Mental Health Field Response - 26-27 Grant Award Agreement
Grant Award Agreement for
Mental Health Field Response
WASPC Grant Award Number
MHFR-25-005
This Grant Award Agreement is made by and between the Washington Association of Sheriffs and Police Chiefs
(WASPC) and Edmonds Police Department (Grantee).
Grantee Name:
Edmonds Police Department
Grantee Doing Business as (DBA):
NA
Tax Identification Number:
91-6001244
Unique Entity Identification Number:
NF1AQNT457R7
Grantee Mailing Address:
250 5th Ave N
City: State: Zip Code:
Edmonds WA 98020
Grantee Primary Contact Name and Title:
Loi Dawkins, Chief of Police
Primary Contact Phone: Primary Contact Email:
425-771-0282 loi.dawkins@edmondswa.gov
WASPC Primary Contact Name and Title:
Cheyenne Sanders
WASPC Contact Phone: WASPC Contact Email:
360-486-2389 csanders@waspc.org
WASPC Mailing Address:
3060 Willamette Drive NE, Suite 200
City: State: Zip Code:
Lacey WA 98516
Grant Program:
Mental Health Field Response
Authority for Award:
RCW 36.28A.440
Grant Start Date:
January 1, 2026
Grant End Date:
June 30, 2027
Total Award Amount: $146,761.07 Funding Source(s):
☒ State Non-Trueblood Phase I, II, and III ($73,380.54)
☐ State Trueblood Phase I, II, and III
☒ HCA Trueblood Expansion Grant ($73,380.54)
Is the grantee a sub-recipient under this agreement?
☒ YES ☐ NO
Purpose of Award:
To provide services to communities in Washington State
as set forth in RCW 36.28A.440. and the grantee’s grant
application.
Service Area:
City of Edmonds
Grantee Signature Printed Name Title Date Signed
WASPC Signature Printed Name Title Date Signed
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Jamie Weimer 8/27/2025Chief of Staff
10/31/2025Mike Rosen Mayor
GRANT AWARD MHFR-25-005 Page 2 of 29
CONTENTS
RECITALS .................................................................................................................................................................................. 4
1 STATEMENT OF WORK (SOW) ......................................................................................................................................... 4
2 DEFINITIONS ................................................................................................................................................................... 4
3 SPECIAL TERMS AND CONDITIONS ................................................................................................................................. 6
3.1 PERFORMANCE EXPECTATIONS ............................................................................................................................. 6
3.2 TERM ...................................................................................................................................................................... 6
3.3 DATA COLLECTION .................................................................................................................................................. 6
3.4 COMPENSATION .................................................................................................................................................... 7
3.5 INVOICE AND PAYMENT ......................................................................................................................................... 7
3.6 GRANTEE AND WASPC GRANT MANAGERS ........................................................................................................... 8
3.7 LEGAL NOTICES ...................................................................................................................................................... 8
3.8 INCORPORATION OF DOCUMENTS AND ORDER OF PRECEDENCE ........................................................................ 9
3.9 INSURANCE ............................................................................................................................................................ 9
4 GENERAL TERMS AND CONDITIONS ............................................................................................................................. 10
4.1 ACCESS TO DATA .................................................................................................................................................. 10
4.2 ADVANCE PAYMENT PROHIBITED ........................................................................................................................ 10
4.3 AMENDMENTS ..................................................................................................................................................... 10
4.4 ASSIGNMENT ....................................................................................................................................................... 10
4.5 ATTORNEYS’ FEES ................................................................................................................................................. 11
4.6 AUDIT ................................................................................................................................................................... 11
4.7 CHANGE IN STATUS .............................................................................................................................................. 11
4.8 CONFIDENTIAL INFORMATION PROTECTION ....................................................................................................... 11
4.9 GRANTEE’S PROPRIETARY INFORMATION ........................................................................................................... 12
4.10 CONFORMANCE WITH 2 CFR § 200 AND RELEVANT STATE AND LOCAL LAWS .................................................... 12
4.11 COVENANT AGAINST CONTINGENT FEES ............................................................................................................ 12
4.12 DEBARMENT ........................................................................................................................................................ 12
4.13 DISPUTES.............................................................................................................................................................. 12
4.14 ENTIRE AGREEMENT ............................................................................................................................................ 13
4.15 FEDERAL FUNDING ACCOUNTABILITY & TRANSPARENCY ACT (FFATA) ............................................................... 13
4.16 FORCE MAJEURE .................................................................................................................................................. 14
4.17 FUNDING WITHDRAWN, REDUCED OR LIMITED ................................................................................................. 14
4.18 GOVERNING LAW ................................................................................................................................................. 14
4.19 HUMAN SUBJECTS PROTECTION ......................................................................................................................... 14
4.20 WASPC NETWORK SECURITY ............................................................................................................................... 15
4.21 INDEMNIFICATION ............................................................................................................................................... 15
4.22 INDEPENDENT CAPACITY OF THE GRANTEE ........................................................................................................ 15
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4.23 INDUSTRIAL INSURANCE COVERAGE ................................................................................................................... 15
4.24 LEGAL AND REGULATORY COMPLIANCE .............................................................................................................. 15
4.25 LIMITATION OF AUTHORITY ................................................................................................................................. 16
4.26 NO THIRD-PARTY BENEFICIARIES ......................................................................................................................... 16
4.27 NONDISCRIMINATION .......................................................................................................................................... 16
4.28 NON-SUPPLANTING CERTIFICATION .................................................................................................................... 16
4.29 OVERPAYMENTS TO Grantee ............................................................................................................................... 16
4.30 PAY EQUITY .......................................................................................................................................................... 16
4.31 PUBLICITY ............................................................................................................................................................. 17
4.32 RECORDS AND DOCUMENTS REVIEW ................................................................................................................. 17
4.33 REMEDIES NON-EXCLUSIVE ................................................................................................................................. 17
4.34 RIGHT OF INSPECTION ......................................................................................................................................... 18
4.35 RIGHTS IN DATA/OWNERSHIP .............................................................................................................................. 18
4.36 RIGHTS OF STATE AND FEDERAL GOVERNMENTS ............................................................................................... 18
4.37 SERVICES TO PERSONS WITH LIMITED ENGLISH PROFICIENCY ........................................................................... 19
4.38 SEVERABILITY ....................................................................................................................................................... 19
4.39 SITE SECURITY ...................................................................................................................................................... 19
4.40 SUBGRANTING ..................................................................................................................................................... 19
4.41 SURVIVAL ............................................................................................................................................................. 20
4.42 CORRECTIVE ACTION PLAN/SUSPENSION/TERMINATION ................................................................................... 20
4.43 TERMINATION PROCEDURES ............................................................................................................................... 21
4.44 WAIVER ................................................................................................................................................................ 22
4.45 WARRANTIES........................................................................................................................................................ 22
SCHEDULE A: STATEMENT OF WORK .................................................................................................................................... 23
SCHEDULE B: APPROVED BUDGET ........................................................................................................................................ 26
EXHIBITS ................................................................................................................................................................................ 29
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GRANT AWARD
RECITALS
House Bill 2982, Chapter 142, Laws of 2018, went into effect on June 7, 2018. The purpose of the grant program is to
assist local law enforcement agencies to establish and expand mental health field response capabilities, utilizing mental
health professionals to professionally, humanely, and safely respond to crises involving persons with behavioral health
issues with treatment, diversion, and reduced incarceration time as primary goals. WASPC has determined that entering
into an Agreement with the Edmonds Police Department will meet WASPC’s needs.
NOW THEREFORE, WASPC awards to the Edmonds Police Department this Grant Award Agreement, the terms and
conditions of which will govern Grantee’s providing to WASPC the services and data from Grantee’s Mental Health Field
Response program.
IN CONSIDERATION of the mutual promises as set forth in this Grant Award Agreement, the parties agree as follows:
1 STATEMENT OF WORK (SOW)
The Grantee will provide the services and staff as described in Schedule A: Statement of Work.
2 DEFINITIONS
“Agreement” or “Award” means the same as “Grant” or “Grant Agreement” or “Grant Award Agreement.”
“Authorized Representative” means a person to whom signature authority has been delegated in writing acting
within the limits of his/her authority.
“Breach” means the unauthorized acquisition, access, use, or disclosure of Confidential Information that
compromises the security, confidentiality, or integrity of the Confidential Information.
“business daysand Hours” means Monday through Friday, 8:00 a.m. to 5:00 p.m., Pacific Time, except for holidays
observed by the state of Washington.
“CFR” means the Code of Federal Regulations. All references in this Agreement to CFR chapters or sections include
any successor, amended, or replacement regulation. The CFR may be accessed at http://www.ecfr.gov.
“Community Agency” means an organization that works with and supports people working through behavioral
health challenges but does not directly provide treatment. The organization can be a nonprofit or
government/public agency as defined in the application.
“Confidential Information” means information that may be exempt from disclosure to the public or other
unauthorized persons under chapter 42.56 RCW or chapter 70.02 RCW or other state or federal statutes or
regulations. Confidential Information includes, but is not limited to, any information identifiable to an individual
that relates to a natural person’s health, (see also Protected Health Information); finances, education, business, use
or receipt of governmental services, names, addresses, telephone numbers, social security numbers, driver license
numbers, financial profiles, credit card numbers, financial identifiers and any other identifying numbers, law
enforcement records, software source code or object code, or WASPC or State security information.
“Contract” where used, shall have the same meaning as “grant” “grant agreement” and “grant award agreement”.
“Contractor” where used shall mean the same as “Grantee.”
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“Data” means information produced, furnished, acquired, or used by Grantee in meeting requirements under this
Agreement.
“Effective Date” means the first date this Agreement is in full force and effect.
“Government/Public Agency” means an educational service district, school district, law enforcement agency,
therapeutic court or probation office, public health district, a recognized American Indian organization, an Urban
Indian Health Organization, or a Tribe.
“Grant” or “Grant Agreement” or “Grant Award Agreement” means this grant document and all schedules,
exhibits, attachments, incorporated documents and amendments.
“Grantee” means the Edmonds Police Department, its employees, officers, and agents. Grantee includes any firm,
provider, organization, individual or other entity performing services under this Grant Award Agreement. It also
includes any Subgrantee retained by Grantee as permitted under the terms of this Agreement.
“WASPC Grant Manager” means the individual identified on the cover page of this Agreement who will provide
oversight of the Grantee’s activities conducted under this Agreement.
"Overpayment" means any payment or benefit to the Grantee in excess of that to which the Grantee is entitled by
law, rule, or this Award, including amounts in dispute.
“Proprietary Information” means information owned by Grantee to which Grantee claims a protectable interest
under law. Proprietary Information includes, but is not limited to, information protected by copyright, patent,
trademark, or trade secret laws.
“Protected Health Information” or “PHI” means individually identifiable information that relates to the provision of
health care to an individual; the past, present, or future physical or mental health or condition of an individual; or
past, present, or future payment for provision of health care to an individual, as defined in 45 CFR § 160.103.
Individually identifiable information is information that identifies the individual or about which there is a
reasonable basis to believe it can be used to identify the individual, and includes demographic information. PHI is
information transmitted, maintained, or stored in any form or medium. 45 CFR § 164.501. PHI does not include
education records covered by the Family Educational Rights and Privacy Act, as amended, 20 USC §
1232g(a)(4)(b)(iv).
“RCW” means the Revised Code of Washington. All references in this Agreement to RCW chapters or sections
include any successor, amended, or replacement statute. Pertinent RCW chapters can be accessed at:
http://apps.leg.wa.gov/rcw/.
“Statement of Work” or “SOW” means a detailed description of the work activities the Grantee is required to
perform under the terms and conditions of this Agreement, including the deliverables and timeline, and is Schedule
A hereto.
“Subgrantee” means a person or entity that is not in the employment of the Grantee, who is performing all or part
of the business activities under this Agreement under a separate Agreement with Grantee. The term “Subgrantee”
means Subgrantee(s) of any tier.
“Subrecipient” shall have the meaning given in 45 CFR § 75.2, or any successor or replacement to such definition,
for any federal award from HHS; or 2 CFR § 200.93, or any successor or replacement to such definition, for any
other federal award.
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“USC” means the United States Code. All references in this Agreement to USC chapters or sections will include any
successor, amended, or replacement statute. The USC may be accessed at http://uscode.house.gov/.
