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Home My WebLink AboutPolicies - New Hope DV/SA (002)GRANT COUNTY COMMISSIONERS AGENDA MEETING REQUEST FORM (Must be submitted to the Clerk of the Board by 12:00pm on Thursday) REQUESTING DEPARTMENT: New Hope REQUEST SUBMITTED BY: SIJZI FOCIG' CONTACT PERSON ATTENDING ROUNDTABLE: SUZI FOCl2 CONFIDENTIAL INFORMATION: ❑YES ® NO DATE: 1.14.2025 PHONE: 764-8402 JVAQ• A!I!Lqlj L I � 9 1 LIUMM-1 61191:4 M - o; I:**'LV mau 0 F-34 ,.® DAgreement / Contract F�AP Vouchers - -- FlAppointment / Reappointment ❑ARPA Related 0Bids / RFPs / Quotes Award DBid Opening Scheduled E]Boards / Committees El Budget El Computer Related 0 County Code DEmergency Purchase 0 Employee Rel. ❑ Facilities Related 017inancial 7Funds 0 Hearing El Invoices / Purchase Orders ❑ Grants — Fed/State/County E]Leases D MOA / MOU ❑ Minutes ❑Ordinances El Out of State Travel F-1 Petty Cash ® Policies ❑ Proclamations 7 Request for Purchase ❑ Resolution 0 Recommendation 7 Professional Serv/Consultant DSupport Letter ElSurplus Req. E]Tax Levies ❑Thank You's DTax Title Property 0WSLCB .47� h_W.-1 GESTED W -,.,..A,-.EN0A- ifto n e _ New H, erm= costr etc.} ope Policy and Procedure Manual has been updated and BOCC acknowledgement and approval signatures are requested. If necessary, was this document reviewed by accounting? ❑ YES 7 NO 0 N/A If necessary, was this document reviewed by legal? ❑ YES ❑ NO 7w N/A DATE OF ACTION: /Z/— APPROVE: DENIED ABSTAIN D1: D2: D3: 4/23/24 DEFERRED OR CONTINUED TO: WITHDRAWN: ;WN Ju M10.0s. be icy and Procedure Approval Letter January 14, 2025 To: New Hope & Kids Hope Employees, Interns and Volunteers Re: Policies and Procedures The complete Policy and Procedures Manual for New Hope has been updated and approved, as signified by signatures below. C y ind Car, ter, Vice Fair Kevin Burgess, Member Rob Joh�,--C�'air Date m �.tter.t. o- or�r_l LOA Ao znr'o qs, bo-fterlarmim' -New Hope Policy and Procedure Tzble of Contents I. Section One: Client Policies Access to Agency Services C1 Individual Service Rights C2 Emergency Shelter Intake Process C3 Provision of Services/Diversity Plan C4 Information and Referral Resources C5 Individual Grievances C6 11. Section Two: Record Keeping Policies Confidentiality RI Client Records R2 Mandated Reporting of Abuse/Neglect R3 Responding to Subpoenas and Warrants ; R4 InfoNet R5 Records Retention, Maintenance and Destruction R6 Data Breach of Personally Identifying Information R7 111. Section Three: Facility Policies Aaency Facilities F 1 Agen' c*y Security F2 Motor Vehicle Use F3 Building Inspection/Fire Safety F4 Shelter Inspection Report F5 IV. Section Four: Human Resources Policies Ethical Standards HRI Conflict of Interest HR2 Recruitment HR3 Management Team Orientation HR4 Training HR5 Review of Policies and Procedures and Job Descriptions HR.6 Access to Personnel Files HR7 Diversity Equity Inclusion Plan HR.8 Travel, Training and Expense Reimbursement HR.9 Staff Supervision HRIO Background Check HRI I V. Section Five: Fiscal Management Policies Fiscal Management FMI Budgeting, Payroll and Cost Allocation FM2 Petty Cash FM3 Revolving Account FM4 Gift Cards FM5 Emergency Financial Assistance FM6 CSAP Contingency Plan FM7 VI. Appendix Title page of Appendix Contents Multiple Appendixes referenced throughout Title: Access to Agency Services_ revision Date: =a# 03/2010, 6/2012, 5/2015, 4/2016, 10/2018 5/2021 10/2024 Po.. It is the policy of New Hope to ensure that employees (and volunteers, when applicable) will provide the following high -quality services free. of charge and without discrimination to the best of their ability in accordance with all contractual requirements and Agency policies and procedures. All clients will have choice of and access to services that must include access to safety, advocacy, information about options, and referrals to helping resources. New Hope services will be offered with the following model: ® Promote safety for all victims of any crime and their dependent children. ® Survivor centered, treating all with dignity and respect. ® Builds upon the strengths and resources of the individual/family; respecting autonomy and self-determination. Supportive of the relationships between victim/survivors ,and their dependent children. ® Offers options and support based on individual circumstances. Assists individuals/families in accessing protection and needed services that are respectful and inclusive of cultural and cornrnunity characteristics. Ensures accountability by involving survivors in evaluation of services they receive. Supports and engages in collaboration with other community agencies and societal systems toward developing a comprehensive response system for survivors and their dependent children. ® Without discrimination by reason of race, color, religion, disability, pregnancy, national origin, sexual orientation, gender, age, ethnicity, income, veteran status, marital status, or any other basis prohibited by federal, state or local law. Procedures: 1) Services may include: a. Crisis Hotline b. Crisis Intervention c. Safety Planning d. Emergency Shelter e. Emergency Transportation f. Emergency Food and Clothing g. Advocacy (General, Legal, Community or Medical) h. Support Groups i. Information and Referral j. Child Care Assistance and Supportive Services for Children k. Therapy Referrals 1. Community Education Activities m. Orientation to the shelter Policy #C1-Access to Agency Services n. A safe and secure play area for children/youth at the shelter o. Resources to parents of children living in the shelter about activities for youth in our community. 2) In the event that any client is non-English speaking or hearing impaired or limited in communicating in any other way, the advocate will make every attempt to provide services in the best manner appropriate. For instance: such as Pacific Interpreters. a. using a face-to-face interpreter b. using a telephone interpreter service c. using a Telecommunication Relay Service d. using VOYCE interpreter service via device or computer access 3) The advocate will provide written materials and information on services provided by New Hope in the language spoken by the client, if available. 4) Staff members and volunteers will provide culturally relevant services to each participant served. New Hope maintains affiliations with local and state level minority interest support and affinity groups. 5) Staff members will facilitate support groups, individual advocacy and all services to ensure that no derogatory or prejudicial attitudes are supported, and that such behavior, when expressed by individuals, is challenged and addressed. Staff members and volunteers will be reminded that cultural diversity is not always visible. 6) Materials are available for victims in several languages. To ensure cultural humility in terms of service delivery, victim demographics will be reviewed to ensure potential barriers to service will be addressed. Steps will be taken to identify and address barriers based upon individual needs. 7) Staff and volunteers are attentive to the degree of importance imparted to marginalized status by the individual. Efforts will be made to match individuals with an advocate of similar language and cultural background when possible. S) New Hope staff, volunteers, and members of the management team incorporate diversity, equity and cultural humility education into their training plans. Policy #Cl-Access to Agency Services POLICIES AND PROCEDURES Title: Individual Services Rights revision Date: Policy 03/2010, 08/2014, 10/2018, 5/2021, 10/2024 Polite; It is the policy of New Hope to provide the highest quality of services available to victims and their families without discrimination by reason of race, color, religion, disability, pregnancy, national origin, sexual orientation, :gender, .age, ethnicity, income, veteran status, marital status, or any other basis prohibited by federal, state or local law. Clients receiving services from New Hope have the right to see and have explained to them their rights. New Hope lists those rights in a Client Statement of Understanding form. Procedures: Implementation of the Client Statement of Understanding is as follows: 1) All persons receiving services from New Hope will receive a copy of the Client Statement of Understanding upon request of any agency services. 2) Staff and/or volunteers will explain and discuss the Client Statement of Understanding to each client thoroughly. 3) Clients will sign the Client Statement of Understanding following explanation and discussion, thereby ensuring the client's understanding and knowledge of said rights and indicating the client's consent to receive services. 4) In the event a signature is not possible, as in an on -call crisis telephone contact, a signature will be obtained at the first opportunity of a face-to-face meeting with the client. If there is not another opportunity to meet with the client face to face, the document may remain unsigned. 5) Persons under the age of 13 must have a parent or legal guardian sign the Client Statement of Understanding form'and consent for them to receive services. 6) Adult clients who have a guardian appointed to make personal decisions on their behalf will have the guardian sign the Client Statement of Understanding form and consent for them to receive services. 7) New Hope staff and/or volunteers will offer a copy of the signed Client Statement of Understanding to the client (or guardian) and scan the original signed Client Statement of Understanding form to the client's electronic file. 8) Clients retain the right to consent or deny participation in public appearances or when New Hope is using identifiable photographs or videotapes of clients as indicated on the Client Statement of Understanding form. *See appendix -Client Statement of Understanding form Policy #C2-Individual Services Rights Policy 111103713 0' Title: Emergency Shelter Intake Revision Date: #_ Process 03/2010, 6/2012, ,�. 10/2018 5 5/20215 fl`ISY 7SSjY;Etillt. ;kt�a ?ftM.'<:YiYc'sF. 10/2024 POLICY #C3 Polic : It is the policy of New Hope to have a fully trained staff or volunteer available 24 hours per day, 365 days per year to take and process requests for emergency domestic violence shelter. Victim/survivors in immediate danger or at immediate risk of harm will receive first priority for shelter. Procedures: Staff advocates, including volunteers will: 1) Determine and confirm validity of need for emergency shelter. Inform and explain the Shelter Rights and Responsibilities prior to placement. Confer with backup on - call staff as needed. Shelter has posted Shelter Rights and Responsibilities for easy accessibility to all residents. 2) Complete placement with intake process specifying the survivor's necessity for shelter. Personally escort and admit the survivor and any dependent children) to the shelter home. Provide essentials, as needed, and inform resident of location of food items and beverages available. Provide an age -appropriate orientation of the shelter to the survivor's dependent children) upon arrival. 3) Make reasonable effort to be present if admitting a survivor and any dependent children) to alternative shelter locations and provide an appropriate orientation to the location if at all possible (motel/hotel). 4) Staff will complete an orientation to the shelter home security system for placement in emergency shelter home. 5) Staff will bring the completed Intake packet and signed Shelter Rights and Responsibilities form into the office of New Hope before noon the next working day. 6) Staff member will make follow-up call to the new resident of shelter to make arrangements for completion of intake packet, inquiries in regard to status of emergency necessities such as food/beverages, personal items, and clothing may be made at this time. 7) If the victim/survivor has pets (dogs, cats) they must be placed in boarding facilities or alternative locations. Unless the victim/survivor has a service animal meeting the definition under RCW 70.84.02, arrangements must be made to accommodate the service animal. Policy #C3-Emergency Shelter Intake Process POLICIES AND PROCEDURES 8) Referrals to other appropriate safe locations may be needed when: New Hope's shelter is full a. The survivor's safety is at risk to remain in our community. b. The survivor is not eligible for New Hope services. c. They have been inappropriately referred to New Hope from another agency. d. The survivor has needs that exceed the level of service provided at our shelter. 9) Staff will complete appropriate shelter forms, make staffing updates to team and on - call staff, and submit any invoices for hotel/motel sheltering by the following business day. Policy #C3-Emergency Shelter Intake Process Title: Provision of Services: Diversity, revision Date: Racial Equity Inclusion and Belonging 12/2008, 5/2015, e.. Plan l 0/2018, 11 /2018, 5/2021 10/2024 rdme'i 6n;tfs. �x5ex9•Y�i. ' POLICY #C4 Polio It is the policy of New Hope to provide quality service delivery that must reflect and respect cultural variety in our rich and diverse communities. New Hope staff, volunteers, and Management Team members will continually strive to meet that goal. New Hope ensures that services are available and delivered to clients without discrimination by reason of race, color, religion, disability, pregnancy, national origin, sexual orientation, gender, age, ethnicity, income, veteran status, marital status, or any other basis prohibited by federal, state or local law. Diversity, Racial Equity Inclusion And Belonging Plan Procedures 1) Goals and objectives will be developed on the New Hope plan that will seek to ensure the staff, volunteers, board and managementyare representative of the communities served. 2) Staff will be involved in the planning and implementation of the plan. r 3) The plan will address capacity to serve the diverse communities served and increase experiences of our diverse staff. 4) The plan will address barriers for accessing services. Policy #C4-Provision of Services Diversity Plan 1 CSAP Standard AGENCY ADMINISTRATION AND OPERATIONS 916 & 417 Dial Title: Information and Referral Revision Date: # Resources 03/2010, 10/2018, 5/2021) 10/2024 Vt P OLI(_X -05 Pol® It is the policy of New Hope to respond 24 hours a day in person or by phone to direct requests for information or assistance related to victim services by assisting the caller/client in evaluating what is needed. The information may be provided verbally or in writing. Procedures: 1) The Community Resources list will be reviewed biannually, and more often if new referral resources are available. The list will be available on -New Hope's shared... network for staff access. 2) A staff member will be designated to review all referral and resource material. Updates will occur at team or through electronic communications: 3) Staff will enter Information and Referral data into InfoNet on a regular basis. 4) Staff will enter hotline calls into InfoNet on a regular basis. Policy #C5-Information and Referral Resources Policy M01:11 IA M Title: Individual Grievances Policy Revision Date: 3/2008 6/2012 10/20181 5/20215 10/2024 POLICY #C6 Polic It is the policy of New Hope to support open communication and encourage the use of various problem solving methods. Clients can report concerns or problems without fear of retaliation or fear of services being denied or reduced as a result of bringing forward their concern. Procedures: If a client comes into conflict with a staff person or volunteer, or they have not been treated fairly as a participant of our program, or has particular concern regarding services: 1) We encourage the client to attempt to resolve concerns with the staff person, volunteer or the Director directly and promptly. 2) If the client does not feel safe address ' ing the conflict with the person directly, they have the option of communicating with the Director. 3) If the client is not satisfied with the outcome of that discussion or if attempts to address concerns are not resolved to their satisfaction, they have the option of filing a formal grievance using the Grievance Procedure for New Hope Clients* form. This grievance form will go to the Director. Note: if the grievance is about the Director, it should be mailed to the Board of Directors at the following address: Board of Grant County Commissioners, PO Box 37, Ephrata, WA 98823 *See appendix- Grievance Procedure for New Hope Clients form Policy #C6-Individual Grievances Policy POLICIES AND PROCEDURES Title: Confidentiality Policy Revision Date: 03/20109 6/2012, 9/2012, 6/20155 10/2018 11/2018 5 3/20205 5/20215 10/2024 -DOT Ifl-V -4-D -1 X -1i %-, _1 rr.L%.-L Polio It is the policy of New Hope to ensure that all services provided to and on behalf of a client are fully confidential as permitted by law. Agents, employees, and volunteers of New Hope must maintain the. confidentiality of all personally identifying information, confidential communications, and any other confidential information. Any and all information that could identify a client must also be kept confidential. New Hope will take all necessary steps to preserve the privacy rights of all clients who seek and receive services from New Hope. Procedures . , 1) Any reports, records, working papers, or other documentation, including electronic files, maintained by New Hope, including information provided to New Hope on behalf of the client must be kept confidential. 2) Any information considered privileged by statute rule; regulation or policy that is shared with New Hope on behalf of a 'client must not be divulged without a valid written waiver (agency ROCI) of the privilege that is based on informed `consent. Informed consent requir . es a Legal and Community Advocate- to Provide thorough and accurate information about the advantages and disadvantages of disclosing confidential communications. 3) Exceptions to this Agency's confidentiality policy are: a. The mandated reporting of abuse or neglect of children; or b. The mandated reporting of abuse or neglect of vulnerable adults; or c. Failure to disclose (otherwise confidential information) is likely to result in a clear, imminent risk of serious physical injury or death to the client or another person; d. To provide information to the judge if ordered by court subpoena in accordance with New Hope's Policy on Responding to Subpoenas and Warrants. 4) Information about clients served is never given by telephone, unless requested by a person that the client has authorized by signing a "Release of Confidential Information " form and to whom the client has given a verbal password, if necessary. All Release of Confidential Information forms are valid for 45 -days unless otherwise specified. All unauthorized requests for information shall be responded to with, "I'm sorry I don't have any information I can share with you about that right now." 5) All staff and volunteers shall receive training on and comply with this policy and shall sign a confidentiality agreement. (See StaOf Confidentiality Form)* Policy M-Confidentiality Policy 11111,11 � 1111 F -M -1-1 ski 6) Further, New Hope will develop and ensure adherence to procedures that effectively implement this policy by all Agency staff and volunteers. 7) Data breach is defined as unauthorized access to, unauthorized acquisition of, or accidental release of personal information that compromises the security, confidentiality or integrity of the personal information of someone receiving services. See Policy R7 for procedures on reporting a data breach. *See Appendix- Staff Confidentiality Form Policy #Rl -Confidentiality Policy t Title: Client Records revision Date: m a"9 12/2008, 04/2012) 06/2013, 07/2014, 8/20189 5/2021 ) 10/2024 r VLl� 17 #JU P.l It is the policy of New Hope to keep all client records private and confidential. All client files will be maintained and managed in accordance with applicable WAC's and RCW's. Procedures: 1) The client's primary advocate will be the key person held responsible to complete and maintain accurate case records for each individual on their caseload. Legal and Community Advocates, staff or volunteers having any contact.: of importance with clients not on their caseload will be held responsible for recording that information. 