Form OGC-1001.4REV 6/2017

DCF Grant Request for Proposal (RFP)

Family Preservation ServicesDCF – Prevention and Protection Services

Release Date: 5/31/2018Due Date: 8/9/2018

Contact: Linda Cambron, Child Welfare Program ManagerOffice of Grants and Contracts

Kansas Department for Children and FamiliesDCF Administration Building

555 S. Kansas Ave., 5th Floor, Topeka, KS 66603linda.cambron@ks.gov

Strong Families Make a Strong Kansas

REQUEST FOR PROPOSAL TABLE OF CONTENTS

I. OVERVIEW 4Timeline for RFP.................................................................................................................................4

II. FUNDING OPPORTUNITY / PROGRAM BACKGROUND 5Program Philosophy.........................................................................................................................5Purpose, Goals and Objectives........................................................................................................6Program Outcomes........................................................................................................................45

III. AWARD INFORMATION 60Funding Information......................................................................................................................60Award Amount and Length...........................................................................................................60Allowable Uses of Funds...............................................................................................................60Match Requirement.......................................................................................................................60

IV. ELIGIBILITY 60DUNS Number..............................................................................................................................60Tax Clearance................................................................................................................................60Debarment Status...........................................................................................................................61Financial Information....................................................................................................................61501(c)3 Status................................................................................................................................61

V. APPLICATION PROCESS 61Questions.......................................................................................................................................61Letter of Intent...............................................................................................................................61How to Apply................................................................................................................................62What an Application Should Include.............................................................................................62

Table of Contents 62Grant Application Information Sheet 62Management Structure 62Program Abstract 63Program Narrative 63

Statement of the Problem 63Project Design63Implementation Plan 63

Grant Budget Request, Budget Narrative/Justification and Cost Allocation Plan 63VI. REVIEW AND SELECTION PROCESS 68

Review Panel.................................................................................................................................68

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Selection Criteria...........................................................................................................................68VII. POST-AWARD REQUIREMENTS 69

Reporting Requirements................................................................................................................69Federal Funding Accountability and Transparency Act (FFATA) Requirements........................69

VIII. CHECKLISTS71Application Checklist....................................................................................................................71Attachment A – Grant Application Information Sheet (OGC-1002)............................................72Attachment B – Grant Budget Request (OGC-1003)....................................................................72Attachment C – Debarment Memorandum....................................................................................76Attachment D – Specific Terms and Conditions (DCF Provisions).............................................77Attachment E – Contractual Provisions (DA-146a)......................................................................89Attachment F – Special Provisions Incorporated by Reference....................................................90Attachment G - Executive Order 18-04 "Policy Regarding Sexual Harassment" Acknowledgement.........................................................................................................................92Appendix A....................................................................................................................................92Appendix B....................................................................................................................................92

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I. OVERVIEW

DCF invites applications from nonprofit, not-for-profit 501(c)3 and/or for-profit child welfare agencies with a physical location in the State of Kansas or a physical location in place by implementation; public and/or private agencies providing child welfare services with established resources and experience to serve the children and families of the State of Kansas regardless of race, religion, color, sex, disability, national origin or ancestry. All applicants must be accredited by a national accrediting health and/or human services organization, such as Council on Accreditation or The Joint Commission and include a letter from their accrediting body with their application reflecting current and good standing.

Timeline for RFP

Release of Request for Proposal May 31, 2018

Written Questions from Potential Grant Applicant Agencies due by 2 p.m. CST June 22, 2018

Answers to Written Questions from Potential Grant Applicant Agencies posted online and e-mailed by DCF July 3, 2018

Letters of Intent RequiredDue by 2 p.m. CST July 13, 2018

Pre-Bid ConferenceInvitation Only toLetters of IntentSubmissions

Grant Applications due no later than 2 p.m. CST

August 9, 2018 to:Linda CambronChild Welfare Program ManagerKansas Department for Children and FamiliesDCF Administration Building555 S. Kansas Ave., 5th FloorTopeka, Kansas 66603

Grant Year July 1, 2019 to June 30, 2023

If you have questions regarding this RFP, please contact: Linda Cambron, Child Welfare Program Manager via e-mail at linda.cambron@ks.gov

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II. FUNDING OPPORTUNITY / PROGRAM BACKGROUND

DCF invites applications from nonprofit, not-for-profit 501(c)3 and/or for-profit child welfare agencies with a physical location in the State of Kansas or a physical location in place by implementation; public and/or private agencies providing child welfare services with established resources and experience to serve the children and families of the State of Kansas regardless of race, religion, color, sex, disability, national origin or ancestry. All applicants must be accredited by a national accrediting health and/or human services organization, such as Council on Accreditation or The Joint Commission and include a letter from their accrediting body with their application reflecting current and good standing. Applicants must successfully communicate a comprehensive approach to providing Family Preservation Services as it relates to the implementation of the program’s standards.

Program PhilosophyDCF believes all Family Preservation Services are based on family-centered practice. As noted on the Child Welfare Information Gateway, http://www.childwelfare.gov/, family-centered practice is characterized by mutual trust, respect, honesty and open communication between parents and service providers. Families are active participants in the discussion of program improvement, service referrals and evaluation. They are active decision-makers in selecting services for themselves and their children. Family and child assessment is strengths-based and solution-focused. Services are community-based and build upon formal and informal supports and resources.

Family-centered practice is based upon these core values: 1. The best place for children to grow up is with their families;2. Providing services that engage, involve, strengthen and support families is the most

effective approach to ensuring children’s safety, permanency and well-being.

Key components of family-centered practice include:1. Working with the family unit to ensure the safety and well-being of all family members.2. Strengthening the capacity of families to function effectively.3. Engaging, empowering and partnering with families throughout the decision and goal-

making process.4. Providing individualized, culturally competent, flexible and relevant services for each family.5. Linking families with formal and informal collaborative, comprehensive, culturally relevant,

community-based and faith-based networks including non-custodial/non-residential parents and extended family for supports and/or services.

Documentation is integral to family centered services. Complete, accurate and timely documentation is the foundation of professional accountability for all case-related activities and the basis for measurement of outcomes for safety, permanence and well-being for children and families. The applicant will describe the documentation system utilized to capture pertinent information related to all interactions with children, families and collaterals. Complete and accurate documentation utilizing DCF approved forms and formats shall be an expectation linked to all requirements and activities associated with this RFP.

DCF is committed to weaving the five (5) protective factors as developed by the Center for the Study of Social Policy into all aspects of the child welfare system and expect these factors to be a part of all grants and/or contracts. Applicants shall explain how these factors will be implemented in their service proposals. The five (5) protective factors known to reduce child maltreatment should be integrated within families, across systems and throughout communities. The five (5) foundational protective factors found at https://www.cssp.org/reform/strengthening-families/basic-one-pagers/Strengthening-Families-Protective-Factors.pdf include:

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1. Parental Resilience 2. Social Connections 3. Concrete Support in Times of Need4. Knowledge of Parenting and Child Development5. Social and Emotional Competence of Children

Purpose, Goals and ObjectivesThe purpose of this RFP is to solicit the design and implementation of an evidence based practice model for Family Preservation Services (FPS) with programming in the designated geographic DCF regions in Kansas. Applicants may bid on more than one region, but must bid for an entire geographic region. Applicants may bid on more than one service program grant within a DCF region, however only one grant per service will be awarded in each region. Each region application must be submitted separately. The application may include a narrative regarding savings from economies of scale if given a multiple region award for the same program service.

The four (4) geographic catchment regions in the State, which match the counties covered by the current four DCF regions are below.

FPS will provide intensive in-home services and case management services to families who have one or more children at risk of out-of-home placement or who will be at risk of out-of-home placement at birth. The family preservation approach is family-centered, with services and supports designed to build on the strengths of the family. They are supportive, culturally competent and address the entire family as well as individual members. For the purposes of this RFP, applicants will be bidding on implementation of a 3-tiered model of FPS. Each tier will have specific program requirements, staff qualifications and outcomes. Through their response to this proposal, the applicant will demonstrate their understanding of DCF’s tiered system of services and describe how they will operationalize an effective approach to program implementation. Designated tiers are as follows:

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Tier 1 – Intensive In-Home FPS (IFPS), provided by a Master’s level practitioner for an intensive and time-limited service period with the intent to mitigate immediate child safety concerns and stabilize family crisis and assess the family’s needs.

Tier 2 – Short-Term FPS Case Management services, provided by a worker dyad consisting of an assigned Case Manager and a Family Support Worker, assessing for existing risk and emergent safety issues and when identified, initiating services to stabilize and support the family.

Tier 3 – Long-Term FPS Case Management services, provided by a worker dyad consisting of an assigned Case Manager and a Family Support Worker. The worker dyad will provide instruction and modeling of skills to help the family maintain stabilization, improve parent/child interactions and meet the essential needs of the family.

For the FPS period, also called “the referral period”, services are designed to eliminate barriers to a child(ren) remaining safely at home. The family helps define barriers to children remaining safely at home, as well as assists in identifying ways to overcome these barriers. Formal assessment tools will be utilized to determine initial and ongoing child safety, identify existing risk factors and establish family/individual needs. Formal assessment results are used to evaluate family attributes for safety, in-home permanency and well-being. Program requirements are designed to provide quality services to families, as well as incorporate the five (5) Child Protective Factors, address the findings of the Federal Child and Family Services Review (CFSR), meet benchmarks within DCF’s Program Improvement Plan (PIP) and support DCF’s Child Welfare Practice Model.

Applicants are required to adhere to all current policies, rules, administrative regulations and statutes which are applicable to providing child welfare services for children and families under this grant. This includes any information identified within the Children and Family Services Review (CFSR) and any potential Program Improvement Plan (PIP). Some of these may be found at the websites listed below:

Section I State Law and RegulationsA. Kansas Statutes Annotated – at the address http://www.kslegislature.org/li/b2017_18/statute/.

a. K.S.A. 38-1008 et seq., Interstate Compact on Juvenilesb. K.S.A. 38-1201 et seq., Interstate Compact on Placement of Childrenc. K.S.A. 38-2201 et seq., Revised Kansas Code for Care of Childrend. K.S.A. 38-2301 et seq., Revised Kansas Juvenile Justice Codee. K.S.A. 39-1601 et seq., Kansas Mental Health Reform Actf. K.S.A. 59-2111 through 59-2143 Kansas Adoption and Relinquishment Actg. K.S.A. 65-501 through 65-534 Kansas Laws and Regulations for Licensing Family Foster

Homes for ChildrenB. Kansas Administrative Regulations – at the address http://www.kssos.org/Pubs/pubs_kar.aspx.

a. K.A.R. 28-4-170 through 28-4-179 Kansas Child Placing Agency Regulationsb. K.A.R. 28-4-800 through 28-4-825 Kansas Rules and Regulations for Family Foster Homes for

Childrenc. K.A.R. 28-4-311 Family Foster Homes for Children and Youth d. K.A.R. 28-4-92 Maternal and Child Healthe. K.A.R. 30-47-3 Foster Care Licensingf. 2009 K.A.R. by Agency 30, 30-46-10, 30-46-14 through 30-46-17 Child Abuse and Neglect

http://www.kssos.org/pubs/KAR/2009/3_030_30_Department_of_Social_and_Rehabilitation_Services_2009_KAR_Vol_3.pdf

g. 2016 Supplement to the K.A.R. 30-46-10, 30-46-17 Child Abuse and Neglect http://www.kssos.org/pubs/KAR/2016/2016_KAR_Supplement_Book_1.pdf

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Section II Federal Law and Regulations1. Public Law – at the address https://www.congress.gov/

a. PL 105-89 Adoption and Safe Families Act of 1997 (H.R.867)b. PL 96-272 Adoption Assistance and Child Welfare Act of 1980 (H.R.3434)c. PL 109-288 Child and Family Services Improvement Act of 2006 (S.3525)d. PL 109-248 Adam Walsh Child Protection and Safety Act of 2006 (H.R.4472)e. PL 109-239 Safe and Timely Interstate Placement of Foster Children Act of 2006 (H.R.5403)f. PL 110-351 Fostering Connections to Success and Increasing Adoptions Act of 2008 (H.R.6893)g. PL 111-148 Patient Protection and Affordable Care Act (H.R.3590)h. PL 111-320 CAPTA Reauthorization Act of 2010 (S.3817)i. PL 112-34 Child and Family Services Improvement and Innovation Act (H.R.2883)j. PL 113-183 Preventing Sex Trafficking and Strengthening Families Act (H.R.4980)k. PL 114-22 Justice for Victims of Trafficking Act of 2015 (S.178)

2. Indian Child Welfare Act (ICWA) 25 USC 1901 et seq.: http://www.nicwa.org/Indian_Child_Welfare_Act/

3. Federal Independent Living Regulations: https://www.acf.hhs.gov/cwpm/programs/cb/laws_policies/laws/cwpm/policy.jsp?idFlag=3

4. Multi-Ethnic Placement Act (MEPA) of 1994 and amended by the Inter-Ethnic Adoption Provisions of 1996 (IEP): https://www.acf.hhs.gov/cwpm/programs/cb/laws_policies/laws/cwpm/policy.jsp?idFlag=4

5. The Americans with Disabilities Act: https://www.ada.gov/6. Health Insurance Portability and Accountability Act (HIPAA): https://www.hhs.gov/hipaa/index.html

Section III Interstate Compacts1. Interstate Compact on the Placement of Children (ICPC):

https://www.childwelfare.gov/topics/permanency/interjurisdictional/icpc/2. Interstate Compact on Adoption and Medical Assistance (ICAMA):

http://aaicama.org/cms/index.php/the-icama3. Interstate Compact on Juveniles (ICJ): https://www.doc.ks.gov/juvenile-services/interstate

Section IV Agency Websites1. State of Kansas Sites

a. Kansas Department for Children and Families (DCF): http://www.dcf.ks.gov/Pages/default.aspxi. Prevention and Protection Services (PPS):

http://www.dcf.ks.gov/services/PPS/Pages/default.aspxii. PPS Outcomes, Data and Reports:

http://www.dcf.ks.gov/services/PPS/Pages/PPSreports.aspxiii. PPS Policy and Procedure Manual:

http://www.dcf.ks.gov/services/PPS/Pages/PPSpolicies.aspxiv. PPS Quality Assurances:

http://www.dcf.ks.gov/services/PPS/Pages/ChildWelfareMonitoring.aspxv. PPS Child and Family Services Reviews:

http://www.dcf.ks.gov/services/PPS/Documents/CFSR/KS_CFSR_Final_Report_2015.pdf

vi. PPS Child and Family Services Reviews Program Improvement Plan:http://www.dcf.ks.gov/services/PPS/Documents/CFSR/KansasCFSRRound3PIP.pdf

vii. PPS Annual Progress and Services Report:http://www.dcf.ks.gov/services/PPS/Documents/Other/TitleIVBStatePlan.pdf

viii. Kansas Child Welfare Practice Model: http://www.dcf.ks.gov/Agency/KCWPTP/Pages/ChildWelfarePracticeModel.aspx

ix. PPS Provider Agreement Services:8

http://www.dcf.ks.gov/services/PPS/Documents/Provider%20Agreement/ProviderAgreementServices.pdf

b. Kansas Department for Health and Environment (KDHE): http://www.kdheks.gov/i. KanCare/Medicaid: http://www.kancare.ks.gov/about-kancare/what-is-kancare

c. Kansas Department for Aging and Disability Services (KDADS): https://www.kdads.ks.gov/home

i. Substance Use Treatment Services: http://www.kdads.ks.gov/commissions/behavioral-health/consumers-and-families/services-and-programs/substance-use-disorder-treatment-services

ii. Kansas Designated Women’s Substance Use Disorder Treatment: http://www.kdads.ks.gov/commissions/behavioral-health/consumers-and-families/services-and-programs/kansas-designated-women's-substance-use-disorder-treatment

iii. Methadone Maintenance Treatment: http://www.kdads.ks.gov/commissions/behavioral-health/consumers-and-families/services-and-programs/methadone-maintenance-treatment

iv. Recovery-Oriented Systems of Care (ROSC): http://www.kdads.ks.gov/commissions/behavioral-health/consumers-and-families/services-and-programs/rosc

2. Federal Websitesa. Department of Health and Human Services: https://www.hhs.gov/

i. Administration for Children & Families Children’s Bureau: https://www.acf.hhs.gov/cbb. Child Welfare Information Gateway: https://www.childwelfare.gov/c. National Center on Substance Abuse and Child Welfare: https://ncsacw.samhsa.gov/d. Social Security Act: https://www.ssa.gov/OP_Home/ssact/title04/0400.htm

i. Title IV Part B – Child and Family Servicesii. Title IV Part E – Federal Payments for Foster Care and Adoption Assistance

e. Title VI, Prohibition Against National Origin Discrimination Affecting Limited English Proficient Persons (LEP): https://www.archives.gov/eeo/laws/title-vi.html

Section V. Casey Life Skills Book: http://lifeskills.casey.org/

Section VI. Adopt U.S. Kids: https://adoptuskids.org/

Section VII. Adopt K.S. Kids: https://www.adoptkskids.org/

Section VIII. Foster K.S. Kids: https://www.fosterkskids.org/

Section IX. Child Welfare League of America: http://www.cwla.org/

A. Scope of Work Family Preservation Services (FPS) are concentrated and clearly defined with an emphasis on home-based, intensive, therapeutic and/or case management services to families in crisis when children are at high risk of out-of-home placement. The decision to refer a family for FPS may be made at any point during DCF’s intake and assessment process.

Within the multi-tiered FPS model, a wide array of services shall be provided with varying approaches and intensity of interventions tailored to meet the needs of the family. Services provided by the applicant should include:

1. Initial safety and needs assessments;

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2. On-going assessment and determination of family needs, strengths and well-being;

3. On-going safety and risk assessments;

4. Screenings for substance use disorders conducted with age-appropriate household members (13 years of age or older, unless there is previously identified use of drugs or alcohol by a child younger than 13 years); referral for, or completion of, an assessment for level of treatment; and monitoring of compliance with treatment recommendations, including random drug testing.

5. Assistance in obtaining core support services (day care, respite care, employment, housing, on-going mental health services, etc.);

6. Child rearing and behavior management coaching for parents;

7. Assessment and expansion of family supports;

8. Coordination of community resources for the family (formal and informal);

9. On-going case evaluation and monitoring to ensure effective service delivery;

10. Teaching family living skills such as Budgeting, Nutrition, etc.

11. Family crisis intervention;

12. Case Management;

13. Individual, Couple and Family Therapy;

14. Healthy relationship building;

15. Trauma informed treatment and services involving understanding, recognizing and responding to the effects of all types of trauma and in accordance with recognized principles of a trauma-informed approach and trauma-specific interventions to address the consequences of trauma and facilitate healing;

16. Development and Monitoring of a Plan of Safe Care for substance-affected infants;

17. For parents or pregnant women who are misusing substances, services also include screening, assessment, referral for and/or providing substance use disorder treatment, including medication-assisted treatment, related aftercare, prenatal health care, vocational assistance and case management as appropriate. Assistance in removing barriers to treatment should also be provided and may include family support, mental health services, domestic violence services, child care, transportation, housing or other supportive services.

B. Population to be Served Referral criteria is specific to the level of service identified to meet a family’s needs in maintaining their child(ren) safely in the home. A referral for services will be made based on the needs of any family member, parent, caregiver, or pregnant woman using alcohol and/or substances who is in crisis, creating the risk of having a child or children removed from the home. When children are at risk, there must be a

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parent/caregiver who is available to protect the child(ren) and who is willing and able to participate in the services. FPS is initiated based on DCF safety and risk assessments identifying children as being at risk of removal from the home and/or maltreatment and the family’s willingness and ability to engage in services. The criterion above applies to all three (3) tiers, or levels, of service interventions.

Referrals to a specific tier of service may be made directly to that service tier at any point during DCF’s assessment and investigation, or the referral may be made by DCF as a result of on-going assessments and recommendations by A FPS Grantee, indicating the need to transition the family to another level of service.

Examples of potential referrals for Tier 1 (Intensive FPS) include, but are not limited to: 1. A family with Affirmed or Substantiated finding(s) of Abuse or Neglect; families with multiple

unsubstantiated findings of Abuse or Neglect; and/or families who have a high rating of risk on DCF’s Risk Assessment tool and the children are at risk for out of home placement or maltreatment without intensive, therapeutic supportive services being put in place immediately;

2. Pregnant women using alcohol and/or substances during pregnancy;

3. Women giving birth to substance-exposed or substance-affected infants;

4. Families with parents and/or child(ren) who screen positive for a current substance use disorder or have been identified as misusing substances, which is affecting the parent’s ability to meet the child(ren)’s basic needs;

5. Families with child(ren) in police protective custody who are placed in temporary emergency housing;

6. Families with mental/emotional illness when the issues have been stabilized and one adult in the household is able and willing to participate in services;

7. A family who has serious emotionally or behaviorally disturbed children and the family believes and expresses they can no longer cope without intervention;

8. A family who has participated in less intensive, unsuccessful interventions and the family is experiencing a crisis.

Examples of potential referrals to Tier 2 (Short-term FPS Case Management Services) included, but are not limited to:

1. Families who need continued supportive case management services for a child’s moderate or high-risk behaviors after completion of Intensive FPS;

2. Families with multiple unsubstantiated findings of abuse or neglect and have a moderate to high assessment of current risk for abuse, neglect or out of home placement without supportive case management services being put in place;

3. Families with affirmed or substantiated abuse or neglect findings with a moderate to high risk of subsequent maltreatment;

4. Families with trauma assessments identifying less than four (4) Adverse Childhood Experiences (ACE’s) and a child at risk of abuse, neglect or out of home placement without on-going case management services;

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5. Families with mental/emotional illness when the crisis has been stabilized and one adult in the household is able and willing to protect the child(ren) and participate in services;

6. Families with a member who screens positive for a current substance use disorder or substance misuse and needs on-going case management services to support their recovery plan;

7. Assessments have been completed by a DCF CPS Specialist or FPS Specialist/Therapist indicating a parent or caregiver has mental health issues placing a child or children at risk of abuse, neglect or out of home placement without on-going case management services;

8. Assessments have been completed by a DCF CPS Specialist or FPS Specialist/Therapist indicating a parent or caregiver lacks adequate parenting skills to care for a child who has demonstrated difficult behavior at school or home placing the child or children at risk of out-of-home placement or in-patient mental health treatment without on-going case management services;

9. Families with a child or children with truancy issues resulting from the child’s unwillingness to attend school or a parent/caregiver’s failure to get the child(ren) to attend school regularly;

10. New parent/caregiver(s) with a substance-exposed or substance-affected infant in which there is the need for developing and/or monitoring an on-going Plan of Safe Care;

Examples of potential referrals to Tier 3 (Long-Term FPS Case Management Services) include, but are not limited to:

1. Families with multiple unsubstantiated allegations of abuse, neglect, or non-abuse neglect and/or have an assessment indicating a low to moderate risk of abuse, neglect, or out of home placement;

2. Families requiring assistance in obtaining core support services (day care, respite planning, employment, housing, connection to on-going mental health services);

3. Families with child(ren) who have truancy issues due to the child’s failure to attend school or other non-abuse or neglect issues;

4. Families who would benefit from comprehensive care coordination;

5. Families in need of assessment and expansion of family support systems;

6. Families who need support in improvement of daily living skills;

7. Families who would benefit from parent education;

8. Parent(s) or child(ren) with a substance use issue who are actively working on a relapse prevention plan;

9. Parent(s) with a substance-exposed or substance-affected infant where there is a need for monitoring an on-going Plan of Safe Care;

10. Families demonstrating generational or chronic issues putting their child or children at risk for out-of-home placement without ongoing supportive services.

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C. Eligibility for FPS Families who have at least one child in out of home placement through a regional Reintegration, Foster Care, Adoption Case Management Grantee, with a goal of reintegration, are not eligible for FPS at any tier level. A FPS referral is terminated when the court places one or more children in the custody of DCF and a referral is made to the Case Management Grantee, unless a court order indicates otherwise.

Adoptive families who are within a six (6) month post finalization adoption period are not eligible for referral to FPS. However, adoptive families who have completed six months of post finalization adoption services, and meet the criteria for referral to any FPS tier, may be referred for FPS services.

A family is ineligible for FPS at any tier level when they have a child who is adjudicated as a juvenile offender and is in the custody of the Kansas Department of Corrections-Juvenile Services (KDOC-JS) or is on probation and the court has ordered another entity to provide similar services; or KDOC-JS has purchased, or is providing, services which are comparable to the services provided by FPS. However, if there are other children in the home who meet the criteria for FPS, a referral can be made, or the services from a prior referral can continue, if the adjudication and KDOC-JS custody occur after referral. The child/youth who is adjudicated and in the custody of the KDOC-JS, or is dually adjudicated, may participate as a member of the family in these services.

A FPS referral may be made for “dually involved youth”. A dually involved youth is identified as an adjudicated child who has abuse or neglect issues distinct and separate from the concerns related to their adjudication as a juvenile offender.

All exceptions to the above eligibility guidelines will be based on current DCF policy and practice and approved in advance by DCF PPS Administration.

D. Services to be Provided The applicant shall demonstrate, through their response to this RFP, the ability and willingness to meet the following requirements:

1. Have a program director assigned full time, for each region possibly awarded through this grant, who will serve as the liaison to DCF on all program and grant related matters;

2. Ensure all staff with therapeutic, case management or family support responsibility have DCF pre-service training. All staff must also receive on-going training whenever deemed appropriate by DCF, regarding family systems, service delivery related to FPS, new policy, statutory changes, initiatives and other matters pertinent to effective grant performance;

3. Provide for the safety, stability and well-being of children and families during the referral period;

4. DCF policy and procedures are the primary guides for practice and service delivery, however, it is expected the Grantee will establish and maintain policy and procedure manuals which detail job functions and service delivery processes which operationalize a practice model approved by DCF and include relevant DCF policies and procedures. No Grantee policies shall conflict with policies contained in the DCF PPS Policy and Procedure Manual.