“WAC” means the Washington Administrative Code. All references to WAC chapters or sections will include any
successor, amended, or replacement regulation. Pertinent WACs may be accessed at: http://app.leg.wa.gov/wac/.
3 SPECIAL TERMS AND CONDITIONS
3.1 PERFORMANCE EXPECTATIONS
Expected performance under this Agreement includes, but is not limited to, the following:
3.1.1 Knowledge of applicable state and federal laws and regulations pertaining to subject of the
Agreement;
3.1.2 Use of professional judgment;
3.1.3 Collaboration with WASPC staff in Grantee’s conduct of the services;
3.1.4 Conformance with WASPC directions regarding the delivery of the services;
3.1.5 Timely, accurate and informed communications;
3.1.6 Regular completion and updating of project plans, reports, documentation and communications;
3.1.7 Regular, punctual attendance at all meetings;
3.1.8 Provision of high-quality services, and
3.1.9 Prior to payment of invoices, WASPC will review and evaluate the performance of Grantee in
accordance with Agreement and these performance expectations and may withhold payment if
expectations are not met or Grantee’s performance is unsatisfactory as defined and evaluated by
WASPC.
3.2 TERM
3.2.1 The initial term of the Award shall be January 1, 2026 and continue through June 30, 2027,
unless terminated sooner as provided herein.
3.2.2 Work performed without an award or amendment signed by the Authorized Representatives of
both parties will be at the sole risk of the Grantee. WASPC will not pay any costs incurred before
the effective date listed on the face sheet attached to this agreement.
3.2.3 A completed Agreement is expected within 30 days following the letter of intent to award. In the
event an Agreement is not signed (through no fault of WASPC) by the Grantee within 30 days,
WASPC may elect to cease negotiations, and withdraw the award.
3.3 DATA COLLECTION
3.3.1 The Grantee shall utilize the data collection tool selected by WASPC, hereinafter referred to as
the WASPC Data Collection Tool, which is the JULOTA Reach Software. The Grantee must provide
sufficient resources to establish the administrative permissions necessary for the WASPC Data
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Collection Tool to be fully operational at the time services begin at the site(s). The Grantee, if
they have not already done so, shall execute the JULOTA “SaaS Use Agreement”, which will be
separately executed between the Grantee and JULOTA within 30 days of the execution of this
Agreement.
3.4 COMPENSATION
3.4.1 The Maximum Compensation payable to Grantee is $146,761.07. As this is a multi-year award it
is subject to the following restrictions:
• The maximum amount payable to the Grantee for services rendered in year one (January 1,
2026-June 30, 2026) is $48,908.36. Funds that are not utilized from year one WILL NOT carry
over to year two and are no longer able to be claimed by the Grantee under any
circumstances.
• 3.4.1.2 The maximum amount payable to the Grantee for services rendered in year two (July
1, 2026-June 30, 2027) is $97,852.71. Funds that are not utilized from year two WILL NOT
carry over to any other period and are no longer able to be claimed by the Grantee under
any circumstances.
3.4.2 Grantee’s compensation for services rendered will be based in accordance with Schedule A:
Statement of Work.
3.5 INVOICE AND PAYMENT
3.5.1 Grantee must submit accurate invoices to WASPC utilizing the online billing tool made available
to Grantee by WASPC. Invoices are due monthly and should be submitted no later than thirty
(30) calendar days following the period for which services are billed. WASPC reserves the right to
deny payment for invoices that are submitted forty-Five (45) calendar days beyond the period for
which services were provided. An exception to this requirement may be found in 3.5.5.
3.5.2 Invoices must describe and document to WASPC’s satisfaction a description of the work
performed, the progress of the project, fees, and a statement that includes the following
language: “We certify pursuant to 2 CFR § 200.201(1)(iii)(3) that the activities described in this
invoice and associated report(s) have been completed,”. If expenses are invoiced, invoices must
provide a detailed breakdown of each type. All invoices will be reviewed and must be approved
by WASPC prior to payment.
3.5.3 Grantee must submit properly itemized invoices to include the following information, as
applicable:
• WASPC Award number “MHFR-25-005”
• Grantee name, address, phone number
• Description of Services
• Date(s) of delivery
• Net invoice price for each item
• Applicable taxes
• Total invoice cost
3.5.4 WASPC will return incorrect or incomplete invoices to the Grantee for correction and reissue.
The Award Number must appear on all invoices, bills of lading, packages, and correspondence
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relating to this Agreement.
3.5.5 Invoices for services rendered under this Agreement from January 1, 2026 to June 30, 2026
MUST be submitted by the Grantee to WASPC by July 14, 2026. WASPC is under no obligation to
pay any claims for the period mentioned above that are submitted on or after July 15, 2026
(“Belated Claims”). WASPC will pay Belated Claims at its sole discretion, and any such potential
payment is contingent upon the availability of funds.
3.5.6 Invoices for services rendered under this Agreement from January 1, 2026 to June 30, 2027
MUST be submitted by the Grantee to WASPC by July 14, 2027. WASPC is under no obligation to
pay any claims for the period mentioned above that are submitted on or after July 15, 2027
(“Belated Claims”). WASPC will pay Belated Claims at its sole discretion, and any such potential
payment is contingent upon the availability of funds.
3.6 GRANTEE AND WASPC GRANT MANAGERS
3.6.1 Grantee’s Grant Manager will have prime responsibility and final authority for the services
provided under this Agreement and be the principal point of contact for the WASPC Grant
Manager for all business matters, performance matters, and administrative activities.
3.6.2 WASPC’s Grant Manager is responsible for monitoring the Grantee’s performance and will be the
contact person for all communications regarding Agreement performance and deliverables. The
WASPC Grant Manager has the authority to accept or reject the services provided and must
approve Grantee’s invoices prior to payment.
3.6.3 The contact information provided below may be changed by written notice of the change (email
acceptable) to the other party.
Grantee: Grant Manager Information WASPC: Grant Manager Information
Name: Loi Dawkins Name: Cheyenne Sanders
Address: 250 5th Ave N
Edmonds, WA 98020 Address:
3060 Willamette Dr NE,
STE 200
Lacey, WA 98516
Phone: 425-771-0282 Phone: (360) 486-2389
Email: loi.dawkins@edmondswa.gov Email: csanders@waspc.org
3.7 LEGAL NOTICES
Any notice or demand or other communication required or permitted to be given under this Agreement or
applicable law is effective only if it is in writing and signed by the applicable party, properly addressed, and
delivered in person, via email, or by a recognized courier service, or deposited with the United States Postal
Service as first-class mail, postage prepaid certified mail, return receipt requested, to the parties at the addresses
provided in this section.
3.7.1 In the case of notice to the Grantee:
Loi Dawkins
Edmonds Police Department
250 5th Ave N
Edmonds, WA, 98020
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3.7.2 In the case of notice to WASPC:
Attention: Chief of Staff
Washington Association of Sheriffs and Police Chiefs
3060 Willamette Drive NE, STE 200
Lacey, WA 98516
3.7.3 Notices are effective upon receipt or four (4) business days after mailing, whichever is earlier.
3.7.4 The notice address and information provided above may be changed by written notice of the
change given as provided above.
3.8 INCORPORATION OF DOCUMENTS AND ORDER OF PRECEDENCE
Each of the documents listed below is by this reference incorporated into this Agreement. In the event of an
inconsistency, the inconsistency will be resolved in the following order of precedence:
3.8.1 Applicable Federal and State of Washington statutes and regulations;
3.8.2 Recitals
3.8.3 Special Terms and Conditions;
3.8.4 General Terms and Conditions;
3.8.5 Schedule A: Statement of Work;
3.8.6 Schedule B: Approved Budget;
3.8.7 Exhibit A: 2025-2027 Grant Application Packet;
3.8.8 Exhibit B: Final Budget Submission; and
3.8.9 Any other provision, term, exhibit or material incorporated herein by reference or otherwise
incorporated.
3.9 INSURANCE
The Grantee must provide insurance coverage as set out in this section. The intent of the required insurance is to
protect the WASPC should there be any claims, suits, actions, costs, damages or expenses arising from any
negligent or intentional act or omission of Grantee or Sub-grantee, Subgrantee, or agents of either, while
performing under the terms of this Agreement. The Grantee must provide insurance coverage that is maintained
in full force and effect during the term of this Award, as follows:
3.9.1 Commercial General Liability Insurance Policy—Provide a Commercial General Liability Insurance
Policy, including contractual liability, in adequate quantity to protect against legal liability arising
out of Agreement activity but no less than $1 million per occurrence/$2 million general
aggregate. Additionally, the Grantee is responsible for ensuring that any Sub-grantees and
Subgrantees provide adequate insurance coverage for the activities arising out of subgrants and
subcontracts.
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3.9.2 Business Automobile Liability—In the event that services delivered pursuant to this Agreement
involve the use of vehicles, either owned, hired, or non-owned by the Grantee, automobile
liability insurance is required covering the risks of bodily injury (including death) and property
damage, including coverage for contractual liability. The minimum limit for automobile liability is
$1,000,000 per occurrence, using a Combined Single Limit for bodily injury and property
damage.
3.9.3 Professional Liability Errors and Omissions–Provide a policy with coverage of not less than $1
million per claim/$2 million general aggregate.
3.9.4 The insurance required must be issued by an insurance company/ies authorized to do business
within the state of Washington, and must name WASPC, its agents and employees as additional
insureds under any Commercial General and/or Business Automobile Liability policy/ies. All
policies must be primary to any other valid and collectable insurance. In the event of
cancellation, non-renewal, revocation or other termination of any insurance coverage required
by this Agreement, the Grantee must provide written notice of such to WASPC within one (1)
Business Day of Grantee’s receipt of such notice. Failure to buy and maintain the required
insurance may, at WASPC’s sole option, result in this Agreement’s termination.
3.9.5 The Grantee shall submit to WASPC a certificate of insurance that outlines the coverage and
limits defined in the Insurance section before any work is performed and will not receive any
payment or reimbursement until such certificate of insurance is provided to WASPC. Grantee
must submit renewal certificates as appropriate during the term of the Award Agreement.
3.9.6 If the Grantee certifies that it is self-insured, is a member of a risk pool, or maintains the types
and amounts of insurance identified above, Grantee will provide certificates of insurance to that
effect to WASPC upon request.
4 GENERAL TERMS AND CONDITIONS
4.1 ACCESS TO DATA
In compliance with RCW 39.26.180 (2), RCW 36.28A.440 and federal rules, the Grantee must provide access to
any data generated under this Agreement to WASPC, the Joint Legislative Audit and Review Committee, the State
Auditor, and any other state or federal officials so authorized by law, rule, regulation, or agreement at no
additional cost. This includes access to all information that supports the findings, conclusions, and
recommendations of the Grantee’s reports, including computer models and methodology for those models.
4.2 ADVANCE PAYMENT PROHIBITED
No advance payment will be made for services furnished by the Grantee pursuant to this Agreement.
4.3 AMENDMENTS
This Agreement may be amended by mutual agreement of the parties. Such amendments will not be binding
unless they are in writing and signed by personnel authorized to bind each of the parties.
4.4 ASSIGNMENT
4.4.1 The Grantee may not assign or transfer all or any portion of this Agreement or any of its rights
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hereunder, or delegate any of its duties hereunder, except delegations as set forth in Section
4.39, Subcontracting/Subgranting, without the prior written consent of WASPC, which may be
withheld at WASPC’s sole discretion. Any permitted assignment will not operate to relieve the
Grantee of any of its duties and obligations hereunder, nor will such assignment affect any
remedies available to WASPC that may arise from any breach of the provisions of this Agreement
or warranties made herein, including but not limited to, rights of setoff. Any attempted
assignment, transfer or delegation in contravention of this Subsection 4.4.1 of the Agreement
will be null and void.
4.4.2 WASPC may assign this Agreement to any public agency, commission, board, or the like, within
the political boundaries of the State of Washington, with written notice of thirty (30) calendar
days to the Grantee.
4.4.3 This Agreement will inure to the benefit of and be binding on the parties hereto and their
permitted successors and assignees.
4.5 ATTORNEYS’ FEES
In the event of litigation or other action brought to enforce the terms of this Agreement, each party agrees to
bear its own attorneys’ fees and costs.