2) Upon initial contact or as soon as possible after initial contact, an intake packet is completed. Intake packets include English language on one side and Spanish language on the other side. The intake packet includes: a. Notice of Your Rights/Informed Consent form* b. Client Statement of Understanding=form* c. Grievance Procedure for New Tope Clients form* d. Release of Confidential Information Forms)* Client signatures, signatures of parent/guardian of children under age 13, and signatures of guardians who have been appointed to make personal decisions of adult clients are gathered on intake 'paperwork. Signatures on document (a) above will indicate informed consent-2has been given. O4t _ 3) Upon completion of an intake packet, an electronic file is established for the client. An electronic file is identified with the client's name and/or Client ID number. Client ID numbers are created by 3 letters, (the first letter represents the county, the second two letters represent the city), then followed by 5 or more numbers as a unique identifier. An electronic file is created within 48 hours of intake or two business days. 4) Each electronic file is stored in the electronic file management system. The electronic file contains basic client information, services provided and scanned copies of intake paperwork. The signed paper copies from intake may be shredded on the* 5' of the month following intake, ensuring scanned copies are saved in the client's electronic file. Storage of paper copies between intake and shredding shall be secured in staff designated "hot file" storage maintained by New Hope. 5) New Hope maintains all client records. This information is used to file statistical reports with fenders to plan our programs and to evaluate our services. In the event data needs to be verified, funding agencies may review these records. Any person reviewing the files will sign a Confidentiality Statement* before being permitted access to them and to the extent possible, personally identifiable information shall be redacted for routine reviews of client files by funders and reviewers. Policy #R2- Client Records 6) Client files/records are kept on the New Hope maintained electronic file management system. They are reasonably protected from fire, flood, theft, earthquakes, or other damage. Archived records (pre -electronic file period) may be stored in a secure location other than the locked files on site. 7) Individuals may access their own client file with a staff person upon 24 hour advance request/notice. Clients will need to produce photo identification and be allowed to review their file only at a New Hope office. All files are the property of New Hope, though individuals may request copies upon written request to the Director. 8) If a court of appropriate jurisdiction has subpoenaed an individual's file, see the Responding to Subpoenas and Warrants Policy. 9) Policy for record protection and retrieval in disaster situations is described in the Disaster Response Policy. 10) In the event that New Hope/program were to cease to exist, all- I ndividual files would be transferred to an appropriate agency, program, or department. 11) Records retention/destruction is governed by the Records Retention and Destruction Policy. n� 12) All services shall be entered into the New Hope database and InfoNet on a monthly basis to reflect services provided. This data will be entered nolaterthan the 10' day following the month services were prodded. *See appendix- Confidentiality Statement Policy #R2- Client Records 2 Title: Mandated Reporting of Revision Date: Abuse/Neglect 03/2017, 10/2018, #RYA 11/2018, 1/2020, 5/2021, 10/2024 A "X�V #R � Policy: It is the policy of New Hope to report suspected abuse or neglect as required by law. (RCW 26.44.030 and RCW 74.34.035) The purpose of mandated reporting is to identify suspected abuse and/or neglect as soon as possible to protect an individual from further harm. Procedures: Reporting should be regarded as a request for an intervention into a suspected incident of abuse or neglect; a report does not necessarily constitute a proven fact — it is the raising of a question about the condition or state of a child or vulnerable adults. ".Mandated reporters" are persons or groups of persons who have frequent contact with children and families and are required by Washington's State law to report suspected cases of abuse and neglect. New Hope staff and volunteers are mandated reporters. 1) When a New Hope staff member or volunteer has reasonable cause or strong suspicion to believe that a child or a vulnerable adult has been abused or neglected a report will be made to CPS/APS and to local law enforcement. The report shall be made at the first opportunity, but in no case longer than forty-eight (48) hours after there is reasonable cause to believe that abuse or neglect has occurred. 2) A Mandated Report form' will be completed for any report made. The mandated report will be scanned and saved in the client's electronic file. Reports made on non - clients will be scanned and saved in a designated "I&R Mandated Reports" file on New Hope's shared drive. 3) All New Hope staff and volunteers are trained in orientation and annually thereafter on mandated reporting laws. 4) Staff will make a report to: a. Nearest area law enforcement non -emergency number, and. b. Child Protective Services, or a) Moses Lake Local Office: 509.764.5757 b) Toll Free Intake Line: 1.800.557.9671 c) After Hours: 1.866.363.4276 d) TTY: 509.764.5685 & 1.800.624.6186 c. Adult Protective Services a) Main Phone Number: 1.877.734.6277 b) APS Online Reporting: Online Incident Report c) APS Email: apscentralintake@dshs.wa.gov d) TTY:1.833.866.5595 Policy M-Mandated Reporting of Abuse/Neglect 5) All employees and volunteers follow New Hope's policy on Mandated Reporting of Abuse/Neglect. Any report, observation, or reasonable suspicion of abuse or neglect, whether physical, mental, or financial, may be reported to the Director or designee in addition to adhering to any legal reporting requirements that the situation may demand. I have read, understand, and agree to this policy. Signature Position *See appendix -Mandated Report form Policy #R3 -Mandated Reporting of Abuse/Neglect Date POLICIES AND PROCEDURES Title: Responding to Subpoenas and Re -vision Date: Warrants 03/2010 10/2012 10/2018, 5/2021 at f 10/2024 P 01Y -1 T.O.-N-L #RA Polio It is the policy of New Hope to respond to subpoenas., warrants and Writs of Habeas Corpus in a manner as directed by the laws of the State of Washington. All client services provided by New Hope are confidential. New Hope recognizes the very personal and private nature of the information that may be shared by those dealing with the trauma of being a victim/survivor. New Hope is committed to honoring the choices of survivors and to provide services in a manner'that facilitates client empowerment. New Hope will take all necessary steps under this policy and Washington and federal law to preserve the privacy rights of those who receive its services, unless expressly authorized by the client to do otherwise. Procedures for Subp enas: Accepting a Subpoena for New Hope The Director of New Hope is designated as the formal custodian of records for the purpose of responding to subpoenas served on New Hope and/or New Hope staff. Generally, subpoenas requiring a witness to bring documents under her/his control should be served on the custodian of records. In the absence of the Director, only the Directors designee . may accept service of a records subpoena and/or subpoena for the deposition of the records custodian. No staff member or volunteer should accept a subpoena. The Director should be immediately notified of all subpoenas, threats of subpoenas or attempts to serve subpoenas. Responding to a Subpoena In most cases, New Hope will inform the client immediately upon receipt of the subpoena. The Director shall. notify the Grant County Prosecuting Attorney's Office ("PAO"), Civil Division, when a subpoena has been served on New Hope. The PAO will determine if the subpoena was properly served and notify the Director of any procedural challenges. If service was proper, the PAO will advise the Director concerning the appropriated response. The Director shall inform the PAO of any specific concerns. All communications between the PAO and New Hope shall be maintained separately by New Hope as confidential materials covered within the scope of attorney -client privilege. A. Subpoena to Disclose Records A subpoena duces tecum requires a witness to bring documents under her/his control to court and/or deposition. If appropriate, New Hope shall comply with the subpoena. This will usually be when the client has given New Hope an informed, explicit, written consent and the client's interest do not conflict Policy #R4-Responding to Subpoenas and Warrants 1 with New Hope's interests. In other instances, New Hope may refuse disclosure based on the victim/agency confidentiality policies. If so, the client will be advised of the options available to New Hope and that a decision will be reached in the near future. Once New Hope has reached a decision on its response, the client will be advised of New Hope's decision. Talking to the Attorney In many situations, conversations with the attorney issuing the subpoena (or intending to issue the subpoena) can resolve the need for subpoena response. In criminal cases where opposing party is being charged, a good relationship with the PAO and understanding of New Hope's role with the victim may suffice. However, it is important to keep in mind that the State's interest, the victim's interest and New Hope's interest may differ. When New Mope Refuses to Disclose When New Hope does not comply with the subpoena, the attorney issuing the subpoena may file a motion to compel discovery. In other words, the attorney is seeking a court order which forces New Hope to comply with the subpoena. New Hope may respond by moving for a protective order to prevent disclosure. At this stage, the PAO will formally appear for New Hope. Client Rpeords (1) R.CW 70.123.075 Client records maintained by domestic violence programs shall not be subject to discovery in any judicial proceeding unless: a. A written pretrial motion is made to a court stating that discovery is requested of the client's domestic violence records; b. The written motion is accompanied by an affidavit or affidavits setting forth specifically the reasons why discovery is requested of the domestic violence program's records; c. The court reviews the domestic violence program's records in camera to determine whether the domestic violence program's records are relevant and whether the probative value of the records is outweighed by the victim's privacy interest in the confidentiality of such records, taking into account the further trauma that may be inflicted upon the victim or the victim's children by the disclosure of the records; and d. The court enters an order stating whether the records or any part of the records are discoverable and setting forth the basis for the court's findings. The court shall further order that the parties are prohibited from further dissemination of the records or parts of the records that are discoverable, and that any portion of any domestic violence program records included in the court file be sealed. 1. For purposes of this section, "domestic violence program" means a program that provides shelter, advocacy, and/or counseling services for domestic violence victims. 2. Disclosure of domestic violence program records is not a waiver of the victim's rights or privileges under statutes, rules of evidence, or common law. 3. If disclosure of a victim's records is required by court order, the domestic violence program shall make reasonable attempts to provide notice to the recipient affected by the disclosure and shall take steps necessary to protect the privacy and safety of the person(s) affected by the disclosure of the information. Policy #R4-Responding to Subpoenas and Warrants 2 (2) RCW 70.125.065 Records maintained by a community sexual assault program and underserved populations provider shall not be made available to any defense attorney as part of discovery in a sexual assault case unless: a. A written pretrial motion is made by the defendant to the court stating that the defendant is requesting discovery of the community sexual assault program or underserved populations provider records; b. The written motion is accompanied by an affidavit or affidavits setting forth specifically the reasons why the defendant is requesting discovery of the community sexual assault program or underserved populations provider records; c. The court reviews the community sexual assault program or underserved populations provider records in camera to determine whether the community sexual assault program or underserved populations provider records are relevant and whether the probative value of the records is outweighed by the victim's privacy interest in the confidentiality of such records taking into account the further trauma that may be inflicted upon the victim by the disclosure of the records to the defendant; and d. The court enters an order stating whether the records or any part of the records are discoverable and setting forth the basis for the court's findings. In this review, the records are not seen by either party to the legal proceeds but are reviewed by the judge. However, once the records are handed over to the judge, and a decision has been made, New Hope has no further control of the records. In Camera Procedures Make two copies of the records before bringing them to court; one complete copy and one copy edited to remove names and addresses based on third party confidentiality. New Hope may attempt to provide the edited copy. If the judge insists on the non -edited copy, it should be provided upon advice of counsel. If the judge rules that a record or parts of a record must be disclosed and has reviewed a non - edited copy, ask if you may provide an edited .copy. Also. ask the judge to return. non -discoverable records to you. Give the client a copy of the judge's order and put a copy in the client's file. B. Subpoena to Testify A subpoena ad testificandum compels a witness to appear to testify. However, RCW 5.60.060(7),(8) generally protects the communication between an advocate and a victim. A sexual assault advocate may not, without the consent of the victim, be examined as to any communication made between the victim and the sexual assault advocate. a. For purposes of this section, "sexual assault advocate" means the employee or volunteer from a community sexual assault program or underserved populations provider, victim assistance unit, program, or association, that provides information, medical or legal advocacy, counseling, or support to victims of sexual assault, who is designated by the victim to accompany the victim to the hospital or other health care facility and to proceedings concerning the alleged assault, including police and prosecution interviews and court proceedings. Policy #R4-Responding to Subpoenas and Warrants 3 POLICIES AND PROCEDURES b. A sexual assault advocate may disclose a confidential communication without the consent of the victim if failure to disclose is likely to result in a clear, imminent risk of serious physical injury or death of the victim or another person. Any sexual assault advocate participating in good faith in the disclosing of records and communications under this section shall have immunity from any liability, civil, criminal, or otherwise, that might result from the action. In any proceeding, civil or criminal, arising out of a disclosure under this section, the good faith of the sexual assault advocate who disclosed the confidential communication shall be presumed. A domestic violence advocate may not, without the consent of the victim, be examined as to any communication between the victim and the domestic violence advocate. a. For purposes of this section, "domestic violence advocate" means an employee or supervised volunteer from a community -based domestic violence program or human services program that provides information, advocacy, counseling, crisis intervention, emergency shelter, or support to victims of domestic violence and who is not employed by, or under the direct supervision of, a law enforcement agency, a prosecutor's office, or the child protective services section of the department of social and health services as defined in RCW 26.44.020. b. A domestic violence advocate may disclose a confidential communication without the consent of the victim if failure to disclose is likely to result in a clear, imminent risk of serious physical injury or death of the victim or another person. This section does not relieve a domestic violence advocate from the requirement to report or cause to be reported an incident under RCW 26.44.030(1) or to disclose relevant records relating to a child as required by RCW 26.44.030(14). Any domestic violence advocate participating in good faith in the disclosing of communications under this subsection is immune from liability, civil, criminal, or otherwise, that might result from the action. In any proceeding, civil or criminal, arising out of a disclosure under this subsection, the good faith of the domestic violence advocate who disclosed the confidential communication shall be presumed. As with a subpoena duces tecum, the steps regarding proper service of the subpoena and talking to the issuing attorney apply. However, if the subpoena is properly served and discussions with the attorney issuing the subpoena are not productive, the advocate may be ordered to testify by the judge after an in -camera review of the documents. The Director should schedule a meeting with the legal response team to prepare the advocate for giving testimony. The advocate should be assisted in preparing for giving testimony and in maintaining the confidentiality of her own address. In most cases a New Hope attorney should accompany the advocate to the proceeding. Unless the subpoena specifically requests records, agency records should never the brought to a legal proceeding. Procedures for Warrants: Search Warrants — RCW 10.79, et seq. 1) Law enforcement attempting to serve a search warrant should be directed to the New Hope Director. Policy #R4-Responding to Subpoenas and Warrants 4 POLICIES AND PROCEDURES 2) The Grant County Prosecuting Attorney's Office ("PAO"), Civil Division, should be contacted in the event questions related to warrant service arise. 3) If a judge has signed the search warrant, if it is certified by the court and appears valid, law enforcement should be allowed to conduct a search. Searches are generally limited to what is listed on the warrant. However, there are times that something laying in the open, while not on the search warrant, may be seized. Arrest Warrants — RCW 10.31, et seq. 1) Anyone attempting to serve an arrest warrant should be directed to the New Hope Director. 2) The Grant County Prosecuting Attorney's Office ("PAO"), Civil Division, should be contacted in the event questions related to warrant service arise. 3) Generally an arrest warrant does not allow entry of a building (see Search Warrants above). However, an arrest warrant should beread/reviewed to determine the parameters of the order including any emergency circumstances. Writs of Habeas Corpus — RCW 7.36, et sego 4) Writs of habeas corpus may be granted in favor of parents, guardians, limited guardians where appropriate, spouses or domestic partners, and next of kin, and to enforce the rights, and for the protection of infants and incompetent and disabled persons. 2) A writ maybe directed to an officer or to the party having a person under restraint. 3) Law enforcement attempting to serve a writ of habeas corpus should be directed to the New Hope Director. 4) The Grant County Prosecuting Attorney's Office ("PAO"), Civil Division, should be contacted in the event questions related to warrant service arise. Warrant to Prevent. Removal -. RCW _7.3.6.190 1) A warrant to prevent removal may be issued by the court directing law enforcement to take a person into custody or restrain them if it is believed the person may be carried out of the jurisdiction of the court to whom an application for a writ has been made or the person will suffer irreparable injury. 