HomeMy WebLinkAboutAgreements/Contracts - New Hope DV/SAK19-106
AMER washirigio,7 STate COUNTY PROGRAM AGREEMENT
Department of DSHS Agreement —Number
Social 1963-59401
71 IV & Health semices Community -Based Domestic
Transforming lives, Violence Program Emergency Shelter
& Supportive Services
This Program Agreement is by and between the State of Washington
Administration-- or Division
Department of Social and Health Services (DSHS) and the County identified
Agreement Number
below, and is issued in conjunction with a County and'DSHS Agreement On
1701
General Terms and Conditions, which is incorporated by reference.
County Agreement Number
DSHS ADMINISTRATION DSHS DIVISION DSHS INDEX - NUMBER
Economic Services Community Services Division 1221
DSHS CONTRACT CODE
Administration
3009CC-63
DSHS GONTAGT NAME AND TITLE DSHS CONTACT ADDRESS
Maureen Kelly PO Box -45710
Program Manager
Olympia, WA 98504
DSHS CONTACT TELEPHONE DSHS CONTACT FAX DSHS CONTACT E-MAIL
�P60)P02-7901 Click here to enter text. maureen.kelfy@dshs.wa..gov
COUNTY NAME COUNTY ADDRESS
Grant County 311 West Third Avenue
New Hope Domestic Violence and Sexual Moses Lake, WA 98837
Assault Sery
COUNTY FEDERAL EMPLOYER IDENTIFICATION COUNTY CONTACT NAME
NUMBER SuziFode
COUNTY CONTACT TELEPHONE COUNTY 'CONTACT FAX COUNTY CONTACT E-MAIL
(509) 764-8402 ]M(509) 766-6574 Sfod22c2j rant. wa. us
IS THE COUNTY A SUBRECIRIENT FOR PURPOSES OF THIS PROGRAM CFDA NUMBERS- MINOR=
AGREEMENT?
Yes 93.671
PROGRAM AGREEMENT START DATE PROGRAM AGREEMENT END DATE MAXIMUM PROGRAM AGREEMENT AMOUNT
07101/2019 1 06130/2020 $5-16,039,00
EXHIBITS. When the box below is marked with an X, the f611-c%Mng Exhibits are attached and are incorporated into this
County Program Agreement by reference.*
Z Exhibits (specify): No IData Security Exhibit Exhibit A — Statement of Work(SOW); Exhibit 8 — Program
Requirements; -Exhibit C — InfoNet Data Requirements; Exhibit D — Budget
E] No Exhibits.
The terms and conditions of this Contract are an integration and representation of the final, entire and exclusive
understanding between the pattes, superseding and merging all previous agreements, writings, and communications, oral
or otherwise, regarding the subject matterofthis Contract. The parties signing below represent that they have read and
understand this Contract, and have the authority to execute this Contract. This Contract shall be binding on DSHS only
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DSHS SiGNATURE
DSHS Central Contract Services
6017CF County Program Agreement (I0-31-2417}
PRINTED NAME(S) AND TITLES}
Cindy Carter, Vice -Chair
Richard Stevens, Member
PRINTED NAME AND TITLE
Cafeb Clark, Contracts Officer
DSHSIESA - Community Services Division
DATE(S) SIGNED
DATE SIGNED
Page 1
x
Special Terms and Conditions
1 Definitions specific to Special Terms. The words and phrases listed below, as used in this Contract,
shall each have the following definitions:
a. "Advocacy" means that the client is involved with an.. advocate in individual or group sessions with
a primary focus of safety planning, empowerment,r and education. of the client through
reinforcement of the client's autonomy and, self, determination. Advocacy also means speaking
and acting for change or justice with -or on behalf of, another person or cause. Advocacy is
survivor -centered and uses non -victim blaming --methods that include:
(1) Identifying barriers and strategies'to.enhance, safety, including safety -planning,
(2) ClarifY gin and increasing awareness of the power and control associated with domestic violence
and the options one may have to obtain resources while staying safe.
(3) Supporting independent decision-making based on the unique needs and circumstances of
each individual,
b. "Advocate" means a trained staff person who works in a domestic violence program and provides
advocacy to clients.
c. "Child care" means the temporary care of.a client's child or children by staff of the domestic
violence program at the program.'s location ora . nother location where the. client is receiving
confidential or individual services from the domestic violence program or is participating in
activities sponsored by the domestic violence program, other than employment, and so long as the
client remains on the premises.
d. "Children/Youth Activities" means age-appropriate activities other than children/youth advocacy,
such as recreational and educational activities.
e. "ChildrenNouth Advocacy" means age-appropriate supportive services that strive -s to assist
childrenlyouth to express feelings about their exposure to domestic violence. Itis an educational,
rather than a therapeutic service, and is focused on providing education.. about domestic violence,
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on an individual basis and in group settings.
f. "Client" means a victim of domestic violence who is accessing services at a domestic violence
program. A client may also be referred to as a survivor, service recipient, *or resident.
g•
"Community advocate" means a. person employed or supervised by :a: domestic violence program
who is trained to provide ongoing assistance and advocacy for victims of domestic violence in
assessing and planning for safety needs, making appropriate social service, legal, and housing
referrals, providing community education, maintaining contacts necessary for prevention efforts,
and developing protocols for local systems coordination.
h. "Community -Based Domestic Violence Program" or "CBDVP" means an organization that
provides, as its primary purpose, assistance and advocacy for domestic violence victims.
Domestic violence assistance and advocacy includes crisis intervention, individual and group
support, information and referrals, and safety assessment and planning. Domestic violence
assistance and advocacy may also include, but is not limited to, provision of shelter; emergency
transportation; self-help services; culturally specific services; legal advocacy; economic advocacy;
and accompaniment and advocacy through medical, legal, immigration, human services, and
financial assistance systems. CBDVPs also provide community education and prevention efforts.
Domestic violence programs that are under the auspices of, or the direct supervision of, a court,
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6017GF County Program Agreement (10-31-2017) Page 2
Special Terms and Conditions
law enforcement or prosecution agency, or the child protective services section of the department
as defined in RCW 26.44-020 are not considered CBDVPs.
i. "Community Education" means information that is provided in community settings about domestic
violence and services related to victims of domestic violence. Community education activities
include: training, presentations, outreach to specific communities or geographic areas, community
events, and media events.
"Compliance Agreement" means a written plan approved by DSHS which identifies deficiencies in
Contractor's performance, describes the steps Contractor must take to correct the deficiencies,
and sets forth timeframes within which such steps must be taken to return Contractor to
compliance with the terms of the Contract.
k. "Confidential Communication" means all information, oral, written or nonverbal, that is transmitted
between a victim of domestic violence and an employee or volunteer of a domestic violence
program in the course of their relationship and in confidence, which means that the employee or
volunteer will not disclose the information to a third person unless authorized in writing by the
victim.
"Confidential Information" includes, but is not limited to, any information, advice, notes, reports,
statistical data, memoranda, working papers, records or the like, made or given during the
relationship between a victim of domestic violence and a domestic violence program, however
maintained. Confidential information includes personally identifying information (see definition
below) and other information that would personally identify a victim of domestic violence who
seeks or has received services from a domestic violence program.
m. "Crisis Hotline" or "Crisis Helplineyl means a designated telephone line of the domestic violence
program that operates twenty-four (24) hours a day, three hundred sixty-five(365) days a year. A
hotline/helpline provides crisis intervention, safety planning, information, and referral services.
n. "Crisis Interventionyl means services provided to an individual in crisis to stabilize an individual's
emotions, clarify issues, and provide support and assistance to help explore options for resolution
of the individual's immediate crisis and needs.
o. "Culturally Specific Supportive Services and Prevention Efforts"
means services and prevention
efforts created by and for specific cultural populations that have been historically underserved or
unserved. Services and prevention efforts are typically designed by and with individuals from the
specific culture who are cognizant ®f the specific community generated risks and protective
characteristics and often utilize the language and settings familiar to thepopulation served.
P. "Domestic Violence" means the infliction or threat of physical harm against an intimate partner, and
includes physical, sexual, and psychological abuse against the partner, and is a part of a pattern of
assaultive, coercive, and controlling behaviors directed at achieving compliance from or control
over that intimate partner. It may include, but is not limited to, a categorization of offenses, as
defined in RCW 10.99.020, committed by one intimate partner against another.
q. "Domestic Violence Program" means an agency, organization, or program with a primary purpose
and history of effective work in providing advocacy, safety assessment and planning, and self-help
services for domestic violence victims in a supportive environment, and includes, but is not limited
to, a CBDVP, emergency shelter, or domestic violence transitional housing program.
r. "Emergency Shelter" means a place of supportive services and safe, temporary lodging offered on
a twenty-four hour, seven-day per week basis to victims of domestic violence and their children.
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6017CF County Program Agreement (10-31-2017) Page 3
Special Terms and Conditions
Domestic violence programs may use hotels and motels for victims who need safe shelter, but the
domestic violence program must also have an emergency shelter that meets the requirements of
Washington Administrative Code (WAC) 388-061A. The mere act of making a referral to
emergency shelter is not itself considered provision of emergency shelter.
s. "Intimate Partner" means a person who is or was married, in a state. registered domestic
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artnershi
p, or in an intimate or dating relationship with another person at the present or at some
time in the past. An intimate partner is also any person who has one or more children in common
with another, person, regardless .of whether they have been married, in a.domestc partnership with
each other, or lived together at any time.
" means a work experience where an individual observes and learns about a job,
t. "Job Shadowing m p
activity, or activities by walking through the work day as a shadow to a skilled and competent
employee. The experience is planned for and structured with the goal of observing behavior and
situations, engaging in interactive questions and answers, ,and experiencing the link. between
learning and practice. Job shadowing may be anywhere from a few hours, to a day, week, or more,
depending on the job or activity.
u. Leg y
al Advocacy " means personal support and assistance with victims of domestic violence to
ensure their interests are represented and their rights upheld within the civil and criminal justice
systems,, including administrative hearings. It includes educating and assisting v
Y ictims in
navi ating the justice systems; assisting victims in evaluating advantages and ;disadvantages of
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articipating in the legal processes; p
facilitating victims' access and participation in the legal
systems; and promoting victims' choices and rights to individuals within the legal systems.