4.6 AUDIT
If Grantee is required by OMB Super Circular 2 CFR § 200.501 and 45 CFR § 75.501 to have an audit of their
financial statements, the Grantee must submit the results of that audit to WASPC no later than 90 (ninety)
calendar days after those results are delivered to the Grantee by their auditor.
4.7 CHANGE IN STATUS
In the event of any substantive change in its legal status, organizational structure, or fiscal reporting
responsibility, the Grantee will notify WASPC of the change. The Grantee must provide notice as soon as
practicable, but no later than thirty (30) calendar days after such a change takes effect.
4.8 CONFIDENTIAL INFORMATION PROTECTION
4.8.1 The Grantee acknowledges that some of the material and information that may come into its
possession or knowledge in connection with this Agreement or its performance may consist of
Confidential Information. The Grantee agrees to hold Confidential Information in strictest
confidence and not to make use of Confidential Information for any purpose other than the
performance of this Agreement, to release it only to authorized employees or Subgrantees or
Subgrantees requiring such information for the purposes of carrying out this Agreement, and not
to release, divulge, publish, transfer, sell, disclose, or otherwise make the information known to
any other party without WASPC’s express written consent or as provided by law. The Grantee
agrees to implement physical, electronic, and managerial safeguards to prevent unauthorized
access to Confidential Information.
4.8.2 The Grantee agrees to comply with all confidentiality requirements of 42 USC section 37899 and
20 CFR § 22 that are applicable to collection, use and revelation of data or information. The
Grantee further agrees, as a condition of grant approval, to submit a Privacy Certificate that is in
accord with the requirements of 28 CFR § 22 and, in particular, section 22.23.
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4.8.3 WASPC reserves the right to monitor, audit, or investigate the use of Confidential Information
collected, used, or acquired by Grantee through this Agreement. Violation of this section by the
Grantee or its Subgrantees or Subgrantees may result in termination of this Agreement and
demand for return of all Confidential Information, monetary damages, or penalties.
4.8.4 The obligations set forth in this section will survive completion, cancellation, expiration,
suspension, or termination of this Agreement.
4.9 GRANTEE’S PROPRIETARY INFORMATION
Grantee acknowledges that WASPC complies with chapter 42.56 RCW, the Public Records Act relating to public
projects, and that this Agreement may be a public record as defined in chapter 42.56 RCW. Any specific
information that is claimed by Grantee to be Proprietary Information must be clearly identified as such by
Grantee. To the extent consistent with chapter 42.56 RCW, WASPC will maintain the confidentiality of the
Grantee’s information in its possession that is marked Proprietary. If a public disclosure request is made to view
the Grantee’s Proprietary Information, WASPC will notify the Grantee of the request and of the date that such
records will be released to the requester unless the Grantee obtains a court order from a court of competent
jurisdiction enjoining that disclosure. If the Grantee fails to obtain the court order enjoining disclosure, WASPC
will release the requested information on the date specified.
4.10 CONFORMANCE WITH 2 CFR § 200 AND RELEVANT STATE AND LOCAL LAWS
4.10.1 Grantee is required to maintain compliance with 2 CFR § 200, its appendices, subparts, and state
and local law.
4.10.2 Grantee is required to maintain compliance with 45 CFR § 96.135—Restrictions on expenditures
of grant.
4.11 COVENANT AGAINST CONTINGENT FEES
The Grantee warrants that no person or selling agent has been employed or retained to solicit or secure this
Agreement upon an agreement or understanding for a commission, percentage, brokerage or contingent fee,
excepting bona fide employees or bona fide established agents maintained by the Grantee for the purpose of
securing business. WASPC will have the right, in the event of breach of this clause by the Grantee, to annul this
Agreement without liability or, in its discretion, to deduct from the price or consideration or recover by other
means the full amount of such commission, percentage, brokerage or contingent fee.
4.12 DEBARMENT
By signing this Agreement, the Grantee certifies that it is not presently debarred, suspended, proposed for
debarment, declared ineligible, or voluntarily excluded in any Washington State or Federal department or agency
from participating in transactions (debarred). The Grantee agrees to include the above requirement in any and
all subgrants and subcontracts into which it enters, and also agrees that it will not employ debarred individuals.
The Grantee must immediately notify WASPC if, during the term of this Agreement, The Grantee becomes
debarred. WASPC may immediately terminate this Agreement by providing the Grantee written notice, if the
Grantee becomes debarred during the term hereof.
4.13 DISPUTES
The parties will use their best, good faith efforts to cooperatively resolve disputes and problems that arise in
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connection with this Agreement. Both parties will continue without delay to carry out their respective
responsibilities under this Agreement while attempting to resolve any dispute. When a genuine dispute arises
between WASPC and the Grantee regarding the terms of this Agreement or the responsibilities imposed herein
and it cannot be resolved between the parties’ Grant Managers, either party may initiate the following dispute
resolution process.
4.13.1 The initiating party will reduce its description of the dispute to writing and deliver it to the
responding party (email acceptable). The responding party will respond in writing within five (5)
business days(email acceptable). If the initiating party is not satisfied with the response of the
responding party, then the initiating party may request that the WASPC Director review the
dispute. Any such request from the initiating party must be submitted in writing to the WASPC
Director within five (5) business days after receiving the response of the responding party. The
WASPC Director will have sole discretion in determining the procedural manner in which he or
she will review the dispute. The WASPC Director will inform the parties in writing within five (5)
business days of the procedural manner in which he or she will review the dispute, including a
timeframe in which he or she will issue a written decision.
4.13.2 A party's request for a dispute resolution must:
• Be in writing.
• Include a written description of the dispute.
• State the relative positions of the parties and the remedy sought.
• State the Agreement number and the names and contact information for the parties.
• This dispute resolution process constitutes the sole administrative remedy available under
this Agreement. The parties agree that this resolution process will precede any action in a
judicial or quasi-judicial tribunal.
4.14 ENTIRE AGREEMENT
WASPC and the Grantee agree that this Agreement is the complete and exclusive statement of the agreement
between the parties relating to the subject matter of the Agreement and supersedes all letters of intent or prior
contracts, oral or written, between the parties relating to the subject matter of the Agreement, except as
provided in the section titled “Warranties”.
4.15 FEDERAL FUNDING ACCOUNTABILITY & TRANSPARENCY ACT (FFATA)
4.15.1 This grant is supported by federal funds that require compliance with the Federal Funding
Accountability and Transparency Act (FFATA or the Transparency Act). The purpose of the
Transparency Act is to make information available online so the public can see how federal funds
are spent.
4.15.2 To comply with the act and be eligible to enter into this Agreement, the Grantee must have a
Unique Entity Identification Number (UEID). A UEID provides a method to verify data about your
organization. If the Grantee does not already have one, a UEID is available free of charge by
registering with www.sam.gov.
4.15.3 Information about the Grantee and this Grant will be made available on
www.uscontractorregistration.com by WASPC as required by P.L. 109-282. WASPC’s Attachment
3: Federal Funding Accountability and Transparency Act Data Collection Form, is considered part
of this Agreement and must be completed and returned along with the Agreement.
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4.16 FORCE MAJEURE
A party will not be liable for any failure of or delay in the performance of this Agreement for the period that such
failure or delay is due to causes beyond its reasonable control, including but not limited to acts of God, war,
strikes or labor disputes, embargoes, government orders or any other force majeure event.
4.17 FUNDING WITHDRAWN, REDUCED OR LIMITED
If WASPC determines in its sole discretion that the funds it relied upon to establish this Agreement have been
withdrawn, reduced or limited, or if additional or modified conditions are placed on such funding after the
effective date of this Agreement but prior to the normal completion of this Agreement, then WASPC, at its sole
discretion, may:
4.17.1 Terminate this Agreement pursuant to the section titled: Termination for Non-Allocation of
Funds;
4.17.2 Renegotiate the Agreement under the revised funding conditions; or
4.17.3 Suspend Grantee’s performance under the Agreement upon five (5) Business Days’ advance
written notice to the Grantee. WASPC will use this option only when WASPC determines that
there is reasonable likelihood that the funding insufficiency may be resolved in a timeframe that
would allow Grantee’s performance to be resumed prior to the normal completion date of this
Agreement.
4.17.4 During the period of suspension of performance, each party will inform the other of any
conditions that may reasonably affect the potential for resumption of performance.
4.17.5 When WASPC determines in its sole discretion that the funding insufficiency is resolved, it will
give the Grantee written notice to resume performance. Upon the receipt of this notice, the
Grantee will provide written notice to WASPC informing WASPC whether it can resume
performance and, if so, the date of resumption. For purposes of this subsection, “written notice”
may include email.
4.17.6 If the Grantee’s proposed resumption date is not acceptable to WASPC and an acceptable date
cannot be negotiated, WASPC may terminate this Agreement by giving written notice to the
Grantee. The parties agree that the Agreement will be terminated retroactive to the date of the
notice of suspension. WASPC will be liable only for payment in accordance with the terms of this
Agreement for services rendered prior to the retroactive date of termination.
4.18 GOVERNING LAW
This Agreement is governed in all respects by the laws of the state of Washington, without reference to conflict
of law principles. The jurisdiction for any action hereunder is exclusively in the Superior Court for the state of
Washington, and the venue of any action hereunder is in the Superior Court for Pierce County, Washington.
4.19 HUMAN SUBJECTS PROTECTION
The Grantee agrees to comply with the requirements of 28 CFR § 46 and all Office of Justice Programs policies
and procedures regarding the protection of human research subjects, including obtainment of Institutional
Review Board approval, and subject informed consent.
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4.20 WASPC NETWORK SECURITY
The Grantee agrees not to attach any Grantee-supplied computers, peripherals or software to the WASPC
Network without prior written authorization from WASPC’s Chief Information Officer.
Unauthorized access to WASPC networks and systems is a violation of WASPC Policy and constitutes computer
trespass in the first degree pursuant to RCW 9A.52.110. Violation of any of these laws or policies could result in
termination of the Agreement and other penalties.
The Grantee will have access to the WASPC visitor Wi-Fi Internet connection while on site.
4.21 INDEMNIFICATION
The Grantee shall defend, indemnify, and save WASPC harmless from and against all claims, including reasonable
attorneys’ fees resulting from such claims arising from intentional or negligent acts or omissions of the Grantee,
its officers, employees, or agents, subgrantees, or Subgrantees, their officers, employees, or agents, in the
performance of this Agreement. This indemnification shall include, but not be limited to, any or all injuries to
persons or damage to property, or breach of confidentiality and notification obligations under the section titled
“Confidential Information Protection” and the section titled “Confidentiality Breach-Required Notification.”
For purposes of the indemnification provisions above, and limited to this section only, the Grantee waives its
protections under RCW Title 51 for employee claims. This limited waiver was specifically negotiated and
bargained for.
4.22 INDEPENDENT CAPACITY OF THE GRANTEE
The parties intend that a Grantor to Grantee relationship will be created by this Agreement with WASPC being
the Grantor. The Grantee and its employees or agents performing under this Agreement are not employees,
officers, or agents of WASPC. The Grantee will not hold itself out as or claim to be an officer or employee of
WASPC by reason hereof, nor will Grantee make any claim of right, privilege or benefit that would accrue to such
employee, officer, or agent under law. Conduct and control of the work will be solely with Grantee.
4.23 INDUSTRIAL INSURANCE COVERAGE
Prior to performing work under this Agreement, the Grantee must provide or purchase industrial insurance
coverage for the Grantee’s employees, as may be required of an “employer” as defined in Title 51 RCW, and must
maintain full compliance with Title 51 RCW during the course of this Agreement.
4.24 LEGAL AND REGULATORY COMPLIANCE
4.24.1 During the term of this Agreement, the Grantee must comply with all local, state, and federal
licensing, accreditation and registration requirements/standards, necessary for the performance
of this Agreement and all other applicable federal, state and local laws, rules, and regulations.
4.24.2 While on WASPC’s premises, the Grantee must comply with WASPC operations and process
standards and policies (e.g., ethics, Internet/email usage, data, network and building security,
harassment, as applicable).
4.24.3 Failure to comply with any provisions of this section may result in the termination of this
Agreement.
