HomeMy WebLinkAboutAgreements/Contracts - New Hope DV/SAEXHibi i z5. vvnentne iDox oeiow Is mare cl with an X,he t I
following Exhibits are attached and are -incorporated into this
County Program Agreement by reference:
Exhibits (specify): EXhibit A — Statement of Work (SOW); Ex h-liblit B — Program Requirements- ch1bit C — I . nfoNet
Data Requirements; Exhibit D — Budget
By their signatures below, the parties agree to the terms and conditions of this CountyProgram Agreement and all
documents incorporated by reference. No other understandings or representations, oral or otherwise, regarding the
et matter of this-RJog am Acireement shall be deemed to exist or bind the parties. The parties signing below certify
hat th*e ge au*or*zeo\to sign this faro, rami Agree ent.
1COU TY I AT PRINTED NAME(S) AND TITLES )
DATE(S) SIGNED
Cindy Carter, BOCC Chair
Danny E Stone, Vice -Chair
ember
DSHS81GNATURE Rob Jones, M
PRINTED NAME AND TITLE DATE
SIGNED
Caleb Clark, Contracts Officer
DSHS/ESA - Community Services Division
DSHS Central Contracts and Legal Services
3089CS Emergency Domestic Violence Shelter and Supportive Services
County Program Agreement (05-17-2021)
RE EI VEE
GR41T COUNTY COMMUSSIONILE-RS',
27J U L2021
Page 1
COUNTY
r" viss-blagloff State
nient of Social
PROGRAM AGREEMENT
DSHS Agreement Number
H'�e a"ith servnkes
community -Based Domestic violence Program
2163-21532
Transforming fives
Emergency Shelter & Supportive Services
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 DSH-S Agreement On
1701
General Terms and Conditions, which is incorporated by reference.
County Agreement Number
DSHS ADMINISTRATION
DSHS DIVISION
DSHS INDEX NUMBER
DSHS CONTRACT CODE
Economic Services
Community Services Division
1221-63
3089CS
Administration
I
DSHS CONTACT NAME AND TITLE
DSHS CONTACT ADDRESS
Maureen Kelly
PO Box 45710
Program Manager
til ymp'18,WA 98504
DSHS CONTACT TELEPHONE DSHS CONTACT FAX DSHS CONTACT E-MAIL
(360)790-3245 Click here to enter text, maureen.kelly@doh s.wa, ov
COUNTY NAME COUNTY ADDRESS
Grant County PO Box 37
Ephrata WA 98823-0037
COUNTY FEDERAL EMPLOYER IDENTIFICATION
COUNTY CONTACT NAME
NUMBER
SuziFode
COUNTY CONTACT TELEPHONE COUNTY CONTACT FAX - -------
COUNTY CONTACT E-MAIL
(509) 764-8402 sfodeaQ,rantcou I ntywa. go -
IS THE, COUNTY A SUBRECIPIENT FOR PURPOSES OF THIS PROGRAM CFDA NUMBERS -------------
AGREEMENT?
Yes 16.575; 93.671
PROGRAM AGREEMENT START DATE
PROGRAM AGREEMENT END DATE
MAXIMUM PROGRAM AGREEMENT AMOUNT
.07/01/2021
$515,888.00
EXHibi i z5. vvnentne iDox oeiow Is mare cl with an X,he t I
following Exhibits are attached and are -incorporated into this
County Program Agreement by reference:
Exhibits (specify): EXhibit A — Statement of Work (SOW); Ex h-liblit B — Program Requirements- ch1bit C — I . nfoNet
Data Requirements; Exhibit D — Budget
By their signatures below, the parties agree to the terms and conditions of this CountyProgram Agreement and all
documents incorporated by reference. No other understandings or representations, oral or otherwise, regarding the
et matter of this-RJog am Acireement shall be deemed to exist or bind the parties. The parties signing below certify
hat th*e ge au*or*zeo\to sign this faro, rami Agree ent.
1COU TY I AT PRINTED NAME(S) AND TITLES )
DATE(S) SIGNED
Cindy Carter, BOCC Chair
Danny E Stone, Vice -Chair
ember
DSHS81GNATURE Rob Jones, M
PRINTED NAME AND TITLE DATE
SIGNED
Caleb Clark, Contracts Officer
DSHS/ESA - Community Services Division
DSHS Central Contracts and Legal Services
3089CS Emergency Domestic Violence Shelter and Supportive Services
County Program Agreement (05-17-2021)
RE EI VEE
GR41T COUNTY COMMUSSIONILE-RS',
27J U L2021
Page 1
Special Terms and Conditions
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
considered CBDVPs.
"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
DSHS Central Contracts and Legal Services
3089CS Emergency Domestic Violence Shelter and Supportive Services
County Program Agreement (05-17-2021)
Page 3
Special Terms and Conditions
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
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
DSHS Central Contracts and Legal Services
3089CS Emergency Domestic Violence Shelter and Supportive Services
County Program Agreement (05-17-2021) Page 4
Special Terms and Conditions
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:
(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
DSHS Central Contracts and Legal Services
3089CS Emergency Domestic Violence Shelter and Supportive Services
County Program Agreement (05-17-2021)
Page 5
Special Terms and Conditions
(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;
(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.
DSHS Central Contracts and Legal Services
3089CS Emergency Domestic Violence Shelter and Supportive Services
County Program Agreement (05-17-2021) Page 6