HomeMy WebLinkAboutAgreements/Contracts - Juvenile (002)GRANT COUNTY
COMMISSIONERS AGENDA MEETING REQUEST FORM
(Must be submitted to the Clerk of the Board by 12:00pm on Thursday)
REQUESTING DEPARTMENT: Juvenile/Youth Services
REQUEST SUBMITTED BY: Suhail Palacios
CONTACT PERSON ATTENDING ROUNDTABLE: Suhail Palacios
CONFIDENTIAL INFORMATION: DYES ®NO
onrE:05/14/2025
PHONE: 509 754 5690 ext.4430
iTYP E (S) F DOC U ME
U WITTED:
(CHECK ALL
THAT APPLY),
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I am requesting permission to Docu-Sign electronically with contractor for Agreement DCYF #2563-62547
between DCYF &Grant County Juvenile Court &Youth Services for the Evidence
Based Expansion contract. Term of Contract: July 1, 2025 to June 30, 2027.
If necessary, was this document reviewed by accounting? ❑ YES
LEGAL-RiMEW:
If this document requires leg
pl! review, ... route to legal or review Prior"
If necessary, was this document reviewed by legal? 0 YES ❑ NO
❑NO ON/A
DATE OF ACTION:.�'� DEFERRED OR CONTINUED TO:
APPROVE: DENIED
D1:
D2:
D3:
ABSTAIN
WITHDRAWN:
■
RECEIVED
MAY 15 2025
GRANT COUNTY COMMISSIONERS MISSIONERS
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May 15, 2025
Board of Grant County Commissioners
PO Box 37
Ephrata, WA 98823
RE: Signature for Contract #2563-62547
Dear Board of County Commissioners:
Please see attached contract for review and approval.
Contractor: DCYF — Evidence Based Expansion
Term of Contract: July 1, 2025 to June 30, 2027
Purpose: The purpose of this Agreement is to fund and support the program services
described in the attached Statement of Work.
I am requesting permission to Docu-Sign electronically with the contractor.
Thank you for considering my request.
Suhail Palacios, Juvenile Court Administrator
Grant County Juvenile Court & Youth Services
P.O. Box 8181303 ABEL ROAD * EPHRATA, WA 98823 * PHONE (509) 754-5690 1 EFAx 1-509-754-5797
Docusign Envelope ID: C2261AA9-7B28-4412-8480-51379D2B0003
fi
COUNTY PROGRAM AGREEMENT
Evidence Based Expansion
DCYF Agreement Number
2563-62547
This Program Agreement is by and between the State of Washington
Administration or Division
Department of Children, Youth & Families (DCYF) and the County identified
Agreement Number
below, and is issued in conjunction with a County and DCYF Agreement On
General Terms and Conditions, which is incorporated by reference.
Count Agreement Number
v g
DCYF ADMINISTRATION
DCYF DIVISION
DCYF INDEX NUMBER
DCYF CONTRACT CODE
Department of Children, Youth,
Children, Youth and Families
1221
2000CC-63
and Families
DCYF CONTACT NAME AND TITLE
DCYF CONTACT ADDRESS
Karena McGovern
1500 Jefferson Street SE
Contract Specialist
Olympia, WA 98501
DCYF CONTACT TELEPHONE
DCYF CONTACT FAX
DCYF CONTACT E-MAIL
360 870-5727
Click here to enter text,
karena.mc overn do f.wa. ov
COUNTY NAME
COUNTY ADDRESS
Grant County
POB 818
Ephrata, WA 98837
COUNTY FEDERAL EMPLOYER IDENTIFICATION
COUNTY CONTACT NAME
NUMBER
Suhail Palacios
COUNTY CONTACT TELEPHONE
COUNTY CONTACT FAX
COUNTY CONTACT E-MAIL
509 754-5690
509 754-5797
sEalacios@2rantcountywa.gov
IS THE COUNTY A SUBRECIPIENT FOR PURPOSES OF THIS PROGRAM
CFDA NUMBERS
AGREEMENT?
No
PROGRAM AGREEMENT START DATE
PROGRAM AGREEMENT END DATE
MAXIMUM PROGRAM AGREEMENT AMOUNT
07/01/2025
06/30/2027
See Exhibits
EXHIBITS. When the box below is marked with an X, the following Exhibits are attached and are incorporated into this
County Program Agreement by reference:
Z Exhibits (specify): Exhibit A: Evidence -Based Expansion Contract Term, Reimbursement Procedures, and
Program Responsibilities; Exhibit B: Statement of Work; Exhibit C: Monthly Project Update Form;
Exhibit D: Monthly Reimbursement Request Form; and Exhibit E: Quarterly Target Update Form.
The terms and conditions of this Contract are an integration and representation of the final, entire and exclusive
understanding between the parties superseding and merging all previous agreements, writings, and communications, oral
or otherwise, regarding the subject matter of this Contract. The parties signing below represent that they have read and
understand this Contract, and have the authority to execute this Contract. This Contract shall be binding on DCYF only
upon signature by DCYF.
COUNTY SIGNATURE(S)
PRINTED NAME(S) AND TITLE(S)
DATE(S) SIGNED
suhai 1 Palacios juvenile court Admi
i st ral:,W/202 5
DCYF SIGNATURE
PRINTED NAME AND TITLE
DATE SIGNED
ka'r�
Karena McGovern Contract specials
5/21/202 5
Department of Children, Youth & Families
2017CF County Program Agreement 6-24-20 Page 1
County General Terms and Conditions
1. Definitions. The words and phrases listed below, as used in the Agreement, shall each have the
following definitions:
a. "Agreement" means this Department of Children Youth & Families (DCYF) County Agreement on
General Terms and Conditions and any exhibits and other documents attached or incorporated by
reference. Unless plainly inconsistent with context, the term "Agreement" includes and refers to all
such agreements collectively.
b. "CFR" means the Code of Federal Regulations. All references in this Agreement and any Program
Agreement to CFR chapters or sections shall include any successor, amended, or replacement
regulation.
c. "County" means the political subdivision of the state of Washington named above performing
services pursuant to this Agreement and any Program Agreement.
d. "County Representative" means an individual in the position of County Manager, County
Administrator, County Executive, or other similar position which reports to the highest governing
body responsible for the subject matter of the Agreement or applicable Program Agreement(s).
e. DCYF Contracts Administrator" means the individual in the DCYF Contracts Department with
oversight authority for the Department of Children Youth & Families statewide agency contracting
procedures, or their appropriate designee.
f. "DCYF Contracts Department" means the Department of Children Youth & Families statewide
agency headquarters contracting office, or successor section or office.
g. "DCYF Representative" means any DCYF employee who has been delegated contract -signing
authority by the DCYF Secretary or his/her designee.
h. "Department of Children, Youth & Families" or "DCYF" means the Washington agency devoted
exclusively to serve and support Washington state's youth and their families.
i. "Debarment" means an action taken by a federal official to exclude a person or business entity from
participating in transactions involving certain federal funds.
j. "General Terms and Conditions" means the contractual provisions contained within this Agreement,
which govern the contractual relationship between DCYF and the County, under the Program
Agreements subsidiary to and incorporating therein by reference this Agreement.
k. "Program Agreement" or "County Program Agreement" means a written agreement between DCYF
and the County containing special terms and conditions, including a statement of work to be
performed by the County and payment to be made by DCYF. This term may also refer to an
agreement between DCYF and the County, which was transferred to DCYF by operation of law.