5. Describe in detail its IFPS and FPS model and plan to implement the model with fidelity, including the identified number of staff to meet the prescribed staffing ratio in each tier of service. The

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intervention model description shall include detailed information about: the practice model components; how safety and risk will be assessed throughout the life of the case and at critical points in the case; how safety plans and family safety networks will be formed; the specific training the in-home workers will have received by the time the grant is finalized; and how fidelity to selected evidence based program interventions will be maintained;

6. Identify their ability to implement a process for responding timely, per DCF PPS PPM, to consumer complaints and shall inform and collaborate with DCF as to the resolution of such complaints. Response to DCF is required, on a DCF PPS PPM specified form, within three (3) working days from the complaint date or sooner if requested. Applicants shall include their model of complaint response in an addendum to the proposal. If the concern is considered a Critical Incident, as defined by DCF PPS PPM, a response may be required by the Grantee the same day or the next business day from knowledge of the event per DCF PPS PPM. Handling of these incidents should be identified within the model description submitted. A log of complaints with details regarding resolution will be required to be submitted with monthly reporting;

7. Refrain from releasing reports, records, or client information to outside sources without written consent from the family;

8. Freely share information between themselves and DCF and, when appropriate, between themselves and the Case Management Grantee. Grantee shall make available all client records and information to DCF (to include unlimited access to any Grantee systems storing DCF information), verbally and/or in written form, the next business day of a request received, unless requested sooner. Within ten (10) days of closure of case files, all information in written, electronic or any other format shall be returned to DCF;

9. Identify how the Grantee will begin tier-specific services and case management responsibility for children and families on the day of referral and end this responsibility at case closure;

10. Organize, update and complete the case file per DCF policy and send it to the DCF regional office within five (5) working days after the referral period of responsibility for the family’s services has expired, or after the case has been referred to the Case Management Grantee;

11. Deliver services to children and families which are culturally competent and are responsive to each family’s unique needs;

12. Report cases of suspected child abuse and/or neglect immediately to the Kansas Protection Reporting Center (KPRC), or any subsequent entity established by the Secretary, in accordance with KSA 38-2223;

13. Submit all reports as required by the court and act as the liaison with the court and district/county attorney for all court involved cases in collaboration with assigned DCF staff;

14. Maintain a public image that is supportive, at all times, towards the public/private partnership;

15. Provide full disclosure, open and direct communication and transparency with DCF in all matters;

16. Maintain case information in writing on a timely basis, completing documentation according to DCF policy, which reflects the complete and current history of assessment information, services provided and progress of services for the family and each family member;

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17. Collaborate with family and schools to ensure all children receive educational assistance determined necessary from educational assessments; advocate for educational assessments if necessary;

18. Facilitate seamless transition for the child and family whenever a child receiving IFPS or FPS services under this grant is placed in DCF custody and referred to the Case Management Grantee for out-of-home care.

a. All information shall be shared with the Case Management Grantee to include a written case closure summary with reasons for referral, dates of referral and services provided, the family’s response to the services received, results of assessments completed, goals achieved and activities completed on the case plan and other relevant information. The FPS case file shall be made available to the Case Management Grantee within timelines established in DCF policy.

b. If the FPS grantee has an open case at the time of referral to the Case Management Grantee, the therapist or case manager assigned to the FPS case shall attend and participate in the Case Transfer meeting with the family.

c. A DCF-approved case transfer form shall be completed when a case moves from one tier of service to another, or case responsibility transfers between workers, a team of workers, a new supervisor or the Case Management Grantee;

19. Describe a process to facilitate a seamless transition of services for children and their family, when the family moves to another Grantee region during the FPS referral period, by continuing to serve the family or by sub-granting with the other region’s FPS Grantee. In these cases, the original Grantee remains responsible for all grant obligations and reporting. A DCF-approved case transfer form shall be completed and provided to the FPS Grantee in the new region. If a child in the family is in the Secretary’s custody when the family moves, a new referral is made to the FPS Grantee where court jurisdiction for the child’s court case is located. The prior referral will then be closed;

20. Describe a process to facilitate a recommendation to DCF, when the tier-specific FPS service period is complete for a family and the children remain at risk of out-of-home placement or maltreatment. All information shall be shared with DCF to include a written case closure summary with date of initial referral, reasons for referral, services provided, the family’s response to the services provided, assessments completed and results, the goals achieved and activities completed on the case plan and a recommendation for continued services. The applicant shall describe a seamless process to transition the case back to DCF, for continued direct services, if DCF denies the recommendation for a consecutive FPS referral. The entire FPS case file shall then be sent to DCF within the timeline specified in DCF policy.

21. Ensure families are involved with their FPS Grantee agency at a policy making level by holding at least two (2) stakeholder feedback meetings per year to which all families, who have completed services within the last six (6) months are included, to solicit input and feedback from families and youth. A written summary of the meetings shall be submitted to DCF;

22. At DCF discretion, make work space available for a DCF staff person to be in a Grantee office with access to all Grantee staff, files and records;

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23. Participate in statewide or regional stakeholder meetings, policy, program improvement or advisory groups including events to promote and support child welfare issues as requested by DCF;

24. Describe how the Grantee will convene a standing advisory board, each member of which is subject to DCF approval, to provide information/feedback on policies and practices. The advisory board shall be convened, at least quarterly, and reports shall be submitted to DCF utilizing a standard DCF format. The advisory board shall be comprised of Stakeholders and a minimum of ten (10) representatives from various agencies and disciplines, including: a mental health provider, the DCF region, Grantee, a past FPS recipient, Community Developmental Disability Organization (CDDO), substance abuse treatment provider, faith based organization, school personnel, law enforcement, Juvenile Intake and Assessment Services (JIAS), early childhood education, Safe Families (as available) and other members deemed appropriate by the Grantee. Applicants shall include a list of proposed and committed members to DCF. The board shall not exceed a total of fifteen (15) participating members. Sign-in sheets and minutes from each meeting will be completed and submitted to DCF within the quarterly reports;

25. Participate and cooperate in the PPS Quality Assurance processes. Ensure Grantee staff participate in an exit conference to obtain feedback on the findings of each case read;

26. Fully cooperate with DCF’s pursuit and implementation of initiatives or other outcome-based programs, including the possible engagement of supplemental service organizations DCF may deem appropriate for such a program’s operation working in conjunction with the Grantee to fulfill the mission of DCF. The Applicant agrees to fully cooperate with any such endeavor;

27. Collaborate in a transition plan approved by DCF in the event a Grantee withdraws or the grant is terminated. Both the current FPS Grantee, and new Grantee, shall designate staff to serve on a transition team to design the plan, with this team being activated within ten (10) working days after the notification of grant awards. The transition plan shall ensure a smooth transition to avoid disruptions, provide for the safety and well-being of children, and provide necessary information to all concerned parties. In the event a new Grantee is awarded the grant; the current Grantee will maintain responsibility for services to all families and children referred for the duration of the service period in which they are participating.

E. Program Requirements As stated above, the FPS program is structured in three (3) distinct tiers, or levels of service delivery, designated as follows:

Tier 1: Intensive Family Preservation Services (IFPS) consists of a service period of up to six (6) weeks in duration. One additional 6-week referral, if intensive interventions remain necessary to ensure the safety of the child(ren), shall be approved by the DCF Regional Assessment and Prevention Program Administrator.

Tier 2: FPS Case Management Services (Short Term) consists of a service period of three (3) to six (6) months in duration. Referrals to Tier 2 may be a result of families transitioning from Tier 1 IFPS or a direct referral based on DCF assessment of risk factors and the family’s needs. As determined by family needs, one additional three (3) to six (6) month referral for Tier 2 level of services shall be approved by the DCF Regional Assessment and Prevention Program Administrator;

Tier 3: FPS Case Management Services (Long Term) consists of a service period of six (6) months to a maximum of one (1) year or 365 days. Referrals to Tier 3 may be a result of a transition from Tier 1 or Tier

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2 services, but will usually be through a direct referral made by DCF based on assessment of risk factors and the family’s needs.

Referral for FPS services, whether made directly to a specific tier or as a transition from another tier of service, will require a DCF referral. A referral from one tier to another shall be made by DCF within three (3) working days of case closure in the previously completed service tier, if ongoing services are determined necessary to address safety and/or risk factors in the family.

Minimum Program Requirements:The following are minimum program requirements for all tiers of service. New or unique program elements supported by research or available data are acceptable and encouraged, but the applicant must describe how each of the following requirements will be implemented. The Grantee shall:

1. Accept all referrals in the designated geographic region. Questions related to the reasons for referral should be directed immediately to the referring DCF Child Protective Services (CPS) Specialist for clarification;

2. Respect the privacy of the child and family;

3. Maintain confidentiality as required by law and DCF policy;

4. Ensure agency staff are available to families as indicated in the tier-specific program requirement section;

5. Acknowledge receipt of referral to DCF in writing by close of business the following business day;

6. Make initial contact with the family within 24 hours, unless a different timeframe is designated by the tier-specific service requirements, and schedule an in-person meeting with the family;

7. Meet in person with the family within two (2) business days of referral, unless a different time frame is specified under tier-specific program requirements or an earlier in-person meeting is directed by the DCF CPS Specialist. The Grantee will immediately request assistance from the DCF CPS Specialist if there is difficulty in beginning the engagement process with the family. If the family fails to engage in FPS, the Grantee shall notify DCF immediately. During an initial meeting with the family, the Grantee shall work with the family (to include any extended family) to develop a safety plan, if needed, and initial case plan, identifying immediate supports for the family and each family member and roles and responsibilities for all team members. The FPS Grantee staff shall leave a copy of the Safety Plan, if developed, and the Initial Case Plan with the family when it is completed. A signed copy shall be provided to the family within 72 hours;

8. Employ diligent efforts to engage the non-custodial/non-residential parent for all FPS activities. All references to “family” in this request for proposal are to include the non-custodial/non-residential parent, if applicable;

9. Respond to family crisis situations within one hour when requested by the family or law enforcement. In person contact is required when determined necessary to ensure child safety or effect positive family change;

10. Develop and utilize a Genogram to identify and assess family relationships and establish potential family support networks;

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11. Complete initial and ongoing DCF approved safety and risk assessments; Assess all family members, as age appropriate, for components of well-being: including social, emotional, physical, educational, intellectual, mental health, substance misuse, domestic violence and parent-child relationships. Assessments shall be completed for a direct referral from DCF to any tier of service by the FPS Grantee, unless the assessment has been completed within the past six (6) months and the results are available to the FPS staff currently providing direct services. The following assessment tools shall be utilized:

a. Structured Decision Making (SDM); SDM shall be an ongoing assessment tool to be completed at initial referral and at critical points in the referral period;

b. Child Stress Disorder Checklist-KS (CSDC-KS) Ages 0-18, screening for child’s history of trauma and current symptoms;

c. Child Report of Post-Traumatic Symptoms (CROPS) Ages 6-18, screening for child’s history of trauma and current symptoms;

d. Ages and Stages Questionnaire – Social Emotional (ASQ-SE) Ages 0-2, screening for social-emotional functioning;

e. Preschool and Early Childhood Functional Assessment Scale (PECFAS) Ages 3-5, assessing behavioral health functioning;

f. Child and Adolescent Functional Assessment Scale (CAFAS) Ages 6-18, assessing behavioral health functioning;

g. Parenting Stress Index – Short Form (PSI-SF) Ages 0-18, assessing parenting stress;h. UNCOPE Ages 13 and older, screening for behaviors consistent with substance use

disorders;i. ACE’s screen for parent(s) – assesses the number of Adverse Childhood Experiences an

adult has experienced.

12. Upon referral to any tier, the Grantee shall work with the family (to include any extended family members) to develop a case plan, based on service tier expectations, identifying specific outcomes for family members which mitigate safety concerns and improve well-being of the family. Outcomes shall address referral reasons, identified needs and assessment results. Other agencies involved with the family and any individuals identified by the family shall be invited and encouraged to attend the case plan meetings. Case plans and case plan goals are subject to review by DCF as they relate to identified safety concerns;

13. Include information about how elements of the Family Group Decision Making model will be incorporated in the case planning process;

14. Assist the family in overcoming barriers to achieving goals and completing activities in case plans;

15. Complete the initial case plan in collaboration with all family members (to include any extended family members) and obtain signatures as designated by tier-specific timelines;

16. A designated worker, depending on the Tier of service, will meet with each child, alone, a minimum of once a month and address case plan goals, activities, safety and wellbeing, per DCF policy;

17. If the family does not meet with the FPS Grantee staff for one (1) week during Tier 1 service period; two (2) weeks during Tier 2 service periods; or, for 32 consecutive days during Tier 3 service period, DCF shall be notified. Notification shall be made immediately if there is an indication the child(ren) are in danger;

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18. Invite DCF CPS Specialist to all case plan meetings and court hearings;

19. Send the completed case plan to DCF within five (5) working days from the date of the case plan meeting;

20. Write court reports summarizing the family’s progress on case plan goals and activities on all court involved cases. Discuss any recommendations to the court with DCF CPS Specialist in advance, submit court reports to the court per local requirements, attend all court hearings and testify as required;

21. Provide DCF with the documentation necessary to file a complete court application/affidavit if it is determined a child cannot remain safely in-home;

22. Purchase the first $500.00 of concrete goods or services to meet the family’s basic needs using appropriate flex funds. After spending $500.00 on concrete support, a request can be made to DCF for additional concrete support funding. Funds for purchase of necessary concrete goods or services shall be made available by the Grantee during service delivery within each tier of service, based on the families identified basic needs. Examples of concrete support include: exterminator services, head lice treatment supplies, clothes, utilities, rent and deposits, bus passes, car repairs, refrigerators, beds, or legal services needed to maintain children safely in the home or with a family member, etc. Concrete support does not include services listed in the DCF Handbook for Client Purchases. Any request for additional expenditures for concrete support is to be approved by DCF;

23. Accept referrals and complete case plans for families whose children are in the Secretary’s custody but remain in-home. For children in DCF custody the following applies:

a. Each child in custody is required to have a Child Case Plan completed in addition to a Family Case Plan. The Child Case Plan, which is separate and distinct from the FPS Family Case Plan, must be completed within 20 days after custody is established and at least every 170 days thereafter;

b. Minimum monthly, alone, in person contact between the assigned FPS Specialist/Therapist or assigned Case Manager and each child in custody is required;

c. Following completion of the FPS Tier 1 service period, the Grantee shall transition the family to one of the FPS Case Management Tiers, and the Grantee must continue to provide case management services, case plan updates, timely court reports, testimony in court, and assistance to the family in completing court orders until the child is released from DCF custody.

24. For children, not in the Secretary’s custody, individual child case plans are not required. The FPS Specialist/Therapist or assigned Case Manager shall ensure a Family Case Plan is completed, which addresses the needs of each family member and meets the timelines in each specific tier of service. The designated Therapist, Case Manager or Family Support Worker shall conduct monthly alone visits with each child to assess child safety and address case planning activities, depending on the Tier of Services being provided;

25. Coordinate with family and medical providers to ensure each child’s identified medical, dental and mental health needs are met;

26. Continue to access medical services via the Medicaid card for children qualifying for Medicaid. Assist families in applying for Medicaid benefits they may be eligible for;

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27. For services covered by Medicaid, the Grantee will be required to enroll as a Kansas Provider for services and follow all applicable requirements for participation as set forth in federal and state statutes and regulations and any related program policies, within the authorities of such statues and regulations of the applicable State agencies. The Grantee shall also agree to comply with all State and federal laws and regulations applicable to services delivered and professional activities. The Kansas Medicaid Provider Manual, Provider Manual revisions and Provider Bulletins represent official Medicaid program limitations and requirements providers must follow to receive payment and to continue participation in the Medicaid program under K.A.R. 30-5-59c(1). The Manual is in addition to the requirements of the Medicaid Provider Agreement and any other contracts such as managed care contracts;

28. The Grantees shall partner with KanCare Managed Care Organizations (MCOs). Grantee shall actively engage with MCO Care Coordinators to ensure access to all available services and supports for children/youth referred to FPS;

29. Provide for periodic drug testing when working with a family when a substance use disorder has been identified. Follow-up services shall be provided as indicated;

30. Refer all children under the age of three to early intervention programs as appropriate. All children under the age of three years who are the victims of affirmed or substantiated abuse or neglect findings shall be referred to Early Childhood Intervention programs and participate as recommended;

31. Develop and/or monitor a written Plan of Safe Care for all infants born substance-affected as determined by a medical professional. Assist family members with referrals for needed services;

32. The Applicant will describe their ability to implement a process to identify and refer women using opioids during pregnancy to medication assisted treatment. Applicant will implement a tracking system to provide outcome data to DCF for this service;

33. In the event the family refuses to meet or cannot be located by the Grantee, after services have been initiated, DCF shall be notified based on the timeframes outlined in the tier-specific program requirement section, unless the children may be in danger, their safety cannot be determined or the family refuses to participate in services. In such cases DCF shall be notified immediately;

34. Schedule and facilitate a case closure conference no less than seven (7) days prior to the anticipated case closure date. The DCF CPS Specialist and family shall be invited to attend. Provide a written case closure summary to DCF and the family at the time of the case closure conference describing the family’s progress, strengths and recommendations for any additional services, if needed, to maintain the child(ren) safely in the home;

35. Conduct open-invitation alumni activities twice per year. All families who have completed FPS within the previous six (6) month period shall be invited. Provide support services to the group, which may include presenting an educational topic appropriate to the group’s needs and facilitating discussion;

36. Provide families with a designated Client Satisfaction Survey at the case closure conference or the last in-home contact, ensure the survey is completed and returned to the worker in a sealed envelope which has the client’s signature across the seal to protect client confidentiality. The FPS worker will

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provide the unopened envelope to their supervisor or management staff for review and documentation. Results of Client Satisfaction Surveys will be compiled using DCF’s format and reported quarterly to DCF;

37. The Grantee shall notify DCF immediately when a family moves out of state, or places their children out of state. If child safety concerns exist or cannot be determined, the Grantee shall facilitate a report to the child protection agency of the new state or county in which the children reside in collaboration with DCF. The Grantee shall move the case to inactive status and document the reason for the status change. DCF shall be notified and services shall be resumed if the family and/or children return to Kansas during the referral period;

38. The Grantee shall notify DCF immediately when a family moves their children to another caregiver’s residence, or refuses to continue FPS services. If child safety concerns exist or cannot be determined, the Grantee shall consult the DCF PPS CPS Specialist regarding a potential referral for the new caregiver or request DCF assistance in re-engaging the current family in FPS.

39. Grantee is obligated to accommodate disabilities to the best of their ability. Grantee will describe within their application their ability to comply with the following:

a. Grantee will make reasonable accommodations when such accommodations are necessary to afford its services and facilities to children and families with disabilities, including children and families whose disabilities impact behavior, unless the accommodations would fundamentally alter the nature of its services or facilities.

b. Grantee will designate a person who shall have responsibility for reviewing all requests for reasonable accommodations which are not granted and ensure any accommodations not granted are not discriminatory.

c. Grantee’s written policies and procedures shall, at a minimum, include the following:i. Designation and publication of information regarding one individual per operating

location who is authorized to receive and review requests for accommodations.

ii. Publication of a process by which parents/caregivers, and guardians of children with disabilities can request reasonable accommodations with respect to child welfare services.

iii. If Grantee does not promptly grant to the parents/caregivers, and/or guardians, Grantee will initiate a discussion with the parent/caregiver, and/or guardian, to explore what accommodation(s) may be necessary.

iv. If a request for an accommodation is denied, Grantee will document all reasons for the denial and shall submit documentation to DCF, the parents/caregivers, and/or guardians who requested such accommodation.

v. Grantee will provide a response to a request for accommodation in writing no later than fifteen (15) business days from the date the request is received.

Tier-specific Staffing/ProgrammingIn addition to the general program requirements identified above, the Applicant will describe their ability to meet the following tier-specific minimum requirements:

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1. Tier 1 – Intensive Family Preservation Services (IFPS)a. A Tier 1 FPS Specialist/Therapist shall be a licensed Masters level practitioner in a DCF-

approved field;

b. One assigned Tier 1 FPS Specialist/Therapist shall conduct DCF-approved assessments and provide an appropriate array of services to mitigate the safety concerns in the DCF referral and stabilize the family crisis;

c. Each Tier 1 FPS Specialist/Therapist shall be dedicated solely to the Tier 1 services;

d. A Tier 1 FPS service period shall be approximately 6-weeks in duration;

e. One additional 6-week referral to Tier 1 FPS shall be allowed only in consultation with the DCF CPS Specialist and shall be approved in advance by the DCF Regional Assessment and Prevention Program Administrator when such an extension will substantially reduce the risk of out-of-home placement or child maltreatment;

f. The Grantee will maintain Tier 1 FPS caseloads at a maximum of 4 families per Tier 1 FPS Specialist/Therapist, unless extenuating circumstances exist and DCF has been consulted;

g. The assigned Tier 1 FPS Specialist/Therapist shall be available to the family 24 hours per day, 7 days per week, with the assigned Supervisor acting as the back-up contact person, in the event the assigned FPS Specialist/Therapist is unavailable;

h. Services shall be provided in the family’s home, or at the family’s request, a location mutually agreed upon by the Grantee and family. However, visits in the home are required when the child safety concerns identified in the FPS referral are environmental or occurring only in the home;

i. There is an expectation the Tier 1 FPS Specialist/Therapist will meet with the family intensively, with a minimum of 30 hours of in-person contact assuming a 6-week service period, or an average of 5 hours per week;

j. Each child residing in the family home must be seen alone a minimum of one time per month by the assigned licensed FPS Specialist/Therapist. These visits must address child safety, well-being and the child’s input regarding, or progress on, completing case plan goals and activities;

k. A case may be suspended in extreme circumstances as determined by the Tier 1 FPS Supervisor and Tier 1 FPS Specialist/Therapist in consultation with the referring DCF CPS Specialist. A case may be suspended for a maximum of two (2) weeks when a family is unable, or unavailable, to meet. Examples of situations where a case could be suspended:

i. Death in the family requiring travel out of referral area,ii. Planned family vacation,

iii. Child(ren) visiting relatives out of state for an extended period of time,iv. Family refuses to continue services and DCF has been notified to assist with re-

engagement efforts.22

l. All Tier 1 FPS Specialists/Therapists shall be supervised by a Masters level (or above) practitioner, licensed in a DCF approved field of practice. Supervisors must have 3 years’ experience in children and family services;

m. A Tier 1 Supervisor shall supervise no more than eight (8) Specialists/Therapists providing Tier 1 services only, for a maximum of 32 open intensive cases;

n. Upon acceptance of a FPS referral, a Tier 1 FPS Specialist/Therapist is expected to contact the family within 24 hours, schedule and facilitate the Initial Family Meeting (IFM) within 48 hours;

o. A Tier 1 FPS Specialist/Therapist shall complete an initial Family Case Plan with the goal of maintenance at home, at the time of the IFM, in collaboration with the family. A copy of the completed case plan shall be provided to the family. The following activities will be included in the initial case plan:

i. All activities to be completed immediately to address the safety concerns and the reasons for referral;

ii. Parents/Caregivers and age appropriate children/youth will participate in the required assessments and screenings as identified in the tier-specific program requirements;

iii. During the case planning process, the Tier 1 Specialist/Therapist will observe the parent-child interaction to gather information and determine follow-up services and additional activities to be included on the subsequent case plan;

iv. If the case is court involved, parents/caregivers agree to follow court orders.

p. A second assessment-based Family Case Plan shall be completed within twenty (20) days of referral;

q. A Child Case Plan shall be completed, in addition to the Family Case Plan, on any child in the custody of DCF to address safety concerns and any court orders pertaining to the child or parents/caregivers. The Child Case Plan shall be completed at IFM, if possible, but within twenty (20) days of referral and submitted to court following local jurisdictional requirements in collaboration with DCF;

r. All completed and signed case plans shall be submitted to DCF within five (5) working days of completion;

s. A Tier 1 FPS Specialist/Therapist shall provide a wide range of goal-directed services to the family, which may include both therapeutic and case management services. Examples of these interventions include, but are not limited to:

i. Crisis Intervention and stabilization;ii. Resolving child abuse and serious neglect concerns;

iii. Therapeutic relationship building for conflictual relationships, including domestic violence and parent-child conflicts;

iv. Providing education, and/or intervention, related to sexual abuse, domestic violence and substance abuse prevention;

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v. Assessing child safety and risk, initially and ongoing, assisting the family in developing a behaviorally specific safety plan and monitoring for child safety;

vi. Screening or assessment for Substance Use Disorders and referring for treatment services when indicated;

vii. Writing and monitoring a Plan of Safe Care when referral is for a Pregnant Woman Using Substances (PWS) or a child is born into the family substance-affected as determined by a medical professional;

viii. Teaching child behavior management skills to parent/caregivers with Seriously Emotionally Disturbed (SED) children or children at risk of inpatient psychiatric treatment;

ix. Family, individual and/or marital therapeutic interventions to address mental health issues;

x. Assisting the family in meeting identified medical needs such as arranging for substance use disorder treatment for family members and assisting in making available follow-up support resources when treatment is completed;

xi. Teaching, assisting and modeling skills needed to provide a positive family environment;

xii. Referring and linking the family with needed community resources and services;xiii. Complete Court Reports within established timelines. Testify in court proceedings

as required on all court involved cases;

t. Crisis intervention and management to mitigate child safety concerns shall be the primary goal of Tier 1 intensive services. Initial determination of safety and risk factors will be identified on the DCF referral form. As part of addressing child safety and family crisis stabilization, the applicant shall identify and describe the use of an evidence-supported crisis intervention or family stabilization model and how it will be implemented with fidelity;

u. The Grantee shall utilize Motivational Interviewing techniques and ensure FPS Specialists/Therapists are trained in the use of these skills in relation to working with all families, but specifically those with substance use disorders;

v. A Tier 1 FPS Specialist/Therapist shall complete DCF-approved family screens and assessments, as age appropriate, within fifteen (15) calendar days of IFM, to include:

i. SDM – SDM shall be an ongoing assessment tool to be completed at initial referral and at critical points in the referral period,

ii. CSDC-KS – Ages 0-18, screening for child’s history of trauma and current symptoms,

iii. CROPS – Ages 6-18, screening for child’s history of trauma and current symptoms,

iv. ASQ – SE – Ages 0-2, screening for social-emotional functioning,v. PECFAS – Ages 3-5, assessing behavioral health functioning,

vi. CAFAS – Ages 6-18, assessing behavioral health functioning,vii. PSI-SF – assessing parenting stress,

viii. UNCOPE – screening for adults and youth 13 and older for current substance use disorders,

ix. ACE’s screen for parent(s) – assesses the number of Adverse Childhood Experiences an adult has experienced.