2) Law enforcement attempting to serve a warrant to prevent removal should be directed to New Hope Director. 3) The Grant County Prosecuting Attorney's Office ("PAO"), Civil Division, should be contacted in the event questions related to warrant service arise. Policy #R4-Responding to Subpoenas and Warrants 5 Title: InfoNet Policy and Procedure Revision Date: 03/20089 4/2012) to 8/2018, 5/2021, 10/2024 POLICY #R5 Polic Beginning July 1, 2006 all clients served shall have all demographic, service, and compliance data entered into the InfoNet System. New Hope shall maintain the security of InfoNet use, client files and data collection information. Procedures: 1) Only authorized staff or volunteers are provided access to InfoNet. 2) All staff shall be informed of the need for security and confidentiality of data and files maintained in or available through the InfoNet System. Access to InfoNet orientation and the InfoNet user manual are available on the OCVA website. 3) All services shall be entered into InfoNet monthly to reflect services provided. This data will beentered no later than the 10' day following the month services were provided. 4) Data in InfoNet is compared with staff services recorded in NCATrak to ensure accuracy of reporting agency services. Utilization review of staff provided direct service hours are recorded internally. Each staff person's service hours are looked at no less than quarterly for a margin of error within 2 hours for every 50 hours of service provided. Policy #R5-Infonet Policy and Procedure Title: Records Retention, revision Date: rj Maintenance and Destruction Policy 03/2010 5/2015 ;� 10/20189 5/2021, 10/2024 r� "aq'�.fhx,s.ik7+±K 3Finr:as. POLICY #R6 P®lie : It is the policy of New Hope to ensure that clients served by New Hope have. their confidentiality guarded and their records stored securely for a given period of time. Upon expiration of said time, client records are destroyed and appropriately disposed of. Procedures: 1) New Hope will maintain client records for at least eight (8) years after the last date of service. 2) For minors under the age of 17, records must be stored for at least three years after turning 18 years of age. This retention schedule will be observed except when otherwise directed or prohibited by state statute, ordinance, or law. 3) Records involved in any open investigation, audit or litigation shall not be destroyed. 4) All personnel will be reminded of the need to maintain confidentiality of records even beyond time of employment. 5) Paper records will be stored in identified and securely locked filing cabinets in the New Hope's office space. Electronic records will be stored in electronic file management system in an organized manner that is password protected and allows access to authorized users only. 6) Paper records are maintained in locked file cabinets and are reasonably protected from fire, flood, theft, earthquakes; or other damage. 7) Inactive records may be stored in same location as #5 above or may be transferred to a securely locked storage area at Grant County's record storage location that is reasonably protected from fire, flood, theft, earthquakes, or other damage. 8) Electronic records are stored on a server and are protected by password and restricted to needed access by job function. Electronic records are automatically backed up to an additional server on a daily basis with county tech services. Network access is restricted to authorized users and the network is separated from the Internet by firewall. 9) Records ready for destruction will be pulled and destroyed by shredding with a professional document shredding service. 10) In case of dissolution of New Hope, records will be forwarded to successor agency. If there is not a successor, ®CVA will be the temporary depository for the records until a successor is determined. Policy #R6- Records Retention and Destruction Policy Title: Data Breach. of Personally Policy Date: # Identifying Information Policy 9/2019 Revised: srW 4ep bWAaV% 3_ 5/2021) 10/2024 POLICY #R7 Policy: It is the policy of New Hope to prioritize the protection of personally identifying client information. Clients may face significant safety and privacy risks if their personal information were shared without their consent. It is our policy to ensure due diligence in the protection of client information as well as have a prompt and careful response in the event of any data breach of personally identifying information. Our policies will follow the requirements set forth by our federal funders, state fenders and RCws 19.255.010—.020, 42.56.010 and 42.56.590. Procedures: The following procedures are intended to mitigate the amount of personally identifying information that could be at risk as well as detail the response of New Hope in the event that a data breach of personally identifying information were to occur. 1) The best practice for data collection is to collect as little information as possible, and to keep it for the minimum amount of time necessary, while taking into consideration documentation requirements of fenders. (See Policy #R6 Records Retention and Destruction Policy) 2) The Director or designee shall review all data security practices with relevant administrative staff to ensure practices are current and secure twice per year. 3) Annually, the Director or designee will: • Review all current data collection and retention practices to ensure that New Hope does not collect information that is unnecessary. • Ensure that retention policies are being followed and data properly destroyed that is no longer required to be kept. • Consult with Grant County Tech Services (GCTS) professionals to ensure that New Hope's data security measures are up-to-date and that the proper mechanisms are in place to protect the information that is collected. In the event of a data breach of personally identifying/confidential client information 1) The Director or designee will make every reasonable effort to contact all individuals whose information may have been compromised. In making contact, care must be taken to: Provide direct written notification to every person affected by a data breach, either by mail or email that carefully considers how to minimize the risks of accidental or intentional interception. Consider how notifications may impact survivors and be prepared to respond by offering advocacy related services, emotional support, and/or referrals as they deal with the fallout of accidental or unauthorized disclosure. Policy #R7- Data Breach of Personally Identifying Information 1 2) Within 24 hours of an actual occurrence of a breach or the detection of an imminent breach of personally identifying, the Director or designee Will inform pertinent OCVA, DSHS Program Managers, or other authorities deemed necessary via email and/or voicemail. Policy #R7- Data Breach of Personally Identifying Infonnation 2 Title: Confidentiality PolicX Revision Date: ;03/2010, 6/2012, - Staff s nature on tls olio 9/2012 6/2015 f 9 h Y > Tc,cates iii'ey've, received �trai,nin 10/2018 11 /2018 r `rrc. fry c x4a. — i 5 on this policy: 3/2020, 5/2021, 10/2024 POLICY #R1 Polio : It is the policy of New Hope to ensure that all services provided to and on behalf of a client are fully confidential as permitted by law. Agents, employees, and volunteers of New Hope must maintain the confidentiality of all personally identifying information, confidential communications, and any other confidential information. Any and all information that could identify a client must also be kept confidential. New Hope will take all necessary steps to preserve the privacy rights of all clients who seek and receive services from New Hope. Procedures: 1) Any reports, records, working papers, or other documentation, including electronic files, maintained by New Hope, including information provided to New Hope on behalf of the client must be kept confidential. 2) Any information considered privileged by statute rule, regulation or policy that is shared with New Hope on behalf of a client must not be divulged without a valid written waiver (agency ROCI) of the privilege that is based on informed consent. Informed consent requires a Legal and Community Advocate to provide thorough and accurate information about the advantages and disadvantages of disclosing confidential communications. 3) Exceptions to this Agency's confidentiality policy are: a. The mandated reporting of abuse or neglect of children; or b. The mandated reporting of abuse or neglect of vulnerable adults; or c. Failure to disclose (otherwise confidential information) is likely to result in a clear, imminent risk of serious physical injury or death to the client or another person; d. To provide information to the judge if ordered by court subpoena in accordance with the New Hope's Policy on Responding to Subpoenas and Warrants _ 4) Information about clients served is never given by telephone, unless requested by a person that the client has authorized by signing a "Release of Confidential Information " form and to whom the client has given a verbal password, if necessary. All Release of Confidential Information forms are valid for 45-days unless otherwise specified. All unauthorized requests for information shall be responded to with, "I'm sorry I don't have any information I can share with you about that right now." 5) All staff and volunteers shall receive training on and comply with this policy and shall sign a confidentiality agreement. (See Staff Confidentiality Form)* Policy #R I -Confidentiality Policy 6) Further, New Hope will develop and ensure adherence to procedures that effectively implement this policy by all Agency staff and volunteers. 7) Data breach is defined as unauthorized access to, unauthorized acquisition of, or accidental. release of personal information that compromises the security, confidentiality or integrity of the personal information of someone receiving services. See Policy R7 for procedures on reporting a data breach. *See Appendix- Staff Confidentiality Form I have received training on and agree to comply with this policy. Signature Policy #Rl -Confidentiality Policy 2 Date Title: Agency Facilities Revision Date: 3/2010, 4/2012, 10/2018 5/2021 10/2024 POLICY #F1 Polio It is the policy of New Hope to provide facilities that will ensure the safe and confidential provision of and access to advocacy and support services for all survivors. Procedures: 1) New Hope will rent/lease and/or buy a building or buildings that have adequate heating, lighting and ventilation; per state and local codes. 2) New Hope will rent/lease and/or purchase a building. or buildings that maintain an entrance and exit that is ADA compliant. 3) New Hope will rent/lease and/or purchase a building or buildings that provide adequate waiting space and is welcoming to all. 4) New Hope will rent/lease and/or purchase a building or buildings that provide convenient, private and sanitary toilet facilities. 5) New Hope will rent/lease and/or purchase a building or buildings that provide an area with sufficient confidential space for personal consultation with individuals and access to a working phone. 6) New Hope will rent/lease and/or purchase a building or buildings that provide an area for children's play and activities. 7) New Hope will ensure the security of all client files whether active or closed. Active paper files will be stored in durable, locking filing cabinets. Closed or inactive files may be stored in archived file boxes in a secure and locked location. Employees will ensure confidentiality, safety and security of client files by locking separate filing cabinets, logging off computer, and locking entrance doors prior to leaving facilities at all times. 8) All New Hope staff and/or janitorial crew will share cleaning responsibilities to ensure a clean and welcoming office space for provision of services. 9) New Hope will provide a competent repair person to restore items to New Hope's satisfaction that are not within landlord responsibilities. If building is purchased, New Hope will assume all repair responsibilities. Policy #F I -Agency Facilities Title: Agency Security Policy Revision Date: ,?r 03/2010, 10/2018) 5/2021, 10/2024 POLICY #F2 Poli It is the policy of New Hope to provide for the safety of all personnel, volunteers and clients. Their safety is of the utmost importance. Staff adheres to standard practices that ensure the safety of all. Procedures: 1) Meetings with clients will be arranged in a well -lit, public place whenever possible. Going to the client's home where a batterer or perpetrator may reside or potentially appear is not safe and highly discouraged. Mobile advocacy needs to have safety considerations for all involved (take cell phone or back up staff person depending on, the situation). 2) When meeting at the New Hope office, staff or volunteer will escort the client to a private room. If someone is in an unsafe situation every precaution will be taken to ensure their, safety. All foot traffic in the office (staff, client, visitor, community partner, volunteer, others) must notify the Administrative Specialist of their presence by checking in. 3) Staff and volunteers shall always be observant of a visitor's behavior. In the case of an aggressive or threatening visitor, staff and/or volunteer will use de-escalation techniques, such as: a. Talking to the person in a calming voice; b. Re -direct the person or ask the individual very politely to leave; c. Staff or volunteer will leave the office; d. - Obtain assistance om a- A od th e- staff mem er; e. Call the Police Department, if necessary. 4) During work hours, staff will let the Administrative Specialist know where they are and provide an approximate time they should return. 5) After office hours, staff and/or volunteer advocates will contact their supervisor or . the Director, informing them of the location they are responding to while on -call. 6) The New Hope office will remain locked outside regular business hours. Policy M-Agency Security Policy W Title: Motor Vehicle Use Revision Date: 03/2008, 10/2018 5/2021 , 10/2024 POLICY #F3 Policy: Any staff or volunteer transporting clients in the Agency car and/or their personal vehicle must possess a valid driver's license, adequate vehicle insurance, and appropriate safety restraints for children and adults. Procedures: Agency Owned Vehicles 1) See Grant County Policy 1201 (Motor Vehicle Use). 2) Agency vehicles are available for use by employees and volunteers while performing work or volunteer duties. 3) Current, valid driver's license is on file with HR. 4) Copy of valid auto insurance is on file with HR. 5) A sign out log is available toreservean appropriate vehicle for the transportation need. 6) Keys and fuel cards are available at the designated check out area. 7) Agency child restraint seats are available for use in county owned vehicles. 8) All vehicles will be returned with the tank at least 1/2fall of fuel. 9) All vehicles will be returned clean and free of personal belongings. 10) Vehicles in need of repair or maintenance will be reported to the Director or designee. 11) Vehicles in need of exterior washing will be taken to car wash by staff. 12) Vehicle mileage log will be completed at each use. 13) Accidents in an Agency owned vehicle will be reported to the Director or designee immediately, and an accident report will be filled out and turned in within 24 hours or next business day. Policy #F3-Motor Vehicle Use Policy 1 Staff Personal Vehicles 1) When all Agency owned vehicles are reserved or gone, staff may use their personal vehicle and get reimbursed for mileage. 2) A county reimbursement form will be completed to get reimbursed, within 30 days of incurring expense. 3) Agency child restraint seats are available for use in staff personal vehicles if needed. Policy #F3-Motor Vehicle Use Policy Title: Building Inspection Fire Safety Revision Date: Policy 03/2010 10/2018 4r 10/2024 POLICY #F4 Poli It is the policy of New Hope to ensure that all business and shelter facilities complete an annual fire inspection. Procedures: New Hope shall comply with state and local laws and regulations. Documentation of compliance will be obtained and made available, as required. Policy #F4-Building Inspection Fire Safety Policy Title: Shelter Inspection Report Revision Date: 9 S03/2010, 10/201$, k4 ��Polic4 � .� 10/2024 ]POLICY U5 Policy: It is the policy of New Hope to use the DSHS Contract Monitoring Tool (GENERAL FACILITY STANDARDS FOR SHELTER HOMES CHECKLISTS for the inspection of the emergency shelter. Procedures: 1) New Hope staff will periodically review the DSHS Contract Monitoring tool to ensure the shelter is meeting compliance standards. Typically, this will be done formally at time of contract renewal and at least one other time throughout the year. 2) Regular informal monitoring of compliance issueswillbe done by all staff at each visit to the shelter. Any concerns will be reported immediately to the Director or designee. 3) See appendix for GENERAL FACILITYSTANDARDSFOR SHELTER HOMES CHECKLIST. 4) If the shelter does not meet the standards, an attempt may be made to obtain a waiver from DSHS. *See appendix -General Facility Standards For Shelter Homes Checklist Policy #F5-Shelter Inspection Report Policy Title: Ethical Standards Policy Revision Date: S. a/ 03/2010, 5/2015, 10/20183 5/2021, i 10/2024 MVP POLICY #HR1 ]Polio°. It is the policy of New Hope to ensure that employees will adhere to ethical standards and principles in the delivery of all Agency services. All New Hope employees are employees of Grant County and by terms of their employment agree to abide by all Grant County policies, procedures and Codes of Ethics. From time to time the Board of County Commissioners (BOCC) amends policies and procedures and/or creates resolutions. Such changes are communicated to all New Hope employees. ]Procedures: 1) Employees are expected to conduct themselves in an ethical manner at all times and assure that all clients are informed regarding their rights as recipients of services. 2) Any advocacy for a client will be offered in a trauma -informed manner with the rights and safety of the client as the paramount concern. 3) All employees follow New Hope's policy on Mandated Reporting of Abuse/Neglect. Any report, observation, or reasonable suspicion of abuse or neglect, whether physical, mental, or financial, shall be reported in adherence to any legal reporting requirements that the situation may demand and subsequently inform the Director or supervisor. 4) Clients have the right to all documented information regarding themselves in case files. Employees and volunteers have an obligation to assist and ensure clients receive such information upon request, following procedure for viewing or obtaining copies of their client case file. Clients may review their own case records with a staff person upon request. All files are the property of New Hope, though they may request copies upon written request to the Director or designee. 5) It is highly discouraged that employees or volunteers accept any gift from clients served, such as: money and/or personal or real property. However, there are circumstances when a client may share tokens of appreciation or abundance of harvest that would be inappropriate to refuse. Those circumstances must be reported to the Director. 6) Employees, volunteers, and their immediate families are also prohibited from the following: a. Using money and personal or real property belonging to a client at any time for any personal reason. b. Using or selling any client's belongings. c. Selling or soliciting any item, product, or cause to any client or Agency staff or volunteer. d. Withholding services pending payment or gifting. Policy #HRl-Ethical Standards Policy 7) Gifts of money, personal, or real property may be given or donated to New Hope as a charitable gift to the extent allowable by law and determined ethically acceptable. 8) Employees will not assume direct responsibility for service provision to clients with whom they have either a personal or professional relationship outside the Agency. 