I. "RCW" means the Revised Code of Washington. All references in this Agreement and any Program
Agreement to RCW chapters or sections shall include any successor, amended, or replacement
statute.
m. "Secretary" means the individual appointed by the Governor, State of Washington, as the head of
DCYF, or his/her designee.
Department of Children, Youth & Families
2017CF County Program Agreement 6-24-20 Page 2
County General Terms and Conditions
n. "Subcontract" means a separate Agreement between the County and an individual or entity
("Subcontractor") to perform all or a portion of the duties and obligations that the County shall
perform pursuant to any Program Agreement.
o. "USC" means the United States Code. All references in this Agreement and any Program
Agreement to USC chapters or sections shall include any successor, amended, or replacement
statute.
p. "WAC" means the Washington Administrative Code. All references in this Agreement and any
Program Agreement to WAC chapters or sections shall include any successor, amended, or
replacement regulation.
2. Amendment. This Agreement, or any term or condition thereof, may be modified only by a written
amendment signed by both parties. Only personnel authorized to bind each of the parties shall sign an
amendment.
3. Assignment. Except as otherwise provided herein in Section 21, the County shall not assign rights or
obligations derived from this Agreement or any Program Agreement to a third party without the prior,
written consent of the DCYF Contracts Administrator and the written assumption of the County's
obligations by the third party.
4. Billing Limitations. Unless otherwise specified in a Program Agreement, DCYF shall not pay any
claims for services submitted more than twelve (12) months after the calendar month in which the
services were performed.
5. Compliance with Applicable Law. At all times during the term of this Agreement and any Program
Agreement, the County and DCYF shall comply with all applicable federal, state, and local laws,
regulations, and rules, including but not limited to, nondiscrimination laws and regulations and the
Health Insurance Portability and Accountability Act of 1996 (HIPAA).
6. County Certification Regarding Ethics. By signing this Agreement, the County certifies that the
County is in compliance with Chapter 42.23 RCW and shall comply with Chapter 42.23 RCW throughout
the term of this Agreement and any Program Agreement.
7. Debarment Certification. The County, by signature to this Agreement, certifies that the County is not
presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded
from participating in this Agreement or any Program Agreement by any federal department or agency.
The County also agrees to include the above requirement in all subcontracts into which it enters.
8. Disputes.
Both DCYF and the County ("Parties") agree to work in good faith to resolve all conflicts at the lowest
level possible. However, if the Parties are not able to promptly and efficiently resolve, through direct
informal contact, any dispute concerning the interpretation, application, or implementation of any
section of the Agreement or applicable Program Agreement(s), either Party may reduce its description
of the dispute in writing and deliver it to the other Party for consideration. Once received, the assigned
managers or designees of each Party will work to informally and amicably resolve the issue within five
(5) business days. If the managers or designees are unable to come to a mutually acceptable decision
within five (5) business days, they may agree to issue an extension to allow for more time.
If the dispute cannot be resolved by the managers or designees, the issue will be referred through each
Agency's respective operational protocols, to the Secretary of DCYF ("Secretary") and the County
Representative or their deputy or designated delegate. Both Parties will be responsible for submitting
Department of Children, Youth & Families
2017CF County Program Agreement 6-24-20 Page 3
County General Terms and Conditions
all relevant documentation, along with a short statement as to how they believe the dispute should be
settled, to the Secretary and the County Representative.
Upon receipt of the referral and relevant documentation, the Secretary and County Representative will
confer to consider the potential options for a resolution, and to arrive at a decision within fifteen (15)
business days. The Secretary and County Representative may appoint a review team, a facilitator, or
both, to assist in the resolution of the dispute. If the Secretary and County Representative are unable to
come to a mutually acceptable decision within fifteen (15) days, they may agree to issue an extension
to allow for more time.
Both Parties agree that the existence of a dispute notwithstanding, the Parties will continue without
delay to carry out all respective responsibilities under the Agreement or applicable Program
Agreement(s) that are not affected by the dispute.
The final decision will be put in writing and will be signed by both the Secretary and County
Representative. If the Agreement is active at the time of resolution and amendment of the Agreement is
warranted for ongoing clarity, the Parties will execute an amendment to incorporate the final decision
into the Agreement. If this dispute process is used, the resolution decision will be final and binding as to
the matter reviewed and the dispute shall be settled in accordance with the terms of the decision.
Notwithstanding the foregoing, each Party reserves the right to litigate issues de novo in court.
9. Entire Agreement. This Agreement and any Program Agreement, including all documents attached to
or incorporated by reference into either, shall contain all the terms and conditions to be agreed upon by
the parties. Upon execution of any Program Agreement, this Agreement shall be considered
incorporated into that Program Agreement by reference. No other understandings or representations,
oral or otherwise, regarding the subject matter of this Agreement or any Program Agreement shall be
deemed to exist or bind the parties.
10. Governing Law and Venue. The laws of the state of Washington govern this Agreement. In the event
of a lawsuit by the County against DCYF involving this Agreement or a Program Agreement, venue
shall be proper only in Thurston County, Washington. In the event of a lawsuit by DCYF against the
County involving this Agreement or a Program Agreement, venue shall be proper only as provided in
RCW 36.01.050.
11. Responsibility. Each party to this Agreement shall be responsible for the negligence of its officers,
employees, and agents in the performance of any Program Agreement. No party to this Agreement or
any Program Agreement shall be responsible for the acts and/or omissions of entities or individuals not
party to this Agreement and any Program Agreement. DCYF and the County shall cooperate in the
defense of tort lawsuits, when possible. Both parties agree and understand that such cooperation may
not be feasible in all circumstances. DCYF and the County agree to notify the attorneys of record in any
tort lawsuit where both are parties if either DCYF or the County enters into settlement negotiations. It is
understood that the notice shall occur prior to any negotiations, or as soon as possible thereafter, and
the notice may be either written or oral.