Advocate" means a person employed by a domestic violence program or court system to
v. "Legal A p
advocate for victims of .domestic violence, within. the civil and criminal legal systems and
administrative hearings, by attending court proceedings, assisting in document and case
preparation, and ensuring linkage with the community advocate.
w. "LEP" means Limited .English Proficiency, and indicates an individual's need for additional support
and assistance in cornprehending the English language.
x. "Live Training" means eve its that are e held at a spetc1IIC Lime and Ingot prerecorded, where
participants have the opportunity to ask ,questions and hear the questions of others in real time.
Examples of live training include everts that are in person, teleconferences, and interactive.
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"Lod in Unit" means one or more rooms used for a victim of domestic violence including rooms
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used for sleeping or sitting.
z. "Match"means the Contractor's. share of the contracted program costs. Match may either be "in-
kind" or "cash." Cash. match includes actual cash spent by the Contractor to support the
contracted services. such as non-federal money contributions front public agencies and private
or antzations or individuals, suc
h as donations. In-kind match includes the value of donated
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gods and. services used to support the contracted services. In-kind contributions can include
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such things :, as donations of expendaIble equipment; office supplies; workspace; and the monetary
value of time contributed by professionals, technical personnel, and other, skilled, and unskilled
labor volunteer so long as the donated services provided are an integral part of the funded
program. All match shall be documented.
aa. Identifying . "Personall Identif in Information" means individually identifying information for or about an
individual including information likely to disclose the location of a victim of domestic violence,
reg ardless of whether the information is encoded, encrypted, hashed, or otherwise protected,
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Special Terms and Conditions
including, but not limited to:
(1) First and last name;
(2) Home or other physical address;
(3) Contact information (including postal, email or Internet protocol address or telephone or
facsimile number);
(4) Social security number;
(5) Driver's license number, passport number, or student identification number;
(6) Religious affiliation;
(7) Date of birth;
(8) Nine digit postal (ZIP) code;
(9) Physical appearance of;
(10) Case file or history; and
(11) Other information that would personally identify a victim of domestic violence who seeks or has
received services from a domestic violence program, or such other information which, taken
individually or together with other identifying information, could identify a particular individual.
bb. "Prevention" means efforts that are designed to ultimately eradicate domestic violence through the
promotion of healthy, respectful, and nonviolent relationships. Successful domestic violence
prevention efforts address change at both the individual and community levels, and tailor
messages to diverse populations. Characteristics of promising prevention practices include
working to decrease risk factors for perpetration of abuse as well as victimization, while at the
same time promoting positive factors that protect individuals from perpetrating or experiencing
abuse.
(1) Domestic violence prevention includes strategies, policies and programs that focus on at least
one (1) of the following:
(a) Increasing community dialogue about the root causes of intimate** partner violence
(b) Shifting cultural norms
(c) Building skills for healthy relationships
(d) Promoting respectful and healthy relationship
(2) Examples of activities that are not considered, prevention include:
(a) Community education as defined in this Contract;
(b) Transformative and restorative justice efforts;
(c) Single session or one-time activities, such as trainings, presentations, or events;
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Special Terms and Conditions
(d) Activities that focus on defining domestic violence, or teaching data, dynamics, and the
impacts of domestic violence;
(e) Providing information on how to access domestic violence services or how to help others
in accessing services;
(f) Supportaro,ups as defined in this Contract (support: groups are considered a supportive
service); and
(g) Activities that focus on improving responsiveness to domestic violence survivors by
community members or system partners.
cc. "Residentyy means a client of the domestic violence program who is residing in a shelter as defined
in this Contract.
dd. "Safety Planning" means a process of thinking through with the victim how to increase safety for
both the victim of domestic violence and any children of the victim. Safety planning addresses
both immediate and long term risks, barriers, or concerns regarding the victim, and any dependent
children in the context of their communities and in relationship with the domestic violence
perpetrator. It is based on knowledge about the specific pattern of the domestic violence
perpetrator's tactics and the protective factors of the victim and any dependent children. Safety
planning can be done formally, informally, in writing or orally, or in any other conversational
process between the victim and advocate.
ee... "Secretary" means the department secretary. or. the: secretary's designee.
ff. "Self -study" is a form of study in which one is, to a large extent, responsible for one's own
instruction. Examples of self -study include reading articles,' books, academic journals, training
mater I ials, engaging in online learning opportunities, and prerecorded webinars. Self -study content
must be current or have historical relevance to the domestic violence advocacy field.
gg. "Shelter" means temporary lodging and supportive services, offered by a CBDVP to victims of
domestic violence and their,. children.
hh. "Staff' means trained persons who are part of a domestic violence program and are paid or
volunteer to provide services to clients.,
ii. "Subcontractor" means an individual or entity to perform all or a portion of the duties and
obligations that the Contractor. is obligated to perform pursuant to this Contract. The Contractor
shall have a written subcontract for any service required by the contract that is performed for a fee
by an entity who is not an employee of the contracted program. Subcontracting for certain
services may be necessary for the Contractor, but in all cases shall require prior written approval
by IDSHS. Any subcontractor shall meet the same contractual requirements as the Contractor.
jj. "Support Group" means interactive groupsessions of two or.more victims of domestic violence that
is facilitated by trained staff on a regular basis. Participants share experiences, offer mutual
support, and receive information and education around a specific topic of. comm -on interest.
Support groups validate the experiences of victims, explore options, build on strengths, and
respect participants' rights to make their own decisions.. A shelter or house meeting where, for
example, chores are discussed, and there is no advocacy provided, is not a support group.
kk. "Supportive Services" means assistance and advocacy for victims of domestic violence and their
children that are designed to meet the needs of victims and children and provided in accordance
with the service model defined in this chapter. Supportive services include, but are not limited to,
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6017CF County Program Agreement (10-31-2017)
Special Terms and Conditions
activities described in the definition of CBDVP.
11. "Underserved" or "Unserved Populations" means populations who face barriers in accessing and
using victim services, including populations underserved or unserved because of religion, sexual
orientation, or gender identity or expression, underserved or unserved racial and ethnic
populations, and populations underserved because of special needs including language barriers,
disabilities, immigration status, and age.
mm. "Victim" means an intimate partner who has been subjected to domestic violence.
nn. "WAC" means the Washington Administrative Code. All references in this Contract to WAC
chapters or sections shall. include any successor, amended, or replacement regulation.
http:-//app.leg .wa-gov/wac/
2. Purpose
The purpose of this Contract is to provide emergency domestic violence shelter and advocacy and
assistance (supportive services) to residential and non-residential victims of domestic violence and any
dependent child(ren) of the victim. In performing the services, requirements and activities covered by
this Contract, the Contractor shall comply with all applicable requirements of the federal Family
Violence Prevention and Victims of Crime Act grants, and the provisions of RCW 70.123 and
Washington Administrative Code 388-61A.
3. Statutory or Administrative Rule Changes
In the event that the Children's Administration should need to incorporate statutory or administrative
rule changes relating to contract services and/or requirements, the parties agree to negotiate in good
faith the incorporation of such additional requirements in this Contract, either by an amendment to this
Contract or by a revised contract that would replace this Contract.
4. Statement of Work — Exhibit A
The Contractor shall ensure that services provided under this Contract at all times meet the
specifications in the Statement of Work attached as Exhibit A.
5. Program Requirements — Exhibit B
The Contractor shall ensure that all qualifications, performance expectations and program requirements
for services provided under this Contract at all times meet I the specifications described in the Program
Requirements attached as Exhibit B.
6. InfoNet Data Requirements — Exhibit C
The contractor shall comply with the requirements for entering mandatory data into the lnfoNet data
collection system, as stated in the InfoNet Data Requirements attached as Exhibit C.
7. Budget— Exhibit D
a. Contractor's budget for providing services under this Contract during the term of the Contract for
the period of performance stated on page 1 of this Contract is attached as Exhibit D. This budget
is based on the Contractor's Renewal Application for funding, as accepted and revised by the
DSHS Program Manager for this Contract. The Renewal Application is incorporated by reference
in this Contract. If the approved budget includes a line item for equipment which was approved for
purchase by the DSHS Program Manager for this Contract, ownership of the equipment shall be
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6017CF County Program Agreement (10-31-2017) Page 7
Special Terms and Conditions
retained by the Contractor.
b. With the exception of Indirect costs, transfer. of funds between, andamong line item budget
categories of the approved Budget must be requested in writing by he Contractor if the cumulative
amount of these transfers exceeds or is expected to exceed $2,000. Budget adjustment requests
must be submitted in writing to the DSHS Program manager. on the Contract Budget Revision,
Request form, and are subject to justification and negotiation. Approved budget revisions shall e
incorporated b reference into this Contract as Addendums to Budget Exhibit D and shall not
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require separate amendments. Transfer of funds to.the Indirect Cost line item .is prohibited.
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c. Notwithstanding any provision of this Contract to the.. contrary, at any time.during the period of
performance, DSHS may analyze Contract expenditures as a proportion of the Contract budget. If
DSHS determines, in its sole discretion, that the Contract funding is underutilized, DSHS, in its
sole discretion, may unilaterally modify the Contract to reduce the balance of the Contract budget.
8. Consideration
a. Maximum Contract Amount. The maximum amount of total compensation payable to the
Contractor for satisfactory performance of the work under this Contract is the. amount stated on
age 1 of this Contract under "Maximum Contract Amount".
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b. Funds payable under this Contract are from the following sources:
(1) $193,979 is allotted under this Contract from the State of_Washington,general fund.
(2).$54,790 allotted under this Contract from the. federal Family Violence Prevention and Services
Act (FVPSA)9rant. The CFDA Number is 93.671.
(3) $516,039 is allotted under this Contract from the federal Victims of Crime Act (VOCA). victim
assistance grant. The CFDA Number is 16.575. $85,802 of the VOCA funding is restricted to
salaries, benefits, and administrative/indirect costs for VOCA and contract eligible staff and
activities as approved by DSHS for Compensation and FTE in the application budget.
c. Allotted funds not ex ended during the parlod ending June 30th shall not be carried forw,� and into
the following fiscal year. Contractor shall obli%ga'L te all funds received under this Contract by the
Contract end date listed on page one of this Contract. All obligated funds shall be liquidated no
later than thirty ( 30) days after the Contract end date listed on page 1 of this Contract, without
exception.
d. Travel Expenses. Travel expenses incurred or paid by the Contractor_ shall: be reimbursed at a rate
not to exceed the current state rate and in accordance with the State of Washington Office of
Financial Management Travel Regulations. Reimbursable travel expenses under this Contract
only include mileage, lodging and per diem rates. Any out-of-state travel must be approved in
.advance by the DSHS Contract Manager for this. Contract. Travel expenses are included in the
maximum contract amount for this Contract. Current rates for travel may be accessed at
htt s:flofm.wa. ov/accountin /administrative-accountin-resources/`travel.