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w. The Grantee shall utilize the results of initial and ongoing assessments throughout the life of the referral and provide ongoing safety assessments at critical times in the case;

x. Assess family’s need for, and provide flex funds to purchase concrete goods and services to meet the family’s basic needs or ensure child safety;

y. The Grantee shall notify the assigned DCF CPS Specialist no later than three (3) calendar days after determining a family cannot be located or the family disengages from services. Grantee shall notify DCF immediately if the child is in danger or a child’s safety cannot be determined;

z. Discuss case closure recommendations with the DCF CPS Specialist prior to case closure;

aa. A case closure conference with the family shall occur no later than seven (7) days prior to anticipated case closure. The DCF CPS Specialist shall be invited to the case closure conference. Case closure documentation shall include family strengths, progress toward case plan goals and activities and recommendations for continued case management services or description of linkage to community services put in place to mitigate any existing safety concerns. A written case closure summary will be provided to the family and DCF;

bb. The Tier 1 FPS Specialist/Therapist shall request the family complete a standardized Customer Satisfaction Survey at, or prior to, the last family contact;

cc. The Tier 1 FPS Specialist/Therapist may close the family’s case at the successful conclusion of the Tier 1 FPS service period, or make recommendation to the DCF CPS Specialist for a referral to an appropriate FPS Case Management tier, based on the family’s assessed needs and existing risk or safety concerns at time of case closure;

dd. Facilitate a meeting with the new FPS Case Management team and DCF CPS Specialist when a Tier 1 FPS family has a planned transition to FPS Case Management Tier 2 or 3 and complete a designated Case Transfer Form;

ee. Participate in identifying elements to be included on an initial and/or assessment-based Family Case Plan with the family, DCF CPS Specialist and new FPS Case Management team prior to case closure, if the family is being transitioned to Tier 2 or Tier 3 FPS Case Management services.

Family Preservation Services Case Management for both Tier 2 (Short-term) and Tier 3 (Long-term) will be provided through a team approach with a worker dyad including a Case Manager with a minimum of a Bachelor’s degree from an accredited university in Social Work or a related field, as defined by DCF and a Family Support Worker (FSW). Together, the FPS case management dyad will have a maximum caseload of 25 families, working with a combination of both Tier 2 and Tier 3 families. Assignments made within the two (2) case management tiers will be expected to balance out caseload responsibilities. Tier 2 services will be provided primarily by the Case Manager with support from a Family Support Worker. Tier 3 services may be provided primarily by the FSW position with oversight of the assigned case manager and FPS supervisor.

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The applicant will describe their understanding of the tiered system of case management and how caseloads will be managed. Applicants will ensure the following minimum program requirements specific to each Case Management Tier are implemented into practice:

1. Tier 2 – FPS Short-Term Case Managementa. FPS Short-Term Case Management Services shall be three (3) to six (6) months in duration;

b. If determined necessary to ensure child safety, by the referring DCF CPS Specialist and DCF Supervisor in collaboration with the assigned FPS Case Manager and Supervisor, one additional three (3) to six (6) month referral for Tier 2 level of services may be approved by the DCF Regional Assessment and Prevention Program Administrator;

c. Caseload size shall be 10 to 12 families in FPS Short Term Case Management Services (Tier 2) per dyad of one assigned Case Manager and one assigned Family Support Worker. This dyad may also provide services to an additional 10-12 families who are receiving Long Term Case Management Services (Tier 3 services, see below) in which the Family Support Worker will be providing the majority of direct services, for a total of 20-24 families per dyad;

d. FPS Case Management teams shall be supervised by an individual who holds a minimum of a Bachelor of Social Work license or is a Licensed Masters level practitioner in a DCF-approved field. Supervisors must have 3 years’ experience in children and family services;

e. A FPS Case Management Supervisor will supervise a maximum of 4 case management dyads, each dyad carrying a maximum of 20-24 families, half receiving Tier 2 services and half receiving Tier 3 services, for a maximum of 100 open case management family cases;

f. There is an expectation A FPS FSW will meet with the family as needed, but the assigned Case Manager shall spend a minimum of one hour weekly meeting face-to-face with the family in the family’s home. The assigned Case Manager shall meet with each child, alone, at least monthly. These visits must address safety, well-being and family’s input and progress on completing case plan activities;

g. A case may be suspended in extreme circumstances as determined by the FPS Supervisor and FPS assigned Case Manager in consultation with the referring DCF CPS Specialist. A case may be suspended for a maximum of two (2) weeks when a family is unable, or unavailable, to meet. Examples of situations where a case could be suspended:

i. Death in the family requiring travel out of referral area;ii. Planned family vacation;

iii. Child(ren) visiting relatives out of state for an extended period;iv. Family refuses to continue services and DCF has been notified to assist with re-

engagement efforts;

h. The Grantee shall provide services in the family’s home, or at the family’s request, a location mutually agreed upon by the Grantee and family. However, if the documented child safety concerns relate specifically to the home environment, visits shall occur in the home;

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i. Applicant will describe their crisis-response policy and practice to ensure every family has access to FPS Case Management staff 24 hours a day, 7 days a week, in the event of an emergency or an immediate child safety concern;

j. Examples of criteria for referral for services would include, but are not limited to, the following:

i. Safety and Risk Assessment by DCF CPS Specialist prior to referral indicating family is at moderate to high risk for subsequent maltreatment or out-of-home placement and/or has a history of multiple intakes unsubstantiated, affirmed or substantiated for abuse or neglect;

ii. Safety and Risk Assessments completed by the DCF CPS Specialist prior to referral or by the FPS Specialist/Therapist during Tier 1 FPS indicating the family is at moderate to high risk for subsequent maltreatment or out-of-home placement without ongoing in-home FPS case management services;

iii. Trauma assessments completed during Tier 1 services by the FPS Specialist/Therapist indicating a child or parent/caregiver has experienced four (4) or more Adverse Childhood Experiences (ACEs) and a child is at risk of abuse, neglect or out-of-home placement without ongoing in-home services;

iv. Substance Use/Misuse screening, such as the UNCOPE, conducted by the DCF CPS Specialist or FPS Tier 1 Specialist/Therapist indicating a child/adolescent or parent/caregiver/pregnant woman has a current substance use disorder which places a child or children at risk of abuse, neglect or out-of-home placement;

v. Based on assessments completed, or information acquired by the DCF CPS Specialist or Tier 1 FPS Specialist/Therapist, indicating a parent or caregiver has identified, stabilized mental health issues, which has the potential to place a child or children at risk of abuse, neglect or out-of-home placement without ongoing FPS in-home services being put in place;

vi. Assessments completed by the DCF CPS Specialist or Tier 1 FPS Specialist/Therapist indicating a parent/caregiver lacks adequate parenting skills to parent a child or children who have demonstrated difficult behavior at school or home, which places the child at risk of out-of-home placement and/or inpatient mental health treatment, without ongoing in-home FPS case management services.

k. All referrals will be accepted by the Grantee if the referral meets any of the criteria listed

above, and/or the DCF CPS Specialist documents other safety or risk concerns deemed appropriate for a Tier 2 referral;

l. Families must be contacted within 24 hours of referral and an in-person meeting scheduled. The assigned Case Manager shall facilitate the Initial Family Meeting (IFM) within 48 hours of the referral;

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m. The assigned Case Manager and Family Support Worker shall work together to provide services to the families on the Licensed Case Manager’s assigned caseload;

n. The applicant will describe their understanding of the transition process taking place when moving a family from intensive services in Tier 1 to a case management Tier 2 or Tier 3. A case closure conference shall occur within two (2) weeks of the anticipated case closure date for Tier 1 services. To assist the family in engaging with newly assigned workers, cases approved for transition from Tier 1 Intensive FPS to one of the two case management tiers will require the assigned case management dyad to participate in the Tier 1 case closure conference, transition case planning and/or safety planning;

o. The applicant shall describe the case planning process for families who transition between tiers. Elements to be included in the case management case plan may be developed at the Tier 1 case closure conference, prior to the date of transition, and will address any safety and/or risk factors identified by the referring DCF CPS Specialist in the written referral to Tier 2;

p. A designated case transfer form shall be completed, reviewed and placed in the case file, when a family moves from Tier 2 services to another service tier or the case is transferred to a new member of the FPS case management team or supervisor;

q. Grantee will ensure DCF-approved screening tools and assessments, as age appropriate, are completed within fifteen (15) calendar days of the Initial Family Meeting (IFM). To guide case planning, the following assessments must be completed with the parents/caregivers and/or children, unless they have previously been completed within the past six (6) months and results are available to the case management team:

i. SDM – SDM shall be an ongoing assessment tool to be completed at initial referral and at critical points in the referral period.

(a) CSDC-KS – Ages 0-18, screening for child’s history of trauma and current symptoms,

(b) CROPS – Ages 6-18, screening for child’s history of trauma and current symptoms,

(c) ASQ-SE – Ages 0-2, screening for social-emotional functioning,(d) PECFAS – Ages 3-5, assessing behavioral health functioning,(e) CAFAS – Ages 6-18, assessing behavioral health functioning,(f) PSI-SF – assessing parenting stress,(g) UNCOPE – screening for substance use disorders,(h) ACE’s screen for parent(s) – assesses the number of Adverse Childhood

Experiences an adult has experienced.

r. A Tier 2 case manager will screen for substance use disorders and refer for assessment and treatment services when indicated;

s. A Tier 2 team member will be responsible for writing and/or monitoring a Plan of Safe Care when referral is for a Pregnant Women Using Substances (PWS) or a child is born into the family that is substance-affected as determined by a medical professional;

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t. Family Support Workers will assist the family with learning skills to strengthen the family system and decrease the risk of abuse, neglect or out-of-home placement, as identified on the case plan;

u. FPS case management staff will provide services utilizing one or more of the evidence based programs from each category in the list below, based on the family’s assessed needs for parenting support, substance use disorder treatment and/or mental health services, ensuring program fidelity:

i. Parenting Support Program(a) 123 Magic: Effective Discipline for children 2-12 years(b) 123 Magic: Effective for adolescents 13-18 years(c) Triple P – Positive Parenting Program(d) Systematic Training for Effective Parenting (STEP) for birth to

adolescence(e) Tuning in to Teens(f) Tuning in to Kids(g) Supporting Father Involvement(h) Parent Management Training- Oregon (PMTO) Model(i) SafeCare

ii. Substance Abuse Treatment for Families(a) Motivational Interviewing(b) Adult-Focused Family Behavior Therapy(c) Project ASSERT (Alcohol and Substance Abuse Services Education and

Referral for Treatment)(d) Project EX(e) Active Parenting of Teens: Families in Action

iii. Mental Health Treatment for Families(a) Alternatives for Families: Cognitive Behavior Therapy(b) Project TALC (Teens and Adults Learning to Communicate)(c) Child FIRST(d) Problem-Solving Therapy(e) Family Talk (Clinician-Based Cognitive Psychoeducational Intervention

for Families)

v. The applicant shall describe how their FPS Case Management team will utilize the results of safety and risk assessments and/or additional assessments completed by the DCF CPS Specialist, Tier 1 FPS Specialist/Therapist or assigned Case Manager, and how they will collaborate with community partners and utilize community resources in linking families to appropriate services.

i. Examples of community referrals include:(a) Community Mental Health Center (CMHC) (b) Psychiatric Residential Treatment Facility (PRTF)

admission/screening/discharge(c) Regional Alcohol and Drug Assessment Center (RADAC)/Licensed

Addiction Counselor (LAC)

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(d) Families Together/Community Developmental Disabilities Organization (CDDO)

ii. Following a referral to a community resource for services, such as a CMHC, PRTF, counseling program or LAC for substance use disorders, a FPS case management team member shall contact the assigned mental health therapist, LAC or contact person to share the results of the completed assessments of the family, the family’s identified needs and the specific needs of the family/family member to address the goals and activities of the case plan as appropriate.

w. The Tier 2 case management team will complete an initial Family Case Plan at the IFM, in

collaboration with the family, to address risk and safety concerns, risk factors, family strengths and protective factors and case plan activities assigned. A copy of the case plan shall be provided to the family. The initial case plan will address the reasons for referral to Tier 2 services and the activities assigned shall address any newly identified safety concerns and/or risk factors;

i. If the family is referred directly by a DCF CPS Specialist, the initial Family Case Plan will be completed at the IFM, which is conducted within 48 hours of the referral. All family members, seven (7) years of age and older who have the cognitive ability to participate, shall sign the case plan. If any required family member fails to sign the case plan at the IFM, every attempt shall be made to engage the family/family member and complete a signed initial case plan within five (5) working days of the referral. This initial case plan shall address the following:

(a) Reasons for referral;(b) Any immediate child safety concerns;(c) Assessments and activities to be completed with the family prior to the

second case plan;(d) Observations by the FPS case management staff related to parent-child

interactions to gain information and determine, in collaboration with the family, additional activities that may be included in the subsequent case plan.

ii. If a determination is made the family needs FPS case management services after completion of Tier 1 services and a referral is approved by DCF, the DCF CPS Specialist, FPS Specialist/Therapist and assigned Case Manager will participate in the transition planning with the family at the case closure conference in preparation for developing an initial case plan with the family within 48 hours of DCF’s referral to case management services;

iii. A second case plan will be completed with the family within 20 calendar days from the referral date, utilizing all available assessments to identify the family’s needs, the services to be provided and activities to be included on the case plan;

iv. Case plans are due to DCF within five (5) working days of the date of completion with the family and will document input from the parents/caregivers and child(ren), by their signatures;

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v. All Family Case Plans will be current and updated by the Grantee within 170 days during the service period;

vi. In addition to a Family Case Plan, a Child Case Plan will be completed within 20 days of the referral, for each child in the custody of DCF to include all applicable court orders, safety-related concerns and identified activities to be completed. Subsequent Child Case Plans must be updated within 170 days. All case plans shall be submitted to DCF and the court per local jurisdictional requirements. A Grantee’s case will not be closed if a child remains in DCF custody, unless the service period has expired and DCF does not make a subsequent referral for ongoing services;

vii. The DCF CPS Specialists will be invited, in advance, to participate in each case plan completed with the family;

x. The assigned Case Manager shall be responsible for completing Court Reports, when applicable, which document the family’s progress in completing case plan activities and court orders, within established timelines and in collaboration with DCF. FPS Case Management staff shall testify in court proceedings as required for all court involved cases;

y. Assess family’s need for and provide flex funds appropriately and within allowable limits to meet the family’s basic needs and/or maintain the child(ren) in the home;

z. Notify assigned DCF CPS Specialist no later than three (3) working days when it has been determined a family cannot be located or the family disengages from services. Notify DCF immediately if any immediate child safety concerns exist or child safety cannot be determined;

aa. The case management team shall discuss Tier 2 case closure recommendations with the DCF CPS Specialist prior to a case closure conference occurring;

bb. A case closure conference shall occur no later than seven (7) days prior to anticipated case closure. The family and DCF CPS Specialist shall be invited to attend the case closure conference. Case closure documentation shall include family strengths, progress toward case plan activities, a recommendation for continued case management services or a description of family’s linkage to community services to mitigate any existing safety factors. A copy of the case closure summary shall be provided to the family and DCF upon case closure.

2. Tier 3 – Long Term FPS Case Managementa. Long-Term FPS Case Management shall be a service period of six (6) months to a maximum

of 365 days in duration, unless approval to close the case earlier is granted by the DCF Regional PPS Program Administrator or designee due to reasons beyond the control of the Grantee, such as the family moving to another state or placing their children with relatives in another state. Case management responsibility will resume if the family moves back in state within the referral period;

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b. As determined by the referring DCF CPS Specialist and DCF supervisor, subsequent referrals for Tier 3 services may be approved and made by DCF in instances where the family continues to need services to avoid the removal of a child from home and/or any child remains in DCF custody at the end of the Tier 3 service period;

c. Caseload size shall be a maximum of 10 to 12 families in Tier 3 Long-Term Case Management services, in addition to 10 to 12 families in Tier 2 being served by the same dyad of workers in Short Term Case Management services;

d. Caseloads will be served by a dyad consisting of an assigned Case Manager, which may be an LBSW or a Bachelor’s level practitioner in a DCF approved professional field, and Family Support Worker. The FPS Case Management dyad caseload size for combined Tier 2 and Tier 3 cases shall not exceed 25 families;

e. FPS Case Management teams shall be supervised by an individual who holds a minimum of a Bachelors of Social Work license or is a Licensed Masters level practitioner in a DCF-approved field. Supervisors must have three (3) years’ experience in child and family services;

f. A FPS Case Management Supervisor will supervise a maximum of 4 case management dyads, for a maximum of 100 Tier 2 and Tier 3 open cases;

g. Frequency of home visits shall be based on assessed family needs and risks as well as case plan goals and activities. The assigned Case Manager or assigned Family Support Worker shall be designated to see each child, alone, at least monthly and these visits must address safety, well-being and the child’s input and progress toward case plan activities and goals per DCF policy. The assigned Family Support Worker is expected to meet with the family face-to-face, at least weekly at the beginning of the referral, until the family is engaged in services. The FSW shall meet face-to-face with the family a minimum of one hour every other week, when the family is learning and practicing new skills, for the duration of the referral period;

h. A case may be suspended in extreme circumstances as determined by the FPS Case Management Supervisor and FPS assigned Case Manager in consultation with the referring DCF CPS Specialist. A case may be suspended for a maximum of two weeks when a family is unable, or unavailable, to meet. Examples of situations where a case could be suspended:

i. Death in the family requiring travel out of the referral area;ii. Planned family vacation;

iii. Child(ren) visiting relatives out of state, or out of region, for an extended period;iv. Family refuses to continue services and DCF has been notified to assist with re-

engagement efforts;

i. Services shall be provided in the family’s home or, at the family’s request, a location mutually agreed upon by the Grantee and family. However, if the documented child safety concerns or risk factors relate specifically to the home environment, visits shall occur in the home;

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j. The applicant will describe their crisis-response policy and practice to ensure every family can access FPS Case Management staff in the event of an emergency or an immediate child safety concern to include after business hours and weekends;

k. Examples of criteria for referral include, but are not limited to, the following: i. Risk Assessment completed by DCF CPS Specialist indicating family is at low to

moderate risk for subsequent maltreatment or out-of-home placement and/or has a history of multiple unsubstantiated intake findings for abuse or neglect, or multiple non-abuse neglect intakes;

ii. Risk Assessment completed during Tier 1 or Tier 2 services by FPS Specialist/Therapist or Licensed Case Manager indicating family remains at low to moderate risk for subsequent maltreatment or out-of-home placement without ongoing in-home support services in place;

iii. Trauma assessment by FPS Specialist/Therapist or Licensed Case Manager during Tier 1 or Tier 2 services indicating the child or parent/caregiver has experienced less than four (4) Adverse Childhood Experiences (ACEs) and child remains at low to moderate risk of abuse, neglect or out-of-home placement without ongoing in-home services in place;

iv. Substance use/misuse screen, such as UNCOPE, conducted by DCF CPS Specialist, FPS Specialist/Therapist or assigned Case Manager indicating a child/adolescent or parent/caregiver/pregnant woman has a substance use disorder, but such disorder is being addressed through treatment and child, or children, are at low to moderate risk of abuse, neglect or out-of-home placement;

v. Formal and/or informal assessments completed by DCF CPS Specialist prior to referral, or FPS Specialist /Therapist or assigned Case Manager during Tier 1 or Tier 2 services, indicating a family is appropriate for referral based on the following criteria in DCF policy:

(a) The family is at risk of having a child(ren) removed;(b) A parent/caregiver is available to protect the child;(c) A parent/caregiver is willing and able to participate in services;(d) A family with chronic problems has experienced a significant change

which makes them able to progress;(e) A parent/caregiver with mental/emotional health issues has been

stabilized;(f) A parent/caregiver with limitations demonstrates an ability to care for self

and children;(g) A parent/caregiver with substance abuse issues functions adequately to

care for children.

vi. Formal and/or informal assessments completed by the DCF CPS Specialist prior to referral, or FPS Specialist/Therapist or licensed Case Manager during Tier 1 or Tier 2 services, indicating a parent/caregiver lacks adequate parenting skills to meet the basic needs of the child or children without additional support services being provided.

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l. All referrals will be accepted if the criteria listed above is met, or other risk factors are

identified by the referring DCF CPS Specialist documenting the need for an extended, low intensity, intervention and support services.

i. Safety and/or risk factors supporting the reason for referral shall be documented clearly in writing;

ii. Families shall be contacted within 48 hours of the referral and the IFM scheduled within five (5) working days of referral.

m. An assigned Case Manager and FSW will work together to provide services to the families on the assigned Case Manager’s assigned caseload, although most Tier 3 direct service will be provided by the FSW, with oversight from the licensed Case Manager and FPS Supervisor;

n. To assist the family in engaging with newly assigned workers, cases approved for transition from another Tier of FPS will require the assigned case management workers to participate in the case closure conference with the Tier 1 Specialist/Therapist or the Tier 2 assigned Case Manager and the referring DCF CPS Specialist, to initiate case planning, and safety planning;

o. A designated case transfer form will be completed and reviewed if FPS Tier 3 services require newly assigned FPS workers and/or supervisor;

p. Examples of services to be provided during the Tier 3 FPS Case Management Services would include, but are not limited to, the following:

i. Screening for substance use disorders and referring for treatment services, when indicated, if not previously identified by DCF or FPS staff;

ii. Writing and/or monitoring a Plan of Safe Care when referral is identified as a PWS or a substance-affected infant, as determined by a medical professional, is born into the family;

iii. The assigned Family Support Worker’s role will be to assist the family with learning skills needed to change behaviors to decrease the risk of abuse, neglect or out-of-home placement, as identified on the case plan. Examples of services and teaching skills provided to the family include, but are not limited to:

(a) Securing adequate housing;(b) Securing adequate basic income needed, to meet the children’s basic

needs, including applying for public benefits and/or seeking employment;(c) Budgeting;(d) Providing guidance on adequate child nutrition and meal planning;(e) Ensuring children attend school as required by law and monitoring

attendance;(f) Advocating for child(ren)’s educational needs;(g) Housekeeping skills needed to maintain a minimally adequate home

environment that is free of safety hazards; (h) Using public transportation or ensuring transportation is available;

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(i) Supporting families in initiating or maintaining linkages to community resources and programs;

iv. The assigned case management dyad may also provide the following support services to the family:

(a) Transporting the family to community resources, appointments, and court hearings, as needed;

(b) Care Coordination in the community;(c) Follow-up monitoring of substance use disorder treatment/services,

including ensuring drug testing is completed as warranted;(d) Ensuring children’s basic needs for physical and dental health are met; (e) Accessing specific services or goods through the CarePortal community

connection if needed and available, or through other community resources.

v. Based on the family’s assessed needs, FPS staff will provide skill building opportunities and parenting support utilizing one or more of the Evidence Based programs from the list below, based on the family’s assessed needs and ensuring program fidelity:

(a) 123 Magic: Effective Discipline for children 2-12 years(b) 123 Magic: Effective for adolescents 13-18 years(c) Triple P – Positive Parenting Program(d) Tuning in to Teens(e) Tuning in to Kids(f) Supporting Father Involvement(g) Systematic Training for Effective Parenting (STEP) for birth to

adolescence(h) SafeCare

vi. To guide case planning, DCF-approved family screenings and assessments, shall be completed within twenty (20) working days of the IFM, with the parents/caregivers and age appropriate children, unless assessments were completed within the past six (6) months and results are available to the assigned Case Manager. It will be the assigned Case Manager’s responsibility to complete the following assessments, if not already completed, and develop a case plan utilizing assessment results to meet the family’s identified needs:

(a) SDM – Safety assessment for child protection and reassessment of risk for families receiving in-home services, throughout the life of the referral at critical points and prior to case closure

(b) CSDC-KS – Ages 0-18 years, screening for child’s history of trauma and current symptoms

(c) CROPS – Ages 6-19 years, screening for child’s history of trauma and current symptoms

(d) ASQ-SE – Ages 0-2 years, screening for social-emotional functioning(e) PECFAS – Ages 3-5 years, assessing for behavioral health functioning(f) CAFAS – Ages 6-18 years, assessing for behavioral health functioning(g) PSI-SF – assessing Parenting Stress(h) UNCOPE – screening for substance use disorder

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(i) ACE’s screen for parent(s) – assesses the number of Adverse Childhood Experiences an adult has experienced

vii. The applicant shall describe how their FPS Case Management dyad will utilize the results of safety and risk assessments and/or additional assessments completed by the DCF CPS Specialist, Tier 1 FPS Specialist/Therapist or assigned Case Manager, and how they will collaborate with community partners and utilize community resources in linking families to appropriate services. Examples of community referrals include, but are not limited to, the following:

(a) CMHC(b) PRTF Admission/Screening(c) RADAC/LAC(d) Families Together/Community Developmental Disabilities Organization

(CDDO)(e) Early Childhood Education(f) Infant Toddler Program(g) Parents as Teachers(h) Public Housing Authority

viii. Following a referral to a community resource including a CMHC, a counseling program, or LAC, a member of the FPS Case Management team will contact the assigned mental health therapist, LAC or contact person to share the results of the assessments completed with the family, the family’s identified needs, and the specific needs of the family/family member to address the goals and activities of the case plan as appropriate.

q. Case Planning shall occur in collaboration with the family and referring DCF CPS Specialist.