12. Independent Status. For purposes of this Agreement and any Program Agreement, the County
acknowledges that the County is not an officer, employee, or agent of DCYF or the state of Washington.
The County shall not hold out itself or any of its employees as, nor claim status as, an officer, employee,
or agent of DCYF or the state of Washington. The County shall not claim for itself or its employees any
rights, privileges, or benefits which would accrue to an employee of the state of Washington. The
County shall indemnify and hold harmless DCYF from all obligations to pay or withhold federal or state
taxes or contributions on behalf of the County or the County's employees.
Department of Children, Youth & Families
2017CF County Program Agreement 6-24-20 Page 4
County General Terms and Conditions
13. Inspection. Either party may request reasonable access to the other party's records and place of
business for the limited purpose of monitoring, auditing, and evaluating the other party's compliance with
this Agreement, any Program Agreement, and applicable laws and regulations. During the term of any
Program Agreement and for one (1) year following termination or expiration of the Program Agreement,
the parties shall, upon receiving reasonable written notice, provide the other party with access to its
place of business and to, its records which are relevant to its compliance with this Agreement, any
Program Agreement, and applicable laws and regulations. This provision shall not be construed to give
either party access to the other party's records and place of business for any other purpose. Nothing
herein shall be construed to authorize either party to possess or copy records of the other party.
14. Insurance. DCYF certifies that it is self -insured under the State's self-insurance liability program, as
provided by RCW 4.92.130, and shall pay for losses for which it is found liable. The County certifies that
it is self -insured, is a member of a risk pool, or maintains insurance coverage as required in any
Program Agreements. The County shall pay for losses for which it is found liable.
15. Maintenance of Records.
During the term of this Agreement and for six (6) years following termination or expiration of this
Agreement, both parties shall maintain records sufficient to:
a. Document performance of all acts required by law, regulation, or this Agreement;
b. Demonstrate accounting procedures, practices, and records that sufficiently and properly document
the County's invoices to DCYF and all expenditures made by the County to perform as required by
this Agreement.
16. Nondiscrimination
a. Nondiscrimination Requirement
(1) During the term of this Contract, Contractor, including any subcontractor, shall not discriminate
on the bases enumerated at RCW 49.60.530(3).
(2) In addition, Contractor, including any subcontractor, shall give written notice of this
nondiscrimination requirement to any labor organizations with which Contractor, or
subcontractor, has a collective bargaining or other agreement.
b. Obligation to Cooperate
Contractor, including any subcontractor, shall cooperate and comply with any Washington state
agency investigation regarding any allegation that Contractor, including any subcontractor, has
engaged in discrimination prohibited by this Contract pursuant to RCW 49.60.530(3).
c. Default
(1) Notwithstanding any provision to the contrary, DCYF may suspend Contractor, including any
subcontractor, upon notice of a failure to participate and cooperate with any state agency
investigation into alleged discrimination prohibited by this Contract, pursuant to
RCW 49.60.530(3).
(2) Any such suspension will remain in place until DCYF receives notification that Contractor,
including any subcontractor, is cooperating with the investigating state agency.
Department of Children, Youth & Families
2017CF County Program Agreement 6-24-20 Page 5
County General Terms and Conditions
(3) In the event Contractor, or subcontractor, is determined to have engaged in discrimination
identified at RCW 49.60.530(3), DCYF may terminate this Contract in whole or in part, and
Contractor, subcontractor, or both, may be referred for debarment as provided in
RCW 39.26.200.
(4) Contractor or subcontractor may be given a reasonable time in which to cure this
noncompliance, including implementing conditions consistent with any court -ordered injunctive
relief or settlement agreement.
d. Remedies for Breach
(1) Notwithstanding any provision to the contrary, in the event of Contract termination or
suspension for engaging in discrimination, Contractor, subcontractor, or both, shall be liable for
contract damages as authorized by law including, but not limited to, any cost difference between
the original contract and the replacement or cover contract and all administrative costs directly
related to the replacement contract, which damages are distinct from any penalties imposed
under Chapter 49.60, RCW.
(2) DCYF shall have the right to deduct from any monies due to Contractor or subcontractor, or that
thereafter become due, an amount for damages Contractor or subcontractor will owe DCYF for
default under this provision.
17. Operation of General Terms and Conditions. These General Terms and Conditions shall be
incorporated by reference into each Program Agreement between the County and DCYF in effect on or
after the start date of this Agreement. These General Terms and Conditions govern and apply only to
work performed under Program Agreements between the parties.
18. Order of Precedence. In the event of an inconsistency in this Agreement and any Program Agreement,
unless otherwise provided herein, the inconsistency shall be resolved by giving precedence, in the
following order, to:
a. Applicable federal and state of Washington statutes and regulations;
b. This Agreement;
c. The Program Agreement(s).
19. Ownership of Material. Material created by the County and paid for by DCYF as a part of any Program
Agreement shall be owned by DCYF and shall be "work made for hire" as defined by 17 USC§ 101. This
material includes, but is not limited to: books; computer programs; documents; films; pamphlets; reports;
sound reproductions; studies; surveys; tapes; and/or training materials. Material which the County uses
to perform a Program Agreement but is not created for or paid for by DCYF is owned by the County and
is not "work made for hire"; however, DCYF shall have a perpetual license to use this material for DCYF
internal purposes at no charge to DCYF, provided that such license shall be limited to the extent which
the County has a right to grant such a license.
20. Severability. The provisions of this Agreement and any Program Agreement are severable. If any
court holds invalid any provision of this Agreement or a Program Agreement, including any provision of
any document incorporated herein or therein by reference, that invalidity shall not affect the other
provisions this Agreement or that Program Agreement.
Department of Children, Youth & Families
2017CF County Program Agreement 6-24-20 Page 6
County General Terms and Conditions
21. Subcontracting. The County may subcontract services to be provided under a Program Agreement,
unless otherwise specified in that Program Agreement. If DCYF, the County, and a subcontractor of
the County are found by a jury or other trier of fact to be jointly and severally liable for personal injury
damages arising from any act or omission under this Agreement or any Program Agreement, then
DCYF shall be responsible for its proportionate share, and the County shall be responsible for its
proportionate share. Should a subcontractor to the County pursuant to a Program Agreement be
unable to satisfy its joint and several liability, DCYF and the County shall share in the subcontractor's
unsatisfied proportionate share in direct proportion to the respective percentage of their fault as found
by the trier of fact. Nothing in this section shall be construed as creating a right or remedy of any kind
or nature in any person or party other than DCYF and the County. This provision shall not apply in
the event of a settlement by either DCYF or the County.