9) If staff or volunteers are approached for services by any client whom they already have a personal relationship with, said staff person or volunteer will transfer responsibility for service delivery to another staff person or volunteer and inform Director or designee. 10) It is also expected that staff will not develop a 'personal relationship with any, client to whom they are providing services. 11) Employees shall not make direct referrals exclusively to a private practice in which Agency personnel, consultants, or their immediately families may be engaged. 12) Employees who leave New Hope to set up private practice may not take original or duplicate -case files with them, without written -permission of the 'client. Clients may choose to transfer to a *private practice by a former New Hope employee if no coercion from the employee is used to influence them. Clients will be reassigned when choosing to remain with New Hope. 13) Any private practitioner using New Hope's premises to conduct private practice must .provide clients s with a clear written statement . that the client is receiving'- those practitioners' services only and not those of New Hope. 14) Any Ne . w Hope employeecionducting private practice in the community must have prior written approval from the New Hope Director and must provide to their private clients a written statement that they are a private practitioner. 15 . The examples above are not intended to be all-inclusive. Any questions in connection. with -this -policy should bedirected ltothe Director. - Policy #HRl -Ethical Standards Policy 2 Title: Conflict of Interest Policy Revision Date: 4 11/2008 5/2015 10/2018, 5/20215 0 10/2024 Polic It is the policy of New Hope to avoid a conflict of interest in its operations. Procedures: 1) Because of the very nature of appointment to the Management Team there are certain opportunities for a conflict to arise. Positions on the Management Team are determined by position within New Hope. All members have an interest in New Hope because they are paid employees by New Hope. 2) The Management Team shall oversee the day-to-day operations of New Hope. a. Decisions that directly impact the position of one of the Management Team members could be cause to consider a conflict of interest situation. b. If one of the Management Team members is directly impacted by a decision to be made, that member will excuse themselves from the Management table. 3) Grant County Board of Commissioners, and employees of New Hope shall not receive gifts, gratuities, or financial gain from New Hope's assets, business affairs, leases, or professional services beyond the employee's regular compensation and expenses related to Agency business. 4) Management Team members shall comply with the county Code of Ethics for all employees and managers. 5) No Management Team member, employee, volunteer, or consultant shall receive any preferential treatment in applying for or receipt of New Hope services. Policy #BR2-Conflict of Interest Policy Title: Recruitment Policy and Revision Date: Procedures 03/2008 5/2015 10/20189 10/2024 POLICY #HR3 Poli It is the policy of New Hope to make every attempt to recruit, employ and promote staff, volunteers, and board members who reflect the diversity of Grant and Adams Counties. Procedures: 1) New Hope's staff and volunteers will follow all county and department policies and procedures. New Hope staff and volunteers will adhere to Grant County's Code of Ethics as stated in Grant County Policy #20 1. - 2) Grant County is an equal opportunity employer with Non -Discrimination practices. 3) New Hope encourages survivors of domestic violence and/ox. sexual assault to apply for employment and/or volunteerism. 4) New Hope employees will participate in on -going training to develop competencies in diversity, equity and inclusion. 5) New Hope will strive to select staff, volunteers and board members who reflect the demographics of the geographic region served. There are some limitations to this with consideration of elected positions and appointment of positions based on job title. Policy #HR3 -Recruitment Policy 1 Title: Management Team Orientation Revision Date: Policy 09/2008, 9/2018, A. 10/2024 POLICY #HR4 Polio It is the policy of New Hope to provide victim service (sexual assault, stalking, child abuse, child sexual abuse, neglect and domestic violence) awareness training to the management team. Orientation packets with the information listed below will be presented. Additional information may be shared as recommended by funders of New Hope (ie. OCVA or DSHS). Procedures: 1) Review orientation packets with members of management that include the following: a. Agency Mission b. Introduce Programs of New Hope (including their core services) i. New Hope 24/7 HelpLine ii. Community Sexual Assault Program I. Core Services 2. Dynamics of sexual abuse/assault iii. Community Based Domestic Violence Program 1. Advocacy 2. Shelter iv. Crime Victims Services Center 1. Region 8 member/service area v. Children's Advocacy Center 1. Grant County Protocol 2. MDT approach c. Agency Structure d. Agency Goals and Objectives e. Methods of Operation f. Finances g. Relevant Community Resources h. Response of medical, legal and social service communities 2) Document completion of orientation Policy #HR4-Management Team Orientation Policy Title: Training Policy Revision Date: 09/2008 5/2010 10/2018, 5/2021, 10/2024 POLICY #HR5 PoliC It is the policy of New Hope to provide on -going training opportunities for employees, management and volunteers of New Hope. Initial training and on -going training for all staff and volunteers is critically important. Training should be current and relevant to the provision of survivor -centered services. Procedures: 1) - Initial Training for the Sexual Assault advocates must include 30 hours of initial sexual abuse/assault training. All trainings must be approved by the Office of Crime Victim's Advocacy (OCVA). The provider of such training must be familiar with the dynamics of sexual abuse/assault and relevant community resources, as well as have an understanding of how medical, legal and social services respond to victims of sexual abuse/assault. 2) On -going Training for the Sexual Assault advocates must include 12 hours of approved training annually. All trainings must be! approved by the Office of Crime Victim's Advocacy (OCVA). 3) Supervisors of Sexual. Assault Advocates (when not the Director) must have the following in addition to the initial training required of advocates: a. two years of relevant experience; b. minimum of 10 hours of general management training; and c. 12 hours of ongoing training each year; may include management related training as part of the required 12 hours of ongoing annual training. 4) Directors of ' Sexual Assault organizations must have the following addition to the initial training required of advocates: a. 6 years management experience (college education may substitute up to 4 years) b. 20 hours of management training specific to not -for -profits c. 12 hours of ongoing training each year; may include management related training as port of the required 12 hours of ongoing annual training. 5) Initial Training for the Children's Advocacy Center advocates and staff must include 24 hours of initial specialized training in victim advocacy. All trainings must include instruction on: a. dynamics of child abuse, b. trauma informed services, c. crisis assessment and intervention, d. risk assessment and safety planning, e. professional ethics and boundaries, f. understanding the coordinated multidisciplinary response, Policy #HR5-Training Policy POLICIES AND PROCEDURES g. understanding, explaining, and affording of victim's legal rights, h. court education., support and accompaniment, i. knowledge of available community and legal resources, referral methods and assistance with access to treatment and other services, including protective orders, housing public assistance, domestic violence intervention, transportation, financial assistance, interpreters, among others as determined for individual clients, j cultural responsiveness and addressing implicit bias in service delivery, k. caregiver resilience, and 1. domestic violence/family violence/children's exposure to domestic violence and poly -victimization. - 6) On -going Training for the Children's Advocacy Center advocates and staff must include 8 hours of approved training every 2 years in the field of victim advocacy and child maltreatment. 7) Initial Training for the Domestic Violence advocates providing supportive services must be completed prior to providing supportive services to clients or their children. The recommended format for initial trainings is live and in -person group sessions. Structured job shadowing and self -study may be included as part of the overall initial training. Initial training must include 20 hours on the following topics: 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; h. Planning, clarifying issues and options, and crisis intervention; i. Providing services and advocacy to individuals from culturally specific populations; and j . Policies and procedures of New Hope. 8) Staff who will be engaged in Domestic Violence prevention efforts must incorporate training on prevention as part of or in addition to the initial training requirements. 9) On -going Training for all Domestic Violence staff who provide either supportive services or are engaged in prevention efforts or both and staff supervisors must have an annual minimum of twenty hours of continuing education training beginning in the state fiscal year after they completed their initial training, and in every year thereafter. Staff who will be engaged in prevention efforts must incorporate training on prevention as part of, or in addition to, the annual continuing education requirements. a. A minimum of ten hours must be live training on topics specifically focused on either serving victims of domestic violence and their children, or prevention efforts, or both. b. The remaining ten hours of training may be satisfied through self -study on topics specifically focused on serving victims of domestic violence and their children, or prevention efforts, or both. Policy #HR5-Training Policy 10) Within six months of being hired as a Domestic Violence advocate supervisor and for each year thereafter, the supervisor must obtain a minimum of five hours of training on supervision. Supervision training can be counted toward the twenty hours of annual continuing education training hours required. Examples of supervision training topics include: leadership skills, job coaching and staff evaluation, multicultural supervision, and how to foster professional development of, and self - care with, advocates. While live in -person training is the preferred method for supervision training, all methods of live and self -study training are acceptable. 11) Supervisors of Domestic Violence staff providing supportive services to domestic violence clients must have the following minimum experience and training requirements prior to being hired as a supervisor: a. At least 2 years of experience providing advocacy to victims of domestic violence within a domestic violence program; and b. A minimum of 50 hours of training on domestic violence issues and advocacy within 3 years prior to being hired as supervisor 12) Domestic Violence admin staff or volunteers are not required to obtain initial and continuing education training as described in this section if they do not: a. Provide supportive services to clients or their children, or b.. Conduct prevention efforts. Examples of staff who are included. in this category are emergency shelter housekeeping staff, individuals providing childcare assistance as defined in this and-1b6okkeeing and -accounting staM.—Weneommend—, however; drat staff - who may come into contact with clients and their children, but who do not provide supportive services or conduct prevention efforts, receive training on the following: a. Confidentiality; b. Relevant policies and procedures of the domestic violence program; and c. Mandated reporting of child abuse/neglect as required by RCW/WAC. 13) Initial Training for the Crime Victim's Service Center advocates must include 30 hours of pre -service advocacy for crime victim's training. All trainings must be approved by the Washington State Department of Commerce. The provider of such training must be familiar with the dynamics of crime victim services and relevant _. _. .__.. . _ community resources, as well as have an understanding of how medical, legal and social services respond to victims of crime. Components of the advocacy core training will include all elements required in the Victim of Crime Service Standards and Definitions. Additionally 10 more hours of training are required in the first year of service based on crime -specific topics. 14) On -going Training for the Crime Victim's Service Center advocates must include 12 hours of approved continuing education annually. All trainings must be approved by the Washington State Department of Commerce. 15) Supervisors of Crime Victim's Service Center Advocates (when not the Director) must have the following in addition to the initial training required of advocates: a. two years of direct advocacy experience 16) Documentation of staff training will be recorded in InfoNet. Policy #HR5-Training Policy Title: Review of Policy Revision Date, Procedures and Job Descriptions 03/2008 5/2015 AW 10/20185 5/2021.1) PLC 10/2024 Polie It is the policy of New Hope to review policies, procedures and job descriptions regularly to remain current with operations within Grant County and consistent with contractual agreements for New Hope's services. Procedures: 1) The Management Team will review Agency policies and/or procedures including staff job descriptions on a regular basis or when deemed necessary. 2) All staff have the opportunity to review their job descriptions as part of their annual performance evaluation. 3) All staff have the opportunity to bring any recommendations for modification of existing policies and procedures. Recommendations are reflected in team meeting minutes and the Director presents the recommendations to the management team. 4) All staff, paid and volunteer, will review any new and/or revised policies and procedures at regular team meetings. 5) Each staff member will be directed to the shared electronic copy of agency Policies and Procedures; as noted on new employee orientation checklist. Policy #HR6-Review of Policy and Procedures Title: Access to Personnel Files Revision Date: Policy 9/2014 10/2018 10/2024 POLICY #HR7 Poli It is the policy of New Hope to maintain staff and volunteer personnel files with County Human Resources. Procedures: To access a personnel file, see Grant County Policy # 412. Policy #HR7-Access to Personnel Files Policy Title: Diversity, Equity and Inclusion Revision Date: Plan 5/2015� 6/20155 1d; h v 4/2017 10/2018 5 5 10/2024 POLICY #HR8 Poli_ cam, It is the policy of New Hope to provide quality services delivered to clients with cultural humility. New Hope strives to recognize and respect diverse cultural factors and the effect of these factors on various communities' need for and access to its services. Cultural factors include: race, education, ethnicity, language, nationality, religion, gender, sexual orientation, socioeconomic class, ability, age, geographic influence, political affiliation and immigration status. Define our Communit GRANT COUNTY Identified Community Diversity, per US Census: Geographic isolation, physical and economic barriers to resources/services, high unemployment rates and low incomes are hallmarks of Grant County. The communities in Grant County include white (52.1 %), Hispanic (43.1 %), Southeast Asian (1.2%), African American (2%), and Native American (2.6%). Grant County's population density is 37 per square mile. Grant County's average household annual income for 2021 is $63,566 compared to the State average of $69,204. A total of 11.7% of Grant County families live with poverty or inadequate income, compared to the State average of 10.2%., ADAMS COUNTY Identified Community Diversity, per US Census: Geographic isolation, physical and economic barriers to resources/services, high unemployment rates and low incomes are hallmarks of Adams County. The communities in Adams County include white (31.5 %), Hispanic (65.5 %), Southeast Asian (1.4%), African American (2.3 %), -and Native American (6.2%). Adams County's population density is 10.7 per square mile. Adams County's average household annual income for 2021 is $54,573 compared to the State average of $695204. A total of 16% of Adams County families live with poverty or inadequate income, compared to the State average of 10.2%. A Diversity -Equity -Inclusion Plan will be developed for the agency every 3 to 4 years. Policy #M-Cultural Competency Plan � bo�b n ., fir tom-orrows4 ]Diversity, Equity and Inclusion Plan GRANT COUNTY Identified Community Diversity, per US Census: Geographic isolation, physical and economic barriers to resources/services, high unemployment rates and low incomes are hallmarks of Grant County. The communities in Grant County include white (52. 1%), Hispanic (43. 1%), Southeast Asian (1.2%), African American (2%), and Native American (2.6%). Grant County's population density is 37 per square mile. Grant County's average household annual income for 2021 is $63,566 compared to the State average of $69,204. A total of 11.7% of Grant County families live with poverty or inadequate income, compared to the State average of 10.2%. A]DAMS COUNTY Identified Community Diversity; per US Census: Geographic isolation, physical and economic barriers to resources/services, high unemployment rates and low incomes are hallmarks of Adams County. The ,communities in Adams .County include white (31.5%), Hispanic (65.5%), Southeast Asian (.1.4%), African American (2.3%), and Native American *(6.2%). Adams County's population density is 10.7 per square mile. Adams County's average household annual income for 2021 is $54,573 compared to the State average of $69,204. A total of 16% of Adams County families live with poverty_ or inadequate income, compared to the State average of 10.2%. BOTH COUNTIES The LGBTQ community is not represented by documented numbers through US Census data above. However, we know there are organizations' and meetings which are.lield by_th s:population. g�roup_throughout the 2 county_ area. Additionally "youth at risk of suicide" is a growing population living within Grant and Adams Counties. They will be included as a part. of New Hope's DEI Plan through a lens of serving people in isolated and rural communities. 1. Diversity Goal: To hire staff and recruit volunteers and board members that are representative of the entire community that we serve. Objective 1: Meet with Human Resources Department to learn what recruiting tools they have available for our department. Task One: Review internal process with county HR. Task Two: Look at software used for county position postings. Task Three: Meet with HR to brainstorm ways to increase the visibility of equity, inclusion and diversity in the way we recruit for positions. A W - VA # 40P Ir O.N is now be h i 'berer tomorrows.. ,i, ni, n 9 s. Objective 2: Research places to advertise positions that have potential to represent our service area's diversity. Task One: Identify where county HR posts openings for recruitment. Task Two: Brainstorm additional places/platforms/partners to list openings. 2.