SAMPLE SERVICE CONTRACT

Public Health Nursing DCYF Contract Number:

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Resulting From Solicitation Number:

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Contractor Contract Number:

CONTRACTOR NAME

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CONTRACTOR doing business as (DBA) Click here to enter text.

CONTRACTOR ADDRESS

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WASHINGTON UNIFORM BUSINESS IDENTIFIER (UBI)

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DCYF INDEX NUMBER

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CONTRACTOR CONTACT

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CONTRACTOR TELEPHONE

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CONTRACTOR FAX

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CONTRACTOR E-MAIL ADDRESS

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DCYF ADMINISTRATION

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DCYF DIVISION

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DCYF CONTRACT CODE

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DCYF CONTACT NAME AND TITLE

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DCYF CONTACT ADDRESS

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DCYF CONTACT TELEPHONE

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DCYF CONTACT FAX

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DCYF CONTACT E-MAIL ADDRESS

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IS THE CONTRACTOR A SUBRECIPIENT FOR PURPOSES OF THIS CONTRACT?

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CFDA NUMBER(S)

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CONTRACT START DATE

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CONTRACT END DATE

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CONTRACT MAXIMUM AMOUNT

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Client Services Provided: Statements of Work and Billing and Payment Information appear in the body of this Contract for ONLY the Client Service(s) designated below:

EXHIBITS. The following Exhibits are attached and are incorporated into this Contract by reference:

|X| Exhibits (specify): EXHIBIT A – DATA SECURITY REQUIREMENTS; EXHIBIT B – STATEMENT OF WORK; EXHIBIT C – STATEMENT OF WORK EXHIBIT D - PROGRAM REQUIREMENTS

The terms and conditions of this Contract are an integration and representation of the final, entire and exclusive understanding between the parties superseding and merging all previous agreements, writings, and communications, oral or otherwise, regarding the subject matter of this Contract. The parties signing below represent that they have read and understand this Contract, and have the authority to execute this Contract. This Contract shall be binding on DCYF only upon signature by DCYF.

CONTRACTOR SIGNATURE

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PRINTED NAME AND TITLE

DATE SIGNED

DCYF SIGNATURE

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DATE SIGNED

Department of Children, Youth & Families Public Health Nursing (09/22/2026) Page 31 Definitions. The words and phrases listed below, as used in this Contract, shall each have the following definitions:

“Contract” or “Agreement” means the entire written agreement between DCYF and the Contractor, including any Exhibits, documents, or materials incorporated by reference. The parties may execute this contract in multiple counterparts, each of which is deemed an original and all of which constitute only one agreement. E-mail or Facsimile transmission of a signed copy of this contract shall be the same as delivery of an original.

“Contractor” means the individual or entity performing services pursuant to this Contract and includes the Contractor’s owners, members, officers, directors, partners, employees, and/or agents, unless otherwise stated in this Contract. For purposes of any permitted Subcontract, “Contractor” includes any Subcontractor and its owners, members, officers, directors, partners, employees, and/or agents.

“DCYF Contracts Administrator” means the individual in the DCYF Contracts Department with oversight authority for the Department of Children, Youth & Families statewide agency contracting procedures, or their appropriate designee.

“DCYF Contracts Department” means the Department of Children, Youth & Families statewide agency headquarters contracting office, or successor section or office.

“Department of Children, Youth & Families” or “DCYF” means the Washington agency devoted exclusively to serve and support Washington state’s youth and their families.

“Debarment” means an action taken by a Federal agency or official to exclude a person or business entity from participating in transactions involving certain federal funds.

“Program Agreement” means an agreement between the Contractor and DCYF containing special terms and conditions, including a statement of work to be performed by the Contractor and payment to be made by DCYF.

“RCW” means the Revised Code of Washington. All references in this Contract to RCW chapters or sections shall include any successor, amended, or replacement statute. Pertinent RCW chapters can be accessed at http://apps.leg.wa.gov/rcw/.

“Regulation” means any federal, state, or local regulation, rule, or ordinance.

“Subcontract” means any separate agreement or contract between the Contractor and an individual or entity (“Subcontractor”) to perform all or a portion of the duties and obligations that the Contractor is obligated to perform pursuant to this Contract.

“WAC” means the Washington Administrative Code. All references in this Contract to WAC chapters or sections shall include any successor, amended, or replacement regulation. Pertinent WAC chapters or sections can be accessed at http://apps.leg.wa.gov/wac/.

Amendment. This Contract may only be modified by a written amendment signed by both parties. Only personnel authorized to bind each of the parties may sign an amendment.

Assignment. The Contractor shall not assign this Contract or any Program Agreement to a third party without the prior written consent of DCYF.

Billing Limitations DCYF shall pay the Contractor only for authorized services provided in accordance with this Contract.

DCYF shall not pay any claims for payment for services submitted more than twelve (12) months after the calendar month in which the services were performed.

The Contractor shall not bill and DCYF shall not pay for services performed under this Contract, if the Contractor has charged or will charge another agency of the state of Washington or any other party for the same services.