The initial case plan will address the reasons for referral to Tier 3 services and activities assigned shall address all safety concerns and/or risk factors identified on the referral form.

i. If a family is referred directly to Tier 3 services by a DCF CPS Specialist, the initial Family Case Plan will be completed at the IFM, which is conducted within five (5) working days of the referral. The initial case plan shall address the reasons for the referral and the assessments/activities to be completed with the family prior to the next case plan. If the family refuses to sign the case plan at the Initial Family Meeting, every attempt shall be made to engage the family and complete a signed case plan. DCF shall be notified immediately if a family refuses to sign a case plan and a request shall be made to DCF to assist the Grantee’s case management staff in engaging the family;

ii. If the family is referred from FPS Tier 1 services, the assigned Case Manager and FSW will participate in a transitional case plan meeting with the FPS Intensive Services Specialist/Therapist and family during the two-week transition period from FPS Intensive Services to Long-Term FPS Case Management Services;

iii. The second assessment-based case plan will be completed with the family within 30 days from the referral date, utilizing all available assessments to identify the family’s needs and the services to be provided;

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iv. Case plans are due to DCF within five (5) working days of the date of completion with the family and will document the parents/caregivers’ and child/children’s input and signatures. All family members seven (7) years of age and older, who have the cognitive ability to participate must sign the case plan;

v. All Family Case Plans will be current and updated within 170 days during the service period by the assigned Case Manager;

vi. In addition to a Family Case Plan, a Child Case Plan will be completed for each child in the custody of DCF within 20 days of the referral and submitted to DCF and the court per local jurisdictional requirements. Each Child Case Plan shall be updated by the assigned Case Manager at least every 170 days and submitted to DCF and the courts per local requirements. A case will not be closed unless the child is released from DCF custody or DCF does not make a subsequent referral at the expiration of the service period;

vii. DCF CPS Specialists will be invited, at least three (3) days in advance, to participate in the initial case plan at the IFM and at least five (5) days in advance for subsequent case plans completed with the family;

r. The assigned Case Manager shall be responsible for completing Court Reports, when applicable, to include the family’s progress in completing case plan goals and activities, within established timelines and in collaboration with DCF. FPS Case Management staff shall testify in court proceedings as required for all court involved cases;

s. Assess the family’s need and provide for flex funds when use of those funds will meet the family’s basic needs and/or are required to maintain the child(ren) safely in the home. Request additional flex funds when necessary from the regional DCF office if the maximum $500.00 has been utilized to meet the family’s identified needs;

t. Notify assigned DCF CPS Specialist no later than five (5) working days when it is determined the family cannot be located or the family disengages from services and collaborate with the referring DCF CPS Specialist on next steps;

u. Discuss case closure recommendations with the DCF CPS Specialist prior to the Tier 3 case closure conference;

v. A case closure conference shall occur no later than seven (7) days prior to the anticipated case closure. The family and DCF CPS Specialist shall be invited to attend the case closure conference;

w. Case closure documentation shall include family strengths, progress toward case plan activities and recommendation for continued FPS case management services; or, a description of linkage to community services put in place to mitigate any existing risk factors. A copy of the case closure summary shall be provided to DCF and the family.

F. Reporting

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The Grantee will have, or will develop prior to grant award, a system to track information identified by DCF’s policy or practice needed to maintain current client information, document worker/child alone visits, worker/family and collateral interactions, statistics for program outcome measurement and be adaptable to developing reports for data as DCF determines necessary to monitor Grantee performance related to child safety and well-being.

The Grantee is required to submit quarterly management reports to DCF outlining new program initiatives, barriers to service delivery, changes in programming, results from Customer Satisfaction Surveys and statistics pertinent to successful program outcomes utilizing a DCF approved format. Included in the quarterly management report should be any actions taken to address client comments or suggestions. Quarterly reports shall include minutes and sign-in sheets from meetings with the Grantee’s established community advisory groups and alumni activities.

The Grantee will establish a client complaint logging system including specific client concerns, dates of initial client contact and resolution of any client complaints. This complaint log shall be made available to DCF at annual site visits or within one (1) business day upon request.

The Grantee will establish a tracking and reporting system to notify DCF of critical and significant incidents, as defined in DCF policy. Critical Incidents shall be reported to DCF within 12 hours of knowledge of the incident and 24 hours, in writing. Reports of Critical Incidents and Significant Incidents shall be separate reports, provided monthly per DCF definitions and policy.

G. Staff/Grantee Qualifications 1. The Grantee must maintain offices in Kansas within the region for which they are applying. They

must be licensed to do business in the State of Kansas. Location and license must be established by the time the grant is signed.

2. All applicants must be accredited by a national accrediting health and/or human services organization, such as Council on Accreditation or The Joint Commission. Applicant must include a letter from their accrediting body with their application reflecting they are current and in good standing.

3. The Grantee must include a discussion of its qualifications and experience in providing the services that are the subject of this RFP. They must be an established firm recognized for its capacity to perform these services. They must be capable of mobilizing sufficient personnel to meet the staffing and service requirements specified in the request. They shall discuss how the organizational structure will facilitate the delivery of services.

4. Staff shall receive a clear background check, based on finger prints submitted to the Kansas Bureau of Investigation, prior to working with DCF clients. All Grantee staff providing direct services to consumers shall have annual criminal record checks through the Kansas Bureau of Investigation, unless enrolled in the RapBack program, and shall be cleared annually through the Kansas Child Abuse and Neglect as well as the Adult Abuse, Neglect, Exploitation Central Registries. Staff who have re-located to Kansas in the last five years shall have an FBI fingerprint check. The FBI fingerprint check is only required once, at the time of hire.

5. Every staff member in a professional position, including specialists and therapists, shall have a minimum of a Master’s Degree from an accredited university and shall be licensed by the Behavioral Sciences Regulatory Board to practice in Kansas (i.e. Social Worker; Marriage and Family

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Therapist; Psychologist; Professional Counselor and/or Addiction Counselor). All case managers shall have a minimum of a Bachelor’s degree in Social Work or a related field, which includes the following: Community Counseling, Human Development, Child and Family Development, Applied Family and Youth Studies, Public Health, Health Sciences, Trauma Studies, Sociology/Social Services, Substance Abuse/Addictions, Education/Early Childhood, or Psychology.

6. All Intensive Family Preservation Services (Tier 1) supervisors shall have a minimum of a Master’s Degree in the human services field, as listed in #5 above, and be licensed to practice in Kansas. All FPS Case Management (Tier 2 or Tier 3) supervisors shall have a minimum of a Bachelor’s Degree in the human service field and be licensed by the Behavioral Sciences Regulatory Board to practice in Kansas. All supervisors shall have at least three (3) years’ experience in child and family services.

7. All para-professionals, including Family Support Workers, working directly with families must have a High School diploma, or equivalent, and two (2) years’ experience in the child and family services field. Two (2) years of education in a human services field may be substituted for two years of experience.

8. The application shall include resumes of administrative personnel assigned to the project, commencing with the Program Director and above. Each region shall have a separate Program Director. The application shall include job descriptions for those filling professional and paraprofessional positions.

9. Clinicians and therapists must be licensed by the Kansas Behavioral Sciences Regulatory Board and meet the Board’s educational and experience requirements.

10. Services shall be provided by an Addiction Counselor or Clinical Addiction Counselor, licensed through the Behavioral Sciences Regulatory Board, for families in which a parent or pregnant woman is affected by a substance use disorder or gives birth to an infant that is substance-affected as determined by a medical professional. If a Grantee does not have appropriately trained and licensed employees to provide assessments and treatment as needed, the Grantee may subcontract with a DCF-approved licensed substance abuse treatment provider to ensure the availability of substance use disorder services.

11. The Grantee shall obtain, maintain and provide proof of Professional Liability and Automobile Liability Coverage for Client Transportation to the Office of Grants and Contracts if award is received.

H. State Services to be Provided 1. Provide oversight, monitoring, guidance and case or program specific direction as deemed

necessary.

2. Identify reasons for referral and child safety concerns to be addressed.

3. Reserve the right to require the reassignment of Grantee’s personnel who work under the grant.

4. Refer the family to the Grantee within 24-hours of DCF decision a family needs FPS.

5. Assist Grantee staff who experience difficulties in beginning the engagement process when requested.

6. Make prompt payment as per the grant payment structure.39

7. Assist Grantee staff with training on the DCF SCRIPTS system for payments and encounter entries utilizing the SCRIPTS web portal.

8. Assure assessment information is available to the Grantee through Kansas Initiative for Decision Support (KIDS) or Structured Decision Making (SDM).

9. Assure additional referral information is sent to or accessible to the Grantee in a timely manner.

10. Support linkages between the Grantees, Juvenile Justice Authority and DCF.

11. Provide DCF case file information to the Case Management Grantee or to the Juvenile Justice Authority.

12. Obtain release of information for all third-party information known to DCF which pertains to the child(ren) and family. Provide the release document to the Grantee in a timely manner.

13. Provide all known information regarding all non-residential parents upon referral.

14. Participate in Initial Family Meetings and subsequent case planning meetings.

15. Collaborate on case closures and participate in case closure conferences with the Grantee and family.

16. Make new referrals for additional or ongoing FPS services when deemed necessary for the child’s safety or prevention of out-of-home placement.

17. Participate in Quality Assurance activities.

18. Coordinate on-site monitoring at least annually.

19. Facilitate the professional judgment resolution process.

20. Notify the FPS Grantee of any critical changes in the family’s situation verbally within twelve (12) hours, followed by written notification within 24 hours.

21. Keep Grantee informed of status of new and ongoing child abuse/neglect assessments.

22. Work with the court and the DCF attorney regarding court orders to meet federal and statutory compliance.

23. Assess safety and recommend to the court if a child cannot remain safely at home in collaboration with Grantee.

24. Notify the FPS Grantee of changes in client eligibility for Medicaid.

25. Provide technical assistance regarding all laws, regulations, policies and procedures impacting child welfare services.

26. Monitor service delivery process as outlined in Grantee’s application and DCF Policy and Procedure Manual (PPM).

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27. Assist with the development of a Performance Improvement Plan (PIP) and monitor the implementation of the plan.

28. Assist with the development of a Corrective Action Plan (CAP) and monitor implementation of the plan.

I. Quality Assurance (QA) and Program Improvement (PI) Quality Assurance (QA) measures compliance against a set of Federal and State standards. This process includes those staff who find there is an issue by reviewing data through reading case files. While they are reading these files, they are looking to see if Grantees are performing as they agreed to perform. In addition, the federal government is looking at the entire Child Welfare System for the State of Kansas to determine if the State of Kansas is performing as they are obligated to perform.

Performance Improvement (PI) is the continuous development of the performance improvement process. This process is the actual work in motion for change within the program. A QA team will read a case and identify where standards are not being met, while PI teams will go beyond that and focus on mentoring or training to make improvements to the work process itself.

QA and PI processes are intended to work together to recognize strengths in actual practices as well as areas needing additional consideration. QA and PI procedures will review in depth the effectiveness of assessments and the material gathering processes used within the child welfare system. Information gathered through the QA and PI practices will provide all administration an idea of performance and will guide QA and PI efforts for both local and Statewide levels.

The main objective for QA and PI is to guarantee the following: the system provides steady, superior services to the children and families of Kansas; the system provides protection and security for children residing in suitable and safe homes; there is a decrease in the opportunity for critical or significant incidents, per DCF policy; and the achievement of constant improvements in all programs and procedures necessary to reach desired outcomes.

The applicant shall identify within their proposal what their QA and PI plan is and should include their activities performed as well as processes and procedures for guaranteeing superior child welfare practices. The two areas may employ the same individuals, however a clear line for QA and PI programs should be identified within the applicant’s proposal. These plans will be updated at the beginning of each fiscal year and are to be submitted to DCF by July 31 of that year. Within this plan, the Applicant must identify their QA and PI processes, data collection and analysis to be performed, internal documentation of findings within and how the Grantee will work to make improvements when they are needed. The new QA and PI plan submitted to DCF should include material regarding local initiatives and/or innovations and how the Applicant is working within the community to provide exceptional service and strengthen families.

QA and PI processes give the Grantee and DCF administration timely and important information regarding negatively sloping trends in a specific process or procedure that could be fixed with timely interventions. If the Grantee identifies within their reviews this trend is occurring, they will be responsible for communicating this information to DCF in a timely manner and suggest ways to improve on performance as quickly as possible to assist in reversing the trend.

The Grantee will be required to work with PPS QA/PI and DCF Administrative Oversight during all QA and PI activities. Some of these activities will include, but are not limited to:

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1. Participation in continuous PI activities;2. Ensuring quality enhancement programs are comprehensive and on-going;3. Submission of quarterly management reports on a format established by DCF;4. Participation in PPS Case Review programs, case reads and stakeholder interviews;5. Provide case files or documentation as requested by DCF for ongoing and targeted case read

activities or audits within five (5) working days of request, unless a shorter timeframe is specified for a specific case;

6. Actively participate in discussions about results from case reads completed;7. Develop, complete and meet all requirements of a Corrective Action Plan (CAP) approved by DCF,

if warranted;8. Develop, complete and meet all requirements of a Program Improvement Plan (PIP) approved by

DCF, if warranted.

Applicant shall identify their training model provided to staff regarding QA and PI to ensure reviews and data collection are consistent. Such items to be included in the training model are: identification of QA roles and relationships, ability to have critical and reflective thinking skills while performing reviews, ability to exercise professional judgment during the review process, ability to utilize practice standards and indicators for evaluation, maintaining reliability, and proper data analysis and information sharing. Grantee shall also ensure staff have no direct contact, supervision, oversight, or consultation for any cases they are involved with reviewing.

Case reviews shall be performed on a quarterly basis, at a minimum. Grantee Administrators will provide overview reports of the results from their case reviews and other performance related data to DCF upon completion of the reviews. Reviews shall be documented on the tool specified by DCF, such as the current Onsite Review Instrument (OSRI). A sample of the current tool can be found as Appendix B. They will highlight successes, areas of opportunity, provide updates on current areas of focus, assess training concerns, performance issues, unit trends, and will work closely with DCF Administrative staff to brainstorm actions to address areas in need of improvement and other PI projects. The Grantee shall keep DCF staff informed of all QA and PI activities to include schedules of reviews to be performed, data analysis, review summary reports, etc.

Upon completion of case reviews, there shall be a scheduled debriefing session to discuss findings. This session will include, at a minimum, Grantee case managers, Grantee supervisors, other Grantee staff as needed and DCF staff. Face-to-face debriefings are preferred, but if there are inabilities to meet in person, a telephone conference call may be allowed. Debriefings must take place as soon as possible after reviews are completed to provide prompt feedback to case managers. If there is a disagreement on the review of a case that cannot be resolved during the review debriefing, PPS staff will send a brief description of such disagreement to PPS Administration. PPS Administration and the Grantee will work towards facilitation of a resolution. Grantee will submit a copy of their case review analysis to DCF upon completion of the debriefing conference.

Grantee PI Supervisors shall provide day-to-day oversight and guidance to case review staff. Grantee PI supervisors shall report results of supervisory reviews to grantee management to ensure all case management requirements are being completed as required, are planned for completion, and are also being tracked appropriately. A summary of these supervisory reviews will be provided to DCF on a quarterly basis, or more often as requested by DCF.

Grantee shall participate in all QA and PI projects requested by DCF. The Secretary of DCF, or other executive staff, may require a review of a specific process, or may require a statewide or local specific project be carried out during the term of the agreement. This specific review will likely require specially

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created review tools and other procedures depending on the review required.

J. Corrective Action Plans (CAP) To assess performance of the Grantee, the State will review and monitor accountability for child welfare programs through direct oversight, case read processes and administrative site visits. Case read and oversight activities are used to assess and improve the delivery of services to families. Results of case read and oversight activities may be published by DCF on the internet or in other public information material.

Poor performance on case read questions, nonconformities identified during an audit, not meeting the requirements of an administrative site review or other sources identifying a significant or repeated problem impairing performance or compliance may lead to the implementation of a Corrective Action Plan (CAP). The components of a CAP are:

Using clearly identified sources of data which identify problems to be investigated. Completing a root cause analysis to identify the cause of a discrepancy or deviation and suggest

corrective actions to potentially prevent recurrence of a similar problem or preventive action to ensure the discrepancies do not occur.

Implementing corrections to rectify the problem which is identified.

If a problem is identified by DCF, the Grantee shall develop a CAP approved by DCF to address the root cause of the issue and action steps to be taken to correct the problem, create improvements and prevent recurrence of the problem. Failure to meet CAP provisions shall require the Grantee to reimburse DCF for costs incurred in resolving the problem.

K. Random Moment Time Study (RMTS) Grantee staff shall participate in the RMTS. The RMTS is an email based system that randomly samples worker’s activities which is then used to determine the state and federal share of costs. Workers are sampled about four (4) to twelve (12) times per calendar quarter. The RMTS is an approved alternative to workers maintaining time records of 100% of paid time and is part of the agency cost allocation plan used to claim federal funds.

Grantees are required to identify the staff to participate in the RMTS and submit or confirm required information for each staff person quarterly. To make this process as simple and easy as possible, Grantees are required to update the roster for the immediate past quarter rather than submit a completely new roster each quarter. DCF will prepare an electronic Microsoft Word file of the roster for the current quarter and send it electronically to the Grantee’s RMTS Coordinator by the first day of the month preceding the end of each calendar quarter (March 1, June 1, September 1 and December 1). Grantees shall review the rosters and update as necessary, including marking the appropriate box for removing an employee from the roster or indicating there are no changes to an employee’s data. Rosters will be returned to DCF electronically by the 15th of the same month (March 15, June 15, September 15 and December 15). Data required on the roster includes the worker’s name, telephone number, e-mail address, employee ID, job class and work schedule. Space is provided for making changes to any of the data elements as well as adding new employees.

It shall be the responsibility of each Grantee to designate an RMTS Coordinator and alternate who will carry out the duties of maintaining and submitting the employee rosters, submitting weekly reports and responding to DCF’s questions related to the RMTS. Weekly reports will be sent electronically by DCF to the Grantees RMTS Coordinator. These reports will list RMTS sample moments for which a response has not been received, responses containing invalid code combinations and responses appearing to have used the

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codes inappropriately.

Coordinators shall contact each staff person listed on the report to obtain the codes and submit responses or changes to DCF electronically within one week of receiving the report.

Training will be provided by DCF on an as needed basis and attendance is a requirement when identified as such by DCF. Grantees are required to provide training to existing and new staff before the individuals can participate in RMTS sampling.

L. MIS Requirements The successful Grantee shall be required to use the State’s Computer Systems to include but not be limited to: FACTS, KIDS, and eSCRIPTS. The grantee is responsible for all costs associated with connecting to and remaining compatible with the State systems including but not limited to grantee site setup and installation of grantee owned equipment. The grantee shall have the ability to communicate with state systems electronically, including the ability to attach documents, as well as provide an electronic way to maintain case files accessible at all times to DCF. Information that may be used to assist the Grantee in determining costs necessary for application purposes is found in Appendix A (DCF Security Policy). Grantee will allow DCF Staff full and unrestricted access to all Grantee owned systems used in the administration of these grants. This is to include, but not be limited to, computer hardware, software systems, file systems, office space, etc.

All materials, included but not limited to, data, forms, procedures, software, manuals, system descriptions and work flows developed by the Grantee under this Agreement shall be owned and transferred to DCF at the conclusion of these grants. DCF hereby grants to the Grantee an irrevocable, royalty-free, nonexclusive right to reproduce, translate and use all material for its own non-commercial purposes.

Accessibility (ADA Compliance): All websites and web applications for DCF must meet the State of Kansas ITEC Policy 1210 (http://da.ks.gov/kito/itec/Policies/itecitpolicy1210.htm) which incorporates the Web Content Accessibility Guidelines (WCAG V2) and Section 508 accessibility guidelines. Websites/web-applications will be tested for accessibility before being placed in production by the testing team which will include but is not limited to testing using a screen reader (JAWS). For guidance on implementing the WCAG go to http://webaim.org/standards/wcag/checklist.

DCF will continue to expand its use of electronic storage and exchange of information. DCF and Grantees must take precautions to ensure the confidentiality and security of information. DCF expects that all Grantees have adequate password-protected desktops, along with firewall protection, and are HIPAA compliant with regard to the electronic data interchange, security, and privacy standards. Electronic interchange of data allows for information to be more efficiently transmitted. DCF will send as much information to Grantees as possible electronically and expects Grantees will do the same.

Over the life of the grant, improvements to systems and innovations in technology may facilitate data exchange of service information, or other case management information including but not limited to client ID, provider name, service start and other dates. In addition, changes to federal reporting requirements of child welfare data may require periodic changes to data attributes exchanged with the Agency, code values, or file structure, in accordance with federal guidance. Grantees shall work with the Agency to incorporate these changes.

The Grantee shall:1. Send the acknowledgment of referral to the regional office via e-mail. (Address will be provided by

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each regional office).

2. Electronically retrieve new referral information and various reports from a state system to which the Grantee has been given access and allow possible imports of this information to their computer system. The Grantee must be able to upload to the same state system encounter files in a specified format.

3. Submit all reports and be able to communicate in a DCF approved format.

4. Agree to work with DCF in this evolving technological environment and respond to new innovations as they are introduced. All information must be compatible with DCF systems and able to be shared through DCF electronic interfaces.

Program OutcomesThe Grantee shall be responsible for providing direct/indirect services supporting the implementation of evidence-based strategies resulting in improvements in targeted state-or community-level factors, while also contributing to state and local outcomes as indicated below:

Grant outcomes use CFSR measurements including “Children are safely maintained in their homes whenever possible and appropriate” and also include the following additional measures:

1. Families are engaged timely in program services; 2. Children are safe from future maltreatment, as defined by a subsequent affirmed or substantiated

finding for abuse or neglect; 3. Children are safely maintained at home, with family; 4. Babies are born substance free to women using non-opioid substances; 5. Pregnant women using opioids will be referred for medication assisted treatment.

The Grantee will be responsible for monthly reconciliations with DCF of program outcome data. Performance based outcomes shall not be rewarded with monetary or otherfinancial bonuses/awards for staff.

The grant performance year is the State Fiscal Year (SFY). Reports required may reflect both federal and state fiscal year periods. If grant outcomes are not met at the completion of the first SFY of the grant, the Grantee shall develop a Program Improvement Plan (PIP) approved by DCF, to address unmet outcomes. The PIP shall include action steps to be taken to improve performance, meet outcomes and demonstrate continued improvement for each unmet outcome. Failure of the Grantee to meet the strategies for improvement of the outcomes may result in penalties or termination of the grant.

If a PIP is necessary after the first year of the grant, individual outcome(s) will be deemed completed as successful when the outcome performance meets the negotiated improvement goal(s) for the entire SFY.

Failure of the Grantee to meet the negotiated improvement goal(s) for the complete SFY, using year-end performance outcomes, may result in termination of the grant. If negotiated improvement goals are not met, liquidated damages may be assessed for each measure not met, equal to 2% of the monthly minimum referral payment. DCF may withhold any damage amount from the July payment in the year following the completion of the PIP. DCF may also impose liquidated damages if standards are not met during the following year(s) of the grant.

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Outcome 1. Families are engaged timely in program services

Outcome 1a: Families are engaged timely in Tier 1 program services

Families are Engaged Timely Population Standard Source

Families referred shall be engaged timely in Family Preservation Services.

Families referred to Family Preservation Tier 1 Services

95.0% FACTS

Operational Definition

Numerator: The # of families referred to Tier 1 Family Preservation Services in each month, excluding retracted referrals, who had a case plan completed and signed within 20 days of the

referral

divided by

Denominator: The # of families referred to Tier 1 Family Preservation Services in each month, excluding retracted referrals

Example:

July 2018 - # of families referred for Family Preservation Services (excluding retractions) = 222 July 2018 - # of families referred for Family Preservation Services (excluding retractions), who had a case plan completed within 20 days of the referral for services = 211For July 2018, the performance rate of family engagement is 95.0% [N=211/D=222]

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Outcome 1b: Families are engaged timely in Tier 2 program services.

Families are Engaged Timely Population Standard Source

Families referred shall be engaged timely in Family Preservation Services.

Families referred to Family Preservation Tier 2 Services

95.0% FACTS

Operational Definition

Numerator: The # of families referred to Tier 2 Family Preservation Services in each month, excluding retracted referrals, who had a case plan completed and signed within 20 days of the

referral

divided by

Denominator: The # of families referred to Tier 2 Family Preservation Services in each month, excluding retracted referrals

Example:

July 2018 - # of families referred for Family Preservation Services (excluding retractions) = 222. July 2018 - # of families referred for Family Preservation Services (excluding retractions), who had a case plan completed within 20 days of the referral for services = 211For July 2018, the performance rate of family engagement is 95.0% [N=211/D=222]

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Outcome 1c: Families are engaged timely in Tier 3 program services.

Families are Engaged Timely Population Standard Source

Families referred shall be engaged timely in Family Preservation Services.

Families referred to Family Preservation Tier 3 Services

95.0% FACTS

Operational Definition

Numerator: The # of families referred to Tier 3 Family Preservation Services in each month, excluding retracted referrals, who had a case plan completed and signed within 30 days of the

referral.

divided by

Denominator: The # of families referred to Tier 3 Family Preservation Services in each month, excluding retracted referrals

Example:

July 2018 - # of families referred for Family Preservation Services (excluding retractions) = 222. July 2018 - # of families referred for Family Preservation Services (excluding retractions), who had a case plan completed within 30 days of the referral for services = 211For July 2018, the performance rate of family engagement is 95.0% [N=211/D=222]

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Outcome 2. Children are safe from future maltreatment as defined by affirmed or substantiated abuse and/or neglect

Outcome 2a: Children referred to Tier 1 program services are safe from future maltreatment as defined by affirmed or substantiated abuse and/or neglect

Safety during Tier 1 Family Preservation Services

Population Standard Source

Families will not experience affirmed or substantiated abuse or neglect during participation in Tier 1 Family Preservation Services.

Families referred to Tier 1 Family Preservation Services with a signed Family Case Plan

95.0% FACTS

Operational Definition

Numerator: The # of families referred to Family Preservation Services for Tier 1 with a signed Family Case Plan, who did not have an affirmed or substantiated finding between date of referral

and date of case closure from the Tier 1 level of program services

divided by

Denominator: The # families referred to Family Preservation Services Tier 1 Services with a signed Family Case Plan

Example:

July 2018- # of families referred for Family Preservation Services Tier 1 with a signed Family Case Plan = 222July 2018 - # of families referred for Family Preservation Services Tier 1 with a signed Family Case Plan, who did not have an affirmed or substantiated finding between referral and date of case closure from Tier 1 services = 215For July 2018, the performance rate of safety during participation in Tier 1 services is 96.8% [N= 215/D=222]

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Outcome 2b: Children referred to Tier 2 program services are safe from future maltreatment defined by affirmed or substantiated abuse and/or neglect

Safety during Tier 2 Family Preservation Services

Population Standard Source

Families will not experience affirmed or substantiated abuse or neglect during participation in Tier 2 Family Preservation Case Management Services.