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4.25 LIMITATION OF AUTHORITY
Only the WASPC Authorized Representative has the express, implied, or apparent authority to alter, amend,
modify, or waive any clause or condition of this Agreement. Furthermore, any alteration, amendment,
modification, or waiver or any clause or condition of this Agreement is not effective or binding unless made in
writing and signed by the WASPC Authorized Representative.
4.26 NO THIRD-PARTY BENEFICIARIES
WASPC and the Grantee are the only parties to this Agreement. Nothing in this Agreement gives or is intended to
give any benefit of this Agreement to any third parties.
4.27 NONDISCRIMINATION
During the performance of this Agreement, the Grantee must comply with all federal and state
nondiscrimination laws, regulations and policies, including but not limited to: Title VII of the Civil Rights Act, 42
U.S.C. §12101 et seq.; the Americans with Disabilities Act of 1990 (ADA), 42 U.S.C. §12101 et seq., 28 CFR Part
35; and Title 49.60 RCW, Washington Law Against Discrimination. In the event of Grantee’s noncompliance or
refusal to comply with any nondiscrimination law, regulation or policy, this Agreement may be rescinded,
canceled, or terminated in whole or in part under the Termination for Default sections, and Grantee may be
declared ineligible for further contracts with WASPC.
4.28 NON-SUPPLANTING CERTIFICATION
No Grant funds will be used to supplant existing state, local, or other non-federal funding already in place to
support current services. Violation of the non-supplanting requirement can result in a range of penalties,
including suspension of future funds under this grant, recoupment of monies provided under this grant, and civil
and/or criminal penalties.
4.29 OVERPAYMENTS TO GRANTEE
In the event that overpayments or erroneous payments have been made to the Grantee under this Agreement,
WASPC will provide written notice to the Grantee and the Grantee will refund the full amount to WASPC within
thirty (30) calendar days of the notice. If Grantee fails to make timely refund, WASPC may charge Grantee one
percent (1%) per month on the amount due, until paid in full. If the Grantee disagrees with WASPC’s actions
under this section, then it may invoke the dispute resolution provisions of Section 4.13 Disputes.
4.30 PAY EQUITY
4.30.1 Grantee represents and warrants that, as required by Washington state law (Engrossed House
Bill 1109, Sec. 211), during the term of this agreement, it agrees to equality among its workers
by ensuring similarly employed individuals are compensated as equals. For purposes of this
provision, employees are similarly employed if (i) the individuals work for Grantee, (ii) the
performance of the job requires comparable skill, effort, and responsibility, and (iii) the jobs are
performed under similar working conditions. Job titles alone are not determinative of whether
employees are similarly employed.
4.30.2 Grantee may allow differentials in compensation for its workers based in good faith on any of the
following: (i) a seniority system; (ii) a merit system; (iii) a system that measures earnings by
quantity or quality of production; (iv) bona fide job-related factor(s); or (v) a bona fide regional
difference in compensation levels.
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4.30.3 Bona fide job-related factor(s)” may include, but not be limited to, education, training, or
experience, which is: (i) consistent with business necessity; (ii) not based on or derived from a
gender-based differential; and (iii) accounts for the entire differential.
4.30.4 A “bona fide regional difference in compensation level” must be (i) consistent with business
necessity; (ii) not based on or derived from a gender-based differential; and (iii) account for the
entire differential.
4.30.5 Notwithstanding any provision to the contrary, upon breach of warranty and Grantee’s failure to
provide satisfactory evidence of compliance within thirty (30) Days of WASPC’s request for such
evidence, WASPC may suspend or terminate this Agreement.
4.31 PUBLICITY
4.31.1 The award of this Grant to Grantee is not in any way an endorsement of Grantee or Grantee’s
Services by WASPC and must not be so construed by Grantee in any advertising or other
publicity materials.
4.31.2 Grantee agrees to submit to WASPC, all advertising, sales promotion, and other publicity
materials relating to this Agreement or any Service furnished by Grantee in which WASPC’s name
is mentioned, language is used, or Internet links are provided from which the connection of
WASPC’s name with Grantee’s Services may, in WASPC’s judgment, be inferred or implied.
Grantee further agrees not to publish or use such advertising, marketing, sales promotion
materials, publicity or the like through print, voice, the Web, and other communication media in
existence or hereinafter developed without the express written consent of WASPC prior to such
use.
4.32 RECORDS AND DOCUMENTS REVIEW
4.32.1 The Grantee must maintain books, records, documents, magnetic media, receipts, invoices or
other evidence relating to this Agreement and the performance of the services rendered, along
with accounting procedures and practices, all of which sufficiently and properly reflect all direct
and indirect costs of any nature expended in the performance of this Agreement. At no
additional cost, these records, including materials generated under this Agreement, are subject
at all reasonable times to inspection, review, or audit by WASPC, the Office of the State Auditor,
and state and federal officials so authorized by law, rule, regulation, or agreement [See 42 USC
1396a(a)(27)(B); 42 USC 1396a(a)(37)(B); 42 USC 1396a(a)(42(A); 42 CFR 431, Subpart Q; and 42
CFR § 447.202].
4.32.2 The Grantee must retain such records for a period of six (6) years after the date of final payment
under this Agreement.
4.32.3 If any litigation, claim or audit is started before the expiration of the six (6) year period, the
records must be retained until all litigation, claims, or audit findings involving the records have
been resolved.
4.33 REMEDIES NON-EXCLUSIVE
The remedies provided in this Agreement are not exclusive, but are in addition to all other remedies available
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under law.
4.34 RIGHT OF INSPECTION
The Grantee must provide right of access to its facilities to WASPC, or any of its officers, or to any other
authorized agent or official of the state of Washington or the federal government, at all reasonable times, in
order to monitor and evaluate performance, compliance, and/or quality assurance under this Agreement.
4.35 RIGHTS IN DATA/OWNERSHIP
4.35.1 WASPC and Grantee agree that all data and work products (collectively “Work Product”)
produced pursuant to this Agreement and received by WASPC will be considered a work for hire
under the U.S. Copyright Act, 17 U.S.C. §101 et seq, and will be owned by WASPC. Grantee is
hereby commissioned to create the Work Product. Work Product includes, but is not limited to,
discoveries, formulae, ideas, improvements, inventions, methods, models, processes,
techniques, findings, conclusions, recommendations, reports, designs, plans, diagrams,
drawings, Software, databases, documents, pamphlets, advertisements, books, magazines,
surveys, studies, computer programs, films, tapes, and/or sound reproductions, to the extent
provided by law. Ownership includes the right to copyright, patent, register and the ability to
transfer these rights and all information used to formulate such Work Product.
4.35.2 If for any reason the Work Product would not be considered a work for hire under applicable law,
Grantee assigns and transfers to WASPC, the entire right, title and interest in and to all rights in
the Work Product and any registrations and copyright applications relating thereto and any
renewals and extensions thereof.
4.35.3 Grantee will execute all documents and perform such other proper acts as WASPC may deem
necessary to secure for WASPC the rights pursuant to this section.
4.35.4 Grantee will not use or in any manner disseminate any Work Product to any third party, or
represent in any way Grantee ownership of any Work Product, without the prior written
permission of WASPC. Grantee will take all reasonable steps necessary to ensure that its agents,
employees, or Subgrantees will not copy or disclose, transmit or perform any Work Product or
any portion thereof, in any form, to any third party.
4.35.5 Material that is delivered under this Agreement, but that does not originate therefrom
(“Preexisting Material”), must be transferred to WASPC with a nonexclusive, royalty-free,
irrevocable license to publish, translate, reproduce, deliver, perform, display, and dispose of such
Preexisting Material, and to authorize others to do so. Grantee agrees to obtain, at its own
expense, express written consent of the copyright holder for the inclusion of Preexisting
Material. WASPC will have the right to modify or remove any restrictive markings placed upon
the Preexisting Material by Grantee.
4.35.6 Grantee must identify all Preexisting Material when it is delivered under this Agreement and
must advise WASPC of any and all known or potential infringements of publicity, privacy or of
intellectual property affecting any Preexisting Material at the time of delivery of such Preexisting
Material. Grantee must provide WASPC with prompt written notice of each notice or claim of
copyright infringement or infringement of other intellectual property right worldwide received
by Grantee with respect to any Preexisting Material delivered under this Agreement.
4.36 RIGHTS OF STATE AND FEDERAL GOVERNMENTS
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In accordance with 45 C.F.R. 95.617, all appropriate state and federal agencies, including but not limited to the
Centers for Medicare and Medicaid Services (CMS), will have a royalty-free, nonexclusive, and irrevocable license
to reproduce, publish, translate, or otherwise use, and to authorize others to use for Federal Government
purposes: (i) software, modifications, and documentation designed, developed or installed with Federal Financial
Participation (FFP) under 45 CFR Part 95, subpart F; (ii) the Custom Software and modifications of the Custom
Software, and associated Documentation designed, developed, or installed with FFP under this Agreement;
(iii) the copyright in any work developed under this Agreement; and (iv) any rights of copyright to which Grantee
purchases ownership under this Agreement.
4.37 SERVICES TO PERSONS WITH LIMITED ENGLISH PROFICIENCY
The Grantee must certify that Limited English Proficiency persons have meaningful access to the services under
this program(s). National origin discrimination includes discrimination on the basis of limited English proficiency
(LEP). To ensure compliance with Title VI of the Safe Streets Act, the Grantee is required to take reasonable steps
to ensure that LEP persons have meaningful access to their programs. Meaningful access may entail providing
language assistance services, including oral and written translation when necessary. The US Department of
Justice has issued guidance for grantees to help them comply with Title VI requirements. The guidance
document can be accessed on the internet at www.lep.gov.
4.38 SEVERABILITY
If any provision of this Agreement or the application thereof to any person(s) or circumstances is held invalid,
such invalidity will not affect the other provisions or applications of this Agreement that can be given effect
without the invalid provision, and to this end the provisions or application of this Agreement are declared
severable.
4.39 SITE SECURITY
While on WASPC premises, Grantee, its agents, employees, or Subgrantees must conform in all respects with
physical, fire or other security policies or regulations. Failure to comply with these regulations may be grounds
for revoking or suspending security access to these facilities. WASPC reserves the right and authority to
immediately revoke security access to Grantee staff for any real or threatened breach of this provision. Upon
reassignment or termination of any Grantee staff, Grantee agrees to promptly notify WASPC.
4.40 SUBGRANTING
4.40.1 Neither Grantee, nor any Subgrantees, may enter into subcontracts for any of the work
contemplated under this Agreement without prior written approval of WASPC. WASPC has sole
discretion to determine whether or not to approve any such subcontract. In no event will the
existence of the subcontract operate to release or reduce the liability of Grantee to WASPC for
any breach in the performance of Grantee’s duties.
4.40.2 Grantee agrees that any proposed subcontracts must be provided to WASPC for review no later
than 10 (ten) business days before such a subcontract’s effective date.
4.40.3 Grantee is responsible for ensuring that all terms, conditions, assurances and certifications set
forth in this Agreement are included in any subcontracts.
4.40.4 If at any time during the progress of the work WASPC determines in its sole judgment that any
Subgrantee is incompetent or undesirable, WASPC will notify Grantee, and Grantee must take
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immediate steps to terminate the Subgrantee's involvement in the work.
4.40.5 The rejection or approval by WASPC of any Subgrantee or the termination of a Subgrantee will
not relieve Grantee of any of its responsibilities under the Agreement, nor be the basis for
additional charges to WASPC.
4.40.6 WASPC has no contractual obligations to any Subgrantee or vendor under Agreement to the
Grantee. The Grantee is fully responsible for all obligations, financial or otherwise, to its
Subgrantees.
4.41 SURVIVAL
The terms and conditions contained in this Agreement that, by their sense and context, are intended to survive
the completion, cancellation, termination, or expiration of the Agreement will survive. The right of WASPC to
recover any Overpayments will also survive the termination of this Agreement.
4.42 CORRECTIVE ACTION PLAN/SUSPENSION/TERMINATION
4.42.1 CORRECTIVE ACTION PLAN—In the event that WASPC determines that the Grantee has failed or
is reasonably likely to fail to comply with any term(s) or condition(s) of this Agreement (to
include any and all attachments, references, appendices, or other documents included or
referenced herein), then WASPC will immediately take steps to mitigate any harmful effects of
such failure(s), and promptly prepare a Corrective Action Plan (CAP) with respect to such
failure(s) and outline the steps WASPC believes to be necessary to remedy such failure(s). In the
event that the Grantee is unable to complete the CAP, WASPC reserves it’s right to proceed with
Termination or Suspension as outlined in the General Terms of this Agreement.