22. Subrecipients.
a. General. If the County is a subrecipient of federal awards as defined by 2 CFR Part 200 and this
Agreement, the County will:
(1) Maintain records that identify, in its accounts, all federal awards received and expended and the
federal programs under which they were received, by Catalog of Federal Domestic Assistance
(CFDA) title and number, award number and year, name of the federal agency, and name of the
pass -through entity;
(2) Maintain internal controls that provide reasonable assurance that the County is managing
federal awards in compliance with laws, regulations, and provisions of contracts or grant
agreements that could have a material effect on each of its federal programs;
(3) Prepare appropriate financial statements, including a schedule of expenditures of federal
awards;
(4) Incorporate 2 CFR Part 200, Subpart F audit requirements into all agreements between the
County and its Subcontractors who are subrecipients;
(5) Comply with the applicable requirements of 2 CFR Part 200, including any future amendments
to 2 CFR Part 200, and any successor or replacement Office of Management and Budget
(OMB) Circular or regulation; and
(6) Comply with the Omnibus Crime Control and Safe streets Act of 1968, Title VI of the Civil Rights
Act of 1964, Section 504 of the Rehabilitation Act of 1973, Title II of the Americans with
Disabilities Act of 1990, Title IX of the Education Amendments of 1972, The Age Discrimination
Act of 1975, and The Department of Justice Non -Discrimination Regulations, 28 C.F.R. Part 42,
Subparts C.D.E. and G, and 28 C.F.R. Part 35 and 39.
b. Single Audit Act Compliance. If the County is a subrecipient and expends $750,000 or more in
federal awards from all sources in any fiscal year, the County will procure and pay for a single audit
or a program -specific audit for that fiscal year. Upon completion of each audit, the County will:
(1) Submit to the DCYF contact person the data collection form and reporting package specified in
2 CFR Part 200, Subpart F, reports required by the program -specific audit guide (if applicable),
and a copy of any management letters issued by the auditor;
(2) Follow-up and develop corrective action for all audit findings; in accordance with 2 CFR Part
200, Subpart F; prepare a "Summary Schedule of Prior Audit Findings" reporting the status of all
audit findings included in the prior audit's schedule of findings and questioned costs.
Department of Children, Youth & Families
2017CF County Program Agreement 6-24-20 Page 7
County General Terms and Conditions
c. Overpayments. If it is determined by DCYF, or during the course of a required audit, that the
County has been paid unallowable costs under this or any Program Agreement, DCYF may require
the County to reimburse DCYF in accordance with 2 CFR Part 200.
23. Survivability. The terms and conditions contained in this Agreement or any Program Agreement which,
by their sense and context, are intended to survive the expiration of a particular Program Agreement
shall survive. Surviving terms include, but are not limited to: Disputes, Responsibility, Inspection,
Maintenance of Records, Ownership of Material, Subcontracting, Termination for Default, Termination
Procedure, and Title to Property.
24. Termination Due to Change in Funding, Agreement Renegotiation or Suspension.
If the funds DCYF relied upon to establish any Program Agreement are withdrawn, reduced or limited,
or if additional or modified conditions are placed on such funding, after the effective date of this
Agreement but prior to the normal completion of any Program Agreement:
a. At DCYF's discretion, the Program Agreement may be renegotiated under the revised funding
conditions.
b. Upon no less than fifteen (15) calendar days' advance written notice to County, DCYF may suspend
County's performance of any Program Agreement when DCYF determines that there is reasonable
likelihood that the funding insufficiency may be resolved in a timeframe that would allow the
County's performance to be resumed prior to the normal completion date of the Program
Agreement. For purposes of this sub -section, "written notice" may include email.
(1) During the period of suspension of performance, each party will inform the other of any
conditions that may reasonably affect the potential for resumption of performance.
(2) When DCYF determines that the funding insufficiency is resolved, it will give the County written
notice to resume performance. Upon the receipt of this notice, the County will provide written
notice to DCYF informing DCYF whether it can resume performance and, if so, the date of
resumption.
(3) If the County's proposed resumption date is not acceptable to DCYF and an acceptable date
cannot be negotiated, DCYF may terminate the Program Agreement by giving written notice to
the County. The parties agree that the Program Agreement will be terminated retroactive to the
effective date of suspension. DCYF shall be liable only for payment in accordance with the
terms of the Program Agreement for services rendered through the retroactive date of
termination.
c. DCYF may terminate the Program Agreement by providing at least fifteen (15) calendar days'
advance written notice to the County. DCYF shall be liable only for payment in accordance with the
terms of the Program Agreement for services rendered through the effective date of termination.
No penalty shall accrue to DCYF in the event the termination option in this section is exercised.
25. Termination for Convenience. The DCYF Contracts Administrator, or appropriate designee, may terminate
this Agreement or any Program Agreement in whole or in part for convenience by giving the County at
least thirty (30) calendar days' written notice addressed to the County at the address shown on the
cover page of the applicable agreement. The County may terminate this Agreement and any Program
Agreement for convenience by giving DCYF at least thirty (30) calendar days' written notice addressed
to: DCYF Contracts Department, PO Box 45710, Olympia, Washington 98504-5710.
Department of Children, Youth & Families
2017CF County Program Agreement 6-24-20 Page 8
County General Terms and Conditions
26. Termination for Default.
a. The DCYF Contracts Administrator, or appropriate designee, may terminate this Agreement or any
Program Agreement for default, in whole or in part, by written notice to the County, if DCYF has a
reasonable basis to believe that the County has:
(1) Failed to meet or maintain any requirement for contracting with DCYF;
(2) Failed to perform under any provision of this Agreement or any Program Agreement;
(3) Violated any law, regulation, rule, or ordinance applicable to this Agreement or any Program
Agreement; or
(4) Otherwise breached any provision or condition of this Agreement or any Program Agreement.
b. Before the DCYF Contracts Administrator, or their appropriate designee, may terminate this Agreement
or any Program Agreement for default, DCYF shall provide the County with written notice of the
County's noncompliance with the agreement and provide the County a reasonable opportunity to
correct the County's noncompliance. If the County does not correct the County's noncompliance
within the period of time specified in the written notice of noncompliance, the DCYF Contracts
Administrator, or appropriate designee, may then terminate the agreement. The DCYF Contracts
Administrator may terminate the agreement for default without such written notice and without
opportunity for correction if DCYF has a reasonable basis to believe that a Client's health or safety is
in jeopardy.
c. The County may terminate this Agreement or any Program Agreement for default, in whole or in part,
by written notice to DCYF, if the County has a reasonable basis to believe that DCYF has:
(1) Failed to meet or maintain any requirement for contracting with the County;
(2) Failed to perform under any provision of this Agreement or any Program Agreement;
(3) Violated any law, regulation, rule, or ordinance applicable to this Agreement or any Program
Agreement; and/or
(4) Otherwise breached any provision or condition of this Agreement or any Program Agreement.
d. Before the County may terminate this Agreement or any Program Agreement for default, the County
shall provide DCYF with written notice of DCYF's noncompliance with the agreement and provide
DCYF a reasonable opportunity to correct DCYF's noncompliance. If DCYF does not correct DCYF's
noncompliance within the period of time specified in the written notice of noncompliance, the County
may then terminate the agreement.