- Cultural Sensitivity/Anti-Oppression Goal: Increase New Hope's capacity to serve its diverse community, including how New Hope can reduce their own biases and incorporate an anti -oppression lens in their work. Objective 1: Reduce stigma and negative biases that exist in our communities for the LGBTQ population. Task One: Create a PRIDE microteam at New Hope. Task Two: Plan an annual PRIDE event during the month of June. Task Three: Regularly attend GSA (Gay/Straight Alliance) meetings at the local community college. Objective 2: Attend and participate in the local Youth Suicide Task Force. Task One: Share awareness campaign information from the YSTF regularly. Task Two: Learn about the risks youth are experiencing through in-house education from New Hope's Youth Homeless Demonstration Project. Objective 3: Celebrate the New Hope diversity regularly as a team. Task One: Identify events to celebrate that at least one of our staff identify with as their culture. Task Two: Schedule and participate in events as a team. 3. Barrier Reduction Goal: Reduce barriers for accessing services at New Hope. Objective 1: Increase ways for isolated/rural survivors to connect with advocates. Task One: Increase opportunities for mobile advocacy. Task Two: Provide gas cards for survivors who need to travel for services. Task Three: Increase ways to communicate virtually with survivors. Objective 2: Reduce language barriers for walk-ins or phone calls. Task One: Share "cheat sheet" of common Spanish/English greeting words to get caller or visitor connected with Spanish speaking advocate. Task Two: Practice access to Language Line at team meetings at least 1 x year. Title: Travel, Training and Expense Revision Date: j. Reimbursement Policy 7/2016, 10/201$, it, 5/2021, 10/2024 POLICY #HR9 P lick It is New Hope's policy to minimize .undue expenses for employees traveling for work - related purposes such as: training, providing services, or other necessary work travel. Procedures: In general, Grant County Policy 1202 should be followed during agency travel. Specific to New Hope'are the following: 1) Each employee of New Hope shall obtain prior approval for travel from the Director or designee. 2) Each employee should use the most prudent way to reserve or purchase travel expenses. 3) More often than not, a reservation for hotel rooms will be made/held with the New Hope card but the employee may use their personal credit card for check -in and secure incidentals, which will not be reimbursed by the county. 4) The per diem rates for meals and hotel will be determined from OFM or GSA (CONUS) and are relevant to the location of the training or estimated time in official travel status. 5) - If mealsareprovided by the training, conference or hotel, the employee's meal per diem rate will be adjusted to reflect the meals provided and no reimbursement will be given for those meals. Continental breakfasts are not considered a meal. 6) The Financial Operations Specialist will assist employees or volunteers in filling out Advance Travel Requests and making of reservations if desired. Policy #HR9-Travel and Training Reimbursement Policy 1 Title: Staff Supervision Policy and Revision Date: Procedures 6/2015 10/2018 5/20215 10/2024 PIr* t�x P�R POLICY #HR10 Polio It is the policy of New Hope to schedule regular supervision, both individually and as a group. Procedure - Each staff member will participate in regularly scheduled supervision session at least once every eight weeks. Individual supervision will be scheduled through availability by the supervisor and the employee. Group supervision happens regularly at team meetings, micro team meetings, and other groupings. The Director and supervisors have an open-door policy allowing staff to address immediate concerns, critical issues, debrief cases and any other relevant issue as needed. The staff is held accountable to all county and Agency policies. and procedures and performance of assigned duties. Policies, procedures and any changes thereto are discussed during team or when "reminders" are necessary. Supervision sessions will include discussions on job duties, performance, training goals and status of on -going education, and any support needed. Notes from each supervision session (informal and formal) will be written and maintained by the Director or supervisor and shared with staff at the next scheduled supervision session. Policy #HR 10- Staff Supervision Policy and Procedures Title: Background Check Policy and Date: 1!?" Procedures 11/2018 6/2019 , 5/2021) 10/2024 POLICY #HR11 Poli It is the policy of New Hope to ensure criminal background checks- are completed on' all employees and volunteers at time of hire and every two years thereafter. Background checks through the WA State Patrol — WATCH program screen for criminal background, sex offender registration, fingerprint search/background check, and child abuse registry. Procedures: 1) Candidates for open positions who are selected for an interview will complete a consent: to complete WATCH background check form at the conclusion of interviews. 2) County Human Resources or designee will run the background check of the candidate or volunteer chosen by the interview team. 3) An offer of employment or volunteer position will be made pending acceptable background check results from WATCH. 4) Further background history checks required by VOCA will be completed upon employment: a. Public sex offender and child abuse websites/registries b. Criminal history registries and similar repositories of criminal history records (WATCH -completed after interview) aAn eligible fingerprint search/background check 5) County Human Resources and the -supervisors of New Hope staff and -volunteers will share a tracking document to ensure no more than 2 years passes between WATCH criminal background checks and 5 years between public sex offender and child abuse registries, and 5 years between fingerprint background checks. Policy #HR I I -Background Check Policy Title: Fiscal Management Policy Revision Date: 09/2010 10/2018 -lot NA 11", 5/2021 10/2024 Tk AUTIG POLICY #FMI Polic : It is the policy of New Hope to prudently manage public resources and employ accounting procedures that are consistent with applicable county, state, and federal requirements, and generally accepted accounting principles (GAAP). See Grant County Policy #1503. Procedures: 1) New Hope shall deliver and/or purchase goods and services prudently. New Hope shall comply with this requirement by purchasing all services consistent with state or county procurement procedures. 2) New Hope shall manage assets of -the Agency under applicable county, state, and federal requirements and generally accepted accounting principles (GAAP) and under the following additional specific requirements: a. Assets of New Hope -include all property, equipment, vehicles, buildings, capital reserve funds, operating reserve funds, risk reserve funds, or self- insurance funds. b. Interest accrued on funds stated in this section shall be accounted for and retained for use by New Hope, per county procedure. c. Property, equipment, vehicles, and buildings shall be properly inventoried with a physical inventory conducted annually. Proceeds from the disposal of any assets shall be retained by New Hope. 3) The county uses a cash basis method of accounting. Under a cash basis of accounting, revenues are recognized when cash is received and deposited. Expenses are recorded in the accounting period when bills are paid. 4) Twice annually the program budget is reviewed. Once in the spring when planning for upcoming grant cycles that run July to June, the state fiscal year. A salary spread worksheet is used to allocating staff FTEs to each fun -ding source/grant. This spreadsheet considers staff benefits costs as well. This process is reviewed again in the fall when the county budgeting process is completed for the upcoming calendar year. A revenue and expense exercise is completed for overall program fiscal balancing. Policy FMI-Fiscal Management Policy Title: Budgeting, Payroll and Cost Revision Date: Allocation Policy 03/2008, 10/2018 r. 10/2024 l POLICY #FM2 Pole, New Hope prepares a formal, written budget of all expected revenues and expenses.. The budget categorizes revenues by source and expenses by types of services and/or program components consistent with GAAP, county standards and BARS. Procedures: 1) The budget period is the calendar year. 2) New Hope prepares a formal, written budget of all expected revenues and expenses, categorizing revenues by source and expenses by types of services and/or program components consistent with GAAP and BARS. 3) The County Commissioners determine the final budget and adopt it .during their yearly budgeting process. 4) All material budget revisions and transfers within. the adopted budget are reviewed and approved by the County Commissioners. Approval of a budget extension is not given until a public meeting is held. Two weeks' notice, published in the paper of record, must be given. 5) New Hope uses the following methodology for cost allocation and payroll distribution: a. All employees of New Hope are required to complete daily time allocation/timesheets on a bi-weekly basis. The timesheets are used to record time actually spent- in the -different cost centers, if applicable as well as vacation, sick leave, and other leaves. b. The Director or designee reviews and approves payroll expenditures, timesheets, overtime and paid or unpaid leave. c. The Financial Operations Specialist distributes the direct staff time to the various BARS accounting projects using a spreadsheet. All salaries and benefits are charged to a general project assigned by. the payroll department. The Financial Operations Specialist completes a journal entry reallocating salary/benefits costs across appropriate projects/grants. 6) New Hope uses the following two methodologies for cost allocation of program expenditures. a. By FTE and Space. Phone, rent, utilities, liability insurance and janitorial services are shared across cost centers (grants) by FTE and the square footage occupied by staff. b. By FTE only. Office supplies, copier leases, fuel, human resources and cell phone costs are all shared across cost centers (grants) by the FTE in the grant. Policy #FM 2-Budgeting, Payroll and Cost Allocation Policy r , �-11 Ora- 1 ' , ,, 1 Title: Petty Cash Policy Revision Date: 3/2011, 8/2018, 5/2021) 10/2024 POLICY #FM3 Polic : It is the policy of New Hope to prudently manage public resources; yet have available petty cash for appropriately determined circumstances. Procedures: 1) New Hope shall have a petty cash account available for emergency purposes such as: a. Client immediate need b. Agency need, where other methods of payment are not -accepted. c. Other circumstances evaluated with supervisor or designee on a case -by -case basis. 2) Cash access shall comply with the following: a. Verbal request to supervisor or designee; stating purpose and amount. b. Other. sources of funding will be explored first, including client's resources. c. Cash will be gathered from locking"petty cash box. d. Entry of cash withdrawal will be made in the accounting ledger. e. Receipt obtained and proper. documentation on receipt will be done by staff. i. "petty cash" written on receipt ii. Source of funds that will reimburse the amount will be written on receipt iii. Staff initials will;: be written on receipt iv. Receipt will be given to Financial Operations Specialist to process for reimbursement. 3) Documentation of petty cash ledger entries will include the following in pencil: a. Date..-. b. Payee (who received the cash) c. Staff initials d. Amount of cash used e. when receipt is collected/provided f. when reimbursement has been made g. Running balance 4) Monthly counts of petty cash will occur periodically with 2 staff verifying the amount of cash in the petty cash box. 5) The Financial Operations Specialist or designee will reconcile the petty cash box regularly. Policy #FM3- Petty Cash Policy Title: Revolving Account Policy Revision Date: } 03/2011, 10/2018, 5/2021, 10/2024 POLICY #PM4 Poli It is the policy of New Hope to prudently manage public resources; yet have available funds for appropriately determined agency emergency circumstances. Procedures: 1) New Hope shall have a revolving checking account and debit card available for emergency purposes such as: a. Client immediate need b. 'Agency need, where other sources of payment are not accepted. c. Other circumstances evaluated with supervisor or designee on a case -by -case basis. 2) Access to the revolving account shall comply with the following steps: a. Verbal request to supervisor; Director or designee; stating purpose and amount. b. Other sources of funding will be explored first, including client's resources. c. Determination if a check -or debit card will be used. d. Checkbook ledger entry will be made. e. Receipt obtained and proper documentation on receipt will be done by staff: i. Tape receipt to blank sheet of paper ii. Copy of check should be stapled to the paper iii. Write on paper next to receipt: , a. "Revolving Account -Check number " or "Revolving Account - debit card'., b. Staff initials, and c. Source of funds where reimbursement will come from iv. The paper with receipt will be given to Accounting Assistant for reimbursement processing v. Checkbook and debit card will be returned to secure locked location 3) The Financial Operations Specialist will reconcile the revolving account regularly. 4) Authorized Signers on the account are determined by the Director. Policy #FM4-Revolving Account Policy 1 I n 1TXVQ pral � , 1 51 a 16'10%; Title: Gift Card Policy Revision Date: 11/2017 5/2021 K� 10/2024 4i"Ttll POLICY #FM5 Polic : It is the policy of New Hope to prudently manage public resources, yet have available gift cards for appropriate emergency circumstances. Procedures: 1) Gift cards may be given to clients who have a critical and urgent need for gas, food, essential clothing items and personal items such as diapers or medication, or other vital needs that can be met through purchases at a store or restaurant. 2) The cards will be kept secured and locked location. The gift card inventory will be tracked by designated staff (Financial Operations, Administrative Specialist, and/or Director). Gift cards distributed will have data entered on tracking sheet adhered to manila envelope containing the gift cards to designate distribution. 3) Tracking sheets will identify where gift cards are to be redeemed, date given, advocate assisting, additional staff witness, amount of gift card given, the card number, recipient's initials and any given notes. 4) Staff wishing to secure gift cards for their clients must complete the "gift card receipt"* and have their client sign it. This receipt will be returned to the manila envelope after obtaining the client's signature indicating they've received the gift card. This also serves as a receipt for accounting purposes. When appropriate client signatures will be redacted to protect confidentiality. 5) Staff wishing to distribute more than $50 in gift cards to their clients must receive prior approval from a supervisor, Director or designee. *See appendix -Gift Card Receipt Policy #FM5-Gift Card Policy Title: Emergency Financial Revision Date: Assistance 10/20173 12/2018, 10/201% 5/20219 10/2024 POLICY #FM6 Polite It is the policy of New Hope to provide appropriate Emergency Financial Assistance to victims of any crime in our service area to eliminate immediate health and safety concerns. Emergency Financial Assistance paid with federal VOCA funds must be for eligible expenses and must be directly related to the victimization experienced by the victim of crime. These immediate concerns may include: • Childcare (when supporting access to services) • Gas vouchers, food vouchers or restaurant vouchers (sometimes in the form of a gift card) - - 1# • Cost to help clients receive services and participate in the criminal/civil justice system • Emergency food, shelter, clothing, and transportation (EFA) • Emergency medicine, prophylactics, durable medical equipment • Parking • Phone and internet services • Relocation expenses • Rent • Towing expenses for recovered vehicles • Utilities • Vehicle expense (connected to services) • Window, door, lock replacement/repair (clients) • Other items on a case -by -case basis with supervisor approval Prm-PdjirPv.- These immediate concerns may not include: • Active investigation and prosecution of criminal activities • Compensation for victims of crime • Conference (hosting) • Food for meetings, conferences, and training events • Lobbying • Medical care (unless related to crime) • Research • Training and education • Cash 1) The Director will budget an amount for Emergency Financial Assistance (EFA) for New Hope clients. Policy #FM6-Emergency Financial Assistance 2) After the budget amount has been decided and. approved by grant fenders, the Financial Operations Specialist will utilize the amount to request gas cards, food cards and grocery cards, as one method of providing EFA to clients. , a. The cards will be stored in a secured and locked location along with tracking forms to keep track of the cards being given out. (see Gift Card Policy) . 3) After the budget amount has been decided and approved by grant funders, advocates may seek methods other than gift cards to provide EFA to victims. a. Employees must seek approval from their supervisor or designee for any Emergency Financial Assistance through a completed Emergency Financial Assistance Request form. b. A Release of Information will be obtained from the client to protect their privacy in payment to any vendor. c. After approval is given, the Financial Operations Specialist will be given the details of the assistance, including client number and client type, and assistance given so the financial assistance can be made in the most expedient manner (agency credit or debit card, on-line payments, petty cash, agency written check, or other method best suited to the circumstance). d. The Emergency Financial Assistance form and all back up documentation will be submitted to the Financial Operations Specialist to process for reimbursement from the appropriate project/grant fonder. 4) Physical items available on -site at New Hope (cell phones, ring cameras, door locks, etc) may be available for EFA, with accountability and sign out logs. 5) when the source of payment for any EFA is strictly VOCA funds, the item must be related to the victimization, and it is determined that it is needed to address a victim's immediate health and safety needs. a. Property (cell phone, furniture) and impound expenses may only be funded if damage is directly related to the crime/victimization. b. Prescriptions and medical items may only be funded if: i. the need for it is connected to the victimization, ii. the item or prescription addresses immediate health and safety needs, AND iii. other source of funding (e.g., insurance, crime victim's compensation, Medicaid) is not expected to be available quickly enough to meet the emergency need. Policy #FM6-Emergency Financial Assistance POLICIES AND PROCEDURES Title: Contingency Plan for Core Services in Funding Reduction/Discontinuation Event POLICY #FM7 Revision Date; 5/2015, 10/2018, 5/20219 10/2024 Pole It is the policy of New Hope to prudently manage revenue resources. In the event that funds are discontinued_ or reduced, a contingency plan to provide core services will be implemented. Plan: The following will be considered New Hope's contingency plan for continuation of core services in the event of a loss or reduction in funding. One or more options listed below, or a combination of several options will be considered depending 'on the situation. 1) New Hope shall leverage volunteer and in -kind resources to serve clients in our service areas. The Director shall re-evaluate the volunteer roster and determine resources available and ability to provide direct services. 2) Staff may be re -assigned to different grants as needed to provide remaining core services. 3) The Director and board may explore alternative funding opportunities to help re- establish program. 4) Review current SA Specialized Grant to see about enhancing Core Services options. 5) Explore county resources for emergency request to use general county funds for core services. 