Families referred to Tier 2 Family Preservation Case Management Services with a signed Family Case Plan

95.0% FACTS

Operational Definition

: Numerator: The # of families referred to Family Preservation Services for Tier 2 with a signed Family Case Plan, who did not have an affirmed or substantiated finding between date of referral

and date of case closure from the Tier 2 level of program services

divided by

Denominator: The # families referred to Family Preservation Services Tier 2 Case Management Services with a signed Family Case Plan

Example:

July 2018 - # of families referred for Family Preservation Services Tier 2 with a signed Family Case Plan = 222July 2018 - # of families referred for Family Preservation Services Tier 2, with a signed Family Case Plan, who did not have an affirmed or substantiated finding between referral and date of case closure from Tier 2 services = 215For July 2018, the performance rate of safety during participation in Tier 2 services is 96.8% [N= 215/D= 222]

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Outcome 2c: Children referred to Tier 3 program services are safe from future maltreatment defined by affirmed or substantiated abuse and/or neglect

Safety during Tier 3 Family Preservation Services

Population Standard Source

Families will not experience affirmed or substantiated abuse or neglect during participation in Tier 3 Family Preservation Case Management Services.

Families referred to Tier 3 Family Preservation Case Management Services with a signed Family Case Plan

95.0% FACTS

Operational Definition

Numerator: The # of families referred to Family Preservation Services for Tier 3 with a signed Family Case Plan, who did not have an affirmed or substantiated finding between date of referral

and date of case closure from the Tier 3 level of program services

divided by

Denominator: The # families referred to Family Preservation Tier 3 Case Management Services with a signed Family Case Plan

Example:

July 2018 - # of families referred for Family Preservation Services Tier 3 with a signed Family Case Plan = 222July 2018 - # of families referred for Family Preservation Services Tier 3, with a signed Family Case Plan, who did not have an affirmed or substantiated finding between referral and date of case closure from Tier 3 services = 215For July 2018, the performance rate of safety during participation in Tier 3 services is 96.8% [N= 215/D= 222]

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Outcome 3. Children are maintained safely at home with family

Outcome 3a: Children are maintained safely at home with family in Tier 1 Services

Children are Maintained at Home with Family during

Family Preservation Services

Population Standard Source

Families will not have a child referred to the foster care program during the referral period of Tier 1 services or within 30 days of case closure.

Families referred to Family Preservation Services for Tier 1 with a signed Family Case Plan

90.0% FACTS

Operational Definition

Numerator: The # of families referred to Tier 1 Family Preservation Services with a signed Family Case Plan, who did not have a child referred to foster care during the service period or within 30

days of case closure

divided by

Denominator: The # of families referred to Family Preservation Services Tier 1 services with a signed Family Case Plan

Example:

July 2018 - # of families referred to Family Preservation Services Tier 1 with a signed Family Case Plan= 222 July 2018 - # of families referred to Family Preservation Services Tier 1, with a signed Family Case Plan, who did not have a child referred to foster care during the service period or within 30 days of case closure = 205For July 2018, the performance rate of families maintaining all children in home is 92.3% [N=205/D=222]

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Outcome 3b: Children are maintained safely at home with family in Tier 2 Services

Children are Maintained at Home with Family during

Family Preservation Services

Population Standard Source

Families will not have a child referred to the foster care program during the referral period of Tier 2 services or within 30 days of case closure.

Families referred to Family Preservation Services for Tier 2 with a signed Family Case Plan

90.0% FACTS

Operational Definition

Numerator: The # of families referred to Tier 2 Family Preservation Services with a signed Family Case Plan, who did not have a child referred to foster care during the service period or within 30

days of case closure

divided by

Denominator: The # of families referred to Family Preservation Services Tier 2 services with a signed Family Case Plan

Example:

July 2018 - # of families referred to Family Preservation Services Tier 2 with a signed Family Case Plan = 222 July 2018 - # of families referred to Family Preservation Services Tier 2 with a signed Family Case Plan, who did not have a child referred to foster care during the service period or within 30 days of case closure = 205 For July 2018, the performance rate of families maintaining all children in home is 92.3% [N=205/D=222]

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Outcome 3c: Children are maintained safely at home with family in Tier 3 Services

Children are Maintained at Home with Family during

Family Preservation Services

Population Standard Source

Families will not have a child referred to the foster care program during the referral period of Tier 3 services or within 30 days of case closure

Families referred to Family Preservation Services for Tier 3 with a signed Family Case Plan.

85.0% FACTS

Operational Definition

Numerator: The # of families referred to Tier 3 Family Preservation Services with a signed Family Case Plan, who did not have a child referred to foster care during the service period or within 30

days of case closure

divided by

Denominator: The # of families referred to Family Preservation Services Tier 3 services with a signed Family Case Plan

Example:

July 2018 - # of families referred to Family Preservation Services Tier 3 with a signed Family Case Plan = 222 July 2018 - # of families referred to Family Preservation Services Tier 3 with a signed Family Case Plan who did not have a child referred to foster care during the service period or within 30 days of case closure = 205 For July 2018, the performance rate of families maintaining all children in home is 92.3% [N=205/D=222]

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Success Indicators

Success Indicator for Outcome 3(a): All children will be maintained in their home safely during Tier 1 services.

All Children are Maintained at Home with Family during

Family Preservation Services

Population Standard Source

Children will not be referred to the foster care program during the referral period of Tier 1 services or within 30 days of case closure.

Total number of children referred to Family Preservation Services for Tier 1 with a signed Family Case Plan.

90.0% FACTS

Operational Definition

Numerator: The # of children referred to Tier 1 Family Preservation Services, with a signed Family Case Plan, who were not referred to foster care during the service period or within 30 days of case

closure

divided by

Denominator: The total # of children referred to Family Preservation Services Tier 1 services with a signed Family Case Plan

Example:

July 2018 – Total # of children referred to Tier 1 Family Preservation Services with a signed Family Case Plan = 300July 2018 – Total # of children referred to Tier 1 Family Preservation Services with a signed Family Case Plan who were not referred to foster care during the service period or within 30 days of case closure = 275For July 2018, the performance rate of the number of children remaining in their home is 91.6% [N=275/D=300]

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Success Indicator for Outcome 3(b): All children will be maintained in their home safely during Tier 2 services.

All Children are Maintained at Home with Family during

Family Preservation Services

Population Standard Source

Children will not be referred to the foster care program during the referral period of Tier 2services or within 30 days of case closure.

Total number of children referred to Family Preservation Services for Tier 2 with a signed Family Case Plan.

90.0% FACTS

Operational Definition

Numerator: The # of children referred to Tier 2 Family Preservation Services, with a signed Family Case Plan, who were not referred to foster care during the service period or within 30 days of case

closure

divided by

Denominator: The total # of children referred to Family Preservation Services Tier 2 services with a signed Family Case Plan

Example:

July 2018 – Total # of children referred to Tier 2 Family Preservation Services with a signed Family Case Plan = 300July 2018 – Total # of children referred to Tier 2 Family Preservation Services with a signed Family Case Plan who were not referred to foster care during the service period or within 30 days of case closure = 275For July 2018, the performance rate of the number of children remaining in their home is 91.6% [N=275/D=300]

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Success Indicator for Outcome 3(c): All children will be maintained in their home safely during Tier 3 services.

All Children are Maintained at Home with Family during

Family Preservation Services

Population Standard Source

Children will not be referred to the foster care program during the referral period of Tier 3 services or within 30 days of case closure.

Total number of children referred to Family Preservation Services for Tier 3 with a signed Family Case Plan.

90.0% FACTS

Operational Definition

Numerator: The # of children referred to Tier 3 Family Preservation Services, with a signed Family Case Plan, who were not referred to foster care during the service period or within 30 days of case

closure

divided by

Denominator: The total # of children referred to Family Preservation Services Tier 3 services with a signed Family Case Plan

Example:

July 2018 – Total # of children referred to Tier 3 Family Preservation Services with a signed Family Case Plan = 300July 2018 – Total # of children referred to Tier 3 Family Preservation Services with a signed Family Case Plan who were not referred to foster care during the service period or within 30 days of case closure = 275For July 2018, the performance rate of the number of children remaining in their home is 91.6% [N=275/D=300]

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Outcome 4. Babies are born substance free to pregnant women using non-opioid substances.

Babies are Born Substance Free

Population Standard Source

Babies are born substance free to pregnant women using substances other than opioids who are referred to Family Preservation Services in all Service Tiers

Families referred to Family Preservation Services in all Service Tiers, with a signed Family Case Plan, for reason of use of substances other than opioids during pregnancy.

90.0% FACTS

Operational Definition

Numerator: The # of births to families referred to Family Preservation Services in all Service Tiers, with a signed Family Case Plan, for reason of use of substances other than opioids during

pregnancy whose babies were born with a negative alcohol and drug toxicology result.

divided by

Denominator: The # of births to families referred to Family Preservation Services in all Service Tiers, with a signed Family Case Plan, for reason of use of substances other than opioids during

pregnancy.

Example:

July 2018 - # of births to families referred to Family Preservation Services in all Service Tiers, with a signed Family Case Plan, for reason of substance abuse during pregnancy = 19. July 2018 - # of births to families referred to Family Preservation Services in all Service Tiers, with a signed Family Case Plan, for reason of use of substances other than opioids during pregnancy whose babies were born with a negative alcohol and drug toxicology result = 18For July 2018, fiscal year to date, the rate of babies born substance free is 94.7% [N=18/D=19].

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Outcome 5: Women using opioids during pregnancy will be referred for medication assisted treatment.

Pregnant Women Using Opioids Will Receive a Referral for

Medication Assisted Treatment during Pregnancy

Population Standard Source

Women using opioids during pregnancy will receive a referral to medication assisted treatment.

Women referred to Family Preservation Services in all Service Tiers, with a signed Family Case Plan, for reason of pregnant women using opioids during pregnancy.

90.0% FACTS

Operational Definition

Numerator: The # of families referred to Family Preservation Services, in all Service Tiers, with a signed Family Case Plan, for reason of pregnant woman using opioids during pregnancy who were referred to

medication assisted treatment during pregnancy,

divided by

Denominator: The # of families referred to Family Preservation Services, with a signed Family Case Plan, for reason of pregnant woman using opioids during pregnancy.

Example:

July 2018 - # of families referred to Family Preservation Services, with a signed Family Case Plan, for reason of pregnant woman using opioids during pregnancy = 19. July 2018 - # of families referred to Family Preservation Services, with a signed Family Case Plan, for reason of pregnant woman using opioids during pregnancy, who were referred for medication assisted treatment during pregnancy = 18For July 2018, the performance rate of pregnant women who were referred for medication assisted treatment during pregnancy is 94.7% [N=18/D=19].

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III. AWARD INFORMATION

Funding Information State General Fund, Children’s Initiative Fund, Promoting Safe and Stable Families Program, Child Welfare Services Grant, Title IV-E Foster Care and Temporary Assistance for Needy Families (TANF).

Award Amount and LengthFour grant awards will be issued based on the four (4) geographic catchment regions in the state and will be issued for the initial funding period of July 1, 2019 through June 30, 2023, with the option for two (2) two (2)-year renewals. Awards are subject to the availability of funds and any modifications or additional requirements possibly imposed by law.

Allowable Uses of FundsPrograms may include, but are not limited to, the following allowable uses of award funds: funds may be used for services provided as approved by DCF policy with guidance from the Federal Uniform Grant Guidance.

Please note, DCF grant awards are for funds specifically allocated to the service within. Grantee agencies will be required to submit regular financial reports itemizing costs incurred. Please also note, the use of funds must meet all federal and/or state requirements, including those contained in the Specific Terms and Conditions (Attachment C), Contractual Provisions (Attachment D), Special Provisions Incorporated by Reference (Attachment E) and must be reasonable, allowable and allocable.

Match RequirementNo match is required for this program.

IV. ELIGIBILITY DCF invites applications from nonprofit, not-for-profit 501(c)3 and/or for-profit child welfare agencies with a physical location in the State of Kansas or a physical location in place by implementation; public and/or private agencies providing child welfare services with established resources and experience to serve the children and families of the State of Kansas regardless of race, religion, color, sex, disability, national origin or ancestry. All applicants must be accredited by a national accrediting health and/or human services organization, such as Council on Accreditation or The Joint Commission and include a letter from their accrediting body with their application reflecting current and good standing.

DUNS Number – Grant applicant agencies must have and provide verification of their DUNS Number at the time of application, which can be obtained by accessing the Dun & Bradstreet website at http://www.dnb.com/get-a-duns-number.html. The DUNS Number is a unique, nine-digit identification number provided by Dun & Bradstreet. Applicant agencies are responsible for submitting their DUNS Number verification with their grant application. Should your agency need assistance with your DUNS number verification, please contact Dun & Bradstreet at 866-705-5711. (There is no cost to obtain this information.)

Tax Clearance – Grant applicant agencies must obtain a valid Kansas Certificate of Tax Clearance by accessing the Kansas Department of Revenue's website at http://www.ksrevenue.org/taxclearance.html. A Tax Clearance is a comprehensive tax account review to determine and ensure that an agency’s account is compliant with all primary Kansas Tax Laws. The Tax Clearance expires every 90 days. Applicant agencies are responsible for submitting a Tax Clearance Certificate with their grant application that is valid at the time of application. This is in accordance with Executive Order 2004-03. Should your agency need assistance with your

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Tax Clearance, please contact the Kansas Department of Revenue at 785-296-3199, or via e-mail at tax.clearance@kdor.ks.gov. (There is no cost to obtain this information.)

Debarment Status – Grant applicant agencies must obtain the debarment status of their agency and its employees by accessing the System for Award Management website at http://www.sam.gov/portal/public/SAM, and performing a search under “Search Records”. As part of the Code of Federal Regulations (45 C.F.R. Part 76), all governmental entities receiving funding from the federal government must participate in a government-wide system for non-procurement debarment and suspension. A person or entity that is debarred or suspended shall be excluded from federal financial and non-financial assistance and benefits under federal programs and activities. Debarment or suspension of a participant in a program by one agency shall have government-wide effect. The Secretary of DCF is authorized to impose debarment. If applicable, the applicant agency must place the Debarment Memorandum template (Attachment C) on their Grantee agency letterhead, initial it and submit it with their grant application. Should you need assistance with the search, please contact the Federal Service Desk at 866-606-8220. (There is no cost to obtain this information.)

Financial Information – Grant applicant agencies must provide the following three documents at the time of application: their most recent Transmittal Letter for Audit; their most recent IRS Form 990 (Return of Organization Exempt from Income Tax); and their most recent year-end financial statement.

501(c)3 Status – Grant applicant agencies must have and provide verification of their 501(c)3 status at the time of application, i.e., their letter from the Internal Revenue Service confirming their 501(c)3 status, if they have it. Verification can also be obtained by accessing the Internal Revenue Service website at http://www.irs.gov/Charities-&-Non-Profits/Exempt-Organizations-Select-Check. Organizations that have received 501(c)3 status are exempt from federal taxes. To receive this status, the organization must operate for a specific purpose–typically, for a charitable, religious, scientific or literary purpose. Applicant agencies are responsible for submitting a copy of their letter from the IRS confirming their 501(c)3 status, or the verification provided from the IRS website, with their grant application. Should your agency need assistance with this information, please contact the IRS at 877-829-5500. (There is no cost to obtain this information.)

V. APPLICATION PROCESS

Questions – Questions regarding the RFP and/or the application process can be submitted by email only to the Child Welfare Program Manager at linda.cambron@ks.gov, no later than 2 p.m. CST on June 22, 2018. Answers to all questions posed to DCF during the designated question period will be posted by July 3, 2018, or as soon as possible thereafter, and can be found at http://www.dcf.ks.gov/Agency/Operations/Pages/OGC/Grant-RFP.aspx.

Letter of Intent – To apply, applicant agencies are required to submit an electronic Letter of Intent (LOI). The LOI must include the following, and must be e-mailed to the Child Welfare Program Manager at linda.cambron@dcf.ks.gov no later than 2 p.m. CST on July 13, 2018:

1. Name and address of the applicant agency2. Statement indicating their intent to apply3. Title of RFP4. Telephone number and email address of the contact person

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How to Apply All technical application sections of the application shall be written without the use of the applicant name. The only identifiable applicant information shall be provided within the Grant Application Information Sheet and other pertinent documents as necessary. Such identifiable information will be separated from the application sections provided to the review panel. Therefore, any applicant information left within the technical application section may cause disqualification of the application.

Applications must be delivered no later than 2 p.m. CST on August 9, 2018. (Applications received after 2 p.m. CST will not be accepted, no exceptions.) Applicants are required to submit one (1) original and thirteen (13) copies, as well as one (1) signed electronic copy (on a flash drive or disk; email not accepted). It is preferable the electronic copy be contained in one (1) PDF file. When one (1) file is not possible, applicants must use appropriately-descriptive file numbers/names (i.e., “1-Table of Contents”, “2-Grant Application Information Sheet”, “3-Program Abstract”, etc.) for all attachments and arrange them in the order indicated in the Application Checklist on page 71.

Applications should be addressed to:Linda Cambron, Child Welfare Program ManagerKansas Department for Children and FamiliesDCF Administration Building555 S. Kansas Ave., 5th FloorTopeka, Kansas 66603

The application must be arranged in the order indicated in the Application Checklist on page 71.

What an Application Should IncludeApplications must include all components described in this section. Failure to submit an application containing all the specified information may negatively affect the review of the application, preclude access to or use of award funds pending satisfaction of the conditions and/or prevent the application from proceeding to the Review Panel for further consideration. Applications are evaluated on a scale of 100 total points.

Table of Contents A Table of Contents must be included as part of the grant application. Include page numbers for each of the major sections and for each attachment.

Grant Application Information SheetComplete the Grant Application Information Sheet (Attachment A). This document must be signed by the Authorizing Official for the applicant agency (an individual in a decision-making capacity at the agency, typically the top-level individual).

Management StructureDescribe the experience and capability of the applicant agency, its staff and its providers. Identify the agency who will serve as the Grantee and fiscal agent responsible for the grant’s administration. Identify the staff team supporting the project, including the name, title and affiliation of each member, as well as a Delegation of Authority from the Board of Directors for the organization (if applicable). Provide documentation of any collaboration already in place (to include copies of any already in place memorandums of agreement) or is occurring on the initiative. Provide resumes or qualification standards for staff, as well as position descriptions for positions required as per the RFP. Include an organizational chart/description, licensing/accreditation/certification documentation, a list of board members and a board member conflict-of-interest statement (if applicable).

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Technical Application Section Shall Include:Program Abstract (10 out of 100 points)The Program Abstract should be no more than one (1) double-spaced page, using Times New Roman 12-point font, with no less than one-inch margins, and should include the following:

Identify the type of applicant agency (non-profit, faith-based, university, etc.). Describe the proposed program for which funding is being requested, including the purpose and

program outcomes, the geographic area to be served, a description of the target population, the estimated number of clients to be served and the services to be provided.

Program Narrative (90 out of 100 points)The Program Narrative must include five sections–Statement of the Problem, Project Design, and Implementation Plan in the order listed below. The Program Narrative should be double-spaced, using Times New Roman 12-point font, with no less than one-inch margins, and should not exceed 75 pages. If the Program Narrative fails to comply with these length-related restrictions, non-compliance may be considered in peer review and in final award decisions. Please number pages “1 of XX”, “2 of XX”, etc.

The following sections should be included as part of the Program Narrative: Statement of the Problem (10 out of 90 points) – Identify and describe the challenges or

needs the program will address with the target population in the geographic area to be served. Provide data to show the nature and scope of the need, citing data references (three-year trend data is preferred). Explain previous or current efforts to address the problem, including an analysis of the outcome of these efforts. Provide a clear and concise statement of the purpose or goal of the program and how the program will address the needs identified.

Project Design (60 out of 90 points) – Describe the services to be provided, and the specific strategies substantiating the project as a comprehensive program. Identify the geographic boundaries of the proposed program, as well as the target population to be served. Describe outreach and referral strategies to ensure access to the target population. Describe how your program will ensure cultural competence, as well as program and physical accessibility for people with disabilities. Describe any potential barriers to implementing the project and strategies to overcome them.

Implementation Plan (20 out of 90 points) – Provide a realistic and detailed Implementation Plan, with a timeline indicating significant milestones in the project. The timeline should include each Project Goal, its related Project Activities and Performance Measures, their expected completion date(s) and the responsible person or organization. Performance Measures should be S.M.A.R.T. (specific, measurable, action-oriented, realistic and time-bound). Outline the specific Program Outcomes of the project and how they will address the problem. Describe how the project will address the allowable uses of funds. Applicants should identify who will collect data, who will be responsible for performance measures and how this information will be used to evaluate and guide the program.

Cost Application Section Shall Include:Grant Budget Request, Budget Narrative/Justification, and Cost Allocation Plan Applicants must submit a Grant Budget Request Workbook (Attachment B), a Budget Narrative/Justification and a Cost Allocation Plan for all years requested within the RFP. The Budget Narrative/Justification must outline how grant funds will be used to support and implement the program and should thoroughly and clearly describe every category of expense listed in the Grant Budget

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Request. It should be mathematically sound and correspond with the information and figures provided in the Grant Budget Request. It should explain how all costs were estimated and calculated and how they are relevant to the completion of the proposed project. It may include tables for clarification purposes but need not be in a spreadsheet format.

The Cost Allocation Plan must summarize how the applicant agency will allocate its costs to its various funding sources.

Costs shall be submitted under the categories within the Grant Budget Request form as follows: A. Administrative Salaries - Applicants shall list all position titles with salaries and wages for all

administrative persons. Examples include the salary or wage of an accountant directly assigned to the award who only does accounting for the award and a receptionist for the office whose sole purpose is to provide services under the award. All administrative salaries and wages should meet the requirements for compensation, personnel services and compensation, contained in 2 CFR Chapter I, Chapter I, Part 200, et al. Uniform Administrative Requirement, Cost Principles and Audit Requirements for Federal Awards; Final Rule, as well as the contractor compensation cap applied to the five most highly compensated employees in management positions at their headquarters, to include the CEO, as per the Office of Management and Budget found at https://obamawhitehouse.archives.gov/omb/procurement_index_exec_comp/.

B. Administrative Fringe Benefits and Taxes - Applicants shall list all position titles with fringe benefits and payroll taxes for all administrative persons. Examples include the fringe benefits and taxes of an accountant directly assigned to the award who only does accounting for the award and a receptionist for the office whose sole purpose is to provide services under the award. All administrative fringe benefits and taxes should meet the requirements for compensation, personnel services and compensation, contained in 2 CFR Chapter I, Chapter I, Part 200, et al. Uniform Administrative Requirement, Cost Principles and Audit Requirements for Federal Awards; Final Rule.

C. Case Management Salaries - Applicant shall list all position titles with salaries/wages of all persons whose primary purpose is directly supporting/interacting with those served under the family preservation award. This includes direct line staff and those involved in the direct supervision and day-to-day management of the direct line staff. This category does include those involved in providing the administrative support for direct program functions. All direct services staff salaries should meet the requirements for compensation, personal services and compensation, contained in 2 CFR Chapter I, Chapter II, Part 200, et al. Uniform Administrative Requirements, Cost Principles and Audit Requirements for Federal Awards; Final Rule.

D. Case Management Fringe Benefits and Taxes - Applicant shall list all position titles with fringe benefits and payroll taxes for all persons whose primary purpose is directly supporting/interacting with those served under the family preservation award. This includes direct line staff and those involved in the direct supervision and day-to-day management of the direct line staff. This category does include those involved in providing the administrative support for direct program functions. All direct services staff fringe benefits and taxes should meet the requirements for compensation, personal services and compensation, contained in 2 CFR Chapter I, Chapter II, Part 200, et al. Uniform Administrative Requirements, Cost Principles and Audit Requirements for Federal Awards; Final Rule.

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E. Operating Expenses - These costs include the direct expenses in support of the award/program. All operating expenses shall meet the requirements for compensation, personal services and compensation, contained in 2 CFR Chapter I, Chapter II, Part 200, et al. Uniform Administrative Requirement, Cost Principles and Audit Requirements for Federal Awards; Final Rule.

1. Telephone and Communication shall include telephones, cell phones, smartphones and other communication expenses.

2. Information Technology shall include internet services, computer network services, computer hardware purchases/leases and software. This shall also include the expenses related to IT contracted services (e.g., fees for a consultant to develop software programs or reports, computer network repairs, etc.). This line does not include salaries of staff working in the organization’s IT department who are employees of the organization.

3. Office Supplies and Printing shall include all office supplies, postage, copiers, printing and publication expenses.

4. Publication Costs shall include electronic and print media, allowable advertising, including distribution, promotion and general handling which are allowable costs.

5. Legal, Accounting, and Audit Contractors/ Consultants shall include expenses related to legal, accounting and audit services provided by contractors or consultants not working for the organization. This line does not include salaries of staff working in the organization's legal, accounting or audit department who are employees of the organization. Retainer fees are not to be included.

6. Human Resource Contractors/Consultants shall include expenses related to Human Resources contractors and consultants. This line does not include salaries of staff working in the organization’s human resource department who are employees of the organization. Retainer fees are not to be included.

7. Other Contractors/Consultants shall include costs of professional and/or consultant services not already reported in other categories. This category shall also include a description of the services each contractor/consultant will be providing.

8. Insurance shall include premiums for general liability and malpractice insurance. This does not include any property insurance, vehicle insurance or life insurance for staff.

9. Equipment shall include service agreements, equipment leases, purchases of equipment not exceeding the organization's capitalization level or $5,000, as well as maintenance and repair of such equipment identified within this category.

10. Staff Development shall include costs associated with providing in-service training and staff development for all employees of the organization. Conference fees and travel associated with attending training not provided by the organization shall be reported within this category.