27. Termination Procedure. The following provisions apply in the event this Agreement or any Program
Agreement is terminated:
a. The County shall cease to perform any services required by the Program Agreement as of the
effective date of termination and shall comply with all reasonable instructions contained in the notice
of termination which are related to the transfer of clients, distribution of property, and termination of
services.
b. The County shall promptly deliver to the DCYF contact person (or to his or her successor) listed on
the first page of the Program Agreement, all DCYF assets (property) in the County's possession,
Department of Children, Youth & Families
2017CF County Program Agreement 6-24-20 Page 9
County General Terms and Conditions
including any material created under the Program Agreement. Upon failure to return DCYF property
within fifteen (15) working days of the Program Agreement termination, the County shall be charged
with all reasonable costs of recovery, including transportation. The County shall take reasonable
steps to protect and preserve any property of DCYF that is in the possession of the County pending
return to DCYF.
c. DCYF shall be liable for and shall pay for only those services authorized and provided through the
effective date of termination. DCYF may pay an amount mutually agreed by the parties for partially
completed work and services, if work products are useful to or usable by DCYF.
d. If the DCYF Contracts Administrator terminates any Program Agreement for default, DCYF may
withhold a sum from the final payment to the County that DCYF determines is necessary to protect
DCYF against loss or additional liability occasioned by the alleged default. DCYF shall be entitled to
all remedies available at law, in equity, or under the Program Agreement. If it is later determined
that the County was not in default, or if the County terminated the Program Agreement for default,
the County shall be entitled to all remedies available at law, in equity, or under the Program
Agreement.
28. Treatment of Client Property. Unless otherwise provided in the applicable Program Agreement, the
County shall ensure that any adult client receiving services from the County under a Program
Agreement has unrestricted access to the client's personal property. The County shall not interfere with
any adult client's ownership, possession, or use of the client's property. The County shall provide clients
under age eighteen (18) with reasonable access to their personal property that is appropriate to the
client's age, development, and needs. Upon termination or completion of the Program Agreement, the
County shall promptly release to the client and/or the client's guardian or custodian all of the client's
personal property. This section does not prohibit the County from implementing such lawful and
reasonable policies, procedures and practices as the County deems necessary for safe, appropriate,
and effective service delivery (for example, appropriately restricting clients' access to, or possession or
use of, lawful or unlawful weapons and drugs).
29. Title to Property. Title to all property purchased or furnished by DCYF for use by the County during the
term of a Program Agreement shall remain with DCYF. Title to all property purchased or furnished by
the County for which the County is entitled to reimbursement by DCYF under a Program Agreement
shall pass to and vest in DCYF. The County shall take reasonable steps to protect and maintain all
DCYF property in its possession against loss or damage and shall return DCYF property to DCYF upon
termination or expiration of the Program Agreement pursuant to which it was purchased or furnished,
reasonable wear and tear excepted.
30. Waiver. Waiver of any breach or default on any occasion shall not be deemed to be a waiver of any
subsequent breach or default. No waiver shall be construed to be a modification of the terms and
conditions of this Agreement unless amended as set forth in Section 2, Amendment. Only the DCYF
Contracts Administrator or designee has the authority to waive any term or condition of this Agreement
on behalf of DCYF.
Department of Children, Youth & Families
2017CF County Program Agreement 6-24-20 Page 10
EXHIBIT A
Evidence -Based Expansion Contract Term, Reimbursement Procedures,
and Program Responsibilities
1. Contract Purpose
The purpose of this Agreement is to fund and support the program services described in the attached
Statement of Work. The contract term begins July 1, 2025, and expires June 30, 2027.
2. Funding
As of July 1, 2025, the rates paid to the County will be the rate calculated for State Fiscal Year (SFY)
2026-2027.
If by July 1, 2025, the County does not have a completed written application for funding approved by JR
and signed by both parties, JR will temporarily reimburse the county according to the rates from the
EBE Contract SFY 2024-2025 (DCYF Contract No. 2363-51931) until September 1, 2025 to provide for
continuity of services.
Once the County's application is signed and approved, the SFY 2026-2027 funding rate shall apply
retroactively to July 1, 2025, and the County is responsible for adjusting its expenditures during the
remainder of the agreement term to account for any discrepancies.
If the County has not properly accounted for the difference between the two rates by April 30, 2026, JR
may adjust the amount reimbursed to the County for the final two months of the agreement to account
for these discrepancies.
3. Statement of Work
As of July 1, 2025, the County is responsible for adhering to the requirements described in Exhibit B:
Statement of Work - Evidence Based Expansion.
If by July 1, 2025, the County does not have a completed written application for funding approved by JR
and signed by both parties, the statements of work from the EBE Contract SFY 2024-2025 shall apply
to all work performed under this agreement until September 1, 2025 to provide for continuity of
services.
Once the County's application is signed and approved, the County shall be responsible for providing
services in accordance with the SFY 2026-2027 Statement of Work from that date forward.
4. Late Applications
If the County does not have a complete written application for funding approved by JR and signed by
both parties by September 1, 2025, JR may discontinue reimbursement until the application is
completed and approved.
Department of Children, Youth & Families
2017CF County Program Agreement 6-24-20 Page 11
EXHIBIT B
STATEMENT OF WORK
Evidence Based Expansion
1. Definitions
The words and phrases listed below, as used in this Contract, shall each have the following definitions:
a. "Client" means any child or adult who is authorized services by DCYF.
b. "County" means the Contractor.
c. "DCYF" means the Department of Children, Youth, and Families.
d. "JR means Juvenile Rehabilitation, a program under DCYF.
e. "JR Bulletins/Policies" means the JR Administrative Policies, which direct JR expectations.
f. "Limited Access" means supervised access to a juvenile(s) that is the result of the person's
regularly scheduled activities or work duties.
g. "Regular Access" means unsupervised access to a juvenile(s), for more than a nominal amount of
time that is the result of the person 7s regularly scheduled activities or work duties.