Compliance with Applicable Law. At all times during the term of this Contract, the Contractor shall comply with all applicable federal, state, and local laws and regulations, including but not limited to, nondiscrimination laws and regulations.

Debarment Certification. The Contractor, by signature to this Contract, certifies that the Contractor is not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded by any Federal department or agency from participating in transactions (Debarred). The Contractor also agrees to include the above requirement in any and all Subcontracts into which it enters. The Contractor shall immediately notify DCYF if, during the term of this Contract, Contractor becomes Debarred. DCYF may immediately terminate this Contract by providing Contractor written notice if Contractor becomes Debarred during the term hereof.

Governing Law and Venue. This Contract shall be construed and interpreted in accordance with the laws of the state of Washington and the venue of any action brought hereunder shall be in Superior Court for Thurston County.

Independent Contractor. The parties intend that an independent contractor relationship will be created by this Contract. The Contractor and his or her employees or agents performing under this Contract are not employees or agents of the Department. The Contractor, his or her employees, or agents performing under this Contract will not hold himself/herself out as, nor claim to be, an officer or employee of the Department by reason hereof, nor will the Contractor, his or her employees, or agent make any claim of right, privilege or benefit that would accrue to such officer or employee.

Inspection. The Contractor shall, at no cost, provide DCYF and the Office of the State Auditor with reasonable access to Contractor’s place of business, Contractor’s records, and DCYF client records, wherever located. These inspection rights are intended to allow DCYF and the Office of the State Auditor to monitor, audit, and evaluate the Contractor’s performance and compliance with applicable laws, regulations, and these Contract terms. These inspection rights shall survive for six (6) years following this Contract’s termination or expiration.

Maintenance of Records. The Contractor shall maintain records relating to this Contract and the performance of the services described herein. The records include, but are not limited to, accounting procedures and practices, which sufficiently and properly reflect all direct and indirect costs of any nature expended in the performance of this Contract. All records and other material relevant to this Contract shall be retained for six (6) years after expiration or termination of this Contract.

Without agreeing that litigation or claims are legally authorized, if any litigation, claim, or audit is started before the expiration of the six (6) year period, the records shall be retained until all litigation, claims, or audit findings involving the records have been resolved.

Nondiscrimination Nondiscrimination Requirement During the term of this Contract, Contractor, including any subcontractor, shall not discriminate on the bases enumerated at RCW 49.60.530(3).

In addition, Contractor, including any subcontractor, shall give written notice of this nondiscrimination requirement to any labor organizations with which Contractor, or subcontractor, has a collective bargaining or other agreement.

Obligation to Cooperate Contractor, including any subcontractor, shall cooperate and comply with any Washington state agency investigation regarding any allegation that Contractor, including any subcontractor, has engaged in discrimination prohibited by this Contract pursuant to RCW 49.60.530(3).

Default Notwithstanding any provision to the contrary, DCYF may suspend Contractor, including any subcontractor, upon notice of a failure to participate and cooperate with any state agency investigation into alleged discrimination prohibited by this Contract, pursuant to RCW 49.60.530(3).

Any such suspension will remain in place until DCYF receives notification that Contractor, including any subcontractor, is cooperating with the investigating state agency.

In the event Contractor, or subcontractor, is determined to have engaged in discrimination identified at RCW 49.60.530(3), DCYF may terminate this Contract in whole or in part, and Contractor, subcontractor, or both, may be referred for debarment as provided in RCW 39.26.200.

Contractor or subcontractor may be given a reasonable time in which to cure this noncompliance, including implementing conditions consistent with any court-ordered injunctive relief or settlement agreement.

Remedies for Breach Notwithstanding any provision to the contrary, in the event of Contract termination or suspension for engaging in discrimination, Contractor, subcontractor, or both, shall be liable for contract damages as authorized by law including, but not limited to, any cost difference between the original contract and the replacement or cover contract and all administrative costs directly related to the replacement contract, which damages are distinct from any penalties imposed under Chapter 49.60, RCW.

DCYF shall have the right to deduct from any monies due to Contractor or subcontractor, or that thereafter become due, an amount for damages Contractor or subcontractor will owe DCYF for default under this provision.

Order of Precedence. In the event of any inconsistency or conflict between the General Terms and Conditions and the Special Terms and Conditions of this Contract or any Program Agreement, the inconsistency or conflict shall be resolved by giving precedence to these General Terms and Conditions. Terms or conditions that are more restrictive, specific, or particular than those contained in the General Terms and Conditions shall not be construed as being inconsistent or in conflict.

Severability. If any term or condition of this Contract is held invalid by any court, the remainder of the Contract remains valid and in full force and effect.

Survivability. The terms and conditions contained in this Contract or any Program Agreement which, by their sense and context, are intended to survive the expiration or termination of the particular agreement shall survive. Surviving terms include, but are not limited to: Billing Limitations; Disputes; Indemnification and Hold Harmless, Inspection, Maintenance of Records, Notice of Overpayment, Ownership of Material, Termination for Default, Termination Procedure, and Treatment of Property.