6) The Director and board may implement a reduction in workforce as a last resort. Policy #FM7-Contingency Plan for Core Services in Funding Reduction/Discontinuation Event New Hope Policies and Procedures ff�=, Staff Confidentiality Form Notice of Right to Confidentiality Release of Confidential Information Client Statement of Understanding General Shelter Facility Standards Checklist DV Screening Tool Equal Employment Opportunity Statement Gift Card Receipt Grievance Form for Clients Mandated Report Form New Hire Orientation Checklist Staff Acknowledgement of Policy Review Shelter Rights and Responsibilities Support Group Confidentiality Statement Support Group Referral Advocacy Outcomes Shelter Outcomes Support Group Outcomes Title: Confidentiality Policy Revision Date: 03/2010 6/2012 W J:Sta igna ur-eon this `-policy 9/20126/2015 10/2018� 11/2018� i n. d i t io' they've lve trainingnlvw rec this fo, cys: 011 3/2020 5/2021 10/2024 . - POLICY #R1 Poli It is the policy of New Hope to ensure that all services provided to and on behalf of a client are fully confidential as permitted by law. Agents, employees, and volunteers of New Hope must maintain the confidentiality of all personally identifying information, confidential communications, and any otherconfidential inform ation. Any and all information that could identify a client must also be kept confidential. New Hope will take all necessary steps to preserve the privacy rights of all clients who seek and receive services from New Hope. Procedures: 1) Any reports, records, working papers, or other documentation, including electronic files, maintained by New Hope, including information provided to New Hope on behalf of the client must be kept confidential. 2) Any information considered privileged by statute rule, regulation or policy that is shared with New Hope on behalf of a client must not be divulged without a valid written waiver (agency ROCI) of the privilege that is based on informed consent. Informed consent requires a Legal and Community Advocate. to provide thorough and accurate information about the advantages anddisadvantages of disclosing confidential communications. 3) Exceptions to this Agency's confidentiality policy are: a. The mandated reporting of abuse or neglect of children; or b. The mandated reporting of abuse or neglect of vulnerable adults; or c. Failure to disclose (otherwise confidential information) -is likely to result in a cle ar, imminent _risk __6_'f 's'e'r-16u's p'hy'_s_i 6 a1 -1-n-J u r-'y'- or death to the-'c'lient or another person; d.. To provide information to the judge if ordered by court subpoena in accordance with the New Hope's Policy on Responding to Subpo enas and Warrants. 4) Information about clients served is never given by telephone, unless requested by a person that the client has authorized by signing a "Release of Confidential Information" form and to whom the client has given a verbal password, if necessary. All Release of Confidential Information forms are valid for 45 -days unless otherwise specified. All unauthorized requests for information shall be responded to with, "I'm sorry I don't have any 'Information I can share with you about that right now." 5) All staff and volunteers shall receive training on and comply with this policy and shall, sign a confidentiality agreement. (See Sta Confidentiality Form)* Of Policy #R1 -Confidentiality Policy D s ki 6) Further, New Hope will develop and ensure adherence to procedures that effectively implement this policy by all Agency staff and volunteers. 7) Data breach is defined as unauthorized access to, unauthorized acquisition of, or accidental release of personal information that compromises the security, confidentiality or integrity of the personal information of someone receiving services. See Policy R7 for procedures on reporting a data breach. *See Appendix- Staff Confidentiality .Form I have received training on and agree to comply with this policy. Signature Policy #Rl-Confidentiality Policy Date —Ar Ap?b ar fmw t"Wilngs. Ixott-r fomrrows. Notice of Your Right to Confidential itylinformed Consent Safety is a priority for those receiving New Hope services. To respect your privacy and -help support your safety and right to make your own decisions, we will make every effort to keep what you tell us confidential. Confidential information includes: • any written or spoken communication between a person seeking/receiving services and any program staff or volunteer; 9 any records or written information identifying a person to whom services are provided; and 0 any information about services provided to an individual. We will not disclose anything about you without your permission, unless a legal exception exists. Legally, we are obligated to release confidential information if we are required by a court order. We are required by law as mandated reporters to contact law enforcement, Child and/or Adult Protective Services if we suspect any child and/or any vulnerable adult has been abused or neglected. We may contact Grant Mental Health Care and/or law enforcement when there is potential suicidal behavior or threat of harm that is likely to result in a clear, imminent risk of serious physical injury or death to you or another person. You may find it helpful for us to share specific and limited information with other agencies, programs, or specific individual(s). You can choose to give permission so that we can release this information about you. If you decide that we can share your information, this will be done by signing a Release of Confidential Information form. However, New Hope may not be able to control what happens to your information once it has been released to the agencies, programs, or specific individual(s) as requested by you, furthermore the agency, program or individual getting your information may be required by law or practice to share your information with others. It is your choice to decide what information you share about yourself and you may change your mind and withdraw the release at any time. You do not have to give permission or sign a release of information in order to receive services. It is completely your decision. I I understand the information provided on this form and give my consent to receive services. Participant Signature Date Guardian Signature, Date if client is under 13 or an adult who has a guardian appointed to make personal decisions New Hope Advocate Date CLIENT STATEMIENT OF UNDERSTANDING I Revised Nov 2018 a ZVI now b--ginnings, beW tomex ow-s. F�A =io 401 ...... La seguridad es una prioridad para aquellos que reciben servicios de Nueva Esperanza. Para respetar su privacidad y ayudar a apoyar su seguridad y el derecho de tomar sus propias decisiones, haremos todo to posible para mantener to que usted nos dice confidencial. La informacion confidential incluye: • cualquier comunicacion escrita o hablada entre una persona que busca/recibe servicios y cualquier personal del programa o voluntario; • cualquier registro o informacion escrita que identifique a una persona a quien se le proporcionen los servicios; y • cualquier informacion sobre los servicios dados a un individuo. No vamos a revelar nada de usted sin su permiso, a menos que exista una exception legal. Legalmente, estamos obligados a dar informacion confidencial si es requerido por una orden de la torte. La ley nos exige que como reporteros obligados nos pongamos en contacto con la policia , servicios de proteccion para ninos y/o adultos si sospechamos que cualquier nino y/o cualquier adulto vulnerable ha sido abusado o descuidado. Podemos contactar a Salud Mental del Condado de Grant y/o la policia cuando hay potential de comportamiento suicida o amenaza de dano que es probable que resulte en un riesgo claro, inminente de lesiones fisicas graves o la muerte a usted o a otra persona. Usted puede encontrar util que nosotros compartamos informacion especifica y limitada con otros agencias, programas o individuos especificos. Puede optar darnos permiso para que podamos liberar esta informacion sobre usted. Si usted decide que nosotros podamos compartir su informacion, esto se hara mediante la firma de una forma de informacion confidencial. Sin embargo, Nueva Esperanza puede no ser capaz de controlar to que suceda con su informacion una vez que se haya dado a las agencias, programas, o individuo (s) especifico (es) segun to solicitado par usted, ademas la agencia, el programa o el individuo que consiga su informacion puede ser requerido por la ley o la practica para compartir su informacion con otros. Es su decision decidir que informacion usted comparte acerca de usted y usted puede cambiar de opinion y retirar la liberacion en cualquier momento. Usted no tiene que dar permiso o f rmar una liberacion de informacion para recibir servicios. Es completamente to decision. Entiendo la informacion proporcionada en esta forma y doy mi a consentimilento para recibir servicios. Firma del participante Firma del Guardian si es menor de 13 o Adulto Vulnerable Fecha Fecha Consejera de Nueva Esperanza Fecha CLIENT STATEMENT QI= UNDERSTANDING ! Revised Nov 2018 new ravings. better tomorromss. I I qiii� � READ FIRST: Before you decide whether or not to let NEW HOPE share some of your confidential information with another agency or person, an advocate at NEW HOPE will discuss with you all alternatives and any potential risks and benefits that could result from sharing your confidential information. If you decide you want NEW HOPE to release some of your confidential information, you can use this form to choose what is shared, how it's shared, with whom, and for how long. I understand that NEW HOPE has an obligation to keep my personal information, identifying information, and my records confidential. I also understand that I can choose to allow NEW HOPE to release some of my personal information to certain individuals or agencies. authorize NEW HOPE to share the following specific information with: Print Name Name: Who I want to have Specific Office at Agency: my information: Phone Number: The information may be shared: in person by phone by fax by mail by e-mail ❑ I understand that electronic mail (e-mail) is not confidential and can be intercepted and read by other people. What info about me will � (List as specifically as possible, for example: name, dates of service, any documents). be shared: Why I want my info (List as specifically as possible, for example: to receive benefits). .. shared: (purpose) Please Note: there is a risk that a limited release of information can potentially open up access by others to air of your contioentiai information held by NEW HOPE. I understand: . ❑ That I do not have to sign a release form. I do not have to allow NEW HOPE to share my information. Signing a release form is completely voluntary. That this release is limited to what I write above. If I would like NEW HOPE to release information about me in the future, I will need to sign another written, time -limited release. ❑ That releasing information. about me could give another agency or person information about'my location and would confirm that I have been receiving services from NEW HOPE. ❑ That NEW HOPE and I may not be able to control what happens to my information once it has been released to the above person or agency, and that the agency or person getting my information may be required by law or practice to share it with others. . Expiration should meet the needy of the victim, This release expires �n: which is typically no more than 45 days, but may ®ate be shorter or longer. understand that this release is valid when I sign it and that I may withdraw my consent to this release at any time either orally or in writing. Mat03 Witness: Rev. 8/2017 nevv beginnings. fter for notrows. �1111111111111 iq i a LEA PRIMERO: Antes de decidir si desea o no que NUEVA ESPERANZA comparta parte de su informacio'n confidencial con otra agencia o persona, una consejera de NUEVA ESPERANZA discutira con usted todas las alternativas y cualquier riesgo, potencial y beneficios que puedan resultar de compartir su informacio'n confidencial. Si usted decide que quiere que NUEVA ESPERANZA libere parte de su informacio'n confidencial, puede utilizar esta forma para elegir lo que se comparte, co'mo se comparte, con quie'n, y por cuanto tiempo. Entiendo que NUEVA ESPERANZA tiene la obligacio'n de mantener mi informacion personal, informacio'n identificativa, y mis registros confidenciales. Tambie'n entiendo que puedo optar por permitir que NUEVA ESPERANZA libere parte de mi informacio'n personal a ciertos individuos o agencias. Yol , autorizo a NUEVA ESPERANZA que comparta la siguiente informacio'n espec'ifica con: Escriba su Nombre A quien quiero que Nombre: tenga mi Oficina espec'Ifica en la Agencia: informacio'n Nu'mero de tele'fono: La informacio'n puede ser compartida: u en persona u por tele'fono H por fax u por correo u por correo electro'nico ❑ Entiendo que. e/ correo efectr6nico(e-mail) no es confidencial y puede ser interceptado y lefdo por otros personas. LQue informaclon (Ponga /o ma's especIficamente posible, por ejemplo: nombre, fechas de servicio, cualquier sobre m'ise documento). compartirAP: ,&Por que qq ' iero mi (Ponga to ma's especfficamente posible, por ejemplo: para recibir beneficios). informadon sea compartida?: (propo'sito) . I i enga en cuenta: existe el riesgo cle que una publicacion limitada de intormacion pueda abrir potencialmente el acceso de otros a toda su, informacio'n confidencial contenida por NUEVA ESPERANZA. Entiendo: ❑ Que no te'ngo que firmar una forma de liberacio'n. No tengo que permitir que NUEVA ESPERANZA comparta mi informacio'n. Firmar una forma de liberacio'n es completamente voluntario. Que esta version se limita a lo que escribi anteriormente. Si quiero que NUEVA ESPERANZA libere informacio'n sobre mi en un futuro, tendre que firmar otra forma de liberacio'n escrita con tiempo- limitado. M Que la liberacio'n de informacio'n sobre m'lpudiera dar a otra agencia o persona informacio'n sobre mi ubicacio'n y confirmara que he estado, recibiendo servicios de NUEVA ESPERANZA. El Que NUEVA ESPERANZA y yo no podemos controlar lo que pase con mi informacio'n una vez que ha sido liberado a la persona o agencia mencionada, y que la agencia o persona que consiga mi informado'n pueden ser requeridas por ]a ley o la pra'ctica que la compartan con otros. F—MM Matto Fecha La expiracifo"n debe cubrir las necesidades de la V ' tima, que es tipicamente no ma"s de 45 dias, IC Pero puede ser ma's corto o ma's largo. Entiendo que esta liberacio'n es va'lida cuando la firmo y que puedo retirar mi consentimiento a esta liberacio" n en cualquier momento, ya sea oralmente o por escrito. Fecha: Firma: U= � s new beginnings. better #omwrows. Client Statement of Understanding consent to receive services at New Hope. I understand I have the right to be treated with dignity and respect. I understand that New Hope has policies that say if I am under the age of thirteen (13), my parent or guardian must provide consent for me to receive services. I understand that New Hope has policies that say if I am considered an adult who has a guardian appointed to make personal decisions on my behalf, my guardian must provide consent for me to receive services. I understand that if I want any confidential information released, I must sign a Release of Confidential Information after speaking with a New Hope staff person. I have the right to withdraw that consent at any time. A signed ROCI statement with New Hope does not give up my right.to have my information protected under other statutes, rules or laws. I understand that communication of confidential information may be necessary between New Hope employees; all New Hope staff members and volunteers have signed Confidentiality Agreements. Communication and use of individual information within agency will be done with respect for the client's privacy and will occur on a "need to know" basis. I understand there are exceptions to the Confidentiality Policy of New Hope, such as mandatory reporting of suspected abuse or neglect of -children or vulnerable adult, or if I am a danger to myself or others. I understand that New Hope will notify me immediately if any of my confidential information has been. subpoenaed. I understand that New Hope will use any means and resources available to try -and keep my information confidential. However, New Hope may not be_ able to control what happens to my information once it has been subpoenaed and there may be a requirement by law or practice that might require all parties to have access to my file. I -understand that I can access my client file with a 24-hour advanced notice and at an agreed upon time with a New Hope.Staff. I will be asked to present photo identification and will only be allowed to review my file at a New Hope office and I understand the files are not allowed to leave the New Hope office. If I wish to take a copy of my records with me, I must make this request in writing to the New Hope Program Director. I may also ask to review New Hope policies and procedures regarding confidentiality, release of client information, and recordkeeping. I understand that while participating in New Hope Services and after -participating in New Hope Services; I agree to keep confidential: a) the location of the New Hope safe shelter, b) other New Hope safe locations, c) New Hope staff and volunteers, and d) other New Hope clients. I understand that New Hope, its staff or volunteers are not responsible for any loss, damage or personal injury that may, occur to me, my family or property while receiving services. Furthermore, I understand New Hope will not assume responsibility for any loss, damage or personal injury that may occur tome, myfamily or property while receiving services. I waive the right to sue for damages in connection with any such loss, damage or injury. I assume full responsibility for myself, my healthcare, my personal belongings, and the care and welfare of my dependents. I understand that as a client of New Hope I will not be photographed or videotaped by staff or volunteers. In addition, I will not be asked nor compelled to participate in any public appearances. However, if I choose to participate in any public event or to be photographed or videotaped, I will be given an opportunity to sign a release form first. I understand that there is a grievance procedure for me as a client of New Hope should I have concerns with the program, its staff or procedures. I may request a grievance form at any time. In the event of my death, I [ ] do [ ] do not authorize New Hope to release documented information and confidential communications about me. Date Client Signature (or guardian if underage 13 or adult who has a guardian appointed to make personal decisions) New Hope Advocate Date CLIENT STATEMENT OF UNDERSTANDING I Revised .duly 2018 .� . � a new begimhvgs. 