9. Billing and Payment
a.
The Contractor shall submit a monthly or bimonthly (every two months) invoice for services
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erformed under this �Gontra�t on State of Washington Invoice Voucher forms (FormA-1 9),
.prepared ared in the manner prescribed by DSHS. Invoices shall not be submitted more frequently than
monthly.
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Special Terms and Conditions
b. The voucher shall be on pre-printed invoice forms provided to the Contractor by DSHS and shall
clearly indicate the contract number, invoice period, and the total reimbursement requested.
c. The invoice shall state the total amount of expenses incurred by the Contractor that is based on
the line items listed in the Budget Exhibit attached as Exhibit D. Contractor shall distinguish
between expenses for "core" services and "prevention" activities. The invoice submittal shall
include the following:
(1) A spreadsheet that includes the Contract budget by line item and category (i.e., core and/or
prevention), amount requested for the invoice by line item and category, YTD (Fear -To -Date
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expenditures by line item and category, and Contract balance by line item and category. Upon
request by the DSHS Program Manager for this Contract, Contractor shall attach, or submit,
copies of all source documentation for expenditures claimed on invoice vouchers submitted for
payment, in the manner requested by DSHS.
(2) An Invoice Documentation Form for any goods and services the Contractor is charging to the
Contract. Items that are eligible for reimbursement will be those negotiated from the
Contractor's application and as agreed to by DSHS. Contractor shall not submit copies of
expenditure source documentation unless requested by DSHS. The form can be accessed and
downloaded at: https://www.dshs-wa.gov/esa/communi.ty-services-offices/resources.
d. The cost or expense billed for each such line item and category shall be charged against the total
amount listed for that line item and category in Exhibit D. The cumulative dollar amount for each
such line item and category, for all invoices submitted by the Contractor, shall not exceed the total
dollar amount stated for that line item and category in the Budget Exhibit, except as provided in
Special Terms and Conditions, Section 7 Budget— Exhibit D, Subsection b., above.
e. Original A-19 invoice vouchers shall be submitted electronically to the DSHS Contact Name listed
on page I of this Contract. The Contractor shall contact the DSHS Contact Name listed onpage 1
of this Contract concerning billing questions.
f. Claims for payment submitted by the Contractor shall be paid by DSHS if received by DSHS no
later than sixty (60) days from the date services were rendered; EXCEPT, the final invoice for
services performed under this Contract shall be submitted to DSHS no later than thirty (30) days
after the Contract end date listed on page 1 of this Contract, without exception.
g. DSHS will not be obligated to pay for services submitted more than three (3) months after the
calendar month in which the services were performed.
h. DSHS shall make payment within thirty (30) days of receipt of a properly completed invoice for
services.
i. Contractor certifies that work performed under this Contract does not duplicate any work to be
charged against any other Contract, subcontract, private grant or other state or federal funding
source.
j. Federal VOCA funds payable under this Contract shall not be used for prevention activities.
k. DSHS may stop payment to the Contractor if reports, activities, or other documentation required
under this Contract are delinquent, i.e., not submitted within ten (10) days of the due date, or are
incomplete.
I. DSHS may, at its sole discretion, withhold or deny payment claimed by the Contractor for services
rendered if Contractor fails to satisfactorily comply with any term or condition of the Contract.
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Special Terms and Conditions
10. Meals and Refreshments - Limitations
exception of food purchased b the Contractor for residents of the emergency domestic
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violence shelter. service, any meals or.refreshments provided by the Contractor, as part of the
contracted services provided, are subject to limitations under the RCW and state and federal
regulations as to (1) the circumstances under which. they may. be provided and claimedas an expense
underthe Contract, and as to (2) the amount of that cost that may be claimed fo-r.rei.m.bursement from
DSHS under the Contract.
refreshments, or food services provided by ,the Contractor in connection with services
a. Meals, ,r p
provided under the Contractmust be an integral part of the service or activity provided by the
Contractor and must advance or support the purpose of the Contract for which the' services are
provided.
of food purchased b the Contractor for residents of the emergency domestic
b. With the exceptionp Y
violence shelter service, the cost of any meals provided by the Contractor in.,connection with the
servicesp rovided under this Contract roust meet the published requirements and guidelines of the
-
Office of Financial Management (OFM) applicable to Washington State employees, in order for
DSHS to reimburse the Contractor for such costs. In the event such costs exceed the amounts
allowable b OFM, DSHS will reimburse the Contractor up to, but not to exceed, the amount
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otherwise allowable by OFM.
(1)-.OFM requirements for reimbursementfor meals with meetings may be found at
h ttos�I + w `ofm a o /sitesMefaoit/fiiesl ubii lie aoy%polic g, : htrr
(2) OFM rates for reimbursement may be found at https://efm 'I a.q-oylaccCunting/administrative-
accou nti ng -rte urces/travel .
costs for meals refreshments, food services or other like items, as may be set forth in any
c. The co ,
Bud et Exhibit for this Contract, are subject to the above limitations and federal laws, regulations,
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policies and guidance, per the Office of Justice Programs (OJP) Financial Guide. The OJP
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Financial Guide can be accessed at: htt s://ol .Cg inancialguide/DOJ/index.htm.
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1'I . Pa nient. Only for Authorized Se," V ices
DSHS shall pay the Contractor only for authorized services provided in accordance with this Contract.
If this Contract is terminated for any.reason, DSHS shall pay only for services authorized and provided
through the date of termination.
12. Funding Stipulations
a. Duplicate Billing. The Contractor must not bill other funding sources for services rendered under
this Contract which would result in duplicate billing to different funding sources for the same
service° Furthermore, the Contractor -shall ensure that no subcontractor bil s any other funding
sources for services rendered under this Contract, which would result in duplicate billing to
different funding sources for the same service.
b. Match. The Contractor shall provide a 20% cash or in-kind match for the federal funds payable
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under this Contract as specified in Exhibit D. Match shall not be from federal funds. The
Contractor may use state. funds payable under this Contract as match toward federal funds
a able under this Contract only to the extent necessary to meet the match required by this
payable
Contract. Any excess state funds shall not be used as match toward federal funds without the prior
writtenp ermission of DSHS If state funds are insufficient to meet the federal match requirement,
Contractor shall provide documentation demonstrating additional match as directed by DSHS.
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Special Terms and Conditions
13. Recovery of Fees for Noncompliance
In the event the Contractor bills for services provided and is paid fees for services that DSHS later finds
were either (a) not delivered (b) unallowable, or (c) not delivered in accordance with applicable
standards or the requirements of this Contract, DSHS shall have the right to recover the fees for those
services from the Contractor, and the Contractor shall fully cooperate during the recovery process.
14. Overpayments and Assertion of Lien
In the event that DSHS establishes overpayments or erroneous payments made to the Contractor
under this Contract, DSHS may secure repayment, plus interest, if any, by requiring the posting of a
bond, assignment of deposit, or some other form of security acceptable to DSHS.
15. Restrictions on Lobbying
In general, as a matter of federal law, federal funds awarded may not be used by the Contractor, or any
Subcontractor at any tier, either directly or indirectly, to support or oppose the enactment, repeal,
modification, or adoption of any law, regulation, or policy at any level of government. See 18 U.S.C.
1913. (There may be exceptions if an applicable federal statute specifically authorizes certain activities
that otherwise would be barred by law.)
Another federal law generally prohibits federal funds awarded from being used by the Contractor, or
any Subcontractor at any tier, to pay any person to influence (or attempt to influence) a federal agency,
a Member of Congress, or Congress (or an official or employee of any of them) with respect to the
awarding of a federal grant or cooperative agreement, subgrant, contract, subcontract, or loan, or with
respect to actions such as renewing, extending, or modifying any such award. See 31 U.S.C. 1352.
Certain exceptions to this law apply, including an exception that applies to Indian tribes and tribal
organizations.
Should any question arise as to whether a particular use of federal funds by a Contractor (or
Subcontractor) would or might fall within the scope of these prohibitions, the Contractor is to contact
DSHS for guidance, and may not proceed without the express prior written approval of DSHS.
16. Business/Financial Assessment
a. The Contractor authorizes DSHS to obtain a financial assessment and/or credit report of the
Contractor's corporation and/or business, and of the principal owner(s) of the corporation and/or
business, at any time prior to or during the term of this Contract. A "principal owner" includes
person(s) or organization(s) with a 25% or more ownership interest in the business.
b. DSHS may deny, suspend, terminate, or refuse to renew or I extend . - a Contract I act if, in the judgment of
DSHS, the Contractor or any partner or managerial employee of the Contractor, or an owner of
50% or more of the Contractor entity, or an owner who exercises control over the Contractor 7 s daily
operations:
(1) Has a credit history which could adversely affect the Contractor's ability to perform the Contract-,
(2) Has failed to meet a financial obligation as the obligation fell due in the normal course of
business; or
(3) Has filed for bankruptcy, reorganization, or receivership within five (5) years of the start date of
the Contract.
17. Compliance Agreement
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Special Terms. and .Conditions
In the event that DSHS identifies deficiencies in Contractor's performanceunder this Contract, .'DSHS
may establish a Compliance Agreement. When presented with a Compliance Agreement, Contractor
ac e intheJimeframe given to correct the
irees to undertake the actions specified in the agreement with
deficiencies. Contractor's failure to do so shall be grounds r termination.o
,fo f this Contract.
18. Investigations of Contractor ®r Related Personnel
a. DSHS may, without prior notice, suspend the Contractor's performance of the Contra ' ct if the
Contractor, or any partner, officer or director of the Contractor, or a subcontractor, or any
employee or volunteer of the Contractor, or. a subcontractor, is investigated. by DSHS or a local,
state or federal agency regarding any matter that, if ultimately established, could, either:
(1) Result in a conviction for violating local, state or federal law, or
(2) In the sole judgment of DSHS, adversely affect the delivery of services under this Contract or
the health, safety or welfare of clients being served by,this Contract.
b. DSHS may also take other lesser action, including, but not limited to, disallowing a staff member,
employee, or other person associated with. the Contractor or subcontractor,, from providing
services, ices, or from having contact with cliebts being served by this Contract, until the investigation is
concluded and a final determination made by the investigating agency.