2. Purpose
As mandated by the Washington State Legislature, the purpose of this Contract is to provide funding to
expand evidence based treatment and training programs administered by local juvenile courts. The
expanded programs include:
• Functional Family Therapy (FFT);
• Multi -Systemic Therapy (MST);
• Coordination of Services (COS);
• Education and Employment Training (EET); and
• Effective Community -Based Programs (ECBP).
3. General Requirements
Upon approval of the County Juvenile Court's Approved Evidence Based Expansion Application
Response, the County Juvenile Court shall:
a. Provide projects and services in compliance with the County Juvenile Court's Approved Evidence
Based Expansion Application Response to the Rehabilitation Administration's Juvenile
Rehabilitation (JR) Evidence Based Expansion Solicitation;
b. Administer a Washington State Juvenile Court prescreen or full risk assessment to participating
youth. Youth who are moderate to high risk on the prescreen assessment must receive a full
assessment. All moderate to high risk youth must receive a reassessment at the end of probation,
in accordance with the timeline specified in the County Juvenile Court's Approved Evidence Based
Application Response; and
Department of Children, Youth & Families
2017CF County Program Agreement 6-24-20 Page 12
c. Ensure compliance with existing Community Juvenile Accountability Act (CJAA) State Quality
Assurance Programs for the following programs: Functional Family Therapy; Multi -systemic
Therapy, Coordination of Services; and Education and Employment Training.
4. Intervention Programs
a. Functional Family Therapy, Multi -systemic Therapy, Coordination of Services, and Education and
Employment Training.
b. The County Juvenile Court must serve the number of youth at the cost budgeted and as detailed in
the County Juvenile Court's Approved Evidence Based Application Response. If the County
Juvenile Court anticipates a deviation from any aspect of its Application Response, it must submit a
written request for prior approval to the JR Juvenile Court Treatment Programs Administrator.
Service delivery must be based on and adhere to the following specifications:
(1) For Functional Family Therapy (FFT):
(a) General precepts/practices contained in FFT, LLC Initial 3-Day Training;
(b) Assessment/Reporting Standards contained in FFT, LLC 1-Day Systems Training;
(c) Clinical feedback from FFT LLC in on -going consultation and site visits;
(d) Feedback from designated FFT statewide Quality Assurance Administrator in on -going
consultation and site visits; and
(e) Precepts/practices of FFT contained in Blueprints for Violence Prevention.
(f) FFT Project Quality Assurance & Quality Improvement Plan, which includes the Therapist
Standards and Clinical Supervisors Standards;
(g) General precepts/practices contained in FFT, LLC Clinical Training Series (Initial and 3
Follow Ups), annual booster training, consultations and clinical oversight; and
(h) Any subcontracts providing FFT must adhere to the FFT Project Standards for model fidelity.
(2) For Multi -systemic Therapy (MST):
(a) Precepts/practices of MST contained in Blueprints for Violence Prevention; and
(b) General precepts/practices contained in training, consultation, and clinical oversight as
overseen by MST Services.
(3) For Coordination of Services (COS):
(a) Precepts and practices contained in Coordination of Services Statewide Manual;
(b) General Precepts and practices contained in the Coordination of Services initial training; and
(c) Precepts and practices contained in the Statewide COS Quality Assurance Plan.
(4) Employment Education and Training (EET):
(a) General precepts and practices contained in the EET Statewide Manual; and
Department of Children, Youth & Families
2017CF County Program Agreement 6-24-20 Page 13
(b) Feedback from designated EET statewide Quality Assurance Specialist in on -going
consultation and site visits.
(c) General precepts and practices contained in the EET Statewide Job Readiness Training
Curriculum;
(d) Precepts and practices contained in the Statewide EET Quality Assurance Plan; and
(e) General Precepts and practices contained in the EET initial training
(5) Effective Community -Based Programs
(a) All Courts must be in compliance with the documentation in the Effective Community -Based
Program Application.
C. For the interventions listed above, the Juvenile Court shall comply with:
(1) The Washington State Institute for Public Policy (WSIPP) evaluation design for CJAA (see
CJAA: Program Evaluation Design, WSIPP November 1998). WSIPP will evaluate recidivism
effects as well as the costs and benefits of the programs. The County Juvenile Court shall
participate with all parties to ensure effective program evaluation.
(2) RCW 13.40.500 through 13.40.550 which requires County Juvenile Courts to collect the name,
date of birth, gender, social security number, and Juvenile Information System (JUVIS) number
for each juvenile enrolled in the Evidence Based Expansion Program (EBP).
5. Performance -Based Contracting Implementation
DCYF is strategically implementing quality and outcome performance measures in contracts that
provide services to children and families as required by House Bill 1661. The purpose of this change is
to help achieve DCYF's long-term outcome goals, with a focus on building partnerships, using data to
learn and improve, and advancing racial equity.
a. DCYF Outcome Goals supported by Juvenile Courts' EBPs include:
(1) Parents and caregivers are supported to meet the needs of children and youth;
(2) Youth school engagement;
(3) High school graduation; and
(4) Youth mental/behavioral health.
b. The quality measures below only apply to Juvenile Court EBP's which are further described in this
Statement of Work.
(1) The Contractor shall participate in ongoing reporting, monitoring, and discussion with DCYF for
the following performance metrics:
Department of Children, Youth & Families
2017CF County Program Agreement 6-24-20 Page 14
Evidence -Based Program Quality Assurance — Education Employment Training (EET)
Goal
All EBP service providers in juvenile courts must meet established quality
assurance standards.
Metric
EET quality assurance standards include fidelity and competency rating
standards for Education and Employment Specialists (EES)
3 EES are providing services, and 3 have a fidelity rating of 2.0, and 3
have a competency rating of 2.0.
All EES have a combined average fidelity rating of 2.7, and
competency rating of at least 2.8.
Target
All EES have a fidelity rating of 2.0, and a competency rating of 2.0; All
EES have a combined average fidelity rating of 2.0, and competency
rating of 2.0.
Reporting
The statewide EET Quality Assurance Specialist will continue to report out
Requirement
this metric on behalf of the juvenile courts quarterly.
Performance
Performance Improvement Plan. This metric will be reviewed quarterly
Management
and if the target is not met within the year, the contractor will be required to
complete a Performance Improvement Plan. This plan will outline strategies
to improve this metric within the next year.