Termination Due to Change in Funding. If the funds DCYF relied upon to establish this Contract or Program Agreement are withdrawn, reduced or limited, or if additional or modified conditions are placed on such funding, DCYF may immediately terminate this Contract by providing written notice to the Contractor. The termination shall be effective on the date specified in the termination notice.

Waiver. Waiver of any breach or default on any occasion shall not be deemed to be a waiver of any subsequent breach or default. Any waiver shall not be construed to be a modification of the terms and conditions of this Contract. Only the DCYF Contracts Administrator or designee has the authority to waive any term or condition of this Contract on behalf of DCYF.

Additional General Terms and Conditions – Client Service Contracts:

Advance Payment DCYF shall not make any payments in advance or anticipation of the delivery of services to be provided pursuant to this Contract.

Construction The language in this Contract shall be interpreted as to its fair meaning and not strictly for or against any party. Any rule of construction to the effect that ambiguities are to be resolved against the drafting party shall not apply in interpreting this Contract.

Contractor Certification Regarding Ethics The Contractor certifies that the Contractor is now, and shall remain, in compliance with Chapter 42.52 RCW, Ethics in Public Service, throughout the term of this Contract.

Health and Safety Contractor shall perform any and all of its obligations under this Contract in a manner that does not compromise the health and safety of any DCYF client with whom the Contractor has contact.

Indemnification and Hold Harmless The Contractor shall be responsible for and shall indemnify, defend, and hold DCYF harmless from any and all claims, costs, charges, penalties, demands, losses, liabilities, damages, judgments, or fines, of whatsoever kind of nature, arising out of or relating to a) the Contractor’s or any Subcontractor’s performance or failure to perform this Contract, or b) the acts or omissions of the Contractor or any Subcontractor.

The Contractor’s duty to indemnify, defend, and hold DCYF harmless from any and all claims, costs, charges, penalties, demands, losses, liabilities, damages, judgments, or fines shall include DCYF’s personnel-related costs, reasonable attorney’s fees, court costs, and all related expenses.

The Contractor waives its immunity under Title 51 RCW to the extent it is required to indemnify, defend, and hold harmless the State and its agencies, officials, agents, or employees.

Nothing in this term shall be construed as a modification or limitation on the Contractor’s obligation to procure insurance in accordance with this Contract or the scope of said insurance.

Industrial Insurance Coverage The Contractor shall comply with the provisions of Title 51 RCW, Industrial Insurance.

If the Contractor fails to provide industrial insurance coverage or fails to pay premiums or penalties on behalf of its employees, as may be required by law, DCYF may collect from the Contractor the full amount payable to the Industrial Insurance accident fund.

DCYF may deduct the amount owed by the Contractor to the accident fund from the amount payable to the Contractor by DCYF under this contract, and transmit the deducted amount to the Department of Labor and Industries, (L&I) Division of Insurance Services. This provision does not waive any of L&I’s rights to collect from the Contractor.

Notice of Overpayment If the Contractor receives a vendor overpayment notice or a letter communicating the existence of an overpayment from DCYF, the Contractor may protest the overpayment determination by requesting an adjudicative proceeding.

The Contractor’s request for an adjudicative proceeding must:

Be received by the Office of Financial Recovery (OFR) at Post Office Box 9501, Olympia, Washington 98507-9501, within twenty-eight (28) calendar days of service of the notice;

Be sent by certified mail (return receipt) or other manner that proves OFR received the request;

Include a statement as to why the Contractor thinks the notice is incorrect; and Include a copy of the overpayment notice.

Timely and complete requests will be scheduled for a formal hearing by the Office of Administrative Hearings. The Contractor may be offered a pre-hearing or alternative dispute resolution conference in an attempt to resolve the overpayment dispute prior to the hearing.

Failure to provide OFR with a written request for a hearing within twenty-eight (28) days of service of a vendor overpayment notice or other overpayment letter will result in an overpayment debt against the Contractor.

DCYF may charge the Contractor interest and any costs associated with the collection of this overpayment.

DCYF may collect an overpayment debt through lien, foreclosure, seizure and sale of the Contractor’s real or personal property; order to withhold and deliver; or any other collection action available to DCYF to satisfy the overpayment debt.

Subcontracting Except as otherwise provided in this Contract, the Contractor shall not subcontract any of the contracted services without the prior approval of DCYF.

Contractor is responsible to ensure that all terms, conditions, assurances and certifications set forth in this Contract are included in any and all Subcontracts, unless an exception to including a particular term or terms has been approved in advance by the DCYF.

Any failure of Contractor or its subcontractors to perform the obligations of this Contract shall not discharge the Contractor from its obligations hereunder or diminish DCYF’s rights or remedies available under this Contract.