SUSPENSION—If WASPC reasonably determines that the Grantee has failed or is reasonably
likely to fail to comply with any term(s) or condition(s) of this Agreement (to include any and all
attachments, references, appendices, or other documents included or referenced herein),
WASPC reserves the right to issue a Notice of Suspension to the Grantee. A Notice of Suspension
acts to suspend this Agreement in its entirety, including suspending payment for future services
provided by Grantee.
In the event a notice of suspension is issued, WASPC agrees to pay Grantee for all services
provided under this Agreement prior to the issuance of the Notice of Suspension.
WASPC reserves the right to reinstate an Agreement at its discretion by issuing a Notice of
Reinstatement, or to move forward with Termination as outlined in Section 4.40 of the General
Terms of this agreement.
TERMINATION FOR DEFAULT—In the event WASPC determines that Grantee has failed to comply
with the terms and conditions of a corrective action plan or the terms of this Agreement, WASPC
has the right to suspend or terminate this Agreement. WASPC will notify Grantee in writing of
the need to take corrective action. If corrective action is not taken within five (5) Business Days,
or other time period agreed to in writing by both parties, the Agreement may be terminated.
WASPC reserves the right to suspend all or part of the Agreement, withhold further payments,
or prohibit Grantee from incurring additional obligations of funds during investigation of the
alleged compliance breach and pending corrective action by Grantee or a decision by WASPC to
terminate the Agreement.
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In the event of termination for default, Grantee will be liable for damages as authorized by law
including, but not limited to, any cost difference between the original Agreement and the
replacement or cover Agreement and all administrative costs directly related to the replacement
Agreement, e.g., cost of the competitive bidding, mailing, advertising, and staff time.
If it is determined that Grantee: (i) was not in default, or (ii) its failure to perform was outside of
its control, fault or negligence, the termination will be deemed a “Termination for Convenience.”
TERMINATION FOR CONVENIENCE—When, at the reasonable discretion of either WASPC or
Grantee, it is in either party's best interest, both WASPC and Grantee may terminate this
Agreement in whole or in part by providing ten (10) calendar days' written notice to the other
party. If this Agreement is so terminated, each party will be liable only for payment in
accordance with the terms of this Agreement for service rendered prior to the effective date of
termination. No penalty shall accrue to either WASPC or Grantee in the event the termination
option in this section is exercised.
TERMINATION FOR NONALLOCATION OF FUNDS—If funds are not allocated to continue this
Agreement in any future period, WASPC may immediately terminate this Agreement by
providing written notice to the Grantee. The termination will be effective on the date specified in
the termination notice. WASPC will be liable only for payment in accordance with the terms of
this Agreement for services rendered prior to the effective date of termination. WASPC agrees to
notify Grantee of such nonallocation at the earliest possible time. No penalty will accrue to
WASPC in the event the termination option in this section is exercised.
TERMINATION FOR WITHDRAWAL OF AUTHORITY—In the event that the authority of WASPC to
perform any of its duties is withdrawn, reduced, or limited in any way after the commencement
of this Agreement and prior to normal completion, WASPC may immediately terminate this
Agreement by providing written notice to the Grantee. The termination will be effective on the
date specified in the termination notice. WASPC will be liable only for payment in accordance
with the terms of this Agreement for services rendered prior to the effective date of termination.
WASPC agrees to notify Grantee of such withdrawal of authority at the earliest possible time. No
penalty will accrue to WASPC in the event the termination option in this section is exercised.
TERMINATION FOR CONFLICT OF INTEREST—Both WASPC and Grantee may terminate this
Agreement by written notice to the other party if either WASPC or Grantee determines, after
due notice and examination, that there is a violation of the Ethics in Public Service Act, Chapter
42.52 RCW, or any other laws regarding ethics in public acquisitions and procurement and
performance of contracts, or Grantee's internal policy. In the event this Agreement is so
terminated, WASPC will be entitled to pursue the same remedies against the Grantee as it could
pursue in the event Grantee breaches the Agreement.
4.43 TERMINATION PROCEDURES
4.43.1 Upon termination of this Agreement, WASPC, in addition to any other rights provided in this
Agreement, may require Grantee to deliver to WASPC any property specifically produced or
acquired for the performance of such part of this Agreement as has been terminated.
4.43.2 WASPC will pay Grantee the agreed-upon price, if separately stated, for completed work and
services accepted by WASPC and the amount agreed upon by the Grantee and WASPC for (i)
completed work and services for which no separate price is stated; (ii) partially completed work
and services; (iii) other property or services that are accepted by WASPC; and (iv) the protection
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and preservation of property, unless the termination is for default, in which case WASPC will
determine the extent of the liability. Failure to agree with such determination will be a dispute
within the meaning of Section 4.13 Disputes. WASPC may withhold from any amounts due the
Grantee such sum as WASPC determines to be necessary to protect WASPC against potential loss
or liability.
4.43.3 After receipt of notice of termination, and except as otherwise directed by WASPC, Grantee
must:
• Stop work under the Agreement on the date of, and to the extent specified in, the notice;
• Place no further orders or subcontracts for materials, services, or facilities except as may be
necessary for completion of such portion of the work under the Agreement that is not
terminated;
• Assign to WASPC, in the manner, at the times, and to the extent directed by WASPC, all the
rights, title, and interest of the Grantee under the orders and subcontracts so terminated;
in which case WASPC has the right, at its discretion, to settle or pay any or all claims arising
out of the termination of such orders and subcontracts;
• Settle all outstanding liabilities and all claims arising out of such termination of orders and
subcontracts, with the approval or ratification of WASPC to the extent WASPC may require,
which approval or ratification will be final for all the purposes of this clause;
• Transfer title to and deliver as directed by WASPC any property required to be furnished to
WASPC;
• Complete performance of any part of the work that was not terminated by WASPC; and
• Take such action as may be necessary, or as WASPC may direct, for the protection and
preservation of the records related to this Agreement that are in the possession of the
Grantee and in which WASPC has or may acquire an interest.
4.44 WAIVER
Waiver of any breach of any term or condition of this Agreement will not be deemed a waiver of any prior or
subsequent breach or default. No term or condition of this Agreement will be held to be waived, modified, or
deleted except by a written instrument signed by the parties. Only the WASPC Authorized Representative has the
authority to waive any term or condition of this Agreement on behalf of WASPC.
4.45 WARRANTIES
4.45.1 Grantee represents and warrants that it will perform all services pursuant to this Agreement in a
professional manner and with high quality and will immediately re-perform any services that are
not in compliance with this representation and warranty at no cost to WASPC.
4.45.2 Grantee represents and warrants that it will comply with all applicable local, State, and federal
licensing, accreditation and registration requirements and standards necessary in the
performance of the Services.
4.45.3 Any written commitment by Grantee within the scope of this Agreement will be binding upon
Grantee. Failure of Grantee to fulfill such a commitment may constitute breach and will render
Grantee liable for damages under the terms of this Agreement. For purposes of this section, a
commitment by Grantee includes: (i) Prices, discounts, and options committed to remain in force
over a specified period of time; and (ii) any warranty or representation made by Grantee to
WASPC or contained in any Grantee publications, or descriptions of services in written or other
communication medium, used to influence WASPC to enter into this Agreement.
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SCHEDULE A: STATEMENT OF WORK
PURPOSE
WASPC intends to enter into an agreement with the Edmonds Police Department for purposes of establishing/continuing
an MHFR Program that adheres to RCW 36.28A.440, to establish and expand mental health field response capabilities,
utilizing mental health professionals to professionally, humanely, and safely respond to crises involving persons with
behavioral health issues with treatment, diversion, and reduced incarceration time as primary goals.
WASPC RESPONSIBILITIES
1. WASPC will provide a Grant Manager to monitor all progress under the program. To accomplish this monitoring
function, WASPC staff may access de-identified data related to program services.
2. The Grant Manager shall provide timely response to Grantee communication.
Grantee RESPONSIBILITIES
1. Grantee must
1.1. Implement the Mental Health Field Response Program as described in their Project Narrative and Project
Timeline (as attached in “Exhibit A)”, with no unapproved substantive derivations. Requests for changes to this
scope of work, or services laid out in the applicant’s Project Narrative and Project Timeline can be made to
csanders@waspc.org. WASPC is under no obligation to grant such a request.
1.2. Include the following elements as central features of their program:
• Grantee must include at least one mental health professional, as defined in RCW 71.05.020, who will
perform field response professional services under the plan. A mental health professional may assist
patrolling law enforcement officers either in the field or in an on-call capacity.
• The mental health professional may also provide preventive, follow-up, training on mental health field
response best practices, or other services at the direction of the local law enforcement agency. Nothing
limits the mental health professional's participation to field patrol.
1.3. Implement the data collection tool as described elsewhere in the Agreement and enter information in an
accurate and timely manner.
1.4. Notify WASPC of any changes in the Agreement or program management.
1.5. Actively participate in any monitoring activities deemed necessary by WASPC.
1.6. Comply with any recommendations that arise from monitoring activities.
1.7. Participate in any WASPC sponsored or facilitated training relative to working with American Indian/Alaskan
Native individuals regarding disparities and needs, Indian health care delivery system, government-to-
government relationships, and applicable federal and state laws and regulations. American Indian/Alaskan
Native means any individual defined at 25 U.S.C. § 1603(1), § 1603(28), or § 1679(a) or who has been
determined eligible as an Indian, under 42 C.F.R. § 136.12.
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Special Considerations
1. To allow agencies to provide the best and most comprehensive services possible, WASPC allows funding to be
utilized for staffing of programs by properly credentialed and trained staff, at the following levels, under the stated
conditions:
1.1. Mental Health Professional (MHP) as defined by RCW 71.05.020:
• Programs must utilize an MHP as defined in RCW 71.05.020 to perform duties established in 36.28A.440(3):
“…assist patrolling officers in the field or in an on-call capacity, provide preventive, follow-up, training on
mental health field response best practices, or other services at the direction of the local law enforcement
agency.”
• MHPs should prioritize grant funded hours to providing services to individuals in crisis.
• MHPs must provide a minimum of 1 hour per week of direct one-on-one supervision to Non-MHPs as
required if the program utilizes non-MHPs.
1.2. Non-MHPs
• Unless licensed to do so, the non-MHP does not provide support or services that would require a license or
certification of any kind from the Washington State Department of Health, the Washington State
Healthcare Authority, or any other governing body with regulatory authority in Washington State.
• Individuals not meeting the definition of MHP as defined by RCW 71.05.020 may provide services under the
following circumstances:
o The non-MHP must receive a minimum of 1 hour per week of direct one-on-one supervision by a
licensed MHP,
o The non-MHP must immediately disengage with an individual that appears to be escalating to a
state of acute crisis or agitation that may present a threat to their physical safety and follow any
steps identified by agency policy.
o Prior to providing services and no less than yearly, the non-MHP must participate in training
relevant to all of the following topics:
• Interacting with and providing social services to individuals with mental health
conditions, to include Substance Use Disorder,
• Program policies and standard operating procedures,
• Necessary and practical physical safety precautions that must be taken when
interacting with community members served by the program,
• Necessary and practical techniques to avoid work related vicarious trauma and
burn-out,
• Please note that the training listed above is meant to represent a bare minimum
standard to which all non-MHPs paid for using funds under this Agreement must
adhere. WASPC expects that agencies will ensure that all of these requirements are
met.
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GRANT AWARD MHFR-25-005 Page 25 of 29
2. Law Enforcement
o WASPC places no conditions or limitations on the program’s use of sworn law enforcement staff
that are included in “SCHEDULE B - Approved Budget.”