Continuous
DCYF will support continuous improvement by establishing a performance
Improvement
feedback loop to share and review performance data with contractors
quarterly.
Evidence -Based Program Completion Rates
Goal
Increase EBP completion rates from established baseline levels.
Metric
Successful EBP completions provide an early indication of success, and
continuous improvement is the goal.
Based on a three-year average (SFY22-24), the following are the
established baseline program completion rates for your court:
EET: NA%
Target
Statewide Averages:
EET: 60.8%
All courts that are below the statewide program completion rate average for
an EBP will show annual incremental improvement.
If a court is at or above the statewide program completion rate average for
an EBP, annual incremental improvement is still desired.
Reporting
The Administrative Office of the Courts (AOC) will continue to report out this
Requirement
metric on behalf of the juvenile courts quarterly.
Performance
Performance Improvement Plan. This metric will be reviewed quarterly
Management
and if the target is not met within the year, the contractor will be required to
complete a Performance Improvement Plan. This plan will outline strategies
nr.
to improve this metric within the next yea..
Continuous
DCYF will support continuous improvement by establishing a performance
Improvement
'feedback loop to share and review performance data with contractors
quarterly.
Department of Children, Youth & Families
2017CF County Program Agreement 6-24-20 Page 15
6. Consideration
The maximum consideration for the Evidenced Based Expansion program for SFY26-27 is identified in
the "Juvenile Court Evidence Based Expansion Funding Awards SFY26-27" list, incorporated by
reference below in Section 11 of this Statement of Work.
a. Under expenditures in SFY26 may not be carried forward to the subsequent fiscal year. A revenue
sharing process may be made available during the latter part of SFY26 and SFY27 for all counties
participating in Evidence Based Expansion contracts, provided funding is available.
b. The full list of priorities is detailed in the "County Juvenile Court's Washington State Juvenile Court
Evidence Based Expansion Application". County Juvenile Courts shall submit the JR provided
"Revenue Sharing Requests/Returns Form" to the JR Juvenile Court Treatment Programs
Administrator no later than May 15 th of each fiscal year. Late submittals shall not be considered,
unless otherwise mutually agreed upon. Revenue sharing increases and decreases will be
awarded by distribution of a revised "Juvenile Court Evidence Based Expansion Funding Awards
SFY26-27 list. The total maximum consideration for this contract may increase or decrease,
depending on the results of revenue sharing distributions and changes in appropriations as directed
by the legislature."
c. JR will review utilization by January 1st each fiscal year. If the County Juvenile Court has
significantly exceeded their proposed cost per participant as detailed in their "County Juvenile
Court's Washington State Juvenile Court Evidence Based Expansion Application", the Juvenile
Court Treatment Programs Administrator and CJAA Advisory Committee shall intervene and a
develop a work plan with the County Juvenile Court to maintain compliance'with their proposed cost
per participant.
d. The cost per participant is determined in the "County Juvenile Court's Washington State Juvenile
Court Evidence Based Expansion Application", incorporated herein by reference."
e. Reimbursable costs include staff salaries, staff benefits, training, fees, quality assurance where
appropriate, and local expenditures on administration.
f. Reimbursement for administrative and equipment costs shall not exceed 15% of the original annual
allotment. Administrative costs include discrete, assignable activities and cost necessary for overall
management and support of a program.
7. Payment and Billing
a. DCYF shall pay the County upon acceptance by DCYF of a properly completed Invoice Voucher (A-
19), or other JR pre -approved invoice document, and the required monthly project forms. JR
retains the right to withhold payment for incomplete or delinquent reimbursement packages.
b. The following Deliverables must be attached with the Invoice Voucher (A-19) and completed before
payment will be made by JR:
(1) Monthly Project Update Form. Use Exhibit C — Monthly Project Update Form. Submit a
separate Update Form for each intervention program (FFT, MST, COS, EET, and ECBP);
(2) Monthly Reimbursement Request Form. Use Exhibit D — Monthly Reimbursement Request
Form. Submit a separate Update Form for each intervention program (FFT, MST, COS, EET,
and ECBP);
(3) Quarterly Target Update Form. Use Exhibit E — Quarterly Target Update Form. Submit a
separate Target Update Form for each intervention program (FFT, MST, COS, EET and ECBP)
Department of Children, Youth & Families
2017CF County Program Agreement 6-24-20 Page 16
to JR within 15 days following each fiscal quarter being reported on. This form does not need to
be submitted with the monthly Invoice Voucher (A-1 9);
(4) Quarterly Outcome Data for Effective Community -Based Programs. Submit quarterly outcome
data as approved in the Effective Community -Based Application. The data does not need to be
submitted with the monthly Invoice Voucher (A-1 9); and
(5) Completed Monthly Business Intelligence Tool (BIT) EBP Summary Report.
c. The County Juvenile Court agrees to accept payment as outlined in this Billing and Payment
Section of the Contract as total and complete remuneration for services provided to offenders under
this Contract. This does not preclude the County from seeking other funding sources. No indirect
costs are allowed.
d. The County Juvenile Court shall use these funds to supplement, not supplant, the amount of
federal, state, and local funds otherwise expended for the services provided under this Contract.
e. Under no circumstance shall the County Juvenile Court bill twice for the same services.
f. The County Juvenile Court shall maintain backup documentation of all costs billed under this
Contract.
g. Stop Payment. If reports required under this Contract are delinquent, JR may stop payment to the
County Juvenile Court until such required reports are submitted to JR.
8. County Compliance
a. Subcontractors
If the County Juvenile Court utilizes subcontractors for the provision of services under this Contract,
the County Juvenile Court must notify the JR Juvenile Court Treatment Programs Administrator in
writing and maintain sufficient documentation to verify that the subcontractors meet all the
requirements under this Contract. In no event shall the existence of a subcontract release or
reduce the liability of the County Juvenile Court for any breach of performance.
b. Other Provisions
The County Juvenile Court shall comply with the following other provisions for all services provided
under this Contract.
(1) Background Check/Criminal History
(a) This requirement applies to any employees, volunteers and subcontractors who may have
unsupervised access to children served under this Contract.
(b) In accordance with Chapters 388-700 WAC (JR -Practices & Procedures), 72.05 RCW
(Children & Youth Services), and by the terms of this contract, the County and each of its
employees, subcontractors, and/or volunteers who may or will have regular access to any
client/juvenile must be cleared through a JR approved criminal history and background
check. In addition, the County, each of their employees, subcontractors, and/or volunteers,
who may or will have limited access to any client/juvenile, may be required to be cleared
through a JR approved criminal history and background check.
