Act, including but not
limited to State and local governments and recipients of Federal research grants, shall clearly state
(1) the percentage of the total costs of the program or project which will be financed with Federal
money,
(2) the dollar amount of Federal funds for the project or program, and
(3) percentage and dollar amount of the total costs of the project or program that will be financed by
non-governmental sources."
28. Mandatory Disclosures
These awards are subject to the requirements in 31 U.S.C. 3321, 41 U.S.C. 2313, and provisions found
in Federal regulations at 45CFR §75.113 and Appendix XII of this part, and 2 CFR Parts 180 and 376
for debarment and suspension. Non -Federal entities must disclose all violations of Federal criminal law
involving fraud, bribery, or gratuity violations potentially affecting the Federal award. Failure to comply
may result in any noncompliance remedies, including debarment and suspension.
29. Non -supplanting certification
No American Rescue Plan Supplemental FVPSA Funds will be used to supplant existing state, local, or
other non-federal funding already in place to support current services. American Rescue Plan
Supplemental FVPSA Funds will be used to increase the total amount of funds used for domestic
violence victim assistance. Violation of the non -supplanting requirement can result in a range of
penalties, including suspension of future funds under this Contract, recoupment of monies provided
under this Contract, and civil and/or criminal penalties.
30. Failure to Address Audit Issues
The Contractor understands and agrees that DSHS may withhold contract funds, or may impose other
related requirements, if (as determined by the HHS awarding agency) the Contractor does not
satisfactorily and promptly address outstanding issues from audits required by the Part 200 Uniform
Requirements (or by the terms of this award), or other outstanding issues that arise in connection with
audits, investigations, or reviews of HHS awards.
31. Smoking Prohibitions
In accordance with Title XII of Public Law 103-227, the "PRO -KIDS Act of 1994," smoking may not be
permitted in any portion of any indoor facility owned or regularly used for the provision of health, day
care, education, or library services to children under the age of 18, if the services are funded by Federal
programs whether directly or through State, Territories, local and Tribal governments. Federal
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programs include grants, cooperative agreements, loans and loan guarantees, subawards, and
contracts. The law does not apply to children's services provided in private residences, facilities funded
solely by Medicare or Medicaid funds, and portions or facilities and used for inpatient drug and alcohol
treatment.
32. Prohibition on Expending HHS Award Funds for Covered Telecommunications Equipment or
Services as Per 2 CFR §200.216
Effective August 13, 2020, 2CFR §200.216 applies to all grant programs.
"Prohibition on certain telecommunications and video surveillance services or equipment."
(a)As described in 2 CFR 200.216, recipients and subrecipients are prohibited to obligate or spend
grant funds (to include direct and indirect expenditures as well as cost share and program) to:
(1)Procure or obtain, (2)Extend or renew a contract to procure or obtain; or (3)Enter into contract (or
extend or renew contract) to procure or obtain equipment, services, or systems that use covered
telecommunications equipment or services as a substantial or essential component of any system, or
as critical technology as part of any system. As described in Pub. L. 115-232, section 889, covered
telecommunications equipment is telecommunications equipment produced by Huawei Technologies
Company or ZTE Corporation (or any subsidiary or affiliate of such entities).
i. For the purpose of public safety, security of government facilities, physical security surveillance of
critical infrastructure, and other national security purposes, video surveillance and telecommunications
equipment produced by Hytera Communications Corporation, Hangzhou Hikvision Digital Technology
Company, or Dahua Technology Company (or any subsidiary or affiliate of such entities).
ii. Telecommunications or video surveillance services provided by such entities or using such
equipment.
iii. Telecommunications or video surveillance equipment or services produced or provided by an entity
that the Secretary of Defense, in consultation with the Director of the National Intelligence or the
Director of the Federal Bureau of Investigation, reasonably believes to be an entity owned or controlled
by, or otherwise, connected to the government of a covered foreign country."
33. Prohibitions on Reprisal; Notice to Employees
Contractor (and any subcontractor) must comply with, and is subject to, all applicable provisions of 41
U.S.C. 4712, including all applicable provisions that prohibit, under specified circumstances,
discrimination against an employee as reprisal for the employee's disclosure of information related to
gross mismanagement of a federal grant, a gross waste of federal funds, an abuse of authority relating
to a federal grant, a substantial and specific danger to public health or safety, or a violation of law, rule,
or regulation related to a federal grant.
The recipient also must inform its employees, in writing (and in the predominant native language of the
workforce), of employee rights and remedies under 41 U.S.C. 4712.