Subrecipients General. If the Contractor is a subrecipient of federal awards as defined by 2 CFR Part 200 and this Agreement, the Contractor shall:

Maintain records that identify, in its accounts, all federal awards received and expended and the federal programs under which they were received, by Catalog of Federal Domestic Assistance (CFDA) title and number, award number and year, name of the federal agency, and name of the pass-through entity;

Maintain internal controls that provide reasonable assurance that the Contractor is managing federal awards in compliance with laws, regulations, and provisions of contracts or grant agreements that could have a material effect on each of its federal programs;

Prepare appropriate financial statements, including a schedule of expenditures of federal awards;

Incorporate 2 CFR Part 200, Subpart F audit requirements into all agreements between the Contractor and its Subcontractors who are subrecipients;

Comply with the applicable requirements of 2 CFR Part 200, including any future amendments to 2 CFR Part 200, and any successor or replacement Office of Management and Budget (OMB) Circular or regulation; and Comply with the Omnibus Crime Control and Safe streets Act of 1968, Title VI of the Civil Rights Act of 1964, Section 504 of the Rehabilitation Act of 1973, Title II of the Americans with Disabilities Act of 1990, Title IX of the Education Amendments of 1972, The Age Discrimination Act of 1975, and The Department of Justice Non-Discrimination Regulations, 28 C.F.R. Part 42, Subparts C.D.E. and G, and 28 C.F.R. Part 35 and 39. (Go to https://ojp.gov/about/offices/ocr.htm for additional information and access to the aforementioned Federal laws and regulations.)

Single Audit Act Compliance. If the Contractor is a subrecipient and expends $1,000,000 or more in federal awards from any and/or all sources in any fiscal year, the Contractor shall procure and pay for a single audit or a program-specific audit for that fiscal year. Upon completion of each audit, the Contractor shall:

Submit to the DCYF contact person the data collection form and reporting package specified in 2 CFR Part 200, Subpart F, reports required by the program-specific audit guide (if applicable), and a copy of any management letters issued by the auditor;

Follow-up and develop corrective action for all audit findings; in accordance with 2 CFR Part 200, Subpart F; prepare a “Summary Schedule of Prior Audit Findings” reporting the status of all audit findings included in the prior audit's schedule of findings and questioned costs.

Overpayments. If it is determined by DCYF, or during the course of a required audit, that the Contractor has been paid unallowable costs under this or any Program Agreement, DCYF may require the Contractor to reimburse DCYF in accordance with 2 CFR Part 200.

Termination for Convenience DCYF may terminate this Contract in whole or in part when it is in the best interest of DCYF by giving the Contractor at least thirty (30) calendar days’ written notice.

The Contractor may terminate this Contract for convenience by giving DCYF at least thirty (30) calendar days’ written notice addressed to DCYF at the address listed on page 1 of this Contract.

Termination for Default The DCYF may immediately terminate this Contract for default, in whole or in part, by written notice to the Contractor if DCYF has a reasonable basis to believe that the Contractor has:

Failed to meet or maintain any requirement for contracting with DCYF;

Failed to protect the health or safety of any DCYF client pursuant to the section entitled Health and Safety of this Contract;

Failed to perform under, or otherwise breached, any term or condition of this Contract; and/or Violated any applicable law or regulation.

If it is later determined that the Contractor was not in default, the termination shall be considered a termination for convenience.

Termination or Expiration Procedure The following terms and conditions apply upon Contract termination or expiration:

The Contractor shall cease to perform any services required by this Contract as of the effective date of termination or expiration.

If the Contract is terminated, the Contractor shall comply with all instructions contained in the termination notice.

The Contractor shall immediately deliver to the DCYF contact named on page one of this Contract, or to his or her successor, all DCYF property in the Contractor’s possession. The Contractor grants DCYF the right to enter upon the Contractor’s premises for the sole purpose of recovering any DCYF property that the Contractor fails to return within ten (10) calendar days of the effective date of termination or expiration of this Contract. Upon failure to return DCYF property within ten (10) calendar days, the Contractor shall be charged with all reasonable costs of recovery, including transportation.

DCYF shall be liable only for payment required under the terms of this Contract for service rendered up to the effective date of termination or expiration.

DCYF may withhold a sum from the final payment to the Contractor that DCYF determines necessary to protect DCYF against loss or additional liability.

The rights and remedies provided to DCYF in this Section are in addition to any other rights and remedies provided at law, in equity, and/or under this Contract, including consequential and incidental damages.

Treatment of Client Property Unless otherwise provided, the Contractor shall ensure that any adult client receiving services from the Contractor has unrestricted access to the client’s personal property.

The Contractor shall not interfere with any adult client’s ownership, possession, or use of the client’s property.

The Contractor shall provide clients under age eighteen (18) with reasonable access to their personal property that is appropriate to the client’s age, development, and needs. Upon termination of services to a client, the Contractor shall immediately release to the client and/or the client’s guardian or custodian all of the client’s personal property.

Treatment of Property All property purchased or furnished by DCYF for use by the Contractor during this Contract term shall remain with DCYF.