19. Disputes
submit a written request for dispute
a. Either party who has a dispute concerning this Contract. may
o amount of any rate set by law, regulation or DSHS policy is not disputable. A
resolution. The
party's written request for dispute resolution'must include:
(1) A statement identifying the issue(s) in dispute; and
(2) The Contractor's name, address, and contract number.
b. The request must be mailed to the following . address* within thirty (30) calendar days after the party
could reasonably be expected to have knowledge of the issue, which.- is disputed.
c. A copy of the current DSHS dispute. resolution process is available at any time by written request.
u
d. Requests for dispute resolution or for a copy of the curren,t'DSHS dispute resol tion process
should be sent to:
Department of Social and Health, Services
Attention: Domestic. Violence Unit
P0. Box 45470
Olympia, WA 98504-5710
This dispute resolution process is the sole administrative remedy available under this Contract.
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6017CF County Program Agreement (10-31-2017)
Special Terms and Conditions
-A-
Community -Based Domestic Violence Program
Emergency Shelter and Supportive Services
Contractor shall provide the following services and activities as described in this Statement of Work. In
performing the services, requirements and activities covered by this Contract, the Contractor shall comply with
all applicable requirements of the federal Family Violence Prevention (FVPSA) and Victims of Crime Act
(VOCA) grants and the provisions of RCW 70.123 Shelters for Victims of Domestic Violence, and Washington
Administrative Code (WAC) 388-61A.
1. Service Model
Supportive services and emergency shelters for victims of domestic violence are essential to provide
protection to victims from further abuse and physical harm. Research demonstrates that access to
supportive services that increase a survivor's knowledge of safety planning and awareness of
community resources leads to increased safety and wellbeing over time. Consequently, the model for
providing services must incorporate the following practices:
a. Services provided to victims must include access to safety, advocacy, information about options,
and referrals to helping resources.
b. Services must use a survivor -centered and empowerment model that:
1) Promotes safety for all victims of intimate partner violence and their children.
2) Is survivor -centered and treats victims with dignity and respect.
3) Builds on the strengths and resources of individuals and families, respecting their autonomy
and self-determination.
4) Supports the relationship between victims and their children.
5) Offers options and support for autonomous decision-making that is based on the needs and
circumstances of each victim and their family. -
6) Assists individuals and families in accessing protection and services that are respectful and
inclusive of cultural and community characteristics.
7) Ensures program accountability by involving victims in evaluating the services they receive
from the domestic violence program.
8) Supports engagement and collaboration with other community agencies and systems for the
purpose of developing a comprehensive response system for victims and their children.
c. The program must refrain from engaging in activities that compromise the safety of victims or their
children.
d. The program must not provide services that blame the victim for the abuse or do not hold the
abuser accountable for the violence. Such services are ineffective and will likely result in further
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Special Terms and Conditions
harm to the victim, up to and including death.
2. Supportive Services
a. Contractor must provide the following:
1) Crisis hotline orhelpline as defined in,._WAC 388_6.1.A-.1040;
2) Crisis intervention;
3) Safety assessment and planning;
4) Emergency domestic violence shelter as defined in WAC 388-61 A-1000 and that meets the
facility standards as defined in WAC 388-61 A-1100 through 1205;
5) Contractor must have a staff person available twenty-four (24) hours a day, three hundred sixty-
five (365) days a year, who is able to assess requests for emergency domestic violence shelter
and arrange for immediate intake into shelter or hotel/motel. Where an individual is eligible for
emergency domestic violence shelter:
6) A staff person must be present to admit an eligible individual into the shelter.
i. Reasonable efforts must be made by the Contractor to have a staff person present to
admit an eligible individual into a safe home or hotel/motel.:
7) Referrals to other services or domestic violence agencies must be provided to an individual
seeking services when:
i. Contractor's shelter is full.
A client residing in shelter must be transferred to another domestic violence program for
client safety reasons.
iii The person seeking shelter is ineligible for Contractor's services.
iv. An inappropriatereferral was. made to Contractor's. domestic violence program.
V. The, person seeking shelter has..problems that require services of another program or
programs before they receive. domestic violence services.
vi. , A location with a private setting to- meet and- assist victims of domestic violence who
have a need for community advocacy or supportive services other than emergency
domestic violence shelter (i.e., non-residential services);
vii. Individual advocacy including legal advocacy;
viii. Support groups;
ix. Language and disability access;
X. Child care assistance during individual advocacy sessions and support groups for the
adult victim;
A. Supportive services and resources for children/youth residing in emergency domestic
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Special Terms and Conditions
violence shelter as defined in WAC 388-61 A-1035;
xii. Emergency transportation assistance or access to transportation;
xiii. Information and referral;
xiv. Community education activities as defined in the Special Terms and Conditions, Section
1; and
xv. Prevention efforts as defined in the Special Terms and Conditions, Section 1.
b. For clients residing in emergency domestic violence shelter, the Contractor:
1) Must provide clients with access to a trained staff person twenty-four (24) hours a day, three
hundred sixty-five (365) days a year.
2) Must give clients the opportunity to receive and participate in supportive services during their
stay in shelter.
3) Cannot require that clients participate in supportive services as a condition of residing in the
shelter.
c. The manner in which supportive services are provided by the Contractor must be in alignment with
the empowerment service model described in this Contract and must also:
1) Include a discussion of safety and options with each victim of domestic violence seeking
assistance.
2) Be respectful and respond to each client's life situation, and respect each person's right to self-
determination;
3) Be provided in a safe and supportive environment that offers the client the opportunity to
examine the events that led to the need for domestic violence services.
4) Be provided in a private setting for the comfort of the client and to protect confidentiality of
conversations.
3. Multi -County Service Area
Contractors in Chelan/Douglas, Benton/Franklin, Asotin/Garfield, Walla Walla/Columbia,
Stevens/Ferry/Lincoln, and Adams/Grant counties shall provide services in, and demonstrate outreach
to, victims of domestic violence in the county adjacent to the Contractor's primary physical location.
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Special Terms and Conditions
PROGRAM REQUIREMENTS
Community -Based Domestic Violence Program
Emergency Shelter and Suppo rtive Services
The . Contractor shall comply with all program and other requirements for providing services under this
Contract, as set forth below.
Acknowle dgement of Federal Funding
Amount obligated by this action: $ 267,720
Federal Award Date: 10/1/2017 — 9/30/2021
Federal Award Identification Number (FAIN): 2018-V2-GX-0046
Total Amount of the Federal Award to Washington State Department of Commerce, Office of Crime
Victims Advocacy: $74,702,737. 00
Awarding Official: Department of Justice, Office of Justice Programs, Office for Victims of Crime
CFDA Number: 16.575
This award is not for research and development.
The Contractor agrees that any publications (written, visual, or sound) but excluding press releases,
newsletters, and issue analyses, issued by the Contractor describing programs or projects funded in
whole or in part with federal funds under this Contract, shall contain the following statements:
"This project was supported by Grant No. 2018-V2-GX-0046 awarded by Office for Victims of Crime,
US Department of Justice. Points of view in this document are those of the author and do not
necessarily represent the official position or policies of the Office for Victims of Crime, US Department
of Justice. Grant funds are administered by the Office of Crime Victims Advocacy, Washington State
Department of COMMERCE."
In the event a correction is required to the Acknowledgement of Federal Funding, an administrative
change will be processed. A change to the Acknowledgement of Federal Funding wi I ii not affect your
budget orscopeof work and notice will be provided.
1. Requirements
The Contractor shall comply with all program and other requirements under this Contract as set forth
below:
a. Contractor shall provide all services in a way that enhances, and does not compromise the safety
of the victims of domestic violence being served.
b. Contractor shall maintain confidentiality of communication and records for any individual provided
direct services funded by the Contract.
c. Contractor is prohibited from charging clients for services provided under this Contract.
d. Contractor shall not use funds payable under this Contract to provide services for domestic
violence abusers and/or perpetrators.
e. Contractor shall not make any direct payment of contract funds to any individual provided services
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6017CF County Program Agreement (10-31-2017)
Special Terms and Conditions
under this contract.
f. Contractor shall not use an income eligibility standard for individuals seeking services under this
Contract. Services shall be provided to victims of domestic violence without regard to income.
g. Contractor shall not engage in activities that compromise the safety of victims or their children
including, but not limited to, mediation, couples counseling, family counseling or any other manner
of joint victim -offender counseling, mandatory counseling for victims, requiring that victims
participate in criminal proceedings, supporting policies or engaging in practices that impose
restrictive conditions (e.g., attend counseling, or seek an order of protection) on the victim in order
to receive services or when the victim requests that an order of protection be rescinded or
modified.
h. Contractor is required to use volunteer(s) in the VOCA-funded program unless the VOCA state
administering agency for this Contract grants a waiver. Contractor -must demonstrate in writing a
compelling reason for a waiver of this requirement.
Contractor shall provide information regarding the availability of the crime victims' compensation
program administered through the Department of Labor and Industries, and assist victims with
application forms and procedures, obtaining necessary documentation, and/or assisting the victim
in checking on claim status.
j. Contractor shall provide services to domestic violence victims whether they are the victim of a
federal, tribal, state, or local crime. There is no requirement that a victim have reported the
violence to law enforcement or any other federal, tribal, state, or local entity in order to receive
services from the Contractor..
2. Training and Qualifications
a. Domestic Violence Staff and Supervisors: Initial, continuing education, and supervisor training of
Contractor staff is critically important. In addition, quality supervision is an integral component for
the provision of excellent advocacy and in supporting staff. Advocates and advocate supervisors
must be able to demonstrate an understanding of the nature and scope of domestic violence as
defined, as well as the historical and societal attitudes in which domestic violence is rooted.
Training must be current and relevant to the provision of empowerment -based advocacy. The
Contractor should also strive to ensure that staff incorporate training on services to marginalized
and .,u nd.erserved popu latio, ns.., as part, of each .,advocate) -s. a n.n.u.alcontinuing ,education. The
Contractor shall ensure that all staff (paid and volunteers) and staff supervisors, meet the following
minimum training and experience requirements prior to staff providing supportive services.
(1) Staff and volunteers providing supportive services and supervisors of staff must obtain a
minimum of twenty (20) hours of initial basic training that covers at least the following topics and
skills:
(a) Theory and implementation of empowerment -based advocacy.
(b) The history of the domestic violence movement.