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INFONET DATA REQUIREMENTS
FVPSA DV Health Supports and COVID Mitigation Funding
April 1, 2022— March 31, 2025
Contractor shall use the InfoNet Data system to document all individuals served, services provided, and other
data as specified by this Contract and DSHS. The following are the mandatory data fields that must be
entered by the Contractor into InfoNet. Contractor shall refer to the InfoNet User Manual, the system
administrator, or the DSHS Program Manager with any questions.
1. Client Information
a. Clients and Cases — Demographics
InfoNet requires that each new individual seeking services receive a client ID number. New client
means someone that has never received services before from the agency. If an individual that
previously received services from the agency returns at a later time to receive victim services, the
agency does not issue a new client ID number. Returning clients shall be identified under their
original client ID number. If Contractor provides services for another crime type such as sexual
assault or general crimes, the same client ID number is used, with a new case opened in InfoNet to
document the sexual assault or general crimes services.
Contractor shall generate an intake in InfoNet for all new clients provided services under this
Contract. The following data elements are mandatory for new client intakes:
(1) Client ID Number
(2) Year of Birth
(3) First Contact Date
(4) Race
(5) Ethnicity
(6) Gender
(7) Client Type
(8) Disability
(9) Homeless
b. Children, Youth, and Secondary Victims
If the Contractor provides services to dependents of the client or to secondary victims, Contractor
shall create a record (not an intake) for each child or secondary victim and enter demographic and
service information for each child or secondary victims. The following data elements are mandatory
for this section:
(1) Year of birth
(2) Gender
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(3) Race
(4) Ethnicity
(5) Service(s) provided to the child(ren) or secondary victim(s)
(6) Staff/volunteer who provided the service(s)
(7) Date service(s) provided
(8) Hours of service
2. Direct Client Services
Contractor shall enter all supportive services provided to individuals served by this Contract. The
following data elements are mandatory:
a. Type of service(s) provided as directed by DSHS
b. Staff/volunteer who provided the service(s)
c. Date service(s) provided
d. Hours of service
3. Staff Training
Initial, continuing education, and supervisor training received by staff and supervisors must be entered
in the Staff Training section of InfoNet. At a minimum, the following data fields must be completed:
a. Training name
b. Training date
c. Number of training hours
d. Individual or organization that sponsored/provided the training
e. Program type
f. Training category
g. Training method
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EXHIBIT D
BUDGET
FVPSA DV Health Supports and COVID Mitigation Funding
April 1, 2022 — March 31, 2025
LINE ITEMAMOUNT �y
....�. , ...,. ��.-��d..��.�rti..�,�...r.,..«,�.,r...r....,��....��..r.,�,..,.,m, .., . _.rr,...,..._...,.r .....,.-......r,,.,.,� x..�...�..y..�.,..N�r�_r�......
SALARIES $1081448:
BENEFITS $161619;
z F
SUBCONTRACTED SERVICES $0
3
° 2'r.,cw.a.erviui.ii-vvx..�.�rii�.v:a
GOODS AND SERVICES
36,3331
,.F ,.:
1
}
INDIRECT $0
,,.�,.......� r., . , , ,. , . ,
' C O N T RAC T T O T AL ��. �.M,._�..�.�..,.�..�._.x�.,.�._.�..._......__..v.,.,.�.ti_......��.�. $161,4001
° 9
9 P
MATCH I Not required
3
f
.::,..:r.::.iiiiiiivi.y...-ri:r..-��i:e;.i .. a:i.e-i ivro... ii i...:..rirvi_ri.. i ii i i.,.,�i . i .a .i . nri ri... ..ru.-zs✓�v�r.os iii i..i.. .ri v ii
Indirect
Contractor's Indirect Cost Rate:
0 None
❑ 10% of MTDC
❑ % FNICR
Match
Match is not required for federal Supplemental FVPSA Funds awarded pursuant to the American
Rescue Plan Act.
Line Item Transfer of Funds and Budget Revision Requests
Transfer of funds between and among line item budget categories of the approved Budget must be
requested in writing by the Contractor if the cumulative amount of these transfers exceeds or is
expected to exceed $2,000.
Budget adjustment requests must be submitted in writing to the DSHS Program Manager using the
Contract Budget Revision Request form, and are subject to justification and negotiation. Approved
budget revisions shall be incorporated by reference into this Contract as Addendums to Budget Exhibit
D and shall not require separate amendments.
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