Title to all property purchased or furnished by the Contractor for which the Contractor is entitled to reimbursement by DCYF under this Contract shall pass to and vest in DCYF.

The Contractor shall protect, maintain, and insure all DCYF property in its possession against loss or damage and shall return DCYF property to DCYF upon Contract termination or expiration.

Taxes Where required by statute or regulation, Contractor shall pay for and maintain in current status all taxes that are necessary for Contract performance. DCYF will pay sales or use taxes, if any, imposed on the services and materials acquired hereunder. Contractor must pay all other taxes including without limitation Washington Business and Occupation Tax, other taxes based on Contractor’s income or gross receipts, or personal property taxes levied or assessed on Contractor’s personal property. DCYF, as an agency of Washington State government, is exempt from property tax.

Contractor shall complete registration with the Washington State Department of Revenue and be responsible for payment of all taxes due on payments made under this Contract in accordance with the requirements of Title 82 RCW and Title 458 WAC. Out-of-state Contractors must contact the Department of Revenue to determine whether they meet criteria to register and establish an account with the Department of Revenue. Refer to WAC 458-20-101 (Tax registration and tax reporting) and call the Department of Revenue at 800-647-7706 for additional information. When out-of-state Contractors are not required to collect and remit sales tax, DCYF shall be responsible for paying use tax, if applicable, directly to the Department of Revenue.

All payments accrued on account of payroll taxes, unemployment contributions, any other taxes, insurance, or other expenses for Contractor or Contractor’s staff shall be Contractor’s sole responsibility.

DCYF General 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:

“Abuse of Client” means the injury, sexual abuse or exploitation, negligent treatment or maltreatment of a client by any person under circumstances which indicate that the client’s health, welfare or safety is harmed thereby.

“Ancillary costs” means costs related only to case related travel to and from the family’s home and/or a community location to provide services which are non-routine expenses such:

Ferry costs;

Bridge tolls; or Meter/lot parking fees.

“Agency” means a public or private agency or other organization providing services to DCYF clients.

“Authorized” means approved by a DCYF Social Service Specialist as evidenced by receipt of a Social Services Payment System (SSPS) notice or other written notice.

“Child Abuse or Neglect” means the injury, sexual abuse, sexual exploitation, female genital mutilation, sex trafficking or severe forms of trafficking, negligent treatment, or maltreatment of a child under circumstances which indicate that the child's health, welfare, or safety is harmed. An abused child is a child who has been subjected to child abuse or neglect.

“Child and Family Team” means a group of professionals and other providing services to the child and family, including family members and the DCYF Social Service Specialist, who are convened regularly by the Contractor to evaluate progress, review the effectiveness of the Service Intervention Plan, and build on the strengths of family member.

“Child” and “Youth” are used interchangeably throughout this Contract and means any unemancipated individual who is under the chronological age of eighteen (18) years. Youth enrolled in high school or a high school completion program are included in this definition until completion of high school or age twenty-one (21), whichever occurs first.

“Client” means any child or adult who is authorized services by DCYF.

“Community-designed” means planning, developing, implementing, and evaluating projects or services in partnership with community members, with residents having a meaningful role in identifying priorities, shaping decisions, and determining desired outcomes based on the needs, strengths, and lived experiences of the community.

“Community Supports/Community Connections” means services that are offered to families by community providers that may include but are not limited to: housing assistance, mental health services, public health services, alcohol and drug treatment, family and social support connection, financial assistance, domestic violence counseling and treatment, educational and employment assistance, parent education, legal services and cultural and language assistance.

“Compliance Agreement” means a written plan approved by DCYF 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 Contactor to compliance with the terms of the Contract.

“Consultant” means a person who is qualified by credential, background, or experience to assist in assessing, evaluating, counseling, or treating the client, and who provides technical, clinical, practical or other relevant assistance to the Contractor in the assessment, evaluation, counseling, or treatment of a client.

“Continuous Quality Improvement or CQI” means activities to improve practice and performance (learning/improvement-focused).

“Corporal Punishment” means any act that willfully inflicts or causes the infliction of physical pain on a child.

“CPS” means Child Protective Services, a program under DCYF.

“CPS Intake” means the process designated to record all referral reports concerning instances of suspected child abuse and neglect, determine if the referral meets CPS referral screening criteria, and make a disposition concerning the referral.

“CPT” means Child Protection Team, a multidisciplinary group of persons with at least four persons from professions that provide services to abused or neglected children and/or parents of such children. The CPT provides confidential case staffing and consultation to DCYF.

“Cultural Adaptations” means modifications made to practices, customs, or expectations to better accommodate a specific culture's values and norms. This includes providing culturally competent training to staff to ensure a comprehensive understanding of local needs, employing linguistically and culturally specific communication and access strategies, and adjusting intervention methods to align with diverse family structures and belief systems.