(c) Active listening skills.
(d) Legal, medical, social service, and systems advocacy.
(e) Anti -oppression and cultural competency theory and practice.
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Special Terms and Conditions
(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 marginalized and.. underserved
p opulations.
(j) Policies and procedures of the domestic. violence program.
'
(k) Initial training must be completed prior to providing supportive services to clients and/or their
dependent children.
(1) The recommended format for initial training is live and in-person group sessions. Structured
job -shadowing and self -study may be inclu*ded as part of the overall initial training. All
Contractor in-house training must be based on a training plan that covers one or more of the
required, initial training topics.
(2) Staff and volunteers providing supportive services and staff supervisors.. must also obtain an
annual minimum of twenty (20) hours . of continuing education training beginning in their second
year with the domestic violence program, and in every year thereafter.
(3) A minimum of ten (10) hours must be live training on topics specifically focused on serving
victims of domestic violence and their. children..
(4) The remaining ten (10) hours of training may be satisfied through self -study on topics
specifically focused on serving victims of domestic violence and their children.
(5) Within six (6) months of being hired as an advocate supervisor and for each year thereafter,
supervisors rvisors must obtain a minimum of five (5) hours of training on supervision. Supervision
training can be counted toward the twenty (20) hours of annual continuing education training
hours.
(6) Contrac tor staff -who do not provide supportive services to clients or their dependent children are
not required to obtain initial and continuing education training as described in this Contract.
Examples of staff that are included in this category are individuals providin 9 child care
assistance as defined in this Contract, and bookkeeping and accounting staff. It is
recommended, however, that staff who come into contact with clients of the domestic violence
program and their dependent children, but who do not provide supportive services, receive
training on the following:
(a). Confidentiality.
(b) Relevant policies and procedures of the domestic violence program.
(c) Mandated reporting of child abuse/neglect as required- by RCW 26.44, Abuse of Children.
(7) Supervisors of staff providing S . upportive services to domestic violence clients shall meet the
following minimum experience and training requirements prior to being hired as a supervisor:
(a) Two (2) years of experience providing advocacy to victims of domestic violence within a
domestic violence program. Domestic violence program means an agency that provides
advocacy for domestic violence clients in a safe, supportive environment as defined in RCW
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Special Terms and Conditions
70.123.
(b) Fifty (50) hours of training on domestic violence issues and advocacy within three (3) years
prior to being hired as a supervisor.
(8) Initial and continuing education training received by staff and supervisors of staff providing direct
services to victims of domestic violence must be entered in the Staff Training section of InfoNet.
See Exhibit C, InfoNet Data Requirements, for the required data elements.
b. Sexual Assault Staff and Supervisors:
c. If the Contract Statement of Work (Exhibit A) specifies services to victims of sexual assault, then
the Contractor shall comply with the staff and supervisor training and experience requirements
outlined in the Office of Crime Victims Advocacy (OCVA) Sexual Assault Service and Training
Standards, which are listed in Appendix A of the associated VOCA funding initiative application
and incorporated by reference in this Contract. The DSHS Contact Name listed on page 1 of this
Contract can provide a copy of these standards upon request.
d. Initial and continuing education training received by staff and supervisors of staff providing direct
services to victims of sexual assault must be entered in the Staff Training section of InfoNet. See
Exhibit C, InfoNet Data Requirements, for the required data elements.
e. Victims of Crime Staff and Supervisors:
(1) If the Contract Statement of Work (Exhibit A) specifies services to victims of crime (not
including domestic violence and sexual assault), then the Contractor shall comply with the staff
and supervisor training and experience requirements outlined in the Office of Crime Victims
Advocacy (OCVA) Victims of Crime Service and Training Standards, which are listed in
Appendix A of the associated VOCA funding initiative application and incorporated by reference
in this Contract. The DSHS Contact Name listed on page 1 of this Contract can provide a copy
of these standards upon request.
(2) Initial and continuing education training received by staff and supervisors of staff providing direct
services to victims of crime (excluding domestic violence and sexual assault) must be entered in
the Staff Training section of InfoNet. See Exhibit C, InfoNet Data Requirements, for the
required data elements.
3. Service Outcome Data Collection
a. Outcome Evaluation Questions. As a condition of receiving federal Family Violence Prevention
and Services Act (FVPSA) funding as part of this Contract, Contractor shall collect and report client
responses to the outcome evaluation questions in Table below.
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6017CF County Program Agreement (10-31-2017) Page 19
<Z'narinl TarmQ nnri (.nnrfltinn.q
Table
ServiceOutcome
Evaluation Question
Response Options
Emergency Domestic
Because of my experience in the shelter, I feel
I know more ways to plan for my safety D Yes ❑ No
Violence Shelter
(please check yes or no):
I know more about com.rn unity.: resources El Yes F-1 No
Supportive Services
Because of the supportive services I have
I know more ways to plan for my safety R Yes R No
(non-residential only)
received from this program so far, Ifeel (please
check yes or no):
I know more about community resources El Yes E] No
Support Groups (non-
Because of attending this support group, I feel
I know more ways to plan for my safety F-1 Yes 0 No
residential only)
(please check yes or no):
I know more about community I re . sources F1 Yes 171 No
uutcome tvalluation wule.5'Lionts
b. Contractor shall provide service recipients the opportunity to respond confidentially to the outcome
evaluation questions.
G. Contractor shall attempt to achieve a minimum outcome evaluation survey return rate of 34% from
adult residents of emergency domestic violence shelter during the period of this Contract.
d. Contractor shall solicit survey responses from clients in each of the three (3) program service
areas as follows:
(1) All adult victims of domestic violence who receive emergency domestic violence shelter from the
Contractor.
(2) All, or a sample of, adult victims of domestic violence who receive in-person non-residential
supportive services from the Contractor, if the Contractor expends IDSHS contract funding to
provide these services.
(3) All, or a sample of, adult victims of domestic violence who participate in non-residential support
groups provided by the Contractor, if the Contractor expends IDSHS contract funding to provide
these services.
e. If the Contractor currently receives the same or substantially similar information from service
recipients for reporting to another funding entity, the Contractor may request that IDSHS accept
that data for meeting the requirement of this Contract. The Contractor shall submit the same or
substantially similar questions it currently uses to the IDSHS Program Manager for review and
approval.
4. Evaluation of Contractor
IDSHS may evaluate the Contractor's performance during the term of the Contract. Areas of review
may include, but are not limited to, the following:
a. Effectiveness of services;
b. Timeliness of services provided;
c. Adherence to contract terms; and
d. Compliance with federal and state statutes.
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Special Terms and Conditions
5. Criminal History Background Check
The Contractor shall initiate a criminal history background check pursuant to RCW 43.43.8327
43.43.834, and 43.20A.710 or successor statutes for all current employees, volunteers, subcontractors
and other persons who may have unsupervised access to children, developmentally disabled persons,
or vulnerable adults. Such persons shall not have unsupervised access to children, developmentally
disabled persons', or vulnerable adults until a satisfactory background check is completed and
documentation qualifying the individual for unsupervised access is returned to the Contractor.
6. Mandated Reporting of Child Abuse or Neglect
The Contractor shall ensure that all current staff who are mandated reporters or who have access to
children read and/or view the materials in the Department of Children, Youth, and Families (DCYF)
Mandated Reporter Toolkit within thirty (30) days of the effective date of a first time-DSHS Contract and
annually thereafter; and that all newly hired staff who are mandated reporters or who have access to
children read and/or view the materials in the Mandated Reporter Toolkit within two (2}weeks of initial
employment. After reading and/or reviewing the materials, staff shall sign and date a statement
acknowledging their duty to report child abuse or neglect and affirming that they understand when and
how to report suspected child abuse or neglect. The Contractor shall retain the signed statement in the
staff personnel file.
The Contractor shall either obtain a copy of the Mandated Reporter Toolkit from DSHS, or access the
Mandated Reporter Toolkit online at: https://www.dcyf.wa.gov/safety/mandated-reporter.
7. Child Passenger Restraint Requirements
The Contractor shall at all times comply, and shall ensure that all employees, volunteers and
subcontractors at all times comply, with the child passenger restraint requirements of RCW 46.61.687
when transporting children or providing transportation to children served under this Contract. RCW
46.61.687 may be accessed at httiD://ar)ps.leq.wa.gov/RCW/default.aspx?,,-ite=46.61.687
Current child passenger restraint requirements may also be accessed on the Washington State Safety
Restraint Coalition's website at http://www.800bucklug.org/.
8. Interpreter Services
a. The Contractor shall provide Limited English Proficient (LEP) clients with certified or otherwise
qualified interpreters and translated documents. The Contractor may use anon -certified
interpreter when a certified interpreter is not available,* provided that the interpreter is qualified to
act as an interpreter for the specific service recipient, and the interpreter does not represent a real
or perceived conflict of interest. Family-, members of the service recipient s*hall not be used as
interpreters.
b. The Contractor shall provide Deaf, Deaf -Blind, or hard of hearing clients with the services of
certified or otherwise qualified interpreters. The Contractor may use a non -certified interpreter
when a certified interpreter is not available, provided that the interpreter is qualified to act as an
interpreter for the specific service recipient, and the interpreter does not represent a real or
perceived conflict of interest. Family members of the service recipient shall not be used as
interpreters.
c. Interpreter and translation services shall be provided at no cost to the client. All interpreter and
translation costs shall be the financial responsibility of the Contractor.
9. Confidentiality
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Special Terms and Conditions
In addition to the General Terms and Conditions of this Contract regarding Confidentiality, the.
Contractor shall ensure that it maintains confidentiality of all client -counselor communications and
information ® verbal, written and electronic -..to inclu,de personally identifying information . of the client,
unless the Contractor has. express written ,authority ,to release information, or otherwise provided by
law. Contractor shall ensure that it complies with the privilege and confidentiality provis.ions. of RCW
5.60.060(8) (a -b), RCW 70.123 and WAC 388-61 A.
Contractor shall comply with section 94.11.5 of the federal VOLA Victim Assistance Program rules
regarding non -disclosure of confidential or private information, and relevant provisions of the U.S.
Department of Justice, Office of Justice Programs Financial Guide.
10. Reporting and Record -Keeping
a. The Contractor must collect and maintain data that measure the performance and effectiveness of
work done under this grant.
b. The Contractor shall enter non -personally identifiable client. demographic, service and compliance
data required by state and federal fund sources in. the InfoNet data`collection system. Mandatory
demographic and service data elements are listed in Exhibit C, and shall be entered in
o be provided by DSHS. The'.Contractor shall
accordance with the data reporting guidance t
maintain documentation and records that support the data reported in InfoNet.