6etW io=mt .ow3. Declaracion de Entendimiento del Cliente Yo, , doy consentimiento para recibir servicios de Nueva Esperanza. Entiendo que tengo derecho a ser tratado con dignidad y respeto. Entiendo que nueva esperanza tiene politicas que dicen que si tengo menos de trece anos de edad (13), mi padre o tutor debe d ar el consentimiento para que yo reciba los servicios. Entiendo que nueva esperanza tiene politicas que dicen que si soy considerado un adulto vulnerable como definido en RCW 74.34.035, y tengo un guardian designado, mi tutor debe dar el consentimiento para que yo reciba los servicios. Entiendo que si quiero que se libere informacion confidencial, debo firmar un papel de liberacion de informacion confidencial despues de hablar con un personal de Nueva Esperanza. Tengo derecho a retirar este consentimiento en cualquier momento. Una declaracion ROCI firmada con nueva esperanza no renuncia a mi derecho a tener mi informacion protegida bajo otras estatuas, reglas o leyes. Entiendo que la comunicacion de informacion confidencial puede ser necesaria entre los empleados de Nueva Esperanza; todos los miembros del personal de Nueva Esperanza y voluntarios han firmado acuerdos de confidencialidad. La comunicacion y el use de la informacion individual dentro de la agencia se hard con respeto a la privacidad del cliente y ocurrira en una base de "necesidad de saber". Entiendo que hay excepciones a la politica de confidencialidad de Nueva Esperanza, tales como los requisitos de reporte obligatorios o si soy un peligro para mi o para otros. Entiendo que-Nueva Esperanza me notificara inmediatamente si alguna de mi informacion confidencial ha sido citada. Entiendo que nueva esperanza usara cualquier medio y recursos disponibles para tratar de mantener mi informacion confidencial. Sin embargo, nueva esperanza puede no ser capaz de controlar to que sucede con mi informacion una vez que ha sido citada y puede haber un requisito por ley o practica que podria requerir que todos las partes tengan acceso a mi archivo. Entiendo que puedo acceder a mi archivo de cliente con un aviso avanzado de 24 horas y en un tiempo acordado con el personal de Nueva Esperanza. Se me pedira que presente una identificacion con foto y solo se me permitira revisar mi archivo en la oficina de Nueva Esperanza y entiendo que los archivos no estan autorizados a salir de la oficina. Si deseo tener una copia de mis expedientes, debo hacer esta peticion por escrito al Director del programa de Nueva Esperanza. Tambien puedo pedir que revisemos las politicas y procedimientos de Nueva Esperanza acerca de confidencialidad, liberacion de informacion de clientes y mantenimiento de registros. Entiendo que mientras participo en los servicios de Nueva Esperanza y despues de haber participado en los servicios de Nueva Esperanza, estoy de acuerdo en mantener confidencial: a) la ubicacion del Refugio de Nueva Esperanza b) otras ubicaciones seguras de Nueva Esperanza, c) el personal de Nueva Esperanza y voluntarios, y d) otros clients de Nueva Esperanza Entiendo que Nueva Esperanza, su personal o voluntarios no son responsables por cualquier perdida, dano o lesion personal que pueda ocurrirme a mi, mi familia o propiedad mientras recibo servicios. Ademas, entiendo que Nueva Esperanza no asumira responsabilidad por cualquier perdida, dano o lesion personal que pueda ocurrirme a mi, a mi familia o mi propiedad mientras recibo servicios. Yo renuncio al derecho de demandar por danos y perjuicios en relacion con cualquier perdida, dano o lesion. Asumo toda la responsabilidad para mi, mi salud, mis pertenencias, y el cuidado y el bienestar de mis dependientes. Entiendo que como cliente de Nueva Esperanza no sere fotografiado o filmado por personal o voluntarios. Ademas, no se me pedira ni se me obligara a participar en ningun evento publico. Sin embargo, si elijo participar en cualquier evento publico o ser fotografiado o filmado, se me dara la oportunidad de firmar antes un papel de liberacion. Entiendo que hay un procedimiento de quejas para mi como cliente de nueva esperanza si tengo preocupaciones con el programa, su personal o procedimientos. Yo puedo solicitar una forma para quejas en cualquier momento. En el caso de mi muerte, yo [ ] autorizo [ ] no autorizo a Nueva Esperanza para publicar informacion documentada y comunicaciones confidenciales acerca mi.. Firma del Cliente (o guardian si es menor de 13 anos o adulto o guardian se es) Consejera de Nueva Esperanza Fecha Fecha CLIENT STATEMENT OF UNDERSTANDING j Revised July 2018 FY24 Emergency Shelter Renewal Application ATTACHMENT B Emergency DV Shelter contractor: FACILITY STANDARDS FOR EMERGENCY DOMESTIC VIOLENCE SHELTERS WAC 388-61A-1100 to 1205 Definition: Emergency shelter means a place of supportive services and d safe, temporary lodging offered on a twenty-four hour, seven-day per week basis to victims of domestic violence and their children. .(Washington Administrative Code (WAC) 388-61A-1000) Ea- a g Rv R W F i2l 2_7 01-M -0 Mae ggm,- r 1. Shelter, premises, equipment, furniture, appliances, and -supplies are in a clean, safe and sanitary condition, free of hazards and in good 'repair. 2. Handrails on stairways, porches and balconies are secure/safe.. 3. Method for securing all windows, doors, and other building accesses to prevent the entry of intruders. 4. 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"-r---Jrs."-?.-�i`<"i._ ,..,'. ,.vrr.✓�a- - _w"Y' �...c '-?:.,•--t.. ��+a �y. -�.:s v ^r'•�-2=v �� o,� rn f•.'7'S•''_- t � - J' 'T, 'irr ; `�'.�:''ti .a"-.�-., r C =r :)._ - =a:=ire-.. - }'_ '":,5a.. t f -�"a ^.1+y.Y -. YVx za `-{: /'t!+'-: .t:.�-!:c :I.�::r:"-ter. .�_-,- rJs� ovG-�. ai.<'Y=.. -.,:fir_ r,_"'ss.--. ice: �='i .: t^.�J�J��'�: ��5.-'y tr.�. _ '•t'i S. There is at least one telephone for incoming/outgoing calls with the following information posted in English/other languages prominently served by the domestic violence agency: emergency telephone numbers and instructions on how residents can access domestic violence agency staff. 9. Domestic violence agency provides on -site or on -call services 24/7 for shelter facility residents. (Contract does not require 24/7 on -site staffing of shelter facility). .. tea. 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Ir-'... �� a•y.-;¢. �� +;'.zry �L•r3„E ,t,,._.>_. . r 1 [' .'Y•... 7 Y" -v •. .. : - _H> ... , . .. --. :� _ ,. : _..._ .. < � • ..r < i �. ry L. t .'k•- l - -, r. .r- .e-- _.. -. .. � ._. <.. _. �. -, .r ._.:.- .... .,-..i,_,-u,. _ �'.. aN. _ ,. _ _. l.� i"1_;- ..i �� is '?'Sr :•{. �.:'t�L- _ ..f _ •ice:,.. 1. Food and beverages are provided to clients residing in shelter unless other resources are immediately available. 2. Food and beverages, including infant formula, are stored at the shelter to provide to clients when other resources are not immediately available -.-_.. and for. -residents who are unable to access other food resources safely. 3. Milk and infant formula are available or accessible at all times. 4. Food and beverages are of safe quality. Storage, preparation, and serving techniques ensure that nutrients are retained and spoilage is prevented. 5. Food and beverages prepared for clients residing in shelter are prepared, served and stored safely and in a sanitary manner. 6. Food prepared for residents is prepared in compliance with WAC 246-215, Temporary Food Service Establishment. 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V....r._, .,. , ..,.r..-...,..._l.,- r„,.r-..._s, ._.�_..._-,,.. : ,...h .�, ,•-:. � _ .�_ Y.. _�_ �. .'n_ .c ,x�.t' --t,� ^,.- .fir _x?�_a�'1 :.'> _ �. , -, .. r, :-e ,. ,_7:. �..r.4 .... _ r r. - �... t`i!: i....--,.. z:._v.- r�,.�:: ,.+�-� _�-,:r,.,r-,r, L•yfa�•. £r2s. <3� �ilr- - �X- :r �- ,-.-r rr�-s. ._ .._. -,;->. , .._ •'S_`^•.. _ .. _._ r sf._ _ .k_: :...-....: ,bf. - tc_t+:.....a --c" _-x:•-E- �'* -c - :^r-rs h � - -•.C24=,_-'` r+s- �E<. -c - i". _ � . � Va=. - _ _ r.:. s- ors- 3-i}. _ :.33.}n:-i.=l?, �: � 3_•_. -. �i_ -t- Ln"�,,,i ' x-,�.kc _ 7. Food is available to prepare for school lunches, if lunch is. not otherwise I vailable to children of shelter residents. S. Clients are provided or have immediate access to food that is in accordance with their religious or cultural beliefs and personal practices. r ..-.�_.::;.`•.::.,..✓. _. ,•c. ,,-- •3r 1:.,.a r r v _ - - _ -:.... T.. t-' '+•- -.- ." >-_s :-. � :... =.1. '?'_°h �L ,2f.. t t . _ > r-.. I _: .. -z _ .... ,-• - F--...,. ,.z_.. .l_ -r, __ , v.. ,. , .. .. .. _ .._._-3 .1_ ,t. "FrS �- F- rt-l'M. L� +i -- .--St._:. rS -G 4.�.._'ti..-. .]C Z 9 .a 1 A. r+�Y .. ._. _.z ...�% a}v .. .- /� .Y.+.x• ]y/��' Z,. �rr - 4r Y V� ■N■ C +-t _ e �V.. - r.t -� - 3. • -i r =f 1 _g - t' •r-� eh y _ ., ._.,, .. _.: .. ,. .:. . - _..: .. ,_ :'... _. ..:.. -.'3 .;,... .. ._ _- _ - �. C .�. .x ue•:- 1: ,. .... -�. .1. .. .y 1 .. ..._ ., _ .. _ ._ .--..Y ,✓ ,4 _e... . ,-..:.. _ ...:.. ,-.. _i. � 4- . .v... } .:�_,�' C a• 'f ! ..� Sr J .t fir::. .cr_, _.. � 4'.: :,i - ti, ', t]'Y :w'. t • 1. Residents and children are assisted in accessing clean,:well-fitting clothing appropriate to the season, individual's age, gender and particular needs. 2. Clothing provided by the agency is clean and stored in a sanitary manner. 3. Clothing provided to an individual becomes the person's personal property and is not shared/retrieved front them when they leave shelter. 1. Clients residing in shelter are provided with personal hygiene products such as soap, hair care products, toothbrush and paste, and deodorant. 2. Hygiene products are provided to individuals that have special needs because of their ethnicity, disability, or medical condition. DSHS Domestic Violence Shelter Contract FY24 Renewal Application — Attachment B Rev. 4/23 Page 4 FY24 Emergency Shelter Renewal Application ATTACHMENT B tY a: '- -:troy • }r •�.._ ..f .sr•-. ,r f'�' � . x..r., . _t,: _� _ _ , f f ,,.`�.. .-, t � >>'_Y: :. - t`"' ^rib•. ` ems-" :t's �� vim= r,3 _. �� "+->,.. ,� - _ : Y 3 4:' "ti rf„=' - �:•n. ,a", :i„_ - _irr-r .r'r r,.9.''. _ Kr -J.i, �K�' � �_ -F t•- -Y,__ .- _X% '-'-�.�-•: aF -^.�.?.-'•r �+ r ...0 . � tc ,� �,r_zirs' T= - - '•�Ts :"rc r•:3., -,i..r_e, •�.'..-w_,. ?3•. .,;'s= +,f""-sS` •.tom "" ..'s. - �e'`x-a-_ •J'.� - � tT.. _ ��kad ;��i: � - -^i..r s.� r. 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La �3T '±-, K.<. - 12 •-. -]n .c,� I'_ � - .3'^:r[ .fir• L-i1 s`�{_S: -,+' 3L• ate,., . {K _ - z..:t .. f_-•-�. �'� ;S,,:r .2. ;>:['_' - - -e/ eeS, _ "r �S. .z'� _ - _._'^v -.7: 1 _taS'_r.�. -,- -rY. ,1• v[e .r`c''.•lr-... -rl. � _ �... ei :,.- 'v+.._-: t�zr `=3i:�•r� �'�=%�: �.4 .J...':�!" _ .✓`'Gr._:_�,�� t-s--, '..G:+.X. i-:5 ,5' -��tih•Kf 7L _ ^a_:r- '_'T::�.:a,>-: ,.r ::.-, i - .�c"',� ,r: •%" `r •'��•: S :4s. ;... ♦ x rt _ s.r ONE, � r'{`� a •- >Ji•'.. �v' '�. �� :,;,Y•' •:-r=: •r'-,:-. #.='.c.. uya :•-,>; -•-`F%.Y. [ ��.,YY _.3Ie `f wit , _ - .'.?, ..T .ram' - -..f^ ]_afni-,cs.. •'t. T.�.. rigs,- .�,,.� v ..aye •c% �' _�-�`'r _ _ _ J'3 _ .[-, f-'ir...0 '�'?�'�- ��.r:. � �•'4'•. _-i+.Yc_3. `. _+F r=.:rry,. - .-+•L%ii::•�T. ,J_ •s... ;-,• .-mot -r. '?r�•.-4. [L„ :15 T'F'iv z$s _ ..r-. •, '9, �`f- .z:r• :. =t„t ' Zl� ....�..cT:-�'+-• -:r•: 7r },Y'+-._••_:.<r Y � ^ <-'� . .rh ,.•uL-'. 'tz�'.x::.s -~S4'- .r - . - .r_r ,. :t.- : �., rtic•_'i?, _.'S+r. ' ,..'�.♦ ,.. ,._.S ..r....c' �3y'STr-� _, ..,.., _ _ _.-_.Y1. +T_ �„ _ .f�.' :1L--- t`".'. '{'r � - -.•.r: i•" _,.•.. ,g-.�•.ev[ ....r-.. .. _..=. e.:., _x:-i4..�.�✓--.• w2:; "-r..�:. %_,r x� �,_ .••a�,2J rr=':,�!': -: �:.�ase- :..7-� *.#r. - .fir.. ai- saF.;',':Sz".�__ .2___ yr - .y'7E' �"Tf _.'-J : }�3:!-- �:TS .J. . __ _ _ _ _ 1. One indoor, flush -type toilet, one nearby hand -washing sink with hot and cold running water, and a bathtub or shower facility, located within the shelter building premises. Hot water cannot exceed 120 degrees. .•2,- 'At least one toilet, sink, and bathing facility for each 15 sh.elter--r:esidents. Floors of bathing facilities must be resistant to moisture. 3. Toilet/bathing facilities provide privacy for residents. 4. Toilets, urinals, and hand -washing sinks appropriate height for children, or safe, clean, water resistant stepstool/platform. 5. Potty chairs/toilet training equipmen't7for toddlers must be maintained, disinfected and kept in sanitary condition. when in use, potty chairs are on washable, water-resistant surfaces. 6. Provide soap, clean washcloths and towels, disposable towels or other hand -drying devices to residents. 3 - 1'i-r. y - u.�c---�,a: Ji6.-,se.:..._z_."_�-i.:_a4_.-.:..._........._�s._..:.>e. - , . z. �, ...- , ..: _.... _ ,ti ; .1^ +1_. k _ t e6 ] ..�x- _ -_.. `�•,: ,.. .^r'S ?-'•--f'rz'^"�C�a`_;._,evr,-.,.-.s-^_.•..��a-• ..._.a.v.-r^r-, c^' .5 •.��,.--r-x _ -._, t, ly J v x �.,. _:r e,_, ._.. �.� .�. ay..,_,- .. -:�.- .. _ N ... ., lire • ..+• LL.�:i -. .J .._'r-. �. - } rLinen. Re uire e,s1� r.•_ ,•Y - L __ ^`Y.. _ 1L- (■p. >1 5,:1 omfane• r ::.. .-vim•-i..', r_. P. - ___a. ,:..,'�Sr. .�- -, L..�:'.::: .; .:,r.. �. - - 1. Bed linen, towels and washcloths are clean and in good repair. 2. After use by a client, bed linens, towels, and washcloths are laundered prior to being used by another client. 3. If the agency uses sleeping bags, a clean liner is provided unless the bag is cleaned between uses by different clients. DSHS Domestic Violence Shelter Contract FY24 Renewal Application - Attachment B Rev. 4/23 Page 5 FY24 Emergency Shelter Renewal Application ATTACHMENT B 4. Clients provided with changes of clean bed linen, towels and washcloths upon their request. .v: .. .. - .. .. _ .. -,... - .. _,_,..>.... -. ..r_ -.o ..� _,__-1, - _ _r_,-:: ,. _•. __a, s,_ - _ ,ice - 51.- _.. __., _-:^.T.,�...-�__ .a... 'r _ _, ,. .,.: _-..... ai�.,. , _. .: _r-.. _,. �xx- _ ..f+__ _..S_ :. , _.. tax -;.a- ^> s. s. ! - rY ,r > .ram.-.v �r [, „Y• ,.._ _ - ,.-_I`'. >.5.cv'-c ..=: ra3 {._,ate - aYri � - j. _ ,.. . .. ra ..r x..-... _+-. _ > __ ,_ Wit• ,. : - ..., .. ._,. _ ... ._, ... > > ,. - �. +-, �},....._. 'e . •'K .. � ..... . � l S � .r . : -.._ti. r r_.._. .. cY'_ , - .....a. �._ .'-- ">.__. .[ �, .. ...w .. . 3't_ _ r _ Y _-, �?,.^-,i .r .x�-.-<.•,. _ <..i ... ].T Jr.,-4 ,r.. , L. .. ,..- _.,•. ,•. ... Yr. rn :. _. :, .. __. f.�_ra'> .x�. I`»i. ., {•,- s: , ...t:+v.._.,....r�-,.:^_'!-- .... rri .. -- - v y .. � - "., s. _:. _. _,- _L" .r•--<. `-2.�...-. .. ..:_. x.. l_ ,n ,-..-,.-n>. II�,,n r. ... r t R. ", ..-. r a. ^ 3 e, u � �ce_m:ents �.. �- �.--i:'�{ ...:._.,-..._..�-.a.-r, ram,-_, ..... -4^-..r. ..r ,.._ ♦. r.. _,._ .JS,: {-a r} .� _ . ,.. _a.-.. .,._ _, ,a- .r..[:_._.�.,._• ,=-:a-'--_` �. �.. -- :s � _ r•.: .....-, -ter.. _ . _ ,•ti. 't.- s. a. .. ...._ ... .+.. _.. . __ .. _ _ , - .... r,. > .v.. ._._ _ _e .��- .-� r. _: _ _ _ � . ' ff�� ^i'ff' %�-. .-efI 1:�• ..r„ : Y. .. a_: ._. .... .. ... .i_ _ ... ,_ >.-„f.._ � z .�._. � -£. .. ..- --5.._ :'•mac z„rr "'�' j%ai •vw`r t:'Fc- � _ - �� C` _ ,:-:..-,,._ . ... _ _,.,__. r,_-_ r. _ e .ir_ .., . -. •s ., .. _ t - •.-. _ ..... ... ,,, ,+ _.. h^! S ..1 - . r f• , . , ?. T ... . _-t.. ^ ._• - _,.. .. _:.G. t'"' _.. _ _ .._. -s..-,..... c ..,.-_ i'_. n'fy� _ zrrt. ......._... -:_r_> .. .+:._ ..._: [... _. ._ >, [.r--. .. ... _ - ., t .Ft___._. _. i .•L_ __. `t-sx a-�w ._C i- b 1' �_.v+.5 -s-r - - _'•"�t,: `.. ..J;'^i:?r•'r _,__ _.. _r -._ _. _ =1 _r. _ �.. .,:•.ate r __r:1 o-. .. _ -.rv_ _ ':._.. -! _ - r - zc•. ` _ -^:xY• ',,,[ _ -x,. 3-.,.•-'4- r _-r?. ..",-.v �"�3. Ct ,�_ '' � ,tom - _ �C� -ly. �kh. 2_� ` t - r. 1. Provide free access to laundry and drying equipment, or make arrangements for regular laundry service. 2. Handle and.store laundry in a sanitary manner. .. ..> .. .. _ _ .i , a _ / - .._._ �. _ _ ..,. r, a•,-. r_ ,,._. ,.._.. , �-.a .[...t c;-:s.._.s�•F 3, Z' C:. - -t.. 7� - �`-+- �.-- T{ti.- 1. Now . ... b .t„�,:: .. ... _ r .L .. x-. ., _ ..._ ...,. .. _. d-c .sw.. .. ..� .... �,.-...._r _.-_.,-... "Y t z� ^ > spa ,!. a ray . _ y Tr, ,::3 r.v Corn. pan _ >> r - t., - - :F -�c x5 a T .._ - .. .. ,._ .,ram. _ ,..o- .r.' .o. i ui ... _. _..".- i- _ - _. _... -.i . • ti c -r -, _ ,-%r' T f. �; 1. Resident roams have safe and adequate heat source. 2. Gas and oil -fired space heaters are prohibited. s „C - "__ •.- .. >.-i__• ._:,-ati. .r..a+ ....-_ .. r.,. -�__ :.:-.s xt., ._rn .. -__.,. __. c .-. ,ter r_. r r Y, - n . IM _ t r [ i z ,.. , .r .- . :'2:=. - .. ..,.- •.,' - _: . _ 1. :_.. _ __ _ . -. _-. .z . .. , - _. • .. -,>; ._.-.., � _. , _.:- , ✓*>t. - - 1 ' -t •f - _t -\� T Y = f-r . .: �. a urrern ,_ [< tlentrlal�Qn.aR r: �-......_ _ ants_ .�: , f - _ �-r ' ,4 , :s'q - t :"Y. -._ .... .. . . .r . .,.. R ,a.: .. ,: -. w, � ,?. '-'T it •t,.r'.• ..r F- r' _ , .. ,_ ..ice .-_. .s -•r .:: i._^ :z:- a :,,_ "r.. a.. ::.. a_2. _.. _ _ ... I _ ... ".". . ........ _ -._ T. _ -u- ._ .. - - ...... .,_<- -a. . _. .i-r -.t - il ••1:: _ � • -. ,- >-.. _. v. _ .r .. ._.. :._ .+c _ _. x t.. ... ... r.._ .•r2. ...-i..-..,� .-f. i.-ef-.:_ f" [4 x .•sk �• C r --<; _ -"4 _'l nM=JS>s^ t. r� - '2r" �:r .+J. - � k_ ._ "K 1. Mechanical exhaust to the outside must ventilate toilets and bathrooms that do not have windows opening to the outside. 2. Natural or mechanical ventilation in all bathrooms, toilet rooms, laundry rooms, and janitor closets that contain wet mops and brushes. 3. Bedrooms and communal living areas have a window or opening to the outside that can be locked or secured from the inside. 4. Gas or oil -fired water heaters and forced -air systems safely vent to the outside. DSHS Domestic Violence Shelter Contract FY24 Renewal Application — Attachment B Rev. 4/23 Page 6 FY24 Emergency Shelter Renewal Application ATTACHMENT B 7 5 i - ..�+. �_r ,. ..-..-1.- )-- ,_, .• .... .....� ,... 2. r - _} _ Y t . ._.. -. _.e ._. .._.-. r, r. 77 ..:_ _.- •..,�. +._., .. ... .,r-• -y sue. 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J...�. .`i fr .. ..r ,. -1f ,t , _ , .-a.. .z ._�' ., • •.-�.._ _. ,. r :_• • .. _ - - w.2 `.f,..� . .. ,• •. .... Y_i _ -.. ' h- r.2, Y.F. t „ -•._ '- -, - .. - - '-- ., , ,�. ....-. __ .::. ... r .:r,. _�,� ._, .., __ .1. _ � r Y,>- _�, - �5- r. _ v3-:-,i....-_. � `S.. - --v,."�j:-'.? -•-.c„ �.t.t �-.r� ice.. : tt r :}^-, .,•sue.. -r :?-r� .T..}l' ?F.' - .. � 3. _ .5 .,,_i ,_s"., .. -.. -- -... .. ., _-.._._r__. .. ...,.J. ..-•... �. 5_. ._ _,_. :... _ f,-... _. r. - 7. -s= >'i ^'."Yy' ..s. re-- ..J.=, 1. Drinking water is from a water system that has been approved by the local health authority or department as safe for human consumption; includes public and individual water systems. 2. Sewage and liquid wastes are discharged into a public sewer system or local health authority approved functioning septic system. �_At .. .. .. .. .. � : - .-.� ,, .., -, .... -'� .. �.��.- -f. d.-. {' 'tea - - • �" .-1 .. � %; n.'.i- ...� - S.. -. _ _ _ .. _ t s.. 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"a --.. __ _._ ... e... ...: ,. _ ....{•:: ..- S.c. _-: _ .... ,. : �.a r. _ t,, _ r.G• ...-r.r. :..._ +»•. �a -•ts ._." .r•� '... .. _ z,... .-.:' .� .,.. { _, .: r.. s -.�. J 1, .,_ . -y _, -. > .:. ..� .v v:. .E.,'.--`,..-_. s5 �i :i,.s.� '•~r; ,;'srs1G•..,-. :t'•.�.s"?r s.. C'.. Y� - -�"e.-_ .cr :. �_, f - ...4. - �.-.Y,•„_. a.y5 ... .- .. -._.. .s,. ..•-- _>.. _ _ .. _. ,.. _.. -, .•- ,.<e z.. -, .. _fie - -...Z . f a- •� if-_ s .F . fp„-x, S%- � ._,. _ ... _. ;1 ♦_ r _., ...... .-. - i._., -. ._ ! c. >-- _-vai-z.w+. _ c+ 3 ._ ,-.. : .. s"^ ,i -�"'a� �.. ��`i...Lz��-: , t•n�;. -� - �':1-'r'� - ..t % ... - �., - __. ., .. -.. , .. _ :.•U, , x_, ..- .. .. _ _. _ -,�. _.. .. .., _ _ : _... .sr _ �-.. i t.'i: - ../`7n - ..-. _. -> ..>,. -, .r ,,.r >-w_t > •Snc .. � .•._ o-.,.e ,.�-- ,..e..,.•r.r -,3_ :.3->..' xJll.lr' - �{i: :G' l' - .. J>, 1. There is sufficient lighting to promote good visibility and comfort for residents. 2. Pets are prohibited in the kitchen during food preparation. 3. First -aid supplies at the shelter include: first aid instruction booklet; bandaids; sterile gauze; adhesive tape; single use packets of antibiotic ointment; antiseptic wipes; hydrocortisone ointment; roller bandage; thermometer (non-'mercury/non-gi.ass); and non -latex gloves.. 4. Shelter residents are provided with a means to safely and securely store and have direct and immediate access to their medications, such as individual lock boxes, lockers with.a key or combination lock, or a similar type of security storage. 5. Medications, including pet medications and herbal remedies, will be stored by residents in a manner that is inaccessible to children. 6. Reasonable efforts are made to keep the shelter free from pests. 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If weapons storage unit has a glass or other breakable front, firearms are a secured with locked cable or chain through trigger guards. 4. Access to firearms, dangerous weapons, and ammunition is only by authorized persons. Explain any "No" answers: DSHS Domestic Violence Shelter Contract FY24 Renewal Application - Attachment B Rev. 4/23 Page 8 Domestic Violence Screening Tool N-0mbre del Cliente Fecha: _. .._.._ _ ._- 3r.... .s, ..,- .. .. a:._ e ._ .. ...:-. ix•�r.