11. Staff Recruitment and Retention shall include costs associated with "help wanted" 65

advertising, operating costs of an employment office necessary to secure and maintain an adequate level of staff, costs of operating an aptitude and educational testing program, travel costs of employees engaged in recruiting personnel, travel costs of applicants for interviews for prospective employment and relocation costs incurred of new employees as long as these costs are incurred as part of the organization's standard recruitment program. Special incentives, fringe benefits and salary allowances to attract professional personnel not meeting the reasonable test or conform to the established practice of the organization are not allowable. Any relocation costs must meet all federal and state statutes and regulations. This shall also include costs necessary to assist in the retention of staff. These are costs incurred in accordance with the organization's documented policies for improvement of working conditions, employer-employee relations, employee health and employee performance. Costs of entertainment, including amusement, diversion and social activities and any associated costs are not allowable.

12. Memberships shall include all fees for licenses, professional membership dues, subscriptions and professional activity costs. These are memberships at the organization level; not individual memberships. Allowable costs are in business, technical and professional organizations only. Memberships in country clubs, social or dining clubs or organizations are not allowable. Subscriptions to business, professional and technical periodicals are allowable. In reporting these costs, provide sufficient detail within the budget narrative for assessment of allowability.

F. Property, Plant and Equipment - These costs include the direct expenses in support of the award/program. All property, plant and equipment shall meet the requirements for compensation, personal services and compensation, contained in 2 CFR Chapter I, Chapter II, Part 200, et al. Uniform Administrative Requirement, Cost Principles and Audit Requirements for Federal Awards; Final Rule.

1. Supplies shall include all supplies purchased for the building and grounds. Shall include all necessary and reasonable expenses incurred for security to protect offices, personnel and work products. Equipment and other supplies shall be reported in this category. Wages for security staff shall be reported under salary categories. Changes to building and offices for security purposes would be considered improvements and straight-line depreciated.

2. Equipment Maintenance and Repairs shall include all maintenance and repair expenses applicable to the capitalized equipment.

3. Utilities shall include expenses related to gas, water, electricity, etc. Phone expenses are reported under Operating Expenses, Telephone and Communication.

4. Real Estate Taxes shall include real property taxes paid during the reporting period.

5. Property Insurance shall include the premiums on insurance coverage against property damage.

6. Rent - Building shall include all recurring building and/or property rent and lease expense.

7. Depreciation - Building shall include the depreciation of any building owned by the 66

organization. The straight-line method of depreciation is required for this award. Amounts reported must be reconciled to a detailed depreciation schedule included with this application.

8. Depreciation - Equipment shall include the depreciation of tangible personal property (including information technology systems) having a useful life of more than one year and a per-unit acquisition cost which equals or exceeds the lesser of the capitalization level established by the organization for financial statement purposes or $5,000. This includes depreciation for computing devices, general purpose equipment, capital assets, information technology systems, special purpose equipment and supplies as defined in 2 CFR Chapter 1, Chapter II, Part 200, et al. Uniform Administrative Requirement, Cost Principles and Audit Requirements for Federal Awards; Final Rule. The straight-line method of depreciation is required for this award. Amounts reported must be reconciled to a detailed depreciation schedule included with this application.

9. Amortization - Leasehold Improvements shall include the amortization of leasehold improvements made to leased property.

10. Building Maintenance shall include all maintenance and repair expenses applicable to the buildings and grounds.

G. Travel - This category shall include company-owned and/or leased automobile costs (automobile insurance, fuel, taxes, maintenance and repairs, depreciation, lease and other associated costs) and staff business travel costs (mileage reimbursement, lodging and subsistence expenses, out-of-state travel costs and other staff business travel related cots). Do not report travel costs associated with transporting children/families in this category. All business travel expenses shall follow all State of Kansas travel regulations and guidance.

H. Client Transportation - This category shall include automobile costs (insurance, fuel, taxes, maintenance and repairs, depreciation, lease and other associated costs) and associated travel costs (mileage reimbursement, lodging and subsistence expenses, out-of-state travel costs and other travel related costs) associated with transporting children/families. This category shall include services provided to the children as well as parents/caregivers in need of transportation to any case specific appointments.

I. Medical Expenses (not reimbursed) - Applicant is responsible for working with the Medicaid program to receive payment for all Medicaid reimbursable services, to determine if the child and family referred are possibly covered by another health insurance policy or any other form of insurance, as well as determine if they are responsible for paying for any services provided. For items within this category to be paid, all other reimbursement options (such as Medicaid, private insurance, other responsible parties) must be utilized first. This category shall only include those costs not paid by Medicaid, private insurance or other responsible parties. Applicant must identify each expense and fully explain within the budget narrative submitted.

J. Flex Funds - This category should only include those items not covered by any other category. Costs for emergency/exception clothing expenses, specialty gifts, trips, extraordinary maintenance, family reunifications costs approved by DCF shall be included within this category. Standard clothing expenses for children in out-of-home custody are covered within the placement rate for the child. Food/meals for children while in transit are to be covered under the client transportation category. Each expense requested shall be explained in detail within the budget narrative included with the

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application.

K. Indirect Costs* - Indirect costs are defined by the Federal Register 2 CFR 200.56 as those costs incurred for a common or joint purpose benefitting more than one cost objective and not readily assignable to the cost objectives specifically benefitted, without effort disproportionate to the results achieved.

1. Indirect Salaries and Wages shall include those costs related to administrative salaries benefiting the entire organization. This could include the salaries of an organization's executive leadership (CEO, CFO, COO, CIO) and others in accounting, purchasing, IT support, HR and other support services provided to the organization as a whole. These salaries and wages are subject to the Office of Management and Budget Contractor Compensation Cap for the five most highly compensated employees found at https://obamawhitehouse.archives.gov/omb/procurement_index_exec_comp/.

2. Indirect Fringe Benefits and Taxes shall include those costs related to administrative fringe benefits and taxes benefiting the entire organization. This could include the fringe benefits and taxes of an organization's executive leadership (CEO, CFO, COO, CIO) and others in accounting, purchasing, IT support, HR and other support services provided to the organization as a whole.

3. Indirect Operating Expenses shall include those operating expenses allocated as indirect expenses for the award/program. All items within this section are the same description as the direct cost categories, however are the indirect allocated amount for the award/program.

4. Indirect Property, Plant and Equipment shall include those property, plant and equipment expenses allocated as indirect expenses for the award/program. All items within this section are the same description as the direct cost categories, however are the indirect allocated amount for the award/program.

*Indirect Costs should not exceed 10 percent of the Grant Budget Request.

VI. REVIEW AND SELECTION PROCESS

Application Review PanelEligible applications will be evaluated, scored and rated by a Review Panel. DCF leadership will use the review ratings and summaries as guidance when selecting projects for awards. Review ratings are advisory only, however, and do not bind DCF to a particular decision. In addition to review ratings, considerations may include, but are not limited to, underserved populations, strategic priorities, past performance, geographic balance and available funding.

Selection CriteriaThe Review Panel will use a scoring guide, which coincides with the RFP, when reviewing applications. The scoring guide uses a system of 100 total points, as noted in Section V – Application Process, as well as below:

1. Program Abstract (10 points)2. Program Narrative (90 points)

a. Statement of the Problem (10 points)b. Project Design (60 points)

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c. Implementation Plan (20 points)

Appearance Before CommitteeAny, all or no applicants may be required to appear before a committee to explain their understanding and approach to the project and/or respond to questions from the committee concerning their application; or the committee may award without conducting negotiations, based on the initial application. DCF reserves the right to request information from the applicants as needed. If information is requested, the committee is not required to request the information from all applicants.

Applicants selected to participate in negotiations may be given an opportunity to submit a revised application and/or budget offer to the committee, subject to a specified cut off time for submittal of revisions. Meetings before the committee are not subject to the Open Meetings Act. Applicants are prohibited from electronically recording these meetings. All information received prior to cut off time will be considered part of the applicant’s revised offer.

No additional revisions shall be made after the specified cut off time unless requested by the committee.

VII. POST-AWARD REQUIREMENTS

Reporting Requirements Grantee agencies will be required to submit the following reports to the designated DCF Program Manager:

Status Reports will be due every month – namely, Aug. 20, Sept. 20, Oct. 20, Nov. 20, Dec. 20, Jan. 20, Feb. 20, March 20, April 20, May 20, June 20, July 20 and so on.

Budget Transaction Reports will be due every month – namely, Aug. 20, Sept. 20, Oct. 20, Nov. 20, Dec. 20, Jan. 20, Feb. 20, March 20, April 20, May 20, June 20, July 20 and so on.

Budget Itemization Reports will be due every month – namely, Aug. 20, Sept. 20, Oct. 20, Nov. 20, Dec. 20, Jan. 20, Feb. 20, March 20, April 20, May 20, June 20, July 20 and so on.

Status, Budget Transaction and Budget Itemization Reports will not be processed without all three (3) reports for the period on file, as well as any other required documentation, as established in the grant award. Specific detailed information required for all reporting will be determined upon award.

Supplemental Reports Required:Supplemental reports required may include, but not be limited to: quarterly management reports, monthly fiscal reports, monthly case update reports and monthly encounter data. Other reporting may be required as determined upon award.

Federal Funding Accountability and Transparency Act (FFATA) RequirementsGrant awards through this RFP will be subject to the Federal Funding Accountability and Transparency Act (FFATA) of 2006. In order to meet these requirements, applicant agencies that are awarded funds will need to provide the names and total compensation for the five most highly-compensated executives of the organization. For more information, the Five Most Highly Compensated Executives form (OGC-4001) can be found on the Grantee Resources page of the DCF Office of Grants and Contracts website at http://www.dcf.ks.gov/Agency/Operations/Pages/Grantee-Resources.aspx.

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State Audit and MonitoringIn general, audits must be conducted in accordance with the provisions contained in 2 CFR Chapter I, Chapter II, Part 200, et al.  Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards; Final Rule. Grantee shall submit a copy of their annual certified public audit of their organization within 180 days of their fiscal year end. These reports shall include separate audited income statements for each agreement.

Applicant agrees authorized federal and State representatives, including but not limited to, personnel of the using agency; independent auditors acting on behalf of the State and/or federal agencies shall have access to and the right to examine records during the grant term and during the six (6) year post agreement period. Delivery of and access to the records shall be at no cost to the State.

This report shall be sent to:Kansas Department for Children and FamiliesOffice of Audit and Consulting Services555 S Kansas, 6th FloorTopeka, KS 66603

The Grantee’s responsibilities regarding obtaining an independent audit of any agreement awarded by DCF are found in DCF’s Audit/Monitoring Policy and Requirements, which can be found on DCF’s website at http://www.dcf.ks.gov/Agency/GC/Pages/Audits/AuditPolicies.aspx. Grantees are required to utilize a different organization to perform their independent audit every three (3) years.

All entities receiving funding are subject to internal monitoring (both fiscal and program) and to audits conducted by DCF Audit Services.

DCF Audit Services, as well as providers requested by DCF to perform auditing services, has the authority, under the provisions of this grant, and federal and State law, to conduct audits in addition to those conducted by an entity’s contracted audit firm. Grantee agrees to cooperate with any and all parties performing auditing services at the request of DCF.

LobbyingNo funds may be expended by the recipient of this award to pay any person for influencing or attempting to influence an officer or employee of any agency, a member of the Legislature or an employee of a member of the Legislature, or to expend in connection with any of the following covered Federal actions: the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into any cooperative agreement, and the extension, continuation, renewal, amendment or modification of any Federal contract, grant, loan or cooperative agreement.

Publicity ReleasesAll publicity releases and materials published in connection with this award shall conspicuously acknowledge support of DCF. All such publicity releases and materials must be sent to DCF Office of Communications for review, via the grant program manager, at least one week in advance of publication. No unauthorized use of the DCF logo is allowed.

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VIII. CHECKLISTS

Application Checklist The following sections must be submitted in this order:

___ Table of Contents ___ Grant Application Information Sheet (OGC-1002) (Attachment A) *signed by Applicants Authorizing Official

___ Worksheet A.2 - Signature Sheet (Attachment A.2) *signed by Applicants Authorizing Official ___ Management Structure___ Organizational Chart/Description___ Staff Resumes___ Licensing/Accreditation/Certification Documentation___ List of Board of Directors ___ Board Member Conflict-of-Interest Statement___ Delegation of Authority from Board of Directors (if applicable)___ Letters of Support

Technical Section of Grant Application:___ Program Abstract___ Statement of Problem*___ Project Design* ___ Implementation Plan**These items are considered part of the narrative and should not exceed the total length of 75 pages, as identified on page 63.

Cost Section of Grant Application:___ Grant Budget Request (OGC-1003) (Attachment B) (Total of 4)

___ Budget Narrative/Justification (Total of 4)___ Cost Allocation Plan (Total of 4 if changes each year)___ Transmittal Letter for Audit___ IRS Form 990___ Year-End Financial Statement

Attachments Section of Grant Application:___ 501(c)(3) Verification (if applicable)___ DUNS Number Verification___ State of Kansas Tax Clearance Certificate___ Debarment Memorandum (Attachment C) *initialed by Applicants Authorizing Official___ Specific Terms and Conditions Signature Page Only (Attachment D) *signed by Authorizing Official

___ Contractual Provisions (DA-146a) Initial Page Only (Attachment E) *initialed by Authorizing Official___ Special Provisions Incorporated By Reference Signature Page Only (Attachment F)*signed by

Applicants Authorizing Official___ Policy Regarding Sexual Harassment Acknowledgement (Attachment G) *signed by Applicants

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Authorizing Official

Attachment A – Grant Application Information Sheet

The grant applicant agency must fill out the Grant Application Information Sheet form (OGC-1002) as well as the Worksheet A.2 – Signature Sheet, acknowledging receipt of questions and answers posted July 3, 2018, and submit both with their grant application (double-click on the icons below to open the forms).

Attachment B – Grant Budget Request

Grant Budget Requests shall be submitted separately for each region for which the applicant is applying. The grant applicant agency must fill out the Grant Budget Request form (OGC-1003) and submit it with its grant application (double-click on the icon below to open the form). The budget request cover sheet reflecting the name of the submitting organization, region and bid rates must be submitted as well. All sections, including a budget narrative, shall be completed and submitted. Any additional information bidders deem as useful may be provided.

The bid rate requested shall be a monthly payment rate covering all direct costs for case management services to be provided. These costs shall include direct services staff, administrative staff, property, plant and equipment.

For reference, the historical open caseloads for family preservation services over the last 12 months is approximately:

Region

April

2017May 2017

June

2017July 2017

Aug 2017

Sept 2017

Oct 2017

Nov 2017

Dec 2017

Jan 2018

Feb 2018

March 2018

April

2018

Year Tota

l

Average Per

MonthWest

Region 1 740 740 726 717 718 726 707 722 707 702 684 669 600 9158 763.167

East Region

2 660 674 666 667 665 658 654 646 649 651 651 639 577 8457 704.75KC

Region 3 517 552 566 586 592 615 642 652 648 655 668 649 606 7948 662.333

Wichita

Region 4 499 501 509 510 520 530 553 562 554 546 547 520 470 6821 568.417

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Each cost section of the application must contain the following:A. Audited financial statements with a management letter for the previous two years. Current unaudited

financial statements will be accepted until 2018 audit is available.

B. A pro-forma budget for each of the four (4) years of the grant (complete detail of all expenses proposed, per year, as well as a budget narrative and cost allocation plan if allocation will change per year).

C. Include an explanation of the organization’s method of allocating costs amongst programs. One-time startup costs Grantees will experience for a limited time shall be separately identified on the pro-forma income statements. The applicable categories and amounts shall be identified, as well as the number of years the expenses will be incurred.

D. An explanation of your organization’s resources to demonstrate the ability to ensure solvency for the period of the grants. This information shall include, but not be limited to the following:

1. Cash balances – as supported by the organization’s submitted balance sheet.2. Other liquid assets – as supported by the organization’s submitted balance sheet.3. Line of credit – specify source and amount. Line of credit letters will need to be provided prior to

finalizing any awards.4. Other sources of revenue available along with supporting documentation. These “other sources”

differ from what would be part of the routine “contributions” and “other – specify” as requested on the Income Statement of the imbedded spreadsheet. For this section, the objective is to ascertain what other revenue sources the organization has to be used to prevent insolvency in the case of financial losses experienced during the grant term.

Assumptions to be used in the application:A. There is no advance funding for startup costs. All payments will be made in accordance with the grant

and the State of Kansas Prompt Payment Act. Payments may be withheld or delayed for failure to comply with the terms of the grant.

B. Payments for new referrals made on or after July 1, 2019, the Grantee will receive a case rate for Family Preservation Services as defined. No cases will be transferred from the current contractors. The case rate is the total payment per family for the tier-specific service period.

C. Revenues and expenses applicable to the grant must be tracked separately from the organization’s other business operations. Additionally, if an organization is awarded a grant for more than one region, revenues and expenses must be tracked separately for each region. Each applicant must provide an explanation of how this will be accomplished within their organization.

D. Payments to Grantees are intended to cover all non-Medicaid costs. The medical card is available for all Medicaid eligible services including, but not limited to, physical, dental, optometry, Kan-Be-Healthy screenings, prescriptions, medically necessary transportation, pharmacological medication management by a psychiatrist, Home and Community Based Waiver services, drug & alcohol treatment services, Local Education Agency services, and mental health services including Psychiatric Residential Treatment. It is the Grantees responsibility to obtain and maintain eligibility to provide Medicaid eligible services payable through the Kansas Medical Assistance Program (KMAP or Medicaid). The

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Grantee is responsible for working with the Medicaid program to receive payment for all Medicaid reimbursable services provided to those clients eligible for Medicaid. Kan-Be-Healthy is the name the State of Kansas uses to refer to the federal program of early, periodic, screening, diagnosis, and treatment. These costs are not to be included in the application rate for services.

E. It is the Grantees responsibility to determine if the child and family referred are possibly covered by another health insurance policy or any other form of insurance coverage to assist with payment of services. Insurance coverages are to include not only private coverage, State-funded health care programs and coverage provided under the Patient Protection and Affordable Care Act of 2010, Public Law 111-148. The Grantee is responsible for submitting all claims to such additional insurance providers to seek payment for services. Provider will not submit any expenses due from other insurance coverages to DCF for payment.

F. It is the Grantees responsibility to determine if the child and family referred, or any others involved, are responsible for paying any services provided by the Grantee. The Grantee is responsible for working with such individuals regarding payments for services. The Grantee will not submit any expense payments due from individuals to DCF for payment.

G. Payment schedule information is as follows:1. Tier 1 Family Preservation Services Referral:

a. 50% of case rate is paid at referral when properly documented in FACTS. If case closes prior to case plan being signed this payment is not recouped.

b. 25% of case rate is paid after case plan is signed and properly documented in FACTS. If case closes after case plan is signed, the first and second payments are not recouped.

c. 25% of case rate is paid after case closure is properly documented in FACTS. Final payment will only be made when a successful case closure occurs, after completion of the fourth week and the case closure documentation is properly documented in FACTS.

d. All payments are recouped if referral is made in error.e. Exceptions can be granted by the DCF PPS Program Administrator to make all three (3)

payments when successful completion of referral is not achieved (for reasons other than the child was removed to out-of-home placement).

f. When a Tier 1 FPS referral closes successfully before the end of the sixth week, no new Tier 1 FPS referral can begin prior to the end of the sixth week. Exceptions can be granted by the DCF PPS Program Administrator.

g. It is allowable for a Tier 2 or Tier 3 referral to be made after a successful early closure of a Tier 1 FPS referral.

2. Tier 2 Family Preservation Services Referral:a. One-third of case rate is paid at referral properly documented in FACTS. If case closes

prior to case plan being signed this payment is not recouped.b. Second-third of case rate is paid after case plan is signed and properly documented in

FACTS. If case closes after the case plan is signed and before the end of the third month, the first and second payments for services are not recouped.

c. Final-third of case rate is paid after successful case closure, third month of services is completed and case closure is properly documented in FACTS.

d. All payments recouped if referral made in error.e. Exceptions can be granted by DCF PPS Program Administrator to make all three (3)

payments when successful completion of referral was not achieved (for reasons other than child removed to out-of-home placement).

f. When a Tier 2 FPS referral closes successfully before the end of the sixth month, no new 74

Tier 2 FPS referral can begin. Exceptions can be granted by the DCF PPS Program Administrator.

g. It is allowable for a Tier 1 or Tier 3 referral to be made after a successful early closure of a Tier 2 FPS referral.

3. Tier 3 Family Preservation Services Referral:a. One-quarter of case rate is paid at referral properly documented in FACTS. If case closes

prior to case plan being signed first payment is not recouped.b. Second-quarter of case rate is paid after case plan is signed and properly documented

FACTS. If case closes after case plan is signed and before the end of the sixth month, first and second payments are not recouped.

c. Third-quarter of case rate is paid after completion of sixth month of services. If case closes successfully after the sixth month and before completion of the ninth month then the first, second and third payments will not be recouped.

d. Final-quarter of case rate is paid after successful case closure, ninth month of services is completed and case closure is properly documented in FACTS.

e. All payments recouped if referral made in error.f. Exceptions can be granted by DCF PPS Program Administrator to make all four (4)

payments when successful completion of referral was not achieved (for reasons other than child removed to out-of-home placement).

g. When a Tier 3 FPS referral closes successfully before the end of the twelfth month, no new Tier 3 FPS referral can begin prior to the end of the twelfth month. Exceptions can be granted by the DCF PPS Program Administrator.

h. It is allowable for a Tier 1 or Tier 2 referral to be made after a successful early closure of a Tier 3 FPS referral.

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Attachment C – Debarment Memorandum

(The grant applicant agency must obtain the debarment status of the agency and its employees by accessing the System for Award Management website at http://www.sam.gov/portal/public/SAM, and performing a search under “Search Records”. As part of the Code of Federal Regulations (45 C.F.R. Part 76), all governmental entities receiving funding from the federal government must participate in a government-wide system for non-procurement debarment and suspension. A person or entity debarred or suspended shall be excluded from federal financial and non-financial assistance and benefits under federal programs and activities. Debarment or suspension of a participant in a program by one agency shall have government-wide effect. The Secretary of DCF is authorized to impose debarment. The Grantee agency must place the memo below on its Grantee agency letterhead, initial it, and submit it with their grant application. Should you need assistance with the search, please contact the Federal Service Desk at 866-606-8220.)

To: Linda Cambron, Child Welfare Program ManagerKansas Department for Children and Families

From: [enter Anticipated Project Director’s Name and Title][enter Grant Applicant Agency]

RE: Debarment Memorandum

Date: [enter date]

This memorandum attests to the fact that we, [Grant Applicant Agency], are in compliance with the debarment requirements for the potential grant award noted above. A search was conducted on today’s date at http://www.sam.gov/portal/public/SAM, which contains a list of parties debarred and excluded from federal procurement and non-procurement programs. Neither [Grant Applicant Agency] nor the staff of [Grant Applicant Agency] are on the list.

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Attachment D – Specific Terms and Conditions (DCF provisions – DCF Notification of Grant Award)

SPECIFIC TERMS AND CONDITIONS1.0 DEFINITIONS

As used throughout this Grant, the following words and terms are used as defined in this paragraph unless (a) the context in which they are used clearly requires a different meaning or (b) a different definition is prescribed for a particular part or portion of a part.

(1) “Grantor” and DCF shall mean The Kansas Department for Children and Families, and its employees, agents and representatives.

(2) “Grantee” shall mean (Q) and its employees, agents, and representatives.(3) “May” denotes the permissive.(4) “Award” denotes this document which sets forth the Grant requirements.(5) “Shall” denotes the imperative.

2.0 NOTICES AND CORRESPONDENCEa. All notices and correspondence shall be sent by either party to the other in all matters dealing with the Grant, as

noted in this NOGA and/or the Grant Forms it references, to the following addresses, unless otherwise directed by DCF:

b. All correspondence, reports, and other documentation required by this Grant shall contain a subject line commencing with this Grant Number ((L)) and followed by the topic.

3.0 GRANT AWARDa. This award is a Grant. A Grant is a legal instrument for transferring money, property or services to the recipient in

order to accomplish a public purpose of support or stimulation where there will be no substantial involvement between the state agency and the recipient during performance as defined in the Federal Grant and Cooperative Agreement Act of 1977, 31 U.S.C. 6304. This act distinguishes federal assistance relationships or Grant and cooperative agreements from procurement relationships or procurement contracts. Unlike a procurement contract, which is a legal instrument for acquiring supplies or services for the direct benefit of or use by the State Government, a grant, like a cooperative agreement, has, as its main purpose, support or stimulation. There are two main types of grants, categorical grants and block grants.

b. The law of the State of Kansas DCF, K.S.A. 39-708C, states the Secretary shall have the power and duty to determine the general policies relating to all forms of social welfare which are administered or supervised by the Secretary. The Secretary has deemed it proper and necessary according to the above statute to enter into a Grant with the Grantee for agreed upon exchange of services listed herein as stated in the Scope of Work. This offer, which asks for a promise in return as the agreed exchange for a promise, is an offer to enter a bilateral agreement.

c. In no event shall the Grantee be entitled to payments for costs incurred in excess of the amount set forth in this Grant without prior written approval of the Grantor. Unless modified by written Amendment to this Agreement, there shall be no allowance for costs incurred outside the Scope of Work set forth in Section 9.0. The Grantee shall only be paid for actual work performed and services delivered.

d. The term of this grant is from (NB) to (NE). The Grantee will not receive payment for any expenditure made or incurred prior to (NB) or after (NE), the term of this Grant award.

4.0 PRINCIPAL PLACE OF PERFORMANCEThe counties served through this Grant include: (G). The target population served by this grant includes (TP).

5.0 INSPECTION AND ACCEPTANCEa. Inspection and acceptance of all submittals shall be accomplished by the DCF Program Manager or his/her duly

authorized representative.b. All effort performed under this Grant is subject to inspection by various agencies. The Grantee may be required to

provide personnel to accompany the regulatory agency inspection or review teams. Grantee personnel shall be knowledgeable concerning the work being inspected. In addition, the Grantee may be required to participate in responding to the request for information or other findings by regulatory agencies.

c. All work accepted during the progress of the Grant is subject to further inspection. If work is found to NOT be in conformance with the Grant, the Grantee will be required to put it into compliance at no additional cost, or payment will be withheld until work is performed in compliance with the Grant.