“Culturally Responsive” means culture includes the shared social behaviors and norms within a society. This can include shared knowledge, beliefs, laws, arts, customs, habits, priorities, expectations, and many other shared practices. Being Culturally Responsive would involve proactively engaging with people in ways that are appropriate within their cultural values, behaviors, and norms.

“Culturally Specific” means proactive learning and engagement regarding the distinct cultural practices of others, referencing specific elements that could be recognized as particular to their cultural ways.

“DCYF Safety Assessment/Safety Plan” means DCYF form 15-258, a DCYF safety assessment tool that is used for all cases. The assessment is used throughout the life of a case to identify whether a child is safe or unsafe.

“DCYF Safety Plan” means DCYF form 15-259, a DCYF safety assessment tool that documents the written arrangement between a family and DCYF that identifies how safety threats to a child will be immediately controlled and managed.

“Eligible Child or youth” means a child/youth who is identified as a participant in an active DCYF case.

“Gatekeeper” means an approved DCYF staff with the authority to refer children for services in this contract.

“Impending Danger” means parenting behavior that is harmful and destructive to a child’s cognitive, social, emotional or physical development that is likely to occur in the immediate to near future that could result in one or more of the following outcomes:

Serious or severe harm;

Injury requiring medical attention;

Life endangering illness; and Death.

“LEP” means Limited English Proficiency, persons are limited in their ability to read, write or speak English or have a limited ability to speak or read English well enough to understand and communicate effectively.

“Monthly Report” means a written report submitted monthly by the Contractor which shall report on the status of services provided to the family under this Contract.

“Motivational Enhancement” means the use of therapeutic strategies engaging the client to pursue changes in behavior consistent with the spirit of Motivational Enhancement Therapy as defined in Miller, W.R., Zweben, A., DiClemente, C.C., Rychtarik, R.G. (1994) Motivational Enhancement Therapy Manual. Washington, DC:National Institute on Alcohol Abuse and Alcoholism, Project MATCH Monograph Series, Volume 2.

“Motivational Interviewing” means the use of clinical skills and techniques consistent with the spirit of Motivational Interviewing as defined in Miller, W. R., & Rollnick, S. (2002). Motivational interviewing: Preparing people for change (2nd edition.).

“Post Dependency” means those families who have adopted a child or have a Guardianship through the Washington State Child Welfare system.

“Practice Supervision” means a person who is qualified by education and experience to answer questions, facilitate knowledge acquisition, and practice corrections necessary to ensure delivery of high quality services delivered within this contract to each family. This includes, but not limited to oversight work deliverables, staff evaluation, review of casework, treatment planning, and family progress for all practitioners and paraprofessional staff delivering services under this contract. Leading to supporting growth, skill development, and ensuring practitioners and paraprofessionals are engaged in ethical, high quality work with families according to specific models and contract obligations.

“Present Danger” means immediate, significant, and clearly observable severe harm or threat of severe harm occurring in the present.

“Program Manager” means a person who is qualified by education and experience to represent the agency at DCYF led program meetings, facilitate quality assurance activities, run reports on agency level performance data, lead Diversity, Equity, Inclusion work, and assist supervisor(s) in implementing practice changes.

“Protective Capacity” means behavioral, cognitive and emotional characteristics that can specifically and directly be associated with a person’s ability and willingness to care for and keep a child safe.

“Risk of Maltreatment” means parenting behavior that is harmful and destructive to a child’s cognitive, social, emotional and/or physical development and when those with parenting responsibility are unwilling or unable to behave differently.

“Safe Child” means a child for whom there is no present danger or impending safety threats and whose caregiver’s protective capacities control existing threats.

“Safety Threats” means family behavior, conditions or circumstances that create present or impending danger resulting in severe impacts on the child.

“Security Incident Response” means the steps taken to respond to a breach of confidential data.

“Serious and Immediate Harm” means a situation where a child is in imminent danger of abuse and neglect that could result in death, life endangering illness, injury requiring medical attention, traumatic emotional harm or severe developmental harm that has lasting effect on the child’s well-being and has a high likelihood of occurring in the immediate future.

“Social Service Specialist” means the assigned DCYF caseworker.

“SSPS” means the DCYF Social Service Payment System, the service authorization and payment system used by DCYF for this Contract “Staffing” means a formal or informal meeting, conducted by a DCYF Social Service Specialist or DCYF staff member with one or more of the following individuals other DCYF staff, practitioner staff of the Contractor and/or other provider, consultants, parents or others, for the purpose of reviewing or discussing, or for making decisions concerning, a client or case.

“Trauma Informed Approach” means use of culturally appropriate assessment and treatment, efforts to strengthen the resilience and protective factors of children and families impacted by and vulnerable to trauma, addressing the impact of caregivers’ trauma on the family system, and maintaining an environment of care for staff that addresses, minimizes, and treats secondary traumatic stress, and that increases staff resilience. All practices shall be consistent with the principles and techniques as defined in Substance Abuse and Mental Health Services Administration. Retrieved March 16, 2015 from: http://www.samhsa.gov/nctic/trauma-interventions.