InfoNet at least
d service data shall be entered into, and in,
C. client demographic an
quarterly'.' Contractori . shall generate InfoNet reports at least quarterly on all clients receiving
services for the previous quarter(s), review the entered data for.accuracy, and correct any errors.
Report data shall be due in InfoNet within 15 days of the end of the preceding quarter.
d. For clients served during the period of this Contract, all demographic., service and compliance data
shall be entered into InfoNet no later thirty (30) days after the Contract end date listed on page 1 of
this Contract.
e. The Contractor shall establish and maintain written procedures for the security of InfoNet use at its
site(s). Procedures shall include:
(1) Only authorized staff are provided access to the InfoNet data and files.
(2). Staff are informed of the need for security and confidentiality of data and files maintained in or
available through the InfoNet system.
(3) That the Contractor shall notify the DSHS, Program Manager for this Contract when an
employee is no longer authorized to access the InfoNet system.
f. Contractor shall also submit semi-annual narrative reports on Contract activities. The report form
.will be provided to the Contractor by the DSHS Program Manager.
9 -
This information on the activities supported by the Contract funding will assist in assessing the
effects that the VOCA Victim Assistance funds have had on services to crime victims within the
jurisdiction.
11. Cost Allocation
The Contractor shall maintain intain a current written cost allocation plan. This plan must clearly and
completely describe the methodology used to determine what portion of shared costs will be allocated
to each funding source being billed for such costs.
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Special Terms and Conditions
12. Client Records
a. Contractor shall maintain a written file for clients who are served pursuant to this Contract. At a
minimum, the files shall:
(1) Include an intake that clearly demonstrates each client's eligibility for domestic violence
services.
(2) Be brief in documenting the supportive services provided to the client if written documentation of
services is also maintained in the client file. Service documentation must be entered into
I nfo Net.
(3) Document only sufficient information to identify the service provided, and not include any
references to client feelings, emotional or psychological assessments, diagnoses, or similar
subjective observations or judgments. Documentation shall not include any direct quotes from
the client.
(4) Include copies of all required releases and client notices.
b. Where supportive services are provided to child/youth of clients, the Contractor shall.
(1) Document in InfoNet the supportive services provided for each child/youth. Written
documentation shall not be included in the file of the parent/guardian.
(2) Be brief in documenting the supportive services provided to the child/youth if written
documentation of services is also maintained in the file of the child/youth. Service
documentation must be entered into InfoNet.
(3) Document only sufficient information to identify the service provided, and not include any
references to the child/youth's feelings, emotional or psychological assessments, diagnoses, or
similar subjective observations or judgments. Documentation shall not include any direct quotes
from the child/youth.
13. Administrative Records
In addition to any other provisions of this Contract governing maintenance of records, the Contractor
shall retain the following administrative records:
a. . Docu me ntatio n that funds received under th is Contract w- e ---r e- used -only * f 6- r- - th- e ----purposes and
services allowed by the /Contract. Funds received under this Contract shall be clearly
distinguished and accounted for distinctly from other contracts, grants, or other funding sources.
b. Fiscal records that substantiate all costs charged to DSHS under this Contract. Contractor shall
maintain appropriate accounting and auditing procedures to ensure proper documentation, fiscal
control, proper management, and efficient disbursement of Contract funds, and in accordance with
applicable provisions of OMB Uniform Guidance.
C. Documentation of all audits, license reviews, contract monitoring reports, and corrective action
reports and action taken.
d. Copies of all subcontracts or other agreements for subcontracted services and the provider's
qualifications for the service to be performed.
e. Copy of the Certificate of Insurance for each subcontractor, if required.
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f. Contractor shall also retain the following protected group data:
(1) A list of current staff by position (not names) -that includes. date.of birth, gender, and identified
p group status, including race, Vietnam Era Veteran, Disabled Veteran, and person of
p
disability.
(2)Data from clients that includes age, gender, and race/ethnicity.
(3) When collecting protected group data the Contractor shall inform staff and clients that:
(a) g Furnishing the information is entirely voluntary; and
(b) The refusal to furnish the data shall not have adverse effects or denial of services.
14. Personnel Records
Contractor shall maintain a personnel record(s) for each staff, paid and volunteer, that includes at least
Contra
the following
a. Application for employment.or resume.
b. Criminal history background check verification.
c. Current job description.
d. Signed and dated statement acknow1edging the duty to report...child abuse/neglect.
15. operating Policies and Procedures
rovisions of this Contract overning maintenance of records, the Contractor
In addition to an other g .
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shall have written policies and procedures covering the following issues:
a. Confidentiality and protection of client records and communication.
b. Nondiscrimination relating to staff, clients, and provision of services.
c. Thep rovision of bilingual and interpreter services to clients.
d. Responding to subpoenas and warrants.
e. Reporting of child abuse as legally mandated.
f. Client access to their files.
g. Grievance procedure for clients.
h. Prohlblteng harassment of s p
' ' service recipients based on rase, sexual orientation, gender identity (or
expression), religion, and national origin, and procedures for addressing violations.
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Emer enc procedures for fire, disaster, first aid, medical and police intervention.
Emergency
j. Security of I nfoNet system by users and the agency.
k. Records retention.
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6017CF County Program Agreement (10-31-2017)
Special Terms and Conditions
I. Accounting procedures.
m. Personnel policies and procedures.
n. Administrative policies and procedures.
16. Monitoring
a. DSHS may schedule on-site monitoring visits with the Contractor to evaluate compliance with the
terms of this Contract and the performance of the program. The Contractor shall provide at no
further cost to DSHS, reasonable access to all program -related records and materials, staff and/or
subcontractor time, and any other documents or information necessary in order to evaluate contract
and program compliance.
b. DSHS may also conduct an investigation if it receives information that the Contractor is out of
compliance with its Contract in accordance with WAC 388-61 A.
iii'1111 IryiWMI
17. Applicability of Part 200 Uniform Requirements
The Uniform Administrative Requirements, Cost Principles, and Audit Requirements in 2 C.F.R. Part
200, as adopted and supplemented by DOJ in 2 C.F.R. Part 2800 (together, the "Part 200 Uniform
Requirements") apply to this FY2018 award from OJP
The Part 200 Uniform Requirements were first adopted by DOJ on December 26, 2014. If this FY 2018
award supplements funds previously awarded by OJP under the same award number (e.g., funds
awarded during or before December 2014), the Part 200 Uniform Requirements apply with respect to
all funds under that award number (regardless of the award date, and regardless of whether derived
from the initial award or a supplemental award) that are obligated on or after the acceptance date of
this FY 2018 award.
For more information and resources on the Part 200 Uniform Requirements as they relate to OJP
awards and subawards ("subgrants"), see the OJP website at
f,
https-.Hoip.qov/Tundinq/Part200U niform Reg uirements. htm.
Record retention and access: Records pertinent to the award that the recipient (and any subrecipient
(-subgrantee') at any tier) must retain -- typically fora period of 3 -years from the date of submission of
the final expenditure report (SF 425), unless a different retention period applies -- and to which the
recipient (and any subrecipient ("subgrantee") at any tier) must provide access, include performance
measurement information, in addition to the financial records, supporting documents, statistical records,
and other pertinent records indicated at 2 C.F.R. 200.333.
In the event that an award -related question arises from documents or other materials prepared or
distributed by OJP that may appear to conflict with, or differ in some way from, the provisions of the
Part 200 Uniform Requirements, the recipient is to contact OJP promptly for clarification.
18. Compliance with DOJ Grants Financial Guide
The Contractor agrees to comply with the financial and administrative requirements set forth in the
current edition of the Office of Justice Programs Financial Guide, which can be found at
https://oig.gov/financialquide/doi/pdfs/DOJ FinancialGuide pdf. References to the DOJ Grants
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Special Terms and Conditions
Financial Guide are to the DOJ Grants Financial Guide as posted on the OJP website .(currently, the
"DOJ Grants Financial Guide" available at https:lloip inancial-q-giLde/DOJ/index.htm), including any
updated version that may be posted during the period of performance. The Contractor agrees to comply
with the DOJ Grants Financial Guide. Compliance with Victims of Crime Act (VOCA) Victim
Assistance Program Final Rule
inperformance of the services, requirements, and activities set forth herein, the Contractor shall comply
with all applicable federal requirements of the Victims of Crime Acts Rule as posted at
https:l/www.federalre inter. q ov/d ocu ments/201 6107/0,8/2 016-1 6085/victi ms-of-cri m e -act-
victim -
assistance -program.
19. Computer Networks
Contractor understands and agrees that it cannot use any federal funds to maintain or establish a
computer network unless such network blocks the viewing, downloading, and exchanging of
pornography.
20. Conferences, Meetings, and Trainings.
The Contractor, and any Subcontractors, must comply with all applicable laws, regulations, policies,
and official DOJ guidance (including specific cost ost limits,prior approval and reporting requirements,
where applicable) governing the use of federal funds for expenses related to conferences (as that term
is def I in e d bY DOJ), including the provision of food and/or beverages at.su.ch, conferences, and costs of
attendance at such conferences.
Information on the pertinent DOJ definition of conferences and the rules applicable to this award
appears in the DOJ Grants Financial Guide (currently, as section 3.10 of "Posta'ward Requirements" in
the"DOJ Grants Financial Guide").
21. EQUAL EMPLOYMENT ENT OPPORTUNITY PROGRAM (EEOP)
The Contractor certifies that you have verified with the appropriate person in your agency that, as a
recipient of VOCA Contract funds, your agency will complete an EEOP Certification to claim either a
m M
mplete emption or limited exemption from the sub iss;on requirement.
A complete exemption means that your agency is not required to prepare an EEOP because it meets
one or more of the following:
a. Recipient has less than 50 employees
b. Recipient is an education institution
c. Recipient is an Indian Tribe
d. Recipient is a medical institution
e. Recipient is a non-profit organization
f. Recipient's award is less than $25,000
A limited exemption of the submission requirement means that your agency has formulated an EEOP
that has been signed and is available for review because the agency has 50 ormoreemployees and is
receiving a single award or subaward of $25,000 or more, but less than $500,000.
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Special Terms and Conditions
22. Equal Opportunity Treatment for Faith Based Organizations
The Contractor agrees to comply with the applicable requirements of 28 CFR Part 38, the Department
of Justice regulation.