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GRANT AWARD MHFR-25-005 Page 26 of 29
SCHEDULE B: APPROVED BUDGET
DEFINITIONS
“Personnel” represents the base salary and wages to individuals employed by the grantee that directly support the
program. This does not include any benefits expenses paid by the grantee. Personnel expenses mut be substantiated
with time and effort reporting (timesheets). (2 CFR § 200.430(i))
“Fringe Benefits” represents allowances and services provided by the grantee to their employees as compensation in
addition to regular salaries and wages. Fringe benefits include, but are not limited to, the costs of leave (vacation, family-
related, sick or military), employee insurance, pensions, and unemployment benefit plans. (2 CFR § 200.431(a))
“Travel” represents transportation, lodging, subsistence, and related expenses incurred by employees who are in travel
status on program related business. All expenses charged to this category must be applied and allocated consistently
throughout the term of the award. (2 CFR § 200.475)
“Equipment” represents property with an acquisition cost of $5,000 or more, and a useful life of one or more years. (2
CFR § 200.1)
“Supplies” represents tangible property other than those described in the definition of equipment. (2 CFR § 200.1)
“Consultants/Contracts” represents the total dollar amount budgeted for the execution of contracts and agreements
with parties not employed by the grantee. Professional and consultant services are rendered by persons who are
members of a particular profession or possess a special skill, and who are not officers or employees of the grantee. These
costs must be reasonable in relation to the services provided. (2 CFR § 200.459)
“Other” represents costs not described in or allocated to another category.
“Indirect” represents those expenses that are related to the conduct of program activities, but that can not be directly
attributable to any particular project. Indirect costs for this award are capped and are not to exceed 15% of actual
eligible expenses. (2 CFR § 200.414)
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GRANT AWARD MHFR-25-005 Page 27 of 29
2025-2026 Approved Budget (Year 1)
January 1, 2026 to June 30, 2026
Budget Category Amount Awarded
A. Personnel $37,078.12
B. Fringe Benefits $11,123.44
C. Travel $0.00
D. Equipment $0.00
E. Supplies $0.00
F. Consultants/Contracts $706.80
G. Other $0.00
H. Indirect $0.00
TOTAL 2025-2026 AWARD $48,908.36
Please note that the “Approved Budget 2025-2026” is the final approved budget for your program during that state
fiscal year. Unspent amounts from the 2025-2026 fiscal year will be forfeited by the grantee and will not be added to
the following fiscal year’s budget amounts.
Funds awarded under this Agreement must be expended as outlined in “EXHIBIT B—FINAL BUDGET SUBMISSION (As
Attached)” unless otherwise noted in the “2025-2026 APPROVED BUDGET NARRATIVE”.
2025-2026 APPROVED BUDGET NARRATIVE:
• No Comments.
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GRANT AWARD MHFR-25-005 Page 28 of 29
2026-2027 Approved Budget (Year 2)
July 1, 2026 to June 30, 2027
Budget Category Amount Awarded
A. Personnel
$74,156.24
B. Fringe Benefits
$22,246.87
C. Travel
$0.00
D. Equipment
$0.00
E. Supplies
$0.00
F. Consultants/Contracts
$1449.60
G. Other
$0.00
H. Indirect
$0.00
TOTAL 2026-2027 AWARD $97,852.72
Please note that the “Approved Budget 2026-2027” is the final approved budget for your program during that state
fiscal year.
Funds awarded under this Agreement must be expended as outlined in “EXHIBIT B—FINAL BUDGET SUBMISSION (As
Attached)” unless otherwise noted in the “2026-2027 APPROVED BUDGET NARRATIVE”.
2026-2027 APPROVED BUDGET NARRATIVE:
• No Comments.
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EXHIBITS
(As Attached)
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Form Name: MHFR 25-27 Application
Submission Time: March 4, 2025 1:00 pm
Browser: Chrome 133.0.0.0 / Windows
IP Address: 74.112.48.2
Unique ID: 1320857886
Location: 37.751, -97.822
Mental Health Field Response Grant Program (MHFR) 25-27 Funding
Application
APPLICANT AGENCY INFORMATION
Is this an initial application for
review of completeness or a final
application submission?
Final Application - Due 3/5/25
Type of Request - Program Type Continue an Existing Program
Lead Agency Edmonds Police Department
Please list any agencies that are
partnering for this application
N/A
Lead Agency/Fiscal Agent
Address
250 5th Ave N
Edmonds, WA 98020
Lead Agency Tax Identification
Number
91-6001244
Lead Agency Unique Entity ID
Number
NF1AQNT457R7
Lead Agency Project Manager's
Name
Rod Sniffen
Lead Agency Project Manager's
Email
rod.sniffen@edmondswa.gov
Lead Agency Project Manager's
Phone
(425) 218-2608
ORGANIZATIONAL OVERVIEW AND KEY PERSONNEL
PROGRAM ABSTRACT
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Program Abstract The City of Edmonds seeks funding to retain our full-time social
worker within the Edmonds Police Department. While the city has
employed a social worker since 2023 due to budget constraints,
funding for this position will be terminated on December 31,
2025. Without continued support, the city will lose a critical
resource that has enhanced law enforcement interactions with
individuals experiencing behavioral health crises and reduced
unnecessary incarceration.
Since 2023, EPD's social worker has worked directly with officers
to provide immediate crisis intervention, stabilization, and
resource connection for individuals experiencing behavioral
health crises. This approach aligns with the grant's goal of
enhancing Intercept 1: Law Enforcement - Pre-Arrest Diversion,
ensuring a professional, humane, and treatment-focused
response. The need for these services continues to grow, as first
responders encounter increasing calls involving complex mental
health and social service needs.
The MHFR grant will enable EPD to retain our current social
worker by funding her position and clinical oversight beginning
January 1, 2026. This support ensures the continuation of our
co-response program, which provides critical assistance to
individuals in crisis while equipping officers with essential
behavioral health expertise. By enhancing crisis intervention, this
initiative reduces criminal justice involvement and strengthens
public safety.
PROGRAM NARRATIVE
PROGRAM TIMELINE
PROGRAM BUDGET
ADDITIONAL APPLICATION SUPPORT DOCUMENTS
DATA COLLECTION & REPORTING
I have reviewed and understand
the Data Collection and Reporting
requirements.
Yes
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
UPLOAD FILES
Organizational Overview and Key
Personnel
https://www.formstack.com/admin/download/file/17669919992
Program Narrative https://www.formstack.com/admin/download/file/17669919993
Program Timeline https://www.formstack.com/admin/download/file/17669919994
Program Budget https://www.formstack.com/admin/download/file/17669919995
Additional Application Support
Documents
https://www.formstack.com/admin/download/file/17669919996
GENERAL TERMS
General Terms Agreement I Agree
GRANT APPLICATION SIGNING AUTHORITY
Applicant Agency Signing
Authority
Rod Sniffen
Title -- Applicant Agency Signing
Authority
Chief of Police
Electronic Signature Agreement I Agree
Signature
Date of Signature Mar 04, 2025
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Organizational Overview and Key Personnel
Organization: Edmonds Police Department
Contact address: 250 5th Ave N Edmonds, WA 98020
Phone Number: 425-771-0200
Key Personnel:
Edmonds Chief of Police: Rodney Sniffen
Email: rod.sniffen@edmondswa.gov
Phone: 425-218-2608
Contact address: 250 5th Ave N Edmonds, WA 98020
The Chief would ultimately oversee the roles and responsibilities of the embedded
social worker.
Assistant Chief of Police: Loi Dawkins
Email: loi.dawkins@edmondswa.gov
Phone: 425-275-2852
Contact address: 250 5th Ave N Edmonds, WA 98020
The Assistant Chief of Police would be at the top of the social worker’s chain of
command (second only to the Chief) and oversee their responsibilities, assignments,
and production results.
Edmonds Police Department Commander: David Machado
Email: david.machado@edmondswa.gov
Phone: 206-549-0441
Contact address: 250 5th Ave N Edmonds, WA 98020
The Commander would be responsible for tracking the data results derived from the
embedded social worker program. These results would be used to effectively identify
the strongest needs of the community and crisis responses provided by the social
worker.
Edmonds Police Department Sergeant: Tom Smith
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Email: richard.smith@edmondswa.gov
Phone: 425-275-6261
Contact address: 250 5th Ave N Edmonds, WA 98020
The Day Sergeant would be the social worker's direct supervisor. They would be the
primary liaison between the social worker and patrol officers if a situation arises in which
the officer is unable to contact the social worker directly. This is a specialty assignment
and the Sergeant selected has the knowledge, training, and passion to assist with the
care crisis responsibilities needed for effective care crisis response. The sergeant would
also be the liaison between the social worker and her chain of command to relay
expectations and directives from the Department.
Social Worker/Crisis Manager/Care Coordinator: Erin Nathan
Email: erin.nathan@edmondswa.gov
Phone: 425-561-2696
Contact address: 250 5th Ave N Edmonds, WA 98020
Erin Nathan is currently contracted to the Edmonds Police Department as a care
coordinator through a grant with the Association of Washington Cities. Erin has an
established working relationship with the Edmonds Police Department and currently
maintains several clients within the Edmonds community. As an employee of the City of
Edmonds, she would continue to provide referral and coordination for community
members to reduce reliance on law enforcement and emergency services, respond to
911 calls with Edmonds Police to assist with in-the-moment coordination and referral,
schedule housing, medical, and mental health appointments for clients, connect families
and individuals to mental health and wraparound services, and assist APS and CPS
with coordination of resources for clients. She has worked in various social worker and
crisis responder roles for the past 15 years.
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CAREER SUMMARY
Personable & dependable professional, social justice focused
SKILLS/QUALIFICATIONS
Care Coordination, Crisis Management, Housing Operations
EXPERIENCE
May 2022 – Present
Compass Health/Edmonds Police Department Social Worker, Edmonds, WA
Provided referral and coordination for community members to reduce reliance on
law enforcement and emergency services.
- Responded to 911 calls with Edmonds Police, to assist with in the moment
coordination and referral.
- Scheduled housing, medical, and mental health appointments for clients.
- Connected families and individuals to mental health and wraparound services,
working to get them insurance, and finding services that will work with their
insurance.
- Follow up on referrals from officers and DV advocate.
- Assisted APS and CPS with coordination of resources for clients.
January 2020 – April 2022
Parkview Services, Affordable Housing Program Director, Shoreline, WA
Developed policies and procedures ensuring compliance with all Federal, State,
and local funders and entities.
- Oversight and administration of day to day operations for 190 tenants and 67
properties, ensuring follow up and satisfaction of service providers and tenants.
- Completed Web Based Annual Reporting System (WBARS) twice annually,
comprised of yearly financials and tenant income and demographic information
for all tenants and properties.
- Applied for city, state, and federal grants to supplement capitol and operating
income for current and potential projects.
- Accounts Receivable and Accounts Payable. Provided support to Finance,
including entering program invoices to QuickBooks, oversight of company check
run including cost centers for outgoing invoices, and company deposits.
- Completed quarterly Operating and Maintenance Vouchers for City of Seattle
and Department of Commerce.
- Monitored spending of all property Replacement and Operating Reserves.
January 2018 – January 2020
Parkview Services, Affordable Housing Program Manager, Shoreline, WA
Managed all aspects of the Affordable Housing Program for persons with
Intellectual & Developmental Disabilities
- Managed lease-ups and renewals for 180 tenants and 65 properties
- Coordinated maintenance and room turns with service providers and
maintenance staff
- Successfully resolved tenant, guardian, and service provider concerns
- Renewed and increased contract rent for 6 Housing Authorities.
Erin Nathan
11+ years in housing
non-profits
8+ years in care
coordination
BA Psychology
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November 2015 – January 2018
Parkview Services, Programs Assistant, Shoreline, WA
Provided support to several internal departments
- Affordable Housing Program for individuals with intellectual & developmental disabilities: Lease
renewals, communication with service providers, income certifications.
- Executive Assistant: Communicated deposits and payables to outside accountant
- Washington Homeownership Resource Center: Collection and distribution of accounts payable
information
December 2014 – November 2015
Healthwise Integrative Medicine, Office Manager, Seattle, WA
Independently managed all office procedures, through communication with the doctor, patients and
outside providers
- Organized calendars to best meet the needs of the doctor and patients.
- Managed fully stocked supplement inventory, including weekly purchasing from multiple vendors.
- Communicated with patient insurance companies, received patient payments.
December 2013 – December 2014
Trupanion Pet Insurance, Data Entry & Claims Assistant, Seattle, WA
Communicated the needs of each claim to clinics and owners, and organized medical records
- Obtained medical records from clinics and owners, clearly communicating claim needs.
- Evaluated claims to determine correct methods of follow up for payout.
- Established communication with clients throughout claims process.