“Unsafe Child” means children are considered unsafe when they are vulnerable to present or impending danger and caregiver(s) are unable or unwilling to provide protection.

“Unusual Incidents” means circumstances or events that concern a child's health, safety or well-being or may impact the child’s living situation or permanent plan.

“Videoconferencing” means Real-time, generally two-way transmission of video images between multiple locations.

Purpose The purpose of this Contract is to provide trauma-informed, community-based, and community-designed public health nursing family support and services to families.

Data Security Requirements – Exhibit A The Contractor shall protect, segregate, and dispose of data from DCYF as described in Exhibit A.

Statement of Work – Exhibit B The Contractor shall provide services and staff as described in the Statement of Work attached as Exhibit B to child welfare involved families.

Statement of Work – Exhibit C The Contractor shall provide services and staff as described in the Statement of Work attached as Exhibit C to families who are not child welfare involved.

Program Requirements – Exhibit D The Contractor shall comply with all program and other requirements for providing services under this Contract, as stated in the Program Requirements, attached as Exhibit D.

Referral Prioritization The Contractor shall accept eligible referrals in the following order of priority:

Families and/or individuals involved with Child Welfare, including an active case in Child Protective Services (CPS) Investigations, Family Assessment Response (FAR), Family Voluntary Services (FVS), Family Reconciliation Services (FRS), Child and Family Welfare Services (CFWS) or Tribal Payment Only (TPO); and Have a child between zero (0) and three (3) years of age; and Have suspected or confirmed Substance Use Disorder (SUD) by a parent or caregiver(s) or a child with prenatal substance exposure.

Families and/or individuals who ave exited Child Welfare services in Washington State within the previous twelve (12) months; and Have a child between zero (0) and three (3) years of age; and Have suspected or confirmed Substance Use Disorder (SUD) by a parent or caregiver(s) or a child with prenatal substance exposure.

Families and/or individuals who have custody of a child between zero (0) and three (3) years of age with confirmed or suspected prenatal substance exposure.

Budget – Exhibit F Contractor’s Budget for providing services under this Contract is attached as Exhibit F. Funds may be transferred between budget line items of the Contractor’s Budget subject to the following conditions:

Transfer of funds up to 10% of the budget line item must be pre-requested in writing to the DCYF Steering Committee prior by the Contractor and may be made without amending this Contract;

Transfer of funds that exceeds 10% of the budget line item shall require a written amendment to this Contract prior to the transfer of funds between budget line items.

Consideration Maximum Contract Amount Total consideration payable to Contractor for satisfactory performance of the work under Exhibit B and Exhibit C Public Health Nursing is up to a maximum of $ including any and all expenses.

Travel Expenses Travel expenses paid by the Contractor shall be reimbursed at the current state rate and in accordance with the State of Washington Office of Financial Management Travel Regulations.

Reimbursable travel expenses under the Public Health Nursing Statement of Work only include mileage.

Travel expenses are included in the maximum contract amount for this Contract and included in the PHN monthly rate.

Current rates for travel can be accessed at: https://ofm.wa.gov/accounting/travel/per-diem-rate-tables/.

Funds Payable by Contract Period The maximum amount payable under the Contract during the term of this Contract is allotted to the following time period: From Month Day, Year to June 20,2027.

Allocated funds not expended during the period ending June 30, 2027 shall not be carried forward into any subsequent contract period.

Ancillary costs Ancillary costs are reimbursed in accordance with the Contractor’s actual costs as documented by receipts provided with the Contractor’s billing statement.

Workforce Needs Evaluation DCYF may in future iterations adjust standards and funding to meet service and management objective.

The Contractor shall participate in an effort led by DCYF to develop true cost models.

Billing The Contractor shall submit a monthly billing form provided by DCYF to the DCYF Public Health Systems Analyst for services performed under this Contract.

The Contractor shall contact the DCYF Public Health Systems Analyst concerning billing questions.

The billing form shall state the amount of each cost or expense incurred by the Contractor in the preceding calendar month that is based on the items listed in the Budget Exhibit. Costs or expenses listed in the billing form must match the corresponding items listed in the Budget Exhibit for costs or expenses that were incurred by the Contractor;

The costs or expense billed for each such item shall be charged against the total amount listed for that item in the Budget Exhibit. The cumulative dollar amount for each such item, for all invoices submitted by the Contractor, shall not exceed the total dollar amount stated for that item in the Budget Exhibit; and Claims for payment submitted by the Contractor shall be paid by DCYF if received by DCYF no later than sixty (60) days from the date services were rendered.

Payment DCYF shall make payment within thirty (30) days of receipt of a properly completed billing form.

Payment of the monthly amount will be contingent on the Contractor meeting contract requirements.

DCYF may withhold payment to the Contractor if reports required under this Contract are delinquent, i.e., not submitted with the monthly invoice, are inaccurate, or incomplete.

DCYF will not be obligated to pay for services submitted more than three (3) months after the calendar month in which the services were performed.