--, -• - •_. _ _-. __. .. -. .'n- _ . _ _�t Ut Ienc�ar;Fsica G Forman d ._ o _ v.:lc- _ r. _='•' .3? _, v.. ' i i� _C v _ _ - Empujando Torcido los brazos o piernas Huesos Rotos Golpea las paredes o puertas Puneteado Sacudido Agarrado Destruye mi propiedad Cacheteado Ahorcado/Estrangulado Pellizcado Dana las mascotas Pateado Arrojado/Tirado Jalado Me fuerza a tener relacciones sexuales Mordido Dejado moretones jalado el pelo Me tira / avienta cosas (zapatos, juguetes etc.) Rasgunado Ojos Morados _t .. _ ... ......a 1 - ci - r .. _.r ... -1.. .. :. .. . _.. .. - __. he _todas.Ias ue a Cica_n � .Hales_ de.Ab_uso _ C �a _ i_c _o . _ , r l } .t - •.F Te hace sentir menos Hace todas las decisiones Me degrada sexualmente Me controls Me llama de nombres Me dice que estoy loca Me Acusa de ser infiel Me llama o manda mensajes constantemente No me deja usar el telefono Amenaza de matarme Me detiene en contra de mi voluntad No me deja usar el carro Me aisla de mis amigos/familia Mo-nitorea mis Ilamadas, textos, o correo electronicO Amenaza reportarme a cps/welfare Me ignora No. me deja dormir Me quits. mi -medicina Controla mi dinero Me hace. pedir dinero No me deja it al doctor Me lnsulta o humilla Me• escupe Amenaza suicidarse si me.voy No me deja trabajar Lee mi correo'.personal/co.rreo electronico Me cierra fuera de la casa Grita, dice groserias Toma mi cheque Me sigue al trabajo/casa Mi pareja ha sido arrestado por Violencia Domestica Amenaza reportarme a inmigracion Amenaza quitarme a los ninos Me acosa en el trabajo Prohibe que Ilame al 911 Trata de poner los ninos encontra m,ia Me hace sentir culpable Acosa a mis amigos o familia Amenaza a lastimar a los.ninos Me culpa por todo Actua celoso/posesivo Minimiza el abuso Usa armas pars amenazarme o lastimarme Viola la Orden de Proteccion/ No Contacto Niega que cualquier abuso sucedio Amenaza lastimarme/pegarme I Tiene otra gente vigilandome/me I siguen Me dice que no la puedo hacer yo sola Tu pareja tiene acceso a armas ? Tu pajera bebe excesivamente? Tu pareja hace drogas? Piensas que to pareja es capaz de matarte? endo o estas viendo a to abusador actualmente? LEIabuEsador frecuenta to trabajo? Sabe donde vives? Revised 9.2011 Client Name 1 Date: w _:.� - _ T: T _, .:._a. r r ... :. _ .. Cl'1.S -rQ-� P' I L �f C I b _.. _ o .Ch ec S _ -- Pushing/Shoving Twisting Arms or legs Broken bones Punches walls/doors Punching Shaking Grabbing Destroys my property Slapping Choking/Strangled Pinching Harms pets Kicking Throwing me Dragging Forces me to have sex (sexual acts) Biting Bruises Pulling hair Throws things at me (shoes, toys etc.) Scratching Black eyes Puts me down Makes all the decisions Sexual put downs Controls me Calls me names Tells me I'm crazy Accuses me of cheating Constant texting or calling Denies me use of the phone Threatens to kill me Holds me against my will Wont let me use the vehicle Isolates me from my friends/family Monitors my phone calls, texts, or email Threatens to report me to welfare/cps Ignores me Refuses to let me sleep Takes my medicine from me Controls money Makes me ask for money Wont let me go to the Dr. Insults or humiliates me Snits on me Thrpatpnr, ci orir p if I Ipa\/A Wont let me work Reads my personal mail/e-mail Locks me out of the house Yells, Screams Cusses Takes my paycheck from me Stalks me at home/work My partner has been arrested for DV Threatens to report me to immigration Threatens to keep the children away from me Harasses me at work Prevents me from making a 911 call Tries to turn the children against me Makes me feel guilty Harasses my friends or family Threatens to hurt the children Blames me for everything Acts Jealous/possessive of me Minimizes the abuse Uses weapons to harm or threaten me Violates NCO/PO Denies any abuse ever happened Threatens to hurt/hit me Has other people watch/follow me Tells me I cant make it on my own Does you partner have access to weapons? Does your partner drink heavily? Does your partner do drugs? Do you think your partner is capable of killing you? Are you living with or seeing the abuser now? Does the abuser know where you live/work/frequent? Revised 9.2011 Equal Employment opportunity: Grant County is an equal opportunity employer and believes that every employee has the right to work in surroundings, which are free from all forms of unlawful discrimination. Grant County is an Equal Employment Opportunity employer. It is against Grant County's policy for any employee to discriminate against an applicant for. employment or another employee on the basis of race, color, and religious creed, sex (including pregnancy), age, marital status, sexual orientation, national origin, or any other classification protected by applicable discrimination laws. Furthermore, no employee of the Company is to discriminate against any applicant or fellow employee on the basis of a disability or status as a disabled veteran or veteran of the Vietnam era. Grant County will make reasonable accommodations, including modification of policies and procedures in appropriate cases for qualified individuals with disabilities, if it can do so without undue hardship. Our policy relates to all phases of recruitment, employment, promotion, training, demotion, transfer, layoff, recall, termination, wages and salary administration, working conditions, employee benefits, application of policies and participation in County sponsored activities. The policies and principles of equal employment opportunity also apply to the selection and treatment of independent contractors, personnel working on Grant County premises who are employed by temporary agencies and any other persons or companies doing business for or with Grant County. Affirmative Actin: It is the policy of Grant County to be fair and impartial in all of its relations with employees and to recognize the dignity of the individual. Grant County's Affirmative Action program is a management tool designed to ensure equal opportunity in all. phases of recruitment, em to y ment,'promotion, training, demotion, transfer, layoff, recall, termination, wages and salary administration, working conditions, employee benefits, application of policies and 'participation in County sponsored activities. It is a diagnostic tool that is used to evaluate the workforce and compares it with the composition of the relevant labor pool outlining practical steps in which to address under utilization of specific groups in all departments and offices throughout the county, Grant County maintains an environment ensuring recognition of each employee's efforts, achievements and cooperation. Employees wirl be treated impartially and allowed, without prejudice, to advance in the- organization, --as their abilities warrant and as -openings occur. Grant County will promote and afford equal treatment and service to all employees and citizens. Grant County views the principle of equal employment opportunity as a vital element in the employment process and as a hallmark of good management. In developing our Affirmative Action Program, Grant County commits to: 1.) Recruiting, hiring, training, and promoting persons in all job classifications without regard to race, color, religion, sex, national origin, disability, veteran status, or any other non job -related characteristic. 2.) Ensuring that promotion decisions are in accordance with equal employment opportunity requirements by imposing only valid, job -related requirements for promotional opportunities. Ensuring that all personnel actions relating to compensation, benefits, transfers, terminations, training, and education are administered in a nondiscriminatory manner. bengvvtninqs. better lomorrows. We care about your experience at New Hope and want to hear from you if you have a grievance or concern. We support open comm ' unication and encourage using various problem solving methods. You can report concerns or problems without fear of services being denied or reduced as a result of your concerns and without fear of mistreatment. If you come into conflict with a staff person or volunteer, or you feel that you have not been treated fairly as a participant of our program, or if you have a particular concern regarding services: We encourage you to 'attempt to resolve concerns with the staff person, volunteer, or the director of the program directly and promptly. If you do not feel safe addressing the conflict with that person directly, you have the option of communicating with that person's supervisor. If you are not satisfied with the outcome of that discussion or if attempts to address your concerns are not resolved to your satisfaction, you have the option of filing a formal grievance using the form below. This grievance form will go to the Director of New Hope. Note: if your grievance is about the Director, it should be mailed to the Board of County Commissio I ners at the following address: P.O.- Box 37, Ephrata, WA 98823. If you have any questions about this procedure, please speak to any staff person. Your name: Your gruevance: (optional) (Fee/ free to use more than the space provided) Please give this to a staff person or mail this form to our Director.* *If your grievance is with the Director, it will go to the Board of County Commissioners. Due to confidentiality rights of staff and personnel, we may not be able to tell you the outcome of this grievance. GRIEVANCE PROCEDURE FOR NEW HOPE CLIENTS I Revise-d JL11y 2018 dd f nel 6egilmings. 6etier tomorrows. Nos preocupamos por su experiencia con Nueva Esperanza y deseamos saber acerca de usted y si usted tiene una queja o preocupacion. Apoyamos la comunicacion abierta y fomentamos el use de varios metodos de resolucion de problemas. Usted puede reportar preocupaciones o problemas sin temor a que los servicios sewn negados o reducidos como resultado de sus preocupaciones y sin miedo al maltrato. Si usted tiene un conflicto con una persona del personal o voluntario, o usted siente que usted no ha sido tratado justamente como participants de nuestro programa, o si usted tiene una preocupacion particular con respecto a servicios: ® Lo animamos a intentar resolver las preocupaciones con la persona del personal, el voluntario, o el director del programa directamente y to antes posible. • Si usted no se siente seguro hablando acerca del conflicto con esa persona directamente, usted tiene la opcion de comunicarse con el supervisor de esa persona Si no esta satisfecho con el resultado de esa discusion o si los intentos de resolver sus inquietudes no estan resueltos a su satisfaction, usted tiene la opcion de presentar una queja formal usando la siguiente forma. Esta forma de quejas ira al Director de Nueva Esperanza. Nota: Si su queja es acerca del director, debe enviarla par correo al Comite de Comisionados del Condado a la siguiente direccion: P.O. Box 37, Ephrata, WA 98823. Si usted tiene alguna pregunta acerca de este procedimiento, por favor hable con cualquier persona del personal. Su nombre: (optional) Fecha: u queja: (Sie" ntase Libre de utilizar mas espacio que el proporcionado) Par favor, dele esto a una persona del personal o envie este formulario a nuestro director. * Si su queja es con el director, ira a al Comite de Comisionados del Condado. Debido a los derechos de confidencialidad de las personas y del personal, es posible que no podamos decirle el resultado de esta queja. GRIEVANCE PRO'\---.'EDUR-E FOR NEW HOPE CLIENTS I Revised July 2018 .NEW HOPE MANDATED REPORTING FORM Suspected Victim(s): Date: ...,.,.: 1': - � � •-. _ - .....�,.: r > . ..r, . ,� � i , ma`s.. � , r. _ .�..�-.. .1- ,r+ .ei tom: ✓t = � = :-.� .^:t -,i -a.•'�.. :>`'L" a•ti _ 1 T+ :R -.� .-S°h.. vi".:...y� ri . .:;`i•- ` ".s. ...... .:.- _ c* ..�.� -c .-s�-•:.. c � 1-.. >.. - -_;e -...>z ,..�:.x..iiTr�:'F.e:..,�,.�.sa..:..-i,.�:w�:w..i:.-siwx�,..zs, �__na�w.a..als...=: :...:::_.. - .� --:r*. aa-.�s,,.�.�x�%-e.}.e:�,; k;s.,i.�w.:.....»»+........•v..s�.�+.tea ....:.: -.... r'. ..,... r.t ..� - `�.L.r::s:;:.:zx:s..»»:v....��.�.,.._wz:,�,.:�»...w.:.:;� a _ z �-3:— -- �a�... } _ '� - '-"`'�-` '.=1,._.--.a,,,..erro��:a��.:.r_¢.:r:c�sszt,�:�.i�..s�<.,t:.<:ii3.6.y.:n�._i: _�.v,.:..>....o�.a...:.,:;a�u'�"'.,« 9;z�.,t.,...r � , Initial Caller Name(s): Parent(s) Name(s), if not Legal Guardian: Street Address: (where ChildlDependent Adult currently resider) city Sate Zip Code Phone Number: 4 Alleged Perpetrator Name: DOB: = Age Sex Y s Specific Allegations (Where? When?): Other information of Alleged Perpetrator: Agency F Intake PE New Hope Advocate: Mandated Report Form 01 /06 , 401 14 new beginnings. better 10mormws. 14"1"1 no I I ;d I... . 1! Employee: New Hope/Kids Hope New Hire Checklist To be completed in the first 90 days ❑ Application ❑ Resume —Cover Letter ❑ Reference Check Form x2 ❑ Interview packet ❑ VOCA Grant Staff Certification Form ❑ Child Abuse/Sex Offender Registry Check ❑ WATCH Background Check ❑ Fingerprint Background Check ❑ Abstract of Driving Record Kids Hope ❑ Job Description - Signed ❑ Letter of Employment ❑ Information and Record Release Form (HR) ❑ Copy of Social Security Card, 1-9 Form ❑ Copy of Driver's License (Front & Back) ❑ Copy of Proof of Auto Insurance ❑ PAR ❑ New Hope/Kids Hope Program Orientation Checklist ❑ Mandated Reporting Assignment ❑ Confidentiality Policy (Policy #R1) ❑ Mandated Reporting of Abuse/Neglect (Policy #R3) ❑ Policy Review Acknowledgement ❑ Core Training o SA o DV o CVS C o CAC Date of Hire: Employee Signature Supervisor Signature New Hope and Kids Hope Policies and Procedures are updated annually and open to staff input for revisions and updates. I have access to agency Policies and Procedures on the shared drive. I have reviewed New Hope and Kids Hope Policies and Procedures. Signature 1 You have the right tobe heard and respected You have the right to make your own decisions You have the right to be supported in your role as parent You have the rig')t to live without the threat of violence You have the right to a healthy, sober, and drug free environment You have the right to live in a clean and safe environmen] You have the right to live in a home in which the location is kept confidential You make the choice to leave the shelter N If the. any of the following occur, I have read the New Hope's Shelter Rights and Responsibilities and understand my rights as a resident as well as the responsibilities that are asked of me while I maintain residency at the shelter. Client's Name Client's Signature Shelter Advocate Date Date New Hope 311 West Third Avenue Moses Lake, WA 98837 Revised 3/23 Responsibilit elter Resident 9 Supervising your children and ensuring their safety, Communicating. with others without physical/verbal violence. Keeping your bedroom and common areas clean. * Washing Vour own dishes and doing your own laundry. * Keeping all medications locke.cl in a lock box provided by New Hope. • Keeping the location of the shelter confidential, no visitors allowed. Smoking or vaping ... the designated area on the back porch only! Notifying staff before 4pm if you are, not spending the night at the shelter Keeping all personal items in your bedroom Keeping all food and beverages out of the bedroomi New Hope 311 West Third Avenue Moses Lake, WA 98837 Revised 3/23 Derechos co toderefugio Tienes derecho de ser oida y respetad,?-- Tienes derecho para hacer tus propias decisiones Tienes derecho de ser apoyada como madre n Tienes derecho de vivir sin preocupacion de amenaza fisic* Tienes derecho de vivir una vida saludable, sobrio y libre de drogas Tienes derecho de vivir en un medio ambiente seguro y limpio Tienes derecho de vivir en una casa donde la ubicacion es confidencial Tu hates la decision de irtc de la casa cuando occurs uno de to siguiente: Yo he leido los derechos y las responsabilidades del refugio Nueva Esperanza y entiendo mis derechos de residente y las responsabilidades que se pile de mi y al mantenerlas, mantengo mi residencia en el refugio. Nombre de Cliente Firma de Cliente Miernbro Personal Fecha Fecha New Hope 311 West Third Avenue Moses Lake, WA 98837 revised 3/23 ResponsabilidadE Tu ere sidente del refugio able de: e Supervisar tus ninos y garantizar la seguridad de ellosf = Comunicarse con otros sin violencia domestica y verbal. Manteniendo su cuarto y la casa limpia. 9 Lavando, sus trastes y su propia ropa. Manteniendo medicamentos encer . rados en Ia caja de seguridad proveido de parte de Nueva Esperanza. • " Manteniendo is ubicacion de] refugio co 'n fidencia1, nose permite visitantes. • Fumando o fumando cigarillo electronico el la parte indicada de la casa,lue . viene siendo el porche de atras solamente. o Noiificando a un miembro personal antes de las 4pm, si no planes quedarse la no'C-he en el refugio. a Mantemendo sus cosas personales en su.cuarto. Mantener comida y bebidas fuera de los cuartos. New Hope 311 West Third Avenue Moses Lake, WA 98837 revised 3/23 Are you |ndanger ....fstosenpe8gro7 l=uno Slower please. ...Mosdespocioporfavor 2=dos ` y=tres Please wait while | get an interpreter . . . 4= ouatro Porƒavoresperemientnasogornoun 5=cinco /ntenmrete 6=seis 7=siete 1snot here, she is|n O=ooho nmestooqui,e8oestoen. g=nueve l0=diez ooyou want toleave avo\cemaU7 Quieresdejorunmensojedevoz? 20=viente 30=trienta She will return un ----- 4O=cuarenta B�reg�soroe/. 50=cincuenta GO=sesenta Monday Lunes 70=setenta Tuesday Murtes 8O=ochenta Wednesday Miercoles 9O=noventa Thuoday Juems 100=sien Friday 0e,nes ~ppublicm*/Policiesand Procedures/ zClient/Spanish Translation Phonechea sheet Are you hndanger?. ...Esuas enpeligr p l=uno Slower please .... Mosdespocioporfrvor 2=dos 3=tres Please wait while | get an interpreter . . . 4= cuatm porfavoresperemientrasogonoun S=oinco mterprete G=seis 7=siete isnot here, she is|n O=ooho noestnoqui,ellaesuzen____.. g=nucve lO=diez Ooyou want toleave avo|cemaUY Quiemsdejorunrnensajedevozy 20=veinte 3O=treinta She will return on -----'' 4O=cuarenta Ella negresoroe/. SO=cincuenta 6O=sesenta Monday Lunes 70=setenta Tuesday Mortes 80=oohenta Wednesday M/erco/es 80=noventa Thursday Juems 100=sien Friday Wemes ~F:Pumicm*/Policmsand Procedures/ NEW HOPE 311 W. Third Avenue Moses Lake, WA 98837 (509) 764-8402 Fax: (509) 766-6574 CONFIDENTIALITY STATEMENT For Support Group As a condition of participating in the group,, I agree not to divulge, or otherwise make known to unauthorized persons outside the agency or any other person, entity, etc., any information about other persons or their situations who are attending this group. I recognize that unauthorized release of confidential information may subject me to civil liability under the provision of Washington State Law, (Signature of Participant) (Signature of Witness) (Date) Support Group Referral- Women of Worth (WOW) Fok N' UENT Client Name: - :' Svrraxi� - ROUP-DETAILS Type of Group: Domestic Violence Location. 311 W. Third Ave. Moses Lake, WA 98837 Day: Thursdays %14.1 -1 Time: 9:30-11:ooa Overview: Women of Worth (WOW) is a support group for survivors of domestic violence where individuals gather to discuss various topics, find support, and focus on healing. ERMI!�SI©� Referred from: I have attended a Support Group with New Hope in the past ❑Yes ❑ No Is Childcare needed in order for you to attend Support Group? ❑Yes No If it is safe, please provide a phone number and email address you can be reached at: Cell Number: Is it safe to leave a voicemail? ❑Yes F-I No Email Address: By signing below, I agree to have a New Hope Support Group facilitator contact me. Signature Date New Hope. 311 W. third Ave. Moses Lake, WA 98837 h �- �J,FtC r.J"� Ss v . r r{•��. a r�'4y+aw �Mct �s'N= Because of the: supportive services d o !; .r -received oNew Hope so far,, I feel: know more ways to plan for my safety Yes No know more about community resources Yes F-]No Because of the, supportive services and advocacy I have:Teceived from New Hope so far., I feel: know more ways to plan for my safety Yes No .1 know more about community resources Yes No Because of the supportive - ; - o advocacy New Hope so far, I feel: know more ways to plan for my safety Yes No know more about community resources Yes No 4"R LmME� e because of my experience in the shelter, I fel: know more ways to plan for my safety ❑Yes ❑No i know more about community resources ❑Yes ❑No 0 Because of my experience in the shelter, I feel: know more ways to plan for my safety ❑Yes ❑No know 0 U U 1 community y resources❑NoYes Because of my experience in the shelter, I feel: I know more ways to plan for my safety ❑Yes ❑No I know more about community resources ❑Yes ❑No PIN ElfM®Rt ,r v.f: : � zX Because of attending this support group, I feel: I know more ways to plan for my safety. Yes I know more about community resources ❑Yes Because of attending this support group, I feel: know more ways to plan for my safety ❑Yes I know more about community resources ❑Yes Because of attending this support group, I feel: I know more ways to plan for my safety ❑Yes I know more about community resources DYes W W W aim Because of attending this support group, I feel: I know more ways to plan for my safety ❑Yes ❑No I know more about community resources ❑Yes ❑No Because of attending this support group, I feel: know mways to plan for my safety Yes ❑ I know more about community resources ❑Yes ❑No Because of attending this support group, I feel: I know more ways to plan for my safety ❑Yes ❑No I know more about community resources ❑Yes ❑No