- Organized medical records for future processing by claims adjusters.
2010- 2013
Downtown Emergency Service Center (DESC), Connections Program, Case Manager, Seattle, WA
Provided case management and office support to a non-profit for homeless adults seeking employment
- Managed case load of 30+ clients, including housing and job searches, and daily living support.
- Assessed clients for eligibility and performed registration of new clients.
- Coordinated social service resources to create the clearest possible route to success.
- Managed all front desk duties, including phones and in person appointments.
2008 - 2010
Downtown Emergency Service Center (DESC), Morrison Hotel, Residential Counselor, Seattle, WA
Supported formerly homeless, mentally ill adults in permanent supportive housing
- Supervised front desk including managing phones, visitor logs, medications.
- Crisis management, coordinating resident crises with 911 dispatch, police, fire, medics, and Mental
Health Professionals.
- Planned activities and conversations to build supportive relationships with clients.
- Created complete documentation reports for future shifts.
2007 – 2008
Eastside Domestic Violence Program, Crisis Line/Support Group Intern, Bellevue, WA
Communicated with callers in crisis to assist in emotional support and community resources
- Completed 40 hour Domestic Violence Training
- Connected crisis callers with community resources, simultaneously completing crisis paperwork.
- Assisted and engaged participants in support group activities and discussions.
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RODNEY SNIFFEN
Law Enforcement Administration and Leadership rsniffen@gmail.com
Personnel, Program, and Project Management 425.359.4811
Master’s Degree in Organizational Management
PROFESSIONAL SUMMARY
§ More than 31 years of experience as a law enforcement leader, administrator, large scale program and
project manager, supervisor, and instructor with the Everett Police Department
§ Performance and results-driven organizational and personnel leader, and transformational manager
§ Manage more than $800,000 budget covering patrol operations, overtime, and training
§ Develop strategic plans to improve systems, create greater efficiencies, and increase productivity
§ Mentor staff and develop leaders; build opportunities for officers to move forward in their careers
§ Maintain active and engaging collaborations and communications with internal and external stakeholders
including city officials, business leaders, diverse communities, and the media
§ Current United States Government Top Security Clearance; United States Air Force Veteran
LEADERSHIP COMPETENCIES AND CORE SKILLS
§ Integrity and Impeccable Work Ethic
§ Personnel Management
§ Organizational Leadership and Culture
§ Policy and Program Development
§ Budget Management and Cost Control
§ Process Improvements and Efficiencies
§ Diversity, Equity, and Inclusion
§ Strategic Thinking and Decision-Making
§ Respectful and Effective Communicator
§ Planning, Organization, and Delegation
§ Performance and Results-Oriented
§ Emotional Intelligence
§ Accountability to Leadership and Example to Staff
§ Adaptable to Changing Priorities
§ Confidentiality and Discretion
§ Calm Presence in all Circumstances
LEADERSHIP AND MANAGEMENT ACCOMPLISHMENTS
Operational and Administrative Management
§ Lead police operations including overseeing more than 75 employees and select specialty teams
§ As Captain of the Investigations Division, lead and manage more than 30 employees and all investigative
units including: Persons, Property, Financial, Special Assault, Forensics, Intelligence, and personnel
assigned to the Snohomish County Drug and Gang Task Force
§ Develop, manage, and implement programs to promote and secure public safety, department cohesion,
city leadership investment, and buy-in from community stakeholders
Diversity and Inclusion Leadership
§ Co-facilitate the Mayor of Everett’s Diversity Advisory Board for more than five years
§ Engage in all diversity, equity, and inclusion initiatives and events involving the city and agency
§ Advocate department’s commitment to equality and inclusion in city government and community
Engagement Leadership
§ Represent Snohomish County law enforcement for the Urban Area Security Initiative (UASI) LE sub-
committee as the co-chair, and the Homeland Security Grant Equipment subcommittee
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§ Research and develop the partnership that is now Region One SWAT under an inter-local agreement with
the Snohomish County Sheriff's office
§ Manage the Citizen’s Volunteer Program
§ Law Enforcement speaker for victims’ panel with Snohomish County Domestic Violence Services
§ Former President and Bargaining Chair of the Everett Police Management Association
§ Former Executive Board President and Member, Everett Police Officers’ Association
Instructor and Program Leadership
§ Washington State Certified Instructor
§ Basic Law Enforcement Academy Staff (BLEA) Instructor; Tactical Instructor; Coordinator for Regional
BLEA Session 474 in Everett
§ Washington State Explorer Program Academy Director and Program Advisor
§ Everett Community College Criminal Justice Program Instructor
§ FBI National Academy Associates Youth Leadership Program, WA Chapter committee member
§ Executive Board Member of the Everett Police Officers’ Association
EXPERIENCE
City of Everett Police Department Mar 1990—Present
Captain, South Precinct Jan 2018—Present
Captain, North Precinct Jan 2017—Jan 2018
Captain, Investigations Division Jan 2016—Jan 2017
§ As Captain of precincts, lead and manage police operations, specialty units, and more than 75 employees
§ Specialty units include Anti-Crime Team, Gang Response Unit, Youth Services, Community Outreach and
Enforcement Team, Parking Enforcement, and the downtown core Bicycle Unit
§ Supervise 33 personnel and manage seven investigative units as Captain of Investigations Division
including: Persons, Property, Financial, Special Assault, Forensics, Intelligence, and Snohomish
County Drug and Gang Task Force personnel
§ Commander of the Snohomish County Multiple Agency Response Team (SMART)
§ Review and approve annual performance evaluations for division and direct reports
§ Maintain respectful and effective communication, and engagement, with subordinates and support staff
Lieutenant, Special Operations April 2010—Dec 2015
Lieutenant, Night Watch Commander June 2008—April 2010
§ Lead and manage the selection, staffing, training, equipment, and budget of the department’s six specialty
teams: Marine Unit, Regional Bomb Team, K-9, Honor Guard, SOG/ALERT Team (civil disturbance), and
the Tactical Unit (Region One SWAT)
§ Lead and manage the Code Enforcement Unit and Youth Services Team comprised of five School
Resource Officers
§ Supervise four patrol sergeants and manage the daily operations of four patrol squads; coordinate
schedules and training; conduct coaching and counseling sessions; and prepare annual performance
evaluations for direct reports
§ Lead investigations into complaints against officers; review uses of force; respond to major incidents
Sergeant, Administrative Jan 2007—June 2008
Sergeant, Traffic Safety Unit (co-assignment) Nov 2007—June 2008
Sergeant, Patrol Aug 2005—Jan 2007
§ Lead and supervise up to 8 officers, oversee investigative workloads, and assist in investigations
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§ Evaluate and deploy tactical strategy and response to rapidly developing circumstances and critical
incidents; lead and manage officers on scene; collaborate with other agencies
§ Manage daily, weekly, and monthly deadlines and goals including schedules, job performance
evaluations, complaint processes, and training schedules
§ Certified Motor Officer; research and facilitate motorcycle purchases, draft policy and procedures for
motorcycle traffic enforcement; apply and oversee traffic safety grant awards
§ Engage with community stakeholders to target crime trends, promote buy-in, and implement solutions
§ Assess risks, vulnerabilities, and strengths of daily patrol operations
§ Mentor officers in daily responsibilities and prepare them for future career assignments
Master Police Officer July 1995—Aug 2005
Police Officer Mar 1990—July 1995
§ Department’s Lead Training Officer; Field Training Officer; Firearms Instructor; Emergency Vehicle
Operations Instructor
§ SWAT Team member (13 years); Special Operations Group/Allied Law Enforcement Team (ALERT)
member; Honor Guard member; Marine Unit Boat operator
§ Conduct proactive patrols; respond to violent crimes, collisions, and public safety threats
§ Testify in court; write detailed Reports of Investigation
§ Emergency and Critical Incident Management, and Crisis Control
SELECTED LEADERSHIP CERTIFICATION
§ 26th Session Northwest Command College 2013
§ National Tactical Officer’s Association Leadership Course 2012
§ 37th Command Institute for Law Enforcement Executives 2010
§ FEMA All Hazards Incident Management Team Training 2010
§ Executive Management Course, Hazardous Devices School 2010
§ CJTC Career Level Certification, Mid Manager 2009
§ Effective Budget Preparation and Management 2009
§ Performance Leadership for Law Enforcement Supervisors & Managers 2008
§ CJTC Career Level Certification, First Level Supervisor 2001
EDUCATION
§ Master of Arts Degree, Organizational Management, specialization in Public Administration Oct 2014
Ashford University, Clinton, IA
§ Certificate of Completion Sept 2014
FBI National Academy Class #257, Quantico, VA
§ Bachelor of Arts Degree, Law Enforcement Administration, Summa Cum Laude June 2013
Ashford University, Clinton, IA
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Program Narrative
Description
• Provide a description of the overall structure of the Program.
The Mental Health Field Response Team Program consists of one Bachelor's-level
social worker. The City of Edmonds Police Department has had access to a social worker since 2022 through a partnership with a third-party behavioral health service provider. Since July 2024, the social worker has been hired directly by the City of Edmonds. The social worker has a BA in Psychology and a background in case
management, housing, and serving people with mental illness, substance abuse
disorder, and domestic violence survivors.
The social worker reports to a daytime Police Sergeant. The social worker works both independently and alongside patrol officers, contacting individuals through scheduled outreach patrols and engaging in follow-up and coordination with individuals who agree
to services.
Referrals can come from officers in the moment of contact, and also after a call has ended. Other referral sources may include walk-ins to the Police Department lobby, and the Edmonds Police Domestic Violence Victim Advocate. Other City departments and locations (Human Services, Edmonds Library) where community members access
services also occasionally provide referrals.
The social worker in this position provides services to the Edmonds community with accessing mental health, substance abuse, housing, financial, or other social services. Services delivered are recovery-focused and include case management, treatment planning, resource identification and assistance with follow through, and identification
and development of natural supports and other providers. The social worker is
responsible for assessing the client's immediate and long-term needs and partnering with clients to develop an individually tailored plan designed to promote stability and recovery. The goal of the Program is to connect community members to a variety of community supports. By providing support to community members in need, the hope is
that the person's well-being increases over time, thereby diverting the person from
higher-risk behaviors and lessening client dependence on law enforcement and/or emergency medical responders.
• Describe how the Program is consistent with the policy approaches of the Mental Health Field Response Program as described in HB 2892.SL, including, but not limited to, Section 1, paragraphs 2 and 3 and the Purpose statement on page 1 of this grant application.
The Mental Health Field Response Team Program social worker responds to 911 calls
alongside law enforcement. The calls include persons with mental health diagnoses who may respond more positively to a social worker rather than a patrol officer. The social worker will monitor calls and attach themselves to the call when appropriate, and can also be requested to respond via radio by an officer.
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The social worker aims to increase the number of calls responded to in person, as the community member involved in the call will likely be more willing to discuss resources at the time of the call or crisis rather than after the crisis has ended. This can begin the
building of trust that supports the person in crisis and increases the likelihood that the
person will access services. The social worker and client will then work together to access those services, thus, over time, increasing reliance on supportive services and decreasing the client's reliance on emergency services.
• Describe the link between the intended participants' needs and the Program's ability to serve those needs.
The individuals who are referred to this Program will be given appropriate referrals to meet their needs. The participants will be engaged in conversation to discuss what
resource they are looking for and also given suggestions for other resources they may
not know about. If the Program does not have an immediate appropriate referral, an effort will be made to communicate with local service providers to brainstorm an appropriate referral together. If the participant would benefit from coordination to access the referral, the social worker will assist with setting up the first appointment and
coordinating transportation. Follow-up will be provided if the participant would benefit
from it, and additional referrals can be made if the participant has additional needs.
• Provide a description of the service area and included catchment area(s). Describe how the proposed program structure and staffing meets the needs of the catchment area, i.e. factoring in travel time, volume of calls and proposed shift structure.
The service area primarily covers the City of Edmonds, and follow-ups are occasionally
performed in neighboring cities when the original contact occurred in Edmonds. The
City of Edmonds is approximately 8.9 square miles with a population of approximately 43,000. Most calls for service tend to be along a north-south 1.5-mile stretch of local highway and the immediate surrounding areas. Travel time to most locations is under 15 minutes. The calls that the social worker responds to alongside patrol officers can be
several times daily or none, depending on the call types that occur that day.