DCYF may, at its sole discretion, withhold payment claimed by the Contractor for services rendered if Contractor fails to satisfactorily comply with any term or condition of the Contract.

Financial Management Contractor must maintain a written financial management system to ensure accurate tracking and internal controls of all financial matters related to this contract, including but not limited to:

Fiscal records that shall substantiate costs charged to DCYF;

Documentation of all costs associated with services provided;

Payroll;

Subcontractors (If applicable); and Travel Cost.

Reconcile invoices and payments no less than quarterly, if you have any payment questions please submit the Payment Inquiry Form available at: https://www.dcyf.wa.gov/services/child-welfare-providers/contracted-services.

Performance-Based Contracting DCYF is strategically implementing quality and performance measures in contracts that provide services to children and families, as required by House Bill 1661. This effort supports DCYF’s long-term goals of building partnerships, using data to learn and improve, and to advance racial equity.

Overpayments and Assertion of Lien In the event that DCYF establishes overpayments or erroneous payments made to the Contractor under this Contract, DCYF may secure repayment, plus interest, if any, through the filing of a lien against the Contractor’s real property, and/or by requiring the posting of a bond, assignment of deposit, or some other form of security acceptable to DCYF.

Subcontracted Staff The Contractor must have the prior approval of DCYF for any other subcontract, in accordance with the section titled “Subcontracting” in the General Terms and Conditions of this Contract.

Insurance The Contractor shall at all times comply with the following insurance requirements.

General Liability Insurance The Contractor shall maintain Commercial General Liability Insurance or Business Liability Insurance, including coverage for bodily injury, property damage, and contractual liability, with the following minimum limits: Each Occurrence - $1,000,000; General Aggregate - $2,000,000. The policy shall include liability arising out of the parties’ performance under this Contract, including but not limited to premises, operations, independent Contractors, products-completed operations, personal injury, advertising injury, and liability assumed under an insured contract. The State of Washington, Department of Children, Youth and Families, its elected and appointed officials, agents, and employees of the state, shall be named as additional insureds.

In lieu of general liability insurance mentioned above, if the Contractor is a sole proprietor with less than three contracts, the Contractor may choose one of the following three general liability policies but only if attached to a professional liability policy, and if selected the policy shall be maintained for the life of the contract:

Supplemental Liability Insurance, including coverage for bodily injury and property damage that will cover the Contractor wherever the service is performed with the following minimum limits: Each Occurrence - $1,000,000; General Aggregate - $2,000,000. The State of Washington, Department of Children, Youth and Families its elected and appointed officials, agents, and employees shall be named as additional insureds.

or Workplace Liability Insurance, including coverage for bodily injury and property damage that provides coverage wherever the service is performed with the following minimum limits: Each Occurrence - $1,000,000; General Aggregate - $2,000,000. The State of Washington, Department of Children, Youth and Families, its elected and appointed officials, agents, and employees of the state, shall be named as additional insureds.

or Premises Liability Insurance and provide services only at their recognized place of business, including coverage for bodily injury, property damage with the following minimum limits: Each Occurrence - $1,000,000; General Aggregate - $2,000,000. The State of Washington, Department of Children, Youth and Families, its elected and appointed officials, agents, and employees of the state, shall be named as additional insured.

Business Automobile Liability Insurance The Contractor shall maintain a Business Automobile Policy on all vehicles used to transport clients, including vehicles hired by the Contractor or owned by the Contractor’s employees, volunteers or others, with the following minimum limits: $1,000,000 per accident combined single limit. The Contractor’s carrier shall provide DCYF with a waiver of subrogation or name DCYF as an additional insured.

Professional Liability Insurance (PL) The Contractor shall maintain Professional Liability Insurance or Errors & Omissions insurance, including coverage for losses caused by errors and omissions, with the following minimum limits: Each Occurrence - $1,000,000; Aggregate - $2,000,000.

Worker’s Compensation The Contractor shall comply with all applicable Worker’s Compensation, occupational disease, and occupational health and safety laws and regulations. The State of Washington and DCYF shall not be held responsible for claims filed for Worker's Compensation under RCW 51 by the Contractor or its employees under such laws and regulations.

Employees and Volunteers Insurance required of the Contractor under the Contract shall include coverage for the acts and omissions of the Contractor’s employees and volunteers. In addition, the Contractor shall ensure that all employees and volunteers who use vehicles to transport clients or deliver services have personal automobile insurance and current driver’s licenses.

Subcontractors The Contractor shall ensure that all subcontractors have and maintain insurance with the same types and limits of coverage as required of the Contractor under the Contract.

Separation of Insureds All insurance policies shall include coverage for cross liability and contain a “Separation of Insureds” provision.

Insurers The Contractor shall obtain insurance from insurance companies identified as an admitted insurer/carrier in the State of Washington, with a Best’s Reports’ rating of B++, Class VII, or better. Surplus Lines insurance companies will have a rating of A-, Class VII, or better.

Evidence of Coverage The Contractor shall, upon…