6.0 SPECIAL GRANT REQUIREMENTSThe Grantor’s Contractual Provisions (DA-146a) is applicable to and a part of this Grant and is incorporated herein by reference as Attachment D.

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7.0 ORDER OF PRECEDENCEIn the event of an inconsistency or conflict between or among provisions of this Grant, the inconsistency shall be resolved by giving precedence as follows:

a. Attachment D (Contractual Provisions – DA-146a)b. Amendments to the Awardc. The Awardd. Attachment E (Special Provisions Incorporated By Reference)e. Other provisions of this Grant, whether incorporated by reference or otherwise.

8.0 GENERAL RELATIONSHIPThe Grantee agrees in all matters relating to this Grant, it shall be acting as an independent contractor and shall assume and pay all liabilities and perform all obligations imposed with respect to the performance of this Grant. The Grantee shall have no right, power or authority to create any obligation, expressed or implied, on behalf of DCF and shall have no authority to represent DCF as an agent.

9.0 SCOPE OF WORK AND DELIVERABLESThe Grantee, as an independent contractor and not as an agent of DCF, shall, in conformance with the Specific Terms and Conditions set forth herein, provide the necessary personnel and material and do all things necessary and/or incidental to the furnishing and delivery to DCF of the supplies or services set forth below, all in accordance with the specifications and other requirements applicable to and referenced therein and as set forth in the award.9.1 BACKGROUND AND SCOPE9.2 SERVICES TO BE PROVIDED 9.3 PERFORMANCE MEASURES9.4 DELIVERABLES AND REPORTING REQUIREMENTS

The work required by this Grant shall be completed in accordance with the respective dates specified in the Grant or as requested by DCF. The Grantee shall submit all required reports as listed below. All reports must be received on or before the required due dates established in the NOGA. Failure to submit the required reporting, regardless of the level of progress or expenditures during the reporting period, shall lead to non-payment of the Budget Transaction Report requested funds, suspension of the grant and/or termination of the grant, at the discretion of DCF. Acceptance of any late deliveries shall not be deemed a waiver of DCF’s right to hold the Grantee liable for any actual loss or damage resulting therefrom, nor shall it act as a modification of the Grantee’s obligation to make future deliveries in accordance with the award set forth in this Section. The completion date for this Grant is (NE).The Grantee must submit the following reports to DCF, using the following forms: Status Report (Form OGC-1006) Budget Transaction Report (Form OGC-1005) Budget Itemization Report (Form OGC-4005)The Grantee may submit the following reports to DCF, using the following forms:

Revision Request (Form OGC-1008) Grantee may submit if they wish to request a revision to their Approved Grant Budget

Authority Equipment Pre-Approval Request (Form OGC-4004) Grantee must submit if they wish to purchase an article of tangible personal property that

has a useful life of more than one year and an acquisition cost (DC-funded portion) of $5,000 or more per unit.

Equipment purchased with grant funds must be returned to DCF upon completion of the grant.

The aforementioned OGC forms, as well all other OGC forms noted in this document, can be found at the DCF Office of Grants and Contracts webpage – http://www.dcf.ks.gov/Agency/Operations/Pages/Grantee-Resources.aspx.

Status Reports are due as follows:Status Reports shall include information regarding Performance Measures. These Performance Measures will be compared with the annual targeted goals as identified in the Grant Proposal to ensure compliance. If no activity took place or no services were provided, then an explanation for such should be included on the Status Report. Budget Transaction Reports will not be processed without a Status Report for the reporting period on file, a Budget Itemization Report, and any other required documentation established herein.

Budget Transaction Reports and Budget Itemization Reports are due as follows:Grantee Agencies shall request payment via the Budget Transaction Report. Requests for

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reimbursement must be limited to those expenditures made consistent with the provisions set forth in this NOGA. Budget Transaction Reports will not be processed without a Status Report for the reporting period on file, a Budget Itemization Report, and any other required documentation established herein. Budget Transaction Reports and Budget Itemization Reports must be submitted every reporting period, even if no expenses were incurred and no activity took place. If no expenses were incurred, then $0.00 should be submitted on the Budget Transaction Report and Budget Itemization Report. Incomplete or incorrect reports will be returned for correction without payment.

If the Budget Transaction Report includes expenses incurred from Sub-Awardees, a copy of the Sub-Grantee Agency’s Tax Clearance(s) and Debarment Memorandum(s) must be submitted with the first Budget Transaction Report in order for any funds to be reimbursed. (Related information can be found in Section10.12–Sub-Awards.)

The last Budget Transaction Report must be marked as FINAL and submitted according to the aforementioned timeline. Under no circumstance will it be accepted more than sixty (60) days beyond the end of the grant term, at which time the funds will be released to another purpose. After payment of the Final Budget Transaction Report, no further amount shall be due or payable by DCF under this Grant.Although receipts and related documentation are not required to be submitted, this original documentation of expenditures must be kept on file and available for inspection by state and/or federal officials.

Reports and Requests must be sent to the following parties, as noted on each Grant Report or Request accordingly. For more information, or should you have any questions, please contact DCF using the contact information below:

9.5 STATE RESOURCES TO BE PROVIDED10.0 FUNDING

The funding amount for this Grant is $(M). Indirect Costs should not exceed 10% of the total Grant Budget. A copy of the Grantee’s federally approved Indirect Cost rate agreement must be included should a different rate be requested.This Grant is reimbursement-based, unless otherwise noted. Grantee must submit regular budget reports itemizing costs incurred, as noted above, and is reimbursed accordingly. Grant funds are paid for services rendered and are not provided as “cash up front.” 10.1 AVAILABILITY OF ANTICIPATED FEDERAL FUNDS

The formal approval of grant awards, and the obligation and reimbursement of funds to them, are contingent upon the availability of anticipated federal funds, as determined by Congress, Kansas statute, other Federal or State action, as well as the Specific Terms and Conditions contained in this NOGA.

10.2 COST PRINCIPLESAt times, the State matches federal funds with state funds and therefore follows federal guidelines and regulations. Requests for reimbursement of grant awards shall be limited to those expenditures made consistent with the provisions of this NOGA and the cost principles set forth as follows:

a. The Code of Federal Regulations (CFR), including 45 CFR Parts 46, 77, 80, 84, 86, 91, 95, 96, 97, and 100; 46 CFR Part 381; 48 CFR Part 31.2. For more information on the CFRs, visit: http://www.ecfr.gov/cgi-bin/ECFR?SID=2d5f57c64e7afab744f98df61bf24177&page=simple.

b. The Office of Management and Budget Circulars have been replaced by the Super-Circular 2 CFR Part 200. For more information on the Super Circular, visit: http://www.ecfr.gov/cgi-bin/text-idx?tpl=/ecfrbrowse/Title02/2cfr200_main_02.tpl.

10.3 ALLOWABLE COSTSCosts must be necessary, reasonable for and allocable to an approved grant award; incurred within the grant award period; itemized in the NOGA’s Approved Grant Budget Authority; and in accordance with the NOGA provisions. State of Kansas purchasing regulations are required to be followed, unless prior approval has been granted. Travel costs under this award are to follow State of Kansas mileage and per-diem rates as stated.

10.4 INELIGIBLE ITEMSItems ineligible for grant award reimbursement include: alcohol, for consumption purposes; land; construction or reconstruction of driving ranges, towers and skid pads; construction, rehabilitation or remodeling of state, local or private buildings or structures; and office furnishings and fixtures. Grant funds shall never be used to purchase property or build facilities.

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Grantees are responsible for paying for grant-funded goods and services in a timely manner. Grant funds may not be used to pay late fees, finance charges, interest, or any costs associated with late or overdue bills. All such costs are the sole responsibility of the Grantee.

10.5 PROPORTIONATE FUNDINGReimbursement of costs for personnel, major equipment and other significant purchases must be limited to the portion utilized on the project.

10.6 DUPLICATION OF FUNDSBy acceptance of this Grant, the Grantee declares and assures that no costs or expenditures which have been funded by other federal or state grant funds have been duplicated or otherwise included as part of the funding request in this Grant.

10.7 SUPPLANTATION OF GRANT FUNDSThe Grantee shall not use grant monies to pay for expenses already being paid for or have been paid for by another source. The Grantee shall not replace or supplant funding of another existing program with funds provided for in this Grant. Funds granted under this Grant Award may not be used for any purpose other than the one defined in this document.

10.8 START-UP COSTSGrantees may have start-up costs approved which were incurred within the ninety (90) day period immediately preceding the effective date of the award. Requests for start-up costs must be negotiated during the pre-award period. Start-up costs must be necessary for the effective and economical conduct of the Grant and the costs must be otherwise allowable. Pre-award expenditures are made at the Grantee’s risk. Approval of start-up costs does not obligate DCF under the following conditions: (1) lack of funding appropriation; (2) if the award is not subsequently made; or (3) if a Grant is made for a lesser amount than the Grantee expected. Start-up costs are one time monies and are not to be approved for continuation Grants.

10.9 PROGRAM INCOMEProgram income means gross income earned by the Grantee that is directly generated by a supported activity or earned as a result of the Grant Award. Program income includes, but is not limited to, income from fees for services performed, the use of rental or real or personal property acquired under the award, the sale of commodities or items fabricated under the award, license fees and royalties on patents and copyrights and interest on loans made with award funds. Interest earned on advances of funds is not program income. Program income does not include the receipt of principal on loans, rebates, credits, documents, etc., or interest earned on any of them.Unless otherwise specified in the Grant, program income received or accrued by the Grantee during the period of this award shall be retained and added to the funds committed to this Grant and used to further Grant objectives. Also, unless otherwise specified, the Grantee shall have no obligation for program income generated and received beyond the period of this award.

10.10 UNEARNED GRANT FUNDSUnless otherwise specified in a Grant award document, all unearned Federal Grant funds on hand at the end of the Grant period shall be returned to DCF within sixty (60) days of the end of the grant period. Revenue is earned when the allowed expenses (according to the Grant terms) are incurred and properly reported (according to the Grant terms) and timely submitted to DCF for reimbursement. The Grantee shall remit the amount due by check or money order payable to DCF as coordinated with the Granting Agency. Grantees may keep any interest or other investment income earned on advances of DCF Grant funds as long as the monies are reinvested in the Grant itself. This includes any interest or investment income earned by Sub-Grantees and cost-type contractors on advances to them that are attributable to advances of DCF Grant funds to the Grantee. DCF may seek recovery of costs due to litigation.

10.11 SUB-AWARDSA Grantee Agency may enter into sub-awards only with prior written approval from DCF. Sub-Grantee Agencies must sign off on and adhere to the Specific Terms and Conditions contained within this NOGA and are subject to the same Tax Clearance and Debarment requirements as the Grantee Agency, as well as the audit requirements outlined within the NOGA. A copy of Sub-Grantee Tax Clearance(s), Debarment Memorandum(s), and the signed Sub-Grantee Acknowledgement Form (OGC-1012), must be submitted with this NOGA for approval. Sub-Grantees shall utilize the grant funds in a manner consistent with their given budget and abide by the restrictions found elsewhere within these Grant conditions.

11.0 PAYMENTS Unless otherwise provided, DCF shall pay amounts due and payable within thirty (30) days after receipt of a valid

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Budget Transaction Report, Budget Itemization Report and Status Report. In accordance with the Kansas Prompt Payment Act (K.S.A 75-6403), payments will be made within thirty (30) days from the date the Report was received by DCF. Please note the “payment date” is considered to be the date on the check to the agency, not the date it is received by the agency. Any payments not processed within thirty (30) days are subject to an interest penalty. Requests for interest to be paid on an invoice must be sent to the Executive Officer of the Agency. Interest will be paid at a rate of 1.5% per month of the unpaid balance due. Total compensation shall not exceed $(M). After payment of the final Budget Transaction Request no further amount shall be due or payable by DCF under this Grant.

12.0 GRANT CHANGES AND BUDGET MODIFICATIONS12.1 REVISION REQUESTS

A Grantee Agency may submit a Revision Request (OGC-1008) during the grant year to their designated OGC Grant and Contract Specialist if they would like to move funding from one line item to another, within the existing grant year, without changing the Total Expense amount. If the requested funding change is less than 10% of the line item amount where the money is coming from no Revision is required. Approval is necessary prior to making any expenditure. In addition, approval is necessary before requesting reimbursement for such expenses. If reimbursement is being requested for monies over 10% of a line item and approval has not been given, those expenses will not be reimbursed. The Grantee Agency shall continue to utilize the grant funds in a manner consistent with the Approved Grant Budget Authority, abiding by the restrictions found elsewhere within these Grant conditions.Revision Requests will not be accepted during the last thirty (30) days of the grant term.

12.2 AMENDMENTSOnly DCF will determine if an Amendment is warranted to extend the Grant Year end date, increase/decrease the Total Expense amount, or change the scope of work within the grant year. a. DCF may at any time, by written order, make changes within the general scope of this Grant,

or any order issued hereunder, in any one or more of the following:i. Description of services to be performed.

ii. Time of performance (i.e., hours of the day, days of the week, etc.)iii. Place of performance of the services.iv. Place of delivery.

b. If any such change causes an increase or decrease in the cost of, or the time required for performance of any part of the work under this Grant, DCF shall make an adjustment in the price, the delivery schedule, or both, and shall modify the Grant.

c. The Grantee must assert its right to an adjustment under this clause within thirty (30) working days of the written notification. However, if DCF decides the facts justify it, DCF may receive and act upon a proposal submitted before final payment of this Grant.

d. Failure to agree on any adjustment shall be a dispute under the Disputes Provision. However, nothing in this provision shall excuse the Grantee from proceeding with the Grant as changed.

e. Except as provided in this provision, no order, statement, or conduct of the Grantee shall be treated as a change to the Grant under this provision or entitle the Grantee to an equitable adjustment.

12.3 MODIFICATIONS SUBJECT TO FUNDING CHANGESThe State of Kansas’ current financial situation does not make it possible for DCF to make firm, unalterable financial commitments. In the event DCF determines lack of funding requires a modification of this Agreement, DCF reserves the right to renegotiate terms and conditions of the Agreement with the Grantee. The Grantee agrees to cooperate with DCF in negotiating this Agreement should DCF determine such modification is necessary to manage the resources available to DCF.In the event DCF is subject to a formal reduction or allotment, DCF reserves the right to alter or adjust the payment amounts or terms of this Agreement to meet funding reductions or allotments by sending a written notice of such alterations or adjustments to the Grantee fifteen (15) days before such alterations or adjustments become effective. Should the Grantee believe there is a need to modify other terms or conditions of the Agreement, DCF will, in good faith, negotiate regarding the terms of the Agreement.

12.4 CHANGES IN KEY PERSONNEL OR BOARD MEMBERSHIPThe Grantee Agency must notify their DCF Program Manager if there are any changes in key personnel at the Grantee Agency and/or changes to board membership. DCF has the right to audit the Grantee Agency if there has been a change in such personnel.

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13.0 DATADCF warrants that technical data issued to the Grantee for use in performing professional services under this Grant shall be current, accurate, complete and adequate for its intended purpose. The Grantee shall notify their DCF Program Manager as soon as possible upon discovering any data deficiency. The DCF Program Manager shall take prompt and reasonable action to reconcile or remedy the data deficiency(ies). The Grantee may have access to private or confidential data maintained by DCF to the extent necessary to carry out its responsibilities under this Grant. The Grantee must comply with all the requirements of the Kansas Open Records Act in providing services under this Grant. The Grantee shall accept full responsibility for providing adequate supervision and training to its agents and employees to ensure compliance with the Act. No private or confidential data collected, maintained or used in the course of the performance of this Grant shall be disseminated by either party except as authorized by statute, either during the period of the Grant or thereafter. The Grantee must agree to return any or all data furnished by DCF promptly at the request of DCF in whatever form it is maintained by the Grantee. On the termination or expiration of this Grant, the Grantee will not use any of such data or any material derived from the data for any purpose and, where so instructed by DCF, will destroy or render it unreadable.

14.0 GOVERNING LAW, CONSENT TO JURISDICTIONThis Award, and any act, agreement, contract or transactions to which they shall apply, or which are contemplated hereby or hereunder, shall be governed by, and construed, interpreted and enforced in accordance with the laws of the State of Kansas and, to the extent applicable, the United States of America.Any dispute arising out of, or any suit or other proceedings pursuant to or arising out of these Specific Terms and Conditions, or any act, agreement, contract or transactions to which they shall apply or which are contemplated hereby or hereunder, shall be subject to the jurisdiction of a court of competent jurisdiction located in the county of Shawnee, State of Kansas, and the Grantee shall take any and all necessary or appropriate action to submit to the jurisdiction of such court.

15.0 COMPLIANCE WITH LAWS AND REGULATIONSThe Grantee agrees it will comply with all federal, state, and local laws and regulations in effect at any time during the course of this Grant. The Grantee shall certify to DCF it will provide a drug-free workplace and as a condition of the Grant, the Grantee will not engage in the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance in conducting any activity with the Grant.

16.0 REMOVAL OF GRANTEE’S PERSONNELIf DCF deems the work of any of the Grantee’s employees to be substandard or unsatisfactory, DCF will advise the Grantee of the reasons for such judgment and allow reasonable time for correcting the substandard or unsatisfactory performance. The Grantee agrees to remove such employees immediately upon completion of the thirty (30) days allotted if DCF deems improvement in the work performance has not been adequate. If one or more of these employees has been designated as key personnel by this Grant, the Grantee agrees to use its best efforts to replace them with others who have substantially equal abilities and qualifications and who are acceptable to DCF.

17.0 NO WAIVER OF CONDITIONSFailure of DCF to insist on strict performance shall not constitute a waiver of any of the provisions of this Grant or waiver of any other default of the Grantee.

18.0 FORCE MAJEUREThe Grantee shall not be liable if the failure to perform this Grant arises out of causes beyond the control of the Grantee. Causes may include, but are not limited to, acts of nature, fires, quarantine, strikes other than by the Grantee’s employees, and freight embargoes.

19.0 TERMINATION19.1 GRANT TERMINATION

The initial term of this Grant shall commence on (NB) and shall continue in effect until (NE) unless terminated sooner pursuant to the provisions of this Agreement.Performance: The Grantee shall perform each and every requirement and condition set forth in the Grant Award which was accepted by DCF in this document. Failure to perform the requirements and conditions set forth in the Grant shall be considered a material breach of this Grant Agreement.Termination for cause: This Grant may be terminated immediately by DCF for cause. Cause for immediate termination is limited to the following: Grantee’s failure to perform the requirements and conditions set forth in their Grant; Grantee’s material breach of the terms and conditions of this agreement; the willful breach, habitual neglect, or other continued failure of the Grantee to abide by any law, rule, procedure or policy which the Grantee has received notice from either DCF or the State of Kansas; the inability to submit a valid Kansas Certificate of Tax Clearance for the Grantee Agency from the Kansas Department of Revenue; the Grantee Agency or any of its employees is found to be debarred or suspended. In the event DCF terminates this agreement for cause the Grantee will be provided written notice of the reasons therefore.

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19.2 TERMINATION DUE TO LACK OF FUNDING APPROPRIATIONIf sufficient funds are not appropriated to continue the function performed in this agreement and for the payment of the charges hereunder, DCF may terminate this agreement at the end of its current fiscal year. DCF agrees to give written notice of termination to the Grantee at least thirty (30) days prior to the end of its current fiscal year, and shall give such notice for a greater period prior to the end of such fiscal year as may be provided in this agreement, except that such notice shall not be required prior to ninety (90) days before the end of such fiscal year. DCF will pay to the Grantee, all regular Grant payments incurred through the end of such fiscal year, plus grant charges incidental to the return of any such equipment. The termination of the Grant pursuant to this paragraph shall not cause any penalty to be charged to the agency or the Grantee.

19.3 TERMINATION FOR CONVENIENCEDCF shall terminate performance of work under this Grant in whole or in part whenever, for any reason, DCF shall determine the termination is in the best interest of the State of Kansas. In the event DCF elects to terminate this Grant pursuant to this provision, the Grantee will be provided written notice at least thirty (30) days prior to the termination date. The termination shall be effective as of the date specified in the notice. The Grantee shall continue to perform any part of the work that has not been terminated by the notice.

19.4 RIGHTS AND REMEDIESIf this Grant is terminated, DCF, in addition to any other rights provided for in this Grant, may require the Grantee to transfer title and deliver to DCF, in the manner and to the extent directed, any completed materials. DCF shall be obligated only for those services and materials rendered and accepted prior to the date of termination.Subject to proof of market price, the measure of damages for non-delivery or repudiation by the Grantee, shall be the difference between the market price at the time when DCF learned of the breach and the Grant price, combined with any incidental and consequential damages, less expense saved as a result of the Grantee’s breach. Market price shall be determined as of the place for tender or, in cases of rejection after arrival or revocation of acceptance, as of the place of arrival.If it is determined, after notice of termination for cause, the Grantee’s failure was due to causes beyond the control of or negligence of the Grantee, the termination shall be a termination for convenience in the best interest of the State. In the event of termination, the Grantee shall receive payment pro-rated for the portion of the Grant period services were provided to and/or goods were accepted by DCF subject to any offset by DCF for actual damages including loss of federal matching funds.The rights and remedies of DCF provided for in this Grant shall not be exclusive and are in addition to any other rights and remedies provided by law.

20.0 SEVERABILITYIf any provision of this Grant is determined by a court of competent jurisdiction to be invalid or unenforceable to any extent, the remainder of this Grant shall not be affected and each provision of this contract shall be enforced to the fullest extent permitted by law.

21.0 REVIEWS AND HEARINGSThe Grantee agrees to advise DCF of all complaints made known to the Grantee and refer all appeals or fair hearing requests to the State. DCF has the discretion to require the Grantee to participate in any review, appeal, fair hearing or litigation involving issues related to this Grant.A fair hearing request must be received within thirty (30) days (ninety (90) days for food assistance) of the date of the agency's notice of action. A fair hearing request must be made in writing (except for food assistance), signed, and sent to the Office of Administrative Hearings, 1020 S Kansas Avenue, Topeka, Kansas 66612-1327. The Fair Hearing Request form can be found at http://www.oah.ks.gov/request.htm. For additional procedures for DCF, see K.A.R. 30-7-64 et. seq., K.S.A. 77-501 et. seq., and K.S.A. 75-37,121. Administrative Disqualification hearings are subject to different procedures pursuant to 7 C.F.R. § 273 and K.A.R. 30-7-100 et. seq.

22.0 HOLD HARMLESSThe Grantee shall indemnify DCF against any and all claims for injury or death of any persons, for loss or damage to any property, and for infringement of any copyright or patent occurring in connection with or in any way incidental to or arising out of the occupancy, use, service, operations or performance of work under this Grant.Neither the State of Kansas nor DCF shall hold harmless or indemnify any Grantee beyond that liability incurred under the Kansas Tort Claims Act (K.S.A. 75-6101 et. seq.).

23.0 CONFLICT OF INTERESTThe Grantee shall not knowingly employ, during the period of this Grant or any extensions of it, any professional personnel who are also in the employ of the State and who are providing services involving this Grant or similar in

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nature to the scope of this Grant. Furthermore, the Grantee shall not knowingly employ, during the period of this Grant or any extensions of it, any State employee who has participated in the making of this Grant until at least two years after his/her termination of employment with the State. All Grant Conflict of Interest issues will be decided in accordance with K.S.A. 46-215 et. seq.

24.0 NONDISCRIMINATION AND WORKPLACE SAFETYThe Grantee agrees to abide by all state, federal and local laws, rules and regulations prohibiting discrimination in employment and controlling workplace safety. Any violation of applicable laws, rules or regulations may result in termination of this Grant.24.1 CIVIL RIGHTS AND NONDISCRIMINATION

The Grantee assures all grant projects provided by the Grantee shall comply with all applicable nondiscrimination requirements, including, but not limited to, Title VI of the Civil Rights Act of 1964, as amended, 42 U.S.C. §2000(d) et seq.; Section 504 of the Rehabilitation Act of 1973, as amended, 29 U.S.C. §794; Subtitle A, Title II of the Americans with Disabilities Act of 1990, as amended, 42 U.S.C. §12131 et seq.; Title IX of the Education Amendments of 1972, as amended, 20 U.S.C. §1681 et seq.; the Age Discrimination Act of 1975, 42 U.S.C. §6101 et seq.; U.S. Department of Justice Nondiscrimination Regulations, 28 C.F.R. Part 42, Subparts C, D, E, and G; and U.S. Department of Justice regulations on disability discrimination, 28 C.F.R. Part 35 and Part 39 administrative requirements.

24.2 EQUAL EMPLOYMENT OPPORTUNITY PLANThe Grantee assures it has formulated an equal employment opportunity plan (EEOP) if required by federal and state law. The Grantee assures it has provided to the DCF the name of a civil rights professional who has lead responsibility for ensuring that all applicable civil rights requirements are met. This person shall act as a liaison for civil rights issues with the U.S. Justice Department, Office of Justice Programs, Office of Civil Rights.

24.3 LIMITED ENGLISH PROFICIENCYThe Grantee assures that procedures have been or will be developed to ensure meaningful access by persons with limited English proficiency who are eligible for assistance or services from any Grantee program. For additional guidance in complying with the LEP assurance, please refer to the U.S. Department of Justice Guidance to Federal Financial Assistance Recipients Regarding Title VI Prohibition Against National Origin Discrimination Affecting Limited English Proficient Persons at 67 C.F.R. 41455 (June 18, 2002) or www.lep.gov.