(c) By execution of this contract, Contractor affirms that Contractor, each of its employees,
subcontractors, and/or volunteers, who may or will have regular access have not been
Department of Children, Youth & Families
2017CF County Program Agreement 6-24-20 Page 17
convicted of any of the following:
Any felony sex offense as defined in 9.94A.030 RCW (Sentencing Reform Act -
Definitions) and 9A.44.130 RCW (Sex Offenses);
ii. Any crime specified in Chapter 9A.44 RCW (Sex Offenses) when the victim was a
juvenile in the custody of or under the jurisdiction of JR; or
iii. Any violent offense as defined in 9.94A.030 RCW (Sentencing Reform Act -Definitions).
(d) Contractor must require that current employees, volunteers, and contracted service
providers who are authorized for regular access to a juvenile(s) report any guilty plea or
conviction of any of the above offenses. The report must be made to the person's supervisor
within seven (7) days of conviction and any person who have reported a guilty plea or
conviction for one or more of these offenses must not have regular access to any offender.
Contractor shall also document background checks/criminal history clearances for
monitoring purposes.
(2) Sexual Misconduct
(a) Sexual Misconduct - 13.40.570 RCW (Sexual misconduct by state employees, contractors)
states that when the Secretary has reasonable cause to believe that sexual intercourse or
sexual contact between the employee of a Contractor and an offender has occurred, the
Secretary shall require the employee of a Contractor to be immediately removed from any
employment position which would permit the employee to have any access to any offender.
(b) By execution of this Contract, Contractor affirms that Contractor, each of its employees,
subcontractors, and/or volunteers are knowledgeable about the requirements of 13.40.570
RCW (Sexual misconduct by state employees, contractors) and of the crimes included in
9A.44 RCW (Sex Offenses).
(c) In addition, the Secretary shall disqualify for employment with a Contractor in any position
with access to an offender, any person:
i. Who is found by the department, based on a preponderance of the evidence, to have
had sexual intercourse or sexual contact with the offender; or
ii. Convicted of any crime specified in chapter 9A.44 RCW (Sex Offenses) when the victim
was an offender
(d) If any actions are taken under 13.40.570 RCW, subsections (3) or (4), the Contractor must
demonstrate to the Secretary they have greatly reduced the likelihood that any of its
employees, volunteers, or subcontractors could have sexual intercourse or sexual contact
with any offender. The Contract shall not be renewed unless the Secretary determines
significant progress has been made.
9. Compliance with JR Policies and Standards
a. In addition to the governing Federal and State laws and regulations, the Contractor shall comply
with all DCYF and JR Rules and Policies as applicable to the services provided.
b. In case of conflict or inconsistency between the aforementioned, the higher standard of compliance
shall prevail.
Department of Children, Youth & Families
2017CF County Program Agreement 6-24-20 Page 18
10. Monitoring
The County shall assist the JR to perform reviews of sites where services are delivered at regular
intervals using agreed upon forms and methods.
11. Items Incorporated by Reference
a. RCW 13.40.500—13.40.550;
b. Juvenile Disposition Sentencing Standards;
c. Evidence -Based Public Policy Options to Reduce Future Prison Construction (October 2006;
d. Providing Evidence -Based Programs with Fidelity in Washington State Juvenile Courts: Cost
Analysis; and
e. The County's SFY 2026-2027 Washington State Juvenile Court Evidence Based Expansion
Application.
12. JR Program Contact Information
The primary program contact for this Contract for DCYF shall be:
Robert Leonard
Program Administrator
Juvenile Rehabilitation
1500 Jefferson St. SE
Olympia, WA 98504-4570
206.639.6009
Robert. Leonard(-dc)f.wa.gov
Department of Children, Youth & Families
2017CF County Program Agreement 6-24-20 Page 19
EXHIBIT C
Juvenile Court Evidence Based Expansion
MONTHLY PROJECT UPDATE FORM SFY26-27
The following information must be submitted on the Monthly Project Update Form, as provided by JR,
for each type of intervention (FFT, MST, COS, EET, and ECBP) and attached to an Invoice Voucher
Form A-19 when submitting requests for payment to JR:
a. County Name
b. Month/Year of Service
c. The court's projected number of youth who will start the program for the current fiscal year
d. The number of youth who started the program during this month (Youth shall only be counted as a
starter one time per evidence based program per probation obligation)
e. The total number of youth who started the program since the beginning of the current fiscal year
f. The number of youth who have successfully completed the program during this month
g. The number of youth who have successfully completed the program since the beginning of the
current fiscal year
h. The total number of youth who are still active in the program and have not completed as of the end
of this month
i. The Total Reimbursement for the program since the beginning of the current fiscal year
j. The County's current cost per youth for the program
k. Program Comments (include barriers to getting youth to start the programs and/or any opportunities
to expand the programs)
Department of Children, Youth & Families
2017CF County Program Agreement 6-24-20 Page 20
EXHIBIT D
Juvenile Court Evidence Based Expansion
MONTHLY REIMBURSEMENT REQUEST FORM SFY26-27
Attach completed Form(s) to an Invoice Voucher Form (A-1 9) when submitting requests for payment
to JR. Note: Complete a separate MONTHLY REIMBURSEMENT REQUEST FORM for each type of
intervention (FFT, MST, COS, EET, and ECBP).
COUNTY
MONTH/YEAR
INTERVENTION PROGRAM
(FFT, MST, ETC.)
COSTS THIS MONTH
$
$
Administrative (not to exceed 15° o
$
TOTAL COST
$
Department of Children, Youth & Families
2017CF County Program Agreement 6-24-20 Page 21
EXHIBIT E
Juvenile Court Evidence Based Expansion
QUARTERLY TARGET UPDATE FORM SFY26-27
Submit completed Form(s) to JR within 15 days following each fiscal quarter being reported on. Note:
Complete a separate QUARTERLY TARGET UPDATE FORM for each type of intervention (FFT, MST,
COS, EET, and ECBP).
COUNTY QUARTER YEAR INTERVENTION PROGRAM
(FFT, MST, ETC.)
PROPOSED QUARTERLY TARGETS
FIRST QUARTER:
SECOND QUARTER:
THIRD QUARTER:
FOURTH QUARTER:
JUL — SEP
OCT —DEC
JAN —MAR
APR — JUN
ACTUAL QUATERLY TARGETS
1. is the number of youth who participated in the project for the quarter being
reported.
2. is the number of youth who completed the project for the quarter being reported.
BARRIERS/ISSUES TO MEETING QUARTERLY PARTICIPATION
Department of Children, Youth & Families
2017CF County Program Agreement 6-24-20 Page 22