23. Examination of Records
The Contractor authorizes Office for Victims of Crime (OVC) and/or the Office of the Chief Financial
Officer (OCFO), and its representatives, access to and the right to examine all records, books, paper or
documents related to the VOCA Contract. The State will further ensure that all VOCA Subcontractors
will authorize representatives of OVC and OCFO access to and the right to examine all records, books,
paper or documents related to the VOCA Contract.
24. Federal tion -Discrimination Requirements
Contractor will comply with any applicable federal non-discrimination requirements, which may include:
a. the Omnibus Crime Control Act and Safe Streets Act of 1968 (42 U.S.C. § 3789d);
b. the Victims of Crime Act (VOCA) of 1984 (34 U.S.C. § 20101);
c. the Juvenile Justice and Delinquency Prevention Act of 2002 (42 U.S.C. § 5672(b));
d. the Civil Rights Act of 1964 (42 U.S.C. § 2000(d));
e. the Rehabilitation Act of 1973 (29 U.S.C. § 794);
f. the Americans with Disabilities Act of 1990 (42 U.S.C. §§ 12131-34);
g. the Education Amendments of 1972 (20 U.S.C. §§ 16817168311685-86);
h. the Age Discrimination Act of 1975 (42 U.S.C. §§ 6101-07);
i. 28 C.F.R. Part 42 (U.S. Department of Justice Regulations — Nondiscrimination, Equal Employment
Opportunity, Policies and Procedures);
j. 28 C.F.R. Part 54 (U.S. Department of Justice Regulations — Nondiscrimination on the Basis of Sex
In Education Programs or Activities Receiving Federal Financial Assistance);
k. Executive Order 13279 (equal protection of the law for -faith based and community organizations);
and 28 C.F.R. Part 37 ((U.S. Department of Justice Regulations —Equal Treatment for Faith Based
Organizations).
Applicant also ensures compliance with Federal law prohibiting Contract recipients from retaliating
against individuals taking action or participating in action to secure rights protected by federal law.
Information about civil rights obligations of Contractors can be found at http-//www.oip.usdoi.qov/ocr/.
25. Fraud, Waste, Abuse, or Misconduct
The Contractor, and any Subcontractor at any tier, must promptly refer to the DOJ OIG any credible
evidence that a principal, employee, agent, Contractor, Subcontractor, Subgrantee, or other person has
either 1) submitted a false claim for grant funds under the False Claims Act; or 2) committed a criminal
or civil violation of laws pertaining to fraud, conflict of interest, bribery, gratuity, or similar misconduct
involving grant funds. Potential fraud, waste, abuse, or misconduct should be reported to the OIG by:
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6017CF County Program Agreement (10-31-2017) Page 27
Special Terms and Conditions
Mail:
Office of the Inspector General Email: oig.hotline�usdoj.gov
U.S. Department of Justice Hotline: (800) 869-4499.
Investigations Division Hotline fax: ' (202) 616-9881
950 Pennsylvania Avenue, NW
Room 4706
Washington, DC 20530
26. General appropriations -law restrictions on the use of federal funds
n ractor and an Subcontractor at an tier, must comply with all applicable restrictions on the
TheContractor,y Y
use of federal funds set out in federal appropriations statutes. Pertinent restrictions, including from
various "general provisions" in the Consolidated Appropriations Act, 2017; are set out at
https://oip govlfunding/Explore/FY17AppropriationsRestrictions.htm and are incorporated by reference here.
Should a question arise as to whether a particular use of federal funds by a contractor (or a
subcontractor) would or might fall within the scope of an appropriations -law restriction, the recipient is
to contact DSHS for guidance, and may not proceed without the express prior written approval of
DSHS.
27. Noncompetitive procurement contracts over $150,000
No VOCA Contract funds will be used to use a noncompetitive approach in any procurement contract
that would exceed the Simplified Acquisition Threshold (currently, $150,000). This condition applies to
agreements that, for the purposes of federal grants administration, OJP considers a procurement
"contract" (and therefore does not consider a subaward).
26. Non -supplanting certification
No VOCA Contract funds will be used to supplant existing state, local, or other non-federal funding
already in place to support current services. VOLA Contract funds will be used to increase the total
amount of funds used for crime victim assistance. Violation of the non -supplanting requirement can
result in a range of penalties, including suspension of future funds under this Contract, recoupment of
monies provided under this Contract, and civil and/or criminal penalties.
29. OJP Training Guiding principles
An training or training materials that the Contractor, or any Subcontractor at any tier, develops or
Y g
delivers with OJP award funds must adhere to the OJP Training Guiding Principles for Contractors and
Subcontractors, available at https://oip qov/funding/oipt� rainingguidingprinclp4es.htm.
30. Reducing' text messaging while driving
Pursuant to executive order 13513, "Federal Leadership on Deducing Text Messaging While Driving,"
74 Fed.Reg. 51225 (October 1, 2009), the Department of Justice encourages recipients and sub -
recipients to adopt and enforce policies banning employees from text messaging while driving any
.vehicle during the course of performing work funded by this Contract, and to establish workplace safety
policies and conduct education, awareness, and other outreach to decrease crashes caused by
distracted drivers.
31. Requirement Pertaining to Prohibited Conduct Related to Trafficking in Persons (Including
Reporting Requirements and OJP Authority to Terminate Contract)
The Contractor and any Subcontractor at any tier, must comply with all applicable requirements
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6017CF County Program Agreement (10-31-2017) Page 28
Special Terms and Conditions
(including requirements to report allegations) pertaining to prohibited conduct related to the trafficking of
persons, whether on the part of recipients, subrecipients, Subcontractors, or individuals defined (for
purposes of this condition) as "employees" of the Contractor or of any Subcontractor.
The details of the Contractor's obligations related to prohibited conduct related to trafficking in persons
are posted on the OJP web site at httr)-.//gj2.gov/funding/Explore/`Proh.ibitedConduct-TraffickingtM
(Contract condition: prohibited conduct by Contractors and Subcontractors related to trafficking in
persons (including reporting requirements and OJP authority to terminate award)), and are incorporated
by reference here.
32. Restrictions and Certifications Regarding Non -Disclosure Agreements and Related Matters
No Contractor or Subcontractor under this Contract, or entity that receives a procurement contract or
subcontract with any funds under this Contract, may require any employee or contractor to sign an
internal confidentiality agreement or statement that prohibits or otherwise restricts, or purports to
prohibit or restrict, the reporting (in accordance with law) of waste, fraud, or abuse to an investigative or
law enforcement representative of a federal department or agency authorized to receive such
information.
The forgoing is not intended, and shall not be understood by the agency making this Contract, to
contravene requirements applicable to Standard Form 312 (which relates to classified information),
Form 4414 (which relates to sensitive comportment information), or any other form issued by a federal
department or agency governing the nondisclosure of classified information.
In accepting this award, the recipient:
a. represents that it neither requires nor has required internal confidentiality agreements or statements
from employees or contractors that currently prohibit or otherwise currently restrict (or purport to
prohibit or restrict), employees or contractors from reporting waste, fraud, or abuse as described
above; and
b. certifies that, if it learns or is notified that it is or has been requiring its employees or contractors to
execute agreements or statements that prohibit or otherwise restrict (or purport to prohibit or
restrict), reporting of waste, fraud, or abuse as described above, it will immediately stop any further
obligations of award funds, will provide prompt written notification to the federal agency making this
award, and will resume (or permit resumption of) such obligations only if expressly authorized to do
so by that agency.
If the Contractor does or is authorized under this Contract to make Subcontractor, procurement
contracts, or both:
It represents that:
c. it has determined that no other entity that the Contractor's application proposes may or will receive
Contract funds (whether through a Subcontract, procurement contract, or subcontract under a
procurement contract) either requires or has required internal confidentiality agreements or
statements from employees or contractors that currently prohibit or otherwise currently restrict (or
purport to prohibit or restrict) employees or contractors from reporting waste, fraud, or abuse as
described above; and
d. it has made appropriate inquiry, or otherwise has an adequate factual basis, to support this
representation; and
e. it certifies that, if it learns or is notified that any Subcontractor, contractor, or subcontractor entity
DSHS Central Contract Services
6017CF County Program Agreement (10-31-2017) Page 29
Special Terms and Conditions
that receives funds under this Contract -is or has been requiring its employees or contractors to
execute. aq reern ents or. statements that: prohibit or otherwise restrict (or purport to prohibit or
porting restrict)reof waste, fraud,or abuseasdescribed above it will immediately stop any further
,
obligation . s I of ward funds to or by that entity, will provide prompt written notification to the federal
agency making this award, and will resume (or permit resumption of) such obligation.. only if
expressly authorized to do so by that agency.
33. Restrictions on Lobbying
Ing eneral, as a matter of federal law, federal funds awarded by OJP may not be used by the
Contractor, or any Subcontractor at any tier, ,either directly or. indirectly, to support .or oppose the
enactment, repeal, modification, or adoption of any law, regulation, or policy at any level of government.
See 18 U.S.C.. 1913. (There may be exceptions, if.an applicable federal statute specifically authorizes
certain activities that otherwise would be barred by law.)
Another federal law generally prohibits federal funds awarded by OJP from being used by the
to pay any person to influence (or attempt to influence) a
Contractor, or any Subcontractor at any tier,
fede I ral agency, a Member of Congress, or Congress (or an official or employee of any of them) with
respect to the awarding of a federal grant or cooperative agreement, subgrant, contract, subcontract, or
loan, or with respect to actions such as renewing extending, or modifying. any, such .award. See 31
U.S.C.. 1352. . Certain exceptions to this law apply, including an exception. that. applies to Indian tribes
and tribal organizations. ,
Should any question arise as to whether a particular use of federal funds by a Contractor (or
Subcontractor) would or might fall within the scope of these prohibitions, the Contractor is to contact
DSHS for guidance, and may not proceed without the express prior written approval of DSHS.
34. Services to Limited English Proficient (LEP) Persons
To ensure compliance with Title VI and the Safe Streets Act, the Contractor is required to take
reasonable steps to ensure that LEP persons have meaningful access to their programs. Meaningful
access may entail providing language assistance services, including interpretation and, translation
f
services where necessary. Contractors are encouraged to consider the need for language services or
_
L 'E: P pe . r . sons, . s erved or encoUntered. botLh in developing their programs and:budgets and In. conducting
theirprograms and activities.. Reasonable costs associated with providing meaningful access for LEP
individuals. are considered allowable program costs.