The social worker works Monday through Friday during the daytime hours when most social service providers are available for referral.
• What process will be used to determine protocols and processes for gathering information from callers by the caller takers and dispatchers (public safety answering points)?
Referring officers are asked to obtain contact information for the referral and to give information about the community members' situation that has caused them to need
services. The protocols have been created based on knowledge and experience
regarding types of information that have been useful in the past. For example, officers are asked to provide vehicle information and parking location if the person being referred resides in their car, as the person's cell phone is often not consistently turned on. Having vehicle information and parking location can be helpful when contacting the
person for the first time. An additional note that has been helpful is if the person has a
history of aggression. Officers are encouraged to give this information to the social
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worker and will often recommend that the social worker respond with at least one officer upon meeting the person.
• How many participants does the Program anticipate it will contact and how many will it serve?
Over the past 6 months, the Program has been referred to about 100 individuals. Of those 100 individuals, approximately 60 were receptive (or able to be found/contacted)
and provided short-term case management to connect them to needed services. We
estimate these numbers to be indicative of the number of individuals to be served in the future.
• Explain the training approach to be implemented throughout the Program for the law enforcement officers, call takers/dispatchers and behavioral health personnel to operate successfully and competently within your agency.
Patrol officers are trained regarding referral guidelines and services available through the Mental Health Field Response Team Program. This training happens at the
Edmonds Police Department after the officers have completed the basic law
enforcement academy. Ongoing behavioral health response training may be implemented as part of annual in-service training.
Training for the social worker with the Program includes educational meetings, coordination with other Snohomish County behavioral health providers, and annual
training implemented by a local co-responder alliance, dependent on grant funding to attend the training.
• Describe the role of the case manager, for programs that will employ dedicated case managers and utilize support services to work with individuals successfully
diverted.
The Mental Health Field Response Team Program will employ one social worker who will coordinate and refer behavioral health and other social services. While the social worker will provide short-term case management, every effort will be made to provide
appropriate referrals and warm hand-offs to long-term case managers for those who can use ongoing support. The social worker will work with the client until ongoing services successfully support them.
• Describe the steps the Program will take to transition diverted individuals from short-term services to more permanent community support services.
The individuals contacted by the Mental Health Field Response Team Program may initially access short-term services such as a one-time visit to a provider. Efforts will be made at the short-term visit to connect them to a longer-term service provider. For
example, a visit to the Swedish Hospital Urgent Care may be a short-term solution.
However, there is a social worker at the Hospital who can assist with navigating the hospital system and obtaining a primary care or other care provider for the individual.
If the individual needs assistance following through with appointments for the long-term provider, the social worker will assist them with appointment reminders and accompany
them to the first appointment to ensure follow-through and a thorough assessment.
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• What wraparound linkage services and resources will be provided in the Program and how are these consistent with evidence-based practices?
Every effort will be made to connect community members to services that appropriately support their current needs. Wraparound services may include natural supports, new provider supports, peer and community-led groups, children and youth programs and providers, medical and behavioral health urgent care, medical and mental health
providers, and long-term case management providers to assist in ongoing case
management for those who may benefit. Resources that community members are connected with are dependent on their interest in receiving services. The benefit of this Program is that the social worker can build relationships with community members, establish trust, and provide further opportunities for community members to access
additional services.
Evidence-based practices will be used to build relationships. The following are examples of evidence-based practices that will be used.
Person-centered Motivational Interviewing: It focuses on building rapport and allows the client to guide the process of their recovery. It is designed to strengthen the person's
motivation towards a specific goal by exploring the person's own ambivalence towards
change.
System Navigation: The social worker will assist individuals with direct referrals to mental health and substance abuse treatment and clean and sober housing. This reduces the individual's effort and minimizes time spent in unsupportive, transient
settings.
Wraparound services: coordinate community-based services in a team intervention approach. A team of professionals assists the person in developing a care plan based on their strengths. The team consists of family and professionals who support the person daily and weekly and provide crisis support 24/7.
Need
• Describe the need for a Mental Health Field Response Team Program in your jurisdiction. What considerations were assessed in determining the need? How does the need relate to the overall goal of the Mental Health Field Response Team Program?
As the price of housing, food, and other goods rises in Snohomish County, the income
of many residents has not increased to meet their needs. According to a 2019 report,
40% of Edmonds residents were cost-burdened, meaning they spent 30% or more of their income on housing expenses. At least 450 Edmonds residents in 2019 were experiencing homelessness, including 117 K-12 students who are unhoused. As these numbers were generated in 2019, they have only continued to rise with increasing costs despite not having completed a survey since that time. KONE Report attached.
Many of the community members the City of Edmonds social worker interacts with are struggling financially, which negatively affects their mental and emotional well-being. When patrol officers refer a community member to the social worker for follow-up, they often do so based on the details of the call. However, upon follow-up, the social worker
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often finds that the person or family's needs encompass more areas than the original referral stated.
The City of Edmonds also has a growing number of persons with mental health,
housing, financial, and substance abuse challenges. With the cities of Everett to the
north and Seattle to the south, an increasing number of people from those neighboring cities often land in the south Snohomish County and Edmonds area.
For the above reasons, the Mental Health Field Response Team Program is an important part of the overall services provided by the Edmonds Police Department and
the City of Edmonds. The Program's goal is to connect community members to supportive services and reduce their reliance on law enforcement and/or emergency medical responders over time. The City has found the Program important to assist those community members who need additional support and assistance navigating community resources.
Partnership and Collaboration
• How will the Program cultivate the development of a coordinated system of care that integrates all services (referral, intake, case planning, service delivery, case
management, evaluation) and includes a feedback loop to all program partners?
The Mental Health Field Response Team Program social worker receives an initial referral and follows up on the referral within 24-48 hours. Oftentimes, the initial follow-up occurs by phone; however, in the case of community members without a means of
communication, attempts to find the person in the community through street patrol are made. At the initial contact, a full assessment is done within reason of the person's capacity. The assessment includes questions about resources that the person has accessed in the past, current struggles, and future goals. A plan is created to follow up on initial resources, often including an additional service provider to create a warm
hand-off. Continued support is given until the community member is successfully connected to the services that they requested. Program partners who provided the referral are given feedback about the referral, first upon receipt of the referral, then once the initial contact has been made, and after the community member has successfully connected to services. The feedback loop creates trust between referral partners and
gives information about what was helpful to the community member to assist that
referral partner in future referrals.
Services
• Describe the partnerships proposed for stabilization, observation, disposition, and custodial transfer.
Initial stabilization for participants who have been deemed to meet ITA criteria is usually done at Swedish Hospital in Edmonds. Swedish's Behavioral Health Assessment Team
then does its own assessment and requests a Designated Crisis Responder (DCR) if
necessary. Based on these assessments and the availability of a bed at Swedish Edmonds, a decision is made on whether the participant will stay at this location or be transferred to another hospital. Patients are sometimes transferred to the Mukilteo
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Evaluation and Treatment (E&T) facility or Smokey Point Behavioral Hospital (less likely) for longer-term involuntary stays.
• What is the process for assessing participants for danger to self and others; what assessment resources will be used?
Upon contact with a community member who has been said to be suicidal, patrol officers will de-escalate the scene until it is safe. The officers will perform an initial
assessment for danger to self and others based on Edmonds Police and Washington
State ITA criteria. The social worker can also be dispatched to those calls and provide additional assessment if the community member is still on the scene. The social worker has ample experience with persons with mental illness and can provide additional assessment and ideas for stabilization and follow up within the hospital system they are
taken to.
• Explain which resources will be engaged for participants who are considered "high utilizers" upon referral, and ongoing.
When contact is made with participants who are considered high utilizers, an effort will
be made to find out which other services are also being utilized to a high degree. For example, many participants also come into contact with the fire department medics or Community Resource Paramedics. The social worker has frequent communication with CRP and follows up when there is a high utilizer who utilizes both police and fire 911. A plan will be made for who the point person is when on shift, and a detailed plan of how
to interact with the participant will be made and dispersed to both police and fire systems.
Meetings will be arranged between the systems that the participant frequently accesses, whether it be police and fire, or another community provider. Assessment will be done of the participant's behavior over time and changes will be made to the plan when needed.
• Describe how individualized case plans will be developed and updated and how this information will be shared with the participant and the Mental Health Field Response Team.
Individual case plans will be developed upon contacting a willing participant. These plans will be created based on the participant's input, utilizing person-centered questions to understand their current thoughts and willingness to access resources. The plan will be presented to the participant both as an overview and in a step-by-step
format that is easy to follow.
The next step will be communicated to the participant, and their input and willingness will be actively sought. Efforts will be made to coordinate the next step with as much or as little assistance as the participant requests. Follow-up will be conducted with the referring officer to inform them of the participant's willingness to access the resource.
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Program Timeline
Mental Health Field Response Team Program - Implementation Timeline
Phase 1: Expansion & Integration (January 2026 - March 2026)
• January 2026:
o Coordination meetings with Edmonds Police Department leadership to refine
referral pathways.
o Update training materials for patrol officers, and other referral sources.
o Implement data tracking protocols to monitor program effectiveness.
• February 2026:
o Conduct refresher training and orientation sessions for patrol officers.
o Strengthen collaboration agreements and referral guidelines with local behavioral
health providers, hospitals, and community organizations.
o Increase integration of social worker into various call types with patrol officers.
• March 2026:
o Assess and refine referral and response workflow.
o Begin collecting new data on service utilization and outcomes.
o Address logistical challenges and optimize coordination with social worker
dispatch.
Phase 2: Full Implementation & Community Engagement (April 2026 - September 2026)
• April - June 2026:
o Conduct joint case consults with South County Fire.
• July - September 2026:
o Enhance focus on diversion outcomes and reducing law enforcement
interactions.
o Launch social media campaigns highlighting program success.
Phase 3: Program Evaluation & Sustainability (October 2026 – December 2026)
• October - December 2026:
o Conduct a year-end program review.
o Identify key successes and areas for improvement.
o Develop a sustainability plan for continued funding and service expansion.
Phase 4: Continue Program Operations & Evaluation (January 2027 – June 2027)
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• January 2027 – June 2027:
o Publish an annual report summarizing program impact and effectiveness.
Implementation Challenges & Mitigation Strategies
• Challenge: Coordination between multiple agencies (police, fire, hospitals).
o Solution: Establish quarterly coordination meetings to ensure streamlined
communication.
• Challenge: Resistance from officers or community members unfamiliar with the
program.
o Solution: Provide ongoing education and success stories to illustrate the
benefits of the social work program. Social worker to proactively dispatch to calls.
• Challenge: Limited initial capacity with only one social worker.
o Solution: Prioritize high-need cases and engage other local providers.
• Challenge: Tracking program success and measuring diversion impact.
o Solution: Implement a structured data collection system from the outset and
conduct quarterly reviews.
This timeline ensures a streamlined and effective implementation of the Mental Health Field
Response Team Program, maximizing social worker support while optimizing law enforcement
and emergency service resources.
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Budget Worksheet
Please ensure that you provide all relevant informaton for each year.
***THIS IS A MULTI YEAR BUDGET WORKSHEET***
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Budget Worksheet
Salary Basis Percentage
of Time
42,285.00 Hourly 100%
Budget Worksheet Year 1
July 1, 2025 - June 30, 2026
Purpose: The Budget Detail Worksheet is provided for your use in the preparation of the budget and budget narrative. All required information (inclu
provided. Any category of expense not applicable to your budget may be left blank. A specific area is available at the end of this spreadsheet that allo
description of funds or items to be provided as program matching funds (cost sharing).
A. Personnel - List each position by title and name of employee, if available. Show the annual salary rate and percentage of time to be devoted to the
for employees engaged in grant activities must be consistent with that paid for similar work within the applicant organization. Include a description of
duties of each position in relationship to fulfilling the project goals and objectives. (Note: Use whole numbers as the percentages of time, an example
25.50)
PositionName
Computation
Erin Nathan Community Social Worker
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
TO
Personnel Narrative
Base
42,285.00$
The Edmonds Police Department has funding for our social worker through December 31, 2025. For year one we would need 42,285.00 for Erin Nathan's salary f
30th, 26.
B. Fringe Benefits - Fringe benefits should be based on actual known costs. List the composition of the fringe benefit package