25.0 AMERICANS WITH DISABILITIES ACT (ADA)The contractor agrees: (a) to comply with the Kansas Act Against Discrimination, (K.S.A. 44-1001 et. seq.) the Kansas Age Discrimination in Employment Act, (K.S.A. 44-111 et seq.) the applicable provisions of the Americans with Disabilities Act, (42 U.S.C. 12101 et. seq.) (ADA) and to not discriminate against any person because of race, religion, color, sex, disability, national origin, ancestry, or age in the admission or access to, or treatment or employment in, its programs or activities; (b) to include in all solicitations or advertisements for employees the phrase “Equal Opportunity Employer; (c) to comply with the reporting requirements set out at K.S.A. 44-1031 and K.S.A. 44-1116; (d) to include those provisions in every subcontract or purchase order so they are binding upon such subcontractor or vendor; (e) a failure to comply with the reporting requirements of (c) above or if the contractor is found guilty of any violation of such acts by the Kansas Human Rights Commission, such violation shall constitute a breach of contract and the contract may be cancelled, terminated or suspended, in whole or in part, by the contracting state agency or the Kansas Department of Administration; (f) if it is determined the contractor has violated applicable provisions of ADA, such violation shall constitute a breach of contract and the contract may be cancelled, terminated or suspended, in whole or in part, by the contracting state agency or the Kansas Department of Administration.Parties to this contract understand the provisions of this paragraph (with the exception of those provisions relating to the ADA) are not applicable to a contractor who employs fewer than four employees during the term of such contract or whose contracts with the contracting state agency cumulatively total $5,000 or less during the fiscal year of such agency.

26.0 HEALTH INSURANCE PORTABILITY AND ACCOUNTABLITY ACT (HIPAA)Confidentiality under the Health Insurance Portability and Accountability Act, 1996 (HIPAA):DCF is a covered entity under the Act and therefore Grantee is not permitted to use or disclose health information in ways DCF could not. This protection continues as long as the data is in the hands of the Grantee.Definition:For purposes of this section, the terms “Protected Health Information” and “PHI” mean individually identifiable information in any medium pertaining to the past, present or future physical or mental health or condition of an individual; the provision of health care to an individual; or the past, present or future payment for provision of health care to an individual that Grantee receives from DCF or that Grantee creates or receives on behalf of DCF. The

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terms “Protected Health Information” and “PHI” apply to the original data and to any data derived or extracted from the original data that has not been de-identified.Electronic protected health information (EPHI) is a subset of PHI and means individually identifiable health information that is transmitted by or maintained in electronic media.

a) Required/Permitted Uses Section 164.504(e)(2)(i): Grantee is required/permitted to use the PHI for the following purposes:

i. Any activity required to ensure compliance and fulfill grant obligationsb) Required/Permitted Disclosures Section 164.504(e)(2)(i): Grantee shall disclose DCF’s PHI only as

allowed herein or as specifically directed by DCF.c) Limitation of Use and Disclosure Section 164.504(e)(2)(ii)(A): Grantee agrees it will not use or further

disclose the PHI other than as permitted or required by this Grant or as required by law.d) Disclosures Allowed for Management and Administration Section 164.504(e)(2)(i)(A) and 164.504(e)(4)

(i): Grantee is permitted to use and disclose PHI received from DCF in its capacity as a Grantee to DCF if such use is necessary for proper management and administration of the Grantee to carry out the legal responsibilities of the Grantee.

e) Minimum Necessary: Grantee agrees to limit the amount of PHI used and/or disclosed pursuant to this section to the minimum necessary to achieve the purpose of the use and disclosure.

f) Safeguarding and Securing PHI Section 164.308, 164.310, 164.312, 164.314 and 164.504(e)(2)(ii)(B): Grantee agrees to implement administrative, physical and technical safeguards that reasonably and appropriately protect the confidentiality, integrity and availability of the PHI and or EPHI the Grantee creates, receives, maintains or transmits. Grantee will furnish DCF with a written description of such safeguards taken upon request. Grantee agrees to allow authorized representatives of DCF access to premises where the PHI and or EPHI is kept for the purpose of inspecting physical security arrangements.

g) Agents and Sub-Grantees Section 164.504(e)(2)(ii)(D): Grantee will ensure any entity, including agents and Sub-Grantees, to whom it discloses PHI received from DCF or created or received by Grantee on behalf of DCF, agrees to the same restrictions and conditions that apply to Grantee with respect to such information.

h) Right to Review: DCF reserves the right to review terms of agreements and contracts between the Grantee and Sub-Grantees as they relate to the use and disclosure of PHI belonging to DCF.

i) Ownership: Grantee shall at all times recognize DCF’s ownership of the PHI.j) Notification Section 164.304, 164.314(a)(C) and164.504(e)(2)(ii)(C) : Grantee shall notify DCF both

orally and in writing of any use or disclosure of PHI and or EPHI not allowed by the provisions of this Grant of which it becomes aware, and of any instance where the PHI is subpoenaed, copied or removed by anyone except an authorized representative of DCF or the Grantee. The Grantee shall report to DCF any security incident within five (5) business days of becoming aware of such incident. For the purposes of this paragraph, “security incident” shall mean the attempted or successful unauthorized access, use, disclosure, modification or interference with systems operations in an information system.

k) Transmission of PHI Section 164.312(c)(1) and 164.312(c)(2): Grantee agrees to follow the HIPAA standards with regard to the transmission of PHI.

l) Employee Compliance with Applicable Laws and Regulations: Grantee agrees to require each of its employees having any involvement with the PHI to comply with applicable laws and regulations relating to confidentiality and privacy of the PHI and with the provisions of this Grant.

m) Custodial Responsibility: Employee of Grantee, is designated as the custodian of PHI and will be responsible for observance of all conditions of use. If custodianship is transferred within the organization, Grantee will notify DCF promptly.

n) Access, Amendment, and Accounting of Disclosures Section 164.504(e)(2)(ii)(E-G): Grantee will provide access to the PHI in accordance with 45 C.F.R. Section 164.524. Grantee will make the PHI available for amendment and incorporate any amendments to the PHI in accordance with 45 C.F.R. Section 164.526. Grantee will make available the information required to provide an accounting of disclosures in accordance with 45 C.F.R. Section 164.528.

o) Documentation Verifying HIPAA Compliance Section 164.504(e)(2)(ii)(H): Grantee will make its policies, procedures and documentation relating to the security and privacy of protected health information, including EPHI, available to the Secretary of Health and Human Services for purposes of determining DCF’s compliance with 45 C.F.R. Parts 160 and 164. Grantee will make these same policies, procedures and documentation available to DCF or its designee upon request.

p) Grant Termination Section 164.314(a)(2)(i)(D) and164.504(e)(2)(ii)(I) : Grantee agrees that within [XX] days of the termination of this Grant, it will return or destroy, at DCF’s direction, any and all PHI it maintains in any form and will retain no copies of the PHI. If the return or destruction of the PHI is not feasible, the protections of this section of the Grant shall be extended to the information, and further use

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and disclosure of PHI is limited to those purposes that make the return or destruction of PHI infeasible. Any use or disclosure of PHI except for the limited purpose is prohibited.

q) Termination for Compliance Violation Section 164.314(a)(2)(i)(D),164.504(e)(2)(iii) and Section 164.504(e)(1)(ii): Grantee acknowledges DCF is authorized to terminate this Grant if DCF determines Grantee has violated a material term of this section of the Grant. If termination of the Grant is not feasible due to an unreasonable burden on DCF, Grantee’s violation will be reported to the Secretary of Health and Human Services, along with steps DCF took to cure or end the violation or breach and the basis for not terminating the grant.

27.0 CRIMINAL PROVISIONBy acceptance of this Grant, the Grantee declares and assures they have not been convicted of any criminal offenses that indicate a lack of integrity or honesty. Crimes indicating a lack of integrity or honesty include, but are not limited to, the following: any conviction of federal, state or local laws for embezzlement; theft; forgery; bribery; falsification or destruction of records; receiving stolen property; racketeering; and violation of antitrust laws. Any conviction(s) incident to obtaining or attempting to obtain or performing a public or private contract, subcontract, grant or sub-grant; or conviction of any other offense which impacts the performance and/or responsibility of a contractor, subcontractor, Grantee or Sub-Grantee are also considered as offenses which lack integrity and honesty. The Grantee shall ensure any employees hired for this Grant are not on any criminal registry (i.e., Adult Protective Services Register).

28.0 TAX CLEARANCEAny Grantee Agency who applies for a DCF Grant Award must obtain a valid Kansas Certificate of Tax Clearance for the Grantee Agency by accessing the Kansas Department of Revenue's website at http://www.ksrevenue.org/taxclearance.html. A Tax Clearance is a comprehensive tax account review to determine and ensure an Agency’s account is compliant with all primary Kansas Tax Laws. A Tax Clearance expires every ninety (90) days. This is in accordance with Executive Order 2004-03.

29.0 DEBARMENTAs part of the Code of Federal Regulations (45 C.F.R. Part 76), all governmental entities receiving funding from the Federal Government must participate in a government wide system for non-procurement debarment and suspension. A person or entity who is debarred or suspended shall be excluded from Federal financial and non-financial assistance and benefits under Federal programs and activities. Debarment or suspension of a participant in a program by one agency shall have government wide effect. The Secretary of DCF is authorized to impose debarment. Before any person or entity enters into a Grant with DCF, the Excluded Parties Lists (located at the web site http://www.sam.gov) shall be researched for potential debarred persons or entities.

30.0 FEDERAL FUNDING ACCOUNTABILITY AND TRANSPARENCY ACT (FFATA)The Federal Funding Accountability and Transparency Act (FFATA) of 2006 requires information on federal awards (federal financial assistance and expenditures) be made available to the public via a single, searchable website. Federal awards include grants, sub-grants, loans, awards, cooperative agreements, and other forms of financial assistance as well as contracts, sub-contracts, purchase orders, task orders, and delivery orders. The legislation does not require inclusion of individual transactions below $25,000. To comply with this legislation, DCF must report sub-recipient information on grantees and contractors. First, the award must be analyzed to see if the funds are federal or state monies. Then a determination must be made whether the awardee has a sub-recipient or vendor relationship with DCF. This is accomplished using the Federal Sub-Recipient v. Vendor Determination Checklist.The Grantee Agency must submit the FFATA Five Most Highly Compensated Executives form (Form OGC-4001) (Attachment C) and submit it with their signed NOGA.

31.0 OWNERSHIPAll data, forms, procedures, software, manuals, system descriptions and work flows developed or accumulated by the Grantee, under this Grant shall be owned by DCF. Grantee may not release any materials without the written approval of DCF.

32.0 PUBLICITY RELEASESAll publicity releases and materials published in connection with the Grant shall conspicuously acknowledge support of the Kansas Department for Children and Families. All such publicity releases and materials must be sent to the Grantee Agency’s designated DCF Program Manager, to be forwarded to the DCF Office of Communications for review, at least one week in advance of publication. No unauthorized use of the DCF logo is allowed.

33.0 WEB DEVELOPMENTWeb-based services must adhere to the same accessibility standards as determined by the State of Kansas. Any website, webpages, or web-based applications developed by a Grantee for DCF shall be in compliance with Kansas Information Technology Executive Council policies, refer to: http://oits.ks.gov/kito/itec/itec-policies. Information Technology Policy #1210, State of Kansas Web Accessibility Requirements, can be found at http://oits.ks.gov/kito/itec/itec-policies/itec-policy-1210. Additional information and guidance is available through

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the Kansas Partnership for Accessible Technology (KPAT) website at http://oits.ks.gov/kpat/. Finally, web content must be in compliance with DCF web standards (DCF-ITS Stands 3401.04) available upon request.

34.0 LOBBYINGNo appropriated funds may be expended by the recipient of this grant to pay any person for influencing or attempting to influence an officer or employee of any agency, a member of the Legislature or an employee of a member of the Legislature, or to expend in connection with any of the following covered Federal actions: the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment or modification of any Federal contract, grant, loan or cooperative agreement.

35.0 CARE OF STATE PROPERTYThe Grantee shall be responsible for the proper care and custody of any state-owned personal tangible property and real property furnished for the Grantee’s use in connection with the performance of this Grant. The Grantee will reimburse DCF for such property’s loss or damage caused by the Grantee, normal wear and tear expected.

36.0 EQUIPMENTThe term “equipment” is defined as an article of tangible personal property with a useful life of more than one (1) year and an acquisition cost of $5,000 or more per unit. The Grantee Agency must submit an Equipment Pre-Approval Request (OGC-4004) to their designated DCF Program Manager if they wish to purchase such an item (the Request must be submitted if the DCF-funded portion is $5,000 or more per unit). Equipment Pre-Approval Requests must be submitted and approved before any purchase of equipment is made. The Grantee Agency may use its own definition of equipment if its definition would at least include all items of equipment as defined here. The Grantee assures, to the extent practicable, all equipment and products purchased with grant funds shall be American made. At the close of this agreement, DCF may request any equipment purchased with these funds be returned to DCF.

37.0 RECORDS37.1 ACCOUNTING SYSTEM

The Grantee Agency’s accounting system shall meet generally accepted accounting principles and OMB Circular provisions.

37.2 MAINTENANCE OF COST RECORDSThe Grantee shall maintain books, records and other documents in such a manner so as to readily identify them directly with the delivery of services outlined in the Grant Award.

37.3 RETENTION OF RECORDS AND REPORTSUnless otherwise specified in this Grant Award document, the Grantee shall preserve and make available all of its books, documents, papers, records and other evidence involving transactions related to this Grant for a minimum of five (5) State fiscal years from the date of the expiration or termination of this agreement. Matters involving litigation shall be kept for the minimum five (5) year period or for one (1) year following the termination of litigation, including all appeals, whichever is longer. Grantee shall notify DCF of any circumstances which impair the integrity or security of such materials during the retention period.The Grantee agrees, authorized federal and state representatives, including but not limited to, personnel of DCF; independent auditors acting on behalf of the State; and/or federal agencies shall have access to and the right to examine records during the grant period and during the five (5) year post-grant period. Delivery of and access to the records shall be at no cost to the State.Grant records and documents must be made available for inspection by DCF personnel or their associates within a reasonable timeframe.

38.0 FEDERAL/STATE GRANTEE/SUB-GRANTEE AUDIT AND MONITORING DETERMINATION

The Grantee’s responsibilities regarding obtaining an independent audit of any grant awarded by DCF are found in DCF’s Audit/Monitoring Policy and Requirements, which can be found on DCF’s website at http://www.dcf.ks.gov/Agency/GC/Pages/Audits/AuditPolicies.aspx. For more information, please contact DCF’s Audit Services at 785.296.3836, or via e-mail at DCF.OACS@ks.gov. All entities receiving funding are subject to internal monitoring (both fiscal and program) and to audits conducted by DCF Audit Services. DCF Audit Services has the authority, under the provisions of this grant, and Federal and State law, to conduct audits in addition to those conducted by an entity’s contracted audit firm.

39.0 ENTIRE AGREEMENTThis Grant constitutes the entire understanding and agreement of and between the parties with respect to the subject matter hereof and supersedes all prior representations and agreements, oral or written. It shall not be varied, except by an instrument in writing of subsequent date, duly executed by authorized representatives of both parties. All work performed by the Grantee, actions taken, and payments made, if any, under any other prior written or oral

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agreements, with respect to this Grant, shall be deemed to have been work performed, actions taken, or payments made under this Grant.

40.0 SPECIAL CONDITIONSAPPROVED GRANT BUDGET AUTHORITY

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If selected as the recipient of this award, I agree on behalf of [Grant Applicant Agency] to abide by the Specific Terms and Conditions (DCF Provisions) described in this document. I understand these Specific Terms and Conditions may change before a final award is put into place.

APPLICANT AGENCY – Authorizing Official

Name:

Title:

Signature:

Date:

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Attachment E – Contractual Provisions (DA-146a) (Kansas provisions – Department of Administration)State of KansasDepartment of AdministrationDA-146a (Rev. 06-12)

CONTRACTUAL PROVISIONS ATTACHMENTImportant: This form contains mandatory contract provisions and must be attached to or incorporated in all copies of any contractual agreement.

If it is attached to the vendor/contractor's standard contract form, then that form must be altered to contain the following provision:"The Provisions found in Contractual Provisions Attachment (Form DA-146a, Rev. 06-12), which is attached hereto, are hereby incorporated in this contract and made a part thereof."The parties agree that the following provisions are hereby incorporated into the contract to which it is attached and made a part thereof, said contract being the day of , 20 .

1. T e r m s He r e i n C on t r o l l i ng P ro v is i ons : It is expressly agreed that the terms of each and every provision in this attachment shall prevail and control over the terms of any other conflicting provision in any other document relating to and a part of the contract in which this attachment is incorporated. Any terms that conflict or could be interpreted to conflict with this attachment are nullified.

2. Ka n sas L a w a n d V e nu e : This contract shall be subject to, governed by, and construed according to the laws of the State of Kansas, and jurisdiction and venue of any suit in connection with this contract shall reside only in courts located in the State of Kansas.

3. T e r mi n at i on D ue T o L ac k Of F u nd i n g A ppropr i at i o n : If, in the judgment of the Director of Accounts and Reports, Department of Administration, sufficient funds are not appropriated to continue the function performed in this agreement and for the payment of the charges hereunder, State may terminate this agreement at the end of its current fiscal year. State agrees to give written notice of termination to contractor at least 30 days prior to the end of its current fiscal year, and shall give such notice for a greater period prior to the end of such fiscal year as may be provided in this contract, except that such notice shall not be required prior to 90 days before the end of such fiscal year. Contractor shall have the right, at the end of such fiscal year, to take possession of any equipment provided State under the contract. State will pay to the contractor all regular contractual payments incurred through the end of such fiscal year, plus contractual charges incidental to the return of any such equipment. Upon termination of the agreement by State, title to any such equipment shall revert to contractor at the end of the State's current fiscal year. The termination of the contract pursuant to this paragraph shall not cause any penalty to be charged to the agency or the contractor.

4. D i sc l ai m e r Of L i a b i l i t y : No provision of this contract will be given effect that attempts to require the State of Kansas or its agencies to defend, hold harmless, or indemnify any contractor or third party for any acts or omissions. The liability of the State of Kansas is defined under the Kansas Tort Claims Act (K.S.A. 75-6101 et s eq . ).

5. A n t i -D i sc r imi n a t i on C l a u se : The contractor agrees: (a) to comply with the Kansas Act Against Discrimination (K.S.A. 44-1001 e t seq . ) and the Kansas Age Discrimination in Employment Act (K.S.A. 44-1111 e t s eq . ) and the applicable provisions of the Americans With Disabilities

Act (42 U.S.C. 12101 e t s eq . ) (ADA) and to not discriminate against any person because of race, religion, color, sex, disability, national origin or ancestry, or age in the admission or access to, or treatment or employment in, its programs or activities; (b) to include in all solicitations or advertisements for employees, the phrase "equal opportunity employer"; (c) to comply with the reporting requirements set out at K.S.A. 44-1031 and K.S.A. 44-1116; (d) to include those provisions in every subcontract or purchase order so that they are binding upon such subcontractor or vendor; (e) that a failure to comply with the reporting requirements of (c) above or if the contractor is found guilty of any violation of such acts by the Kansas Human Rights Commission, such violation shall constitute a breach of contract and the contract may be cancelled, terminated or suspended, in whole or in part, by the contracting state agency or the Kansas Department of Administration; (f) if it is determined that the contractor has violated applicable provisions of ADA, such violation shall constitute a breach of contract and the contract may be cancelled, terminated or suspended, in whole or in part, by the contracting state agency or the Kansas Department of Administration. Contractor agrees to comply with all applicable state and federal anti-discrimination laws. The provisions of this paragraph number 5 (with the exception of those provisions relating to the ADA) are not applicable to a contractor who employs fewer than four employees during the term of such contract or whose contracts with the contracting State agency cumulatively total $5,000 or less during the fiscal year of such agency.

6. A c ce p ta n ce O f C on t r ac t : This contract shall not be considered accepted, approved or otherwise effective until the statutorily required approvals and certifications have been given.

7. A r b i t r at i on, Da m a g es, W a rr a n t ie s : Notwithstanding any language to the contrary, no interpretation of this contract shall find that the State or its agencies have agreed to binding arbitration, or the payment of damages or penalties. Further, the State of Kansas and its agencies do not agree to pay attorney fees, costs, or late payment charges beyond those available under the Kansas Prompt Payment Act (K.S.A. 75-6403), and no provision will be given effect that attempts to exclude, modify, disclaim or otherwise attempt to limit any damages available to the State of Kansas or its agencies at law, including but not limited to the implied warranties of merchantability and fitness for a particular purpose.

8. Re pr ese n tat i ve 's A u t hor i t y T o C on t r act : By signing this contract, the representative of the contractor thereby represents that such person is duly authorized by the contractor to execute this contract on behalf of the contractor and that the contractor agrees to be bound by the provisions thereof.

9. Res pon s i b i l i t y For T axe s : The State of Kansas and its agencies shall not be responsible for, nor indemnify a contractor for, any federal, state or local taxes which may be imposed or levied upon the subject matter of this contract.

10. I n s ur a n c e : The State of Kansas and its agencies shall not be required to purchase any insurance against loss or damage to property or any other subject matter relating to this contract, nor shall this contract require them to establish a "self-insurance" fund to protect against any such loss or damage. Subject to the provisions of the Kansas Tort Claims Act (K.S.A. 75-6101 et s eq . ), the contractor shall bear the risk of any loss or damage to any property in which the contractor holds title.

11. I n f o r m at i o n : No provision of this contract shall be construed as limiting the Legislative Division of Post Audit from having access to information pursuant to K.S.A. 46-1101 et se q .

12. T he El eve n t h A m e nd m e n t : "The Eleventh Amendment is an inherent and incumbent protection with the State of Kansas and need not be reserved, but prudence requires the State to reiterate that nothing related to this contract shall be deemed a waiver of the Eleventh Amendment."

13. Ca m p a i g n C on t r i bu t i ons / Lo b b y i ng: Funds provided through a grant award or contract shall not be given or received in exchange for the making of a campaign contribution. No part of the funds provided through this contract shall be used to influence or attempt to influence an

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______ Authorized Representative

officer or employee of any State of Kansas agency or a member of the Legislature regarding any pending legislation or the awarding, extension, continuation, renewal, amendment or modification of any government contract, grant, loan, or cooperative agreement.

Attachment F – Special Provisions Incorporated by Reference (federal provisions)

SPECIAL PROVISIONS INCORPORATED BY REFERENCE1.0 Definitions

The following definitions apply:"Federal Award" – Federal grant award to DCF under which this award is issued."Award" – this contractual instrument (Grant, or task schedule under this Grant, or purchase order), including changes."Prime contract" – DCF Grant under which this award is issued.

2.0 Clauses Applicable to AwardThe clauses below and on the following pages, are incorporated herein by reference and made a part of this award, with the same force and effect as if set forth in full text. Upon request DCF will make their full text available. In all such clauses, unless the context of the clause requires otherwise, the term "Grantee" shall mean Grantee, the term "Grant" shall mean this award, and the terms "Government", "Grantor", and equivalent phrases shall mean DCF and DCF Purchasing Representative, respectively, except when a right, act, authorization, or obligation can be granted or performed only by the Federal Government or the Federal Government's Contracting Officer for the prime contract, or his duly authorized representative, or when access to proprietary data is required. The listed clauses shall apply to the Grantee in such manner as is necessary to reflect the position of the Grantee as a Grantor to DCF, to insure the Grantee's obligations to DCF and to the Federal Government, and to enable DCF to meet the obligations under the prime contract.

Regulation Number Title

5 CFR Part 1320 Controlling Paperwork Burdens on the Public

31 CFR Part 205 Withdrawal of Cash from the Treasury for Advances Under Federal Grant and Other Programs

37 CFR Part 401 Rights to Inventions Made By Nonprofit Organizations and Small Business Firms Under Government Grants, Contracts, and Cooperative Agreements

42 CFR Part 2 Confidentiality of Alcohol and Drug Abuse Patient Records45 CFR Part 5 Availability of Information to the Public45 CFR Part 15 Relocation Assistance and Real Property Acquisition Policies45 CFR Part 16 Department Grant Appeals Process45 CFR Part 46 Protection of Human Subjects45 CFR Part 77 Remedial Actions Applicable to Letter of Credit Administration

45 CFR Part 80 Nondiscrimination Under Programs Receiving Federal Assistance Through the Department of Health and Human Services; Implementation of the Title CVI of the Civil Rights Act of 1964

45 CFR Part 84 Nondiscrimination on the Basis of Handicap in Programs and Activities Receiving or Benefiting from Federal Financial Assistance

45 CFR Part 86 Nondiscrimination on the Basis of Sex in Education Programs and Activities Receiving or Benefiting from Federal Financial Assistance

45 CFR Part 91 Nondiscrimination on the Basis of Age in HHS Programs and Activities45 CFR Part 95 General Administration- Grant Programs (Public Assistance and Medical Assistance)45 CFR Part 96 Block Grants45 CFR Part 97 Consolidation of Grants to the Insular Areas45 CFR Part 100 Intergovernmental Review of Department of Health and Human Services Programs and Activities46 CFR Part 381 Cargo Preference48 CFR Part 31.2 Contracts with Commercial Organizations (For-profit cost principles for grants)

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Regulation Number TitleOMB Circular A-21 Cost Principles for Educational InstitutionsOMB Circular A-50 Audit Follow-upOMB Circular A-87 Cost Principles for State, Local and Indian Tribal GovernmentsOMB Circular A-89 Catalog of Federal Domestic AssistanceOMB Circular A-102 Grants and Cooperative Agreements With State and Local Governments

OMB Circular A-110 Uniform Administrative Requirement for Grants and Other Agreements with Institutions of Higher Education, Hospitals, and Other Non-Profit Organizations

OMB Circular A-122 Cost Principles for Non-Profit Organizations OMB Circular A-123 Management’s Responsibility for Internal Control

OMB Circular A-133 Audits of States, Local Governments, and Non-Profit Organizations

OMB Circular A-134 Financial Accounting Principles and Standards

OMB Circular A-136 Financial Reporting Requirements

For more information on the Code of Federal Regulations (CFRs), visit: http://www.ecfr.gov/cgi-bin/ECFR?SID=2d5f57c64e7afab744f98df61bf24177&page=simple.

For more information on the Office of Management and Budget (OMB) Circulars, visit: http://www.whitehouse.gov/omb/circulars_default.

APPLICANT AGENCY – Authorizing Official

Name:

Title:

Signature:

Date:

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Attachment G – Executive Order 18-04 “Policy Regarding Sexual Harassment”

The grant applicant agency must sign the Department of Administration Acknowledgement Memorandum regarding Executive Order 18-04 “Policy Regarding Sexual Harassment” and submit it with its grant application (double-click on the icon below to open the Executive Order and form).

Appendix A – DCF Security Policy

Appendix B – Current Onsite Review Instrument (OSRI)

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