35. Breach of Personally Identifiable Information (P11)
The Grantee must st have writtenprocedures in place to respond in the event of an actual or imminent
"breach" (OMB M-17-12) if it (or a subcontract/subgrantee)-- 1) creates, collects, uses, processes,
stores, maintains, disseminates, discloses, or disposes of "personally identifiable information (PII) (2
CFR 200.79) within the scope of an OJP grant -funded program or activity, or 2) uses o . r operates a
"Federal information system" (OMB Circular A -130).. The recipient's breach procedures must include a
-,.
requirement to report actual or imminent breach of PH to theirCommerce Grant Manager no later than
24 hours after an occurrence of an actual breach, or the detection of an imminent breach.
36. Fail.ure to Address.Audi.t Issues
The Contractor understands and agrees that COMMERCE may withhold grant funds, or may impose
other related requirements, if (as determined by the DOJ awarding agency) the Contractor does not
satisfactorily and promptly addre . ss outstanding issues from audits required by thePart 200 Uniform
Requirements (or by the terms of this award), or other outstanding issues that arise in connection with
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Special Terms and Conditions
audits, investigations, or reviews of DOJ awards.
37. Prohibitions on Reprisal; Notice to Employees
Contractor (and any subgrantee/subcontractor) must comply with, and is subject to, all applicable
provisions of 41 U.S.C. 4712, including all applicable provisions that prohibit, under specified
circumstances, discrimination against an employee as reprisal for the employee's disclosure of
information related to gross mismanagement of a federal grant, a gross waste of federal funds, an
abuse of authority relating to a federal grant, a substantial and specific danger to public health or
safety, or a violation of law, rule, or regulation related to a federal grant.
The recipient also must inform its employees, in writing (and in the predominant native language of the
workforce), of employee rights and remedies under 41 U.S.C. 4712.
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Special Terms and Conditions
EXHIBIT C
INFONET DATA REQUIREMENTS
Community -Based Domestic Violence Program
Emergency Shelter and S"upportive.services,
Contractor shall use the InfoNet Data system to document all individuals served,. services provided, and other
data as specified by this Contract and DSHS. The following are the mandatory data fields that must be
entered by the Contractor into InfoNet. Contractor shall refer to the InfoNet User Manual, the system
administrator, or the DSHS Program Manager with any questions.
1. Client Information
a. Clients and Cases -- Demographics
InfoNet requires that each new individual seeking services receive a client ID number. New client
means someone that has never received services before from the program. If an individual that
previously received services from the program returns at a later time to receive domestic violence
services, the program does not issue a new client ID number. Returning clients shall be identified
under their original client ID number. If Contractor provides services for another crime type such as
sexual assault or general crimes, the same client ID number is used, with a new case opened in
InfoNet to document the sexual assault or general crimes services.
Contractor shall generate an intake in InfoNet for all new clients that are provided services under
this Contract. The following data elements are mandatory for new client intakes:
(1) Client ID Number
(2) Year of Birth
(3) First Contact Date
(4) Race
(5) Ethnicity
(6) Gender
(7) Client Type: Domestic Violence
(8) Disability
(9) Homeless
b. Children and Youth
If the Contractor provides services to dependents of the client, Contractor shall create a record (not
an intake) for each child and enter demographic and service information for each child. The
following data elements are mandatory for this section:
(1) Year of birth
(2) Gender
(3) Race
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Special Terms and Conditions
(4) Ethnicity
(5) Service(s) provided to the child(ren)
(6) Staff/volunteer who provided the service(s)
(7) Date service(s) provided
(8) Hours of service
(9) Shelter in/out date for the child(ren)
2. Direct Client Services
Contractor shall enter all supportive services provided to individuals served by this Contract. The
following data elements are mandatory:
1) Type of service(s) provided
2) Staff/volunteer who provided the service(s)
3) Date service(s) provided
4) Hours of service
5) Shelter beg in/end date for the adult victim
3. Domestic Violence Hotline Calls/Information and Referral Services
Contractor shall enter all contacts that are hotline/crisis telephone calls and requests for information
and referral services, whether by telephone, in-person or some other method. Telephone calls from
clients (new, returning) shall not be entered into this section. Rather, telephone contacts/services
provided to clients shall be documented as Direct Client Services that correlate with their client I D
number. The following data elements are mandatgAr for this section:
1) Date of the call or request
2) Type of intervention or service requested
3) "Unmet Request for Emergency DV Shelter". Unmet request for shelter means that a victim of
domestic violence Is seeking Emergency shelter from' your program- but yoU-a r*- e ---'-'u*-- h 'able to
provide emergency shelter because the shelter is at capacity. Do not select the option
"Emergency DV shelter at capacity" if the individual was not provided shelter because their
needs were inappropriate, and therefore ineligible, for the services of your domestic violence
program, e.g. non-domestic violence related homelessness. Do not select option if the
caller is not seeking emergency shelter, or if the caller receives emergency shelter from your
program in any capacity (including shelter in a hotel). The list box includes the following
options:
1 ) Select An Item (default value)
2) Emergency DV shelter at capacity
3) Not eligible for emergency DV shelter
4) Other reason unable to shelter
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Special Terms and.Conditi.o.ns
4. Community Education
Community Education is defined as all presentations of information or tra.inings about domestic violence
and/or services related to victims of domestic violence. Presentations and trainings that are specifically
targeted for audiences of children or youth should be identified as "Youth all other presentations and
training s, including those for mixed age audiences, should be identified as "Adult/Mixed.".. The
following data elements are mandatory and shall be entered in the .1 DSHS Community Education tab:
1) Date of presentation or training (Non -STOP funded events/activities)
2) Title of presentation or training (text field)
3) Type of Activity (List Box)
The list box includes the following options:
1) Trai — Teaching skills to other professionals, institutions, or organizations on
domestic violence.
2) Presentation — Providing general and/or specific information related to domestic
violence and/or services related to victims of domestic violence.
3) Outreach — Targeted, proactive movement into a specific community nity or
geographic area for the purpose of building trust and rapport, so that access to domestic
violence services and information can be increased.
4) Community Event — Events focused on raising awareness and providing
information about, domestic violence, your program and services where the number of
recipients of the information cannot be determined., Examples include rallies, fairs,
vigils, and other similar events.
5) Media (Newspaper, Television or R Raising awareness about domestic
violence and/or services related to victims of domestic violence by means of
appearances on radio,/TV, newspaper articles, producing PSAs and similar media events
where the number of recipients of the information cannot be determined.
4) Audience (List Box)
The list box includes the following options:
1) Adult/Mixed
2) Youth
5) Number of participants rticipa'nts for Training, Presentation, and. Outreach Activities
5. Prevention Activities
Domestic Violence Prevention means efforts designed to ultimately eradicate domestic violence
through the promotion of healthy, respectful, and nonviolent relationships. Prevention activities
promote change at both the individual and community levels, tailor messages to diverse populations.
Prevention activities work to decrease risk factors for perpetration of abuse as well as victimization
while at the same time promoting positive factors that protect individuals from experiencing or
perpetrating abuse.
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Special Terms and Conditions
The Contractor shall record and report the following information about their Prevention Activities
completed during the period of performance in the DSHS DV Prevention tab:
1) Date of activity (text field)
2) Name of the prevention series or training (text field)
3) Age level of participants (list box)
4) Activity location (list box and text field)
5) Number and frequency of sessions (text field)
6) Number of participants (text field)
6. Staff Training
Initial, continuing education, and supervisor training received by staff and supervisors must be entered
in the Staff Training section of InfoNet. At a minimum, the following data fields must be completed:
1) Training name
2) Training date
3) Number of training hours
4) Individual or organization that sponsored /provided the training
5) Program type
6) Training category
7) Training method
7. End of Year Report
Contractor shall enter the following information in the DSHS Shelter End of Year Report tab. Data
shall be entered into InfoNet and be available for DSHS to download no later than sixty (60) days after
the Contract end date listed on page one of this Contract.
1) Service Outcome Data (See also, Exhibit B, Section 3)
2) Volunteer Information
1 ) Number of volunteers in the domestic violence program
2) Amount of volunteer time (in hours)
3) Responses to Narrative Questions
4) Prevention Efforts Questions
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6017CF County Program Agreement (10-31-2017) Page 35
Match
The Contractor shall provide $ 66,817 cash or in-kind match for Victims of Crime Act (VOCA) funds payable
under this Contract.
The Contractor shall provide $ 10,958 cash or in-kind match for Family Violence Prevention and Services Act
(FVPSA j funds payable under this Contract.
Klatch shall not be from federal funds. The Contractor may use state funds payable under this Contract as
match toward` federal Tunds payable under this'Contract only to the extent necessary to meet the match
required b thisantractn Any excess 'state `finds' shall not be used as match toward federal fund's without the
q Y
prior written permission of DSHS,
If state funds are insufficient to meet the federal matchrequirement, Contractor shall provide documentation
demonstrating additional match as directed by DSHS.
DSHS Central Contract Services
6017CF County Program Agreement (10-31-2017) Page 36
Special Terms and Conditions
Exhibit D
BUDGET
Community -Based Domestic Violence Program
Emergency Shelter and Supportive Services
Line Item
Prevention Total
Core Amount Amount
Salaries
2727964 227047
-_2957011
Benefits
110 837 107844
1217681
Subcontracted
Services
Goods and
847689
47657
897346
Services
Indirect
Subtotal
4687490
377548
506,038
Training Bank
57:000
Lan ua a Bank
57000
Contract Total
5161039
Match 77,775
Match
The Contractor shall provide $ 66,817 cash or in-kind match for Victims of Crime Act (VOCA) funds payable
under this Contract.
The Contractor shall provide $ 10,958 cash or in-kind match for Family Violence Prevention and Services Act
(FVPSA j funds payable under this Contract.
Klatch shall not be from federal funds. The Contractor may use state funds payable under this Contract as
match toward` federal Tunds payable under this'Contract only to the extent necessary to meet the match
required b thisantractn Any excess 'state `finds' shall not be used as match toward federal fund's without the
q Y
prior written permission of DSHS,
If state funds are insufficient to meet the federal matchrequirement, Contractor shall provide documentation
demonstrating additional match as directed by DSHS.
DSHS Central Contract Services
6017CF County Program Agreement (10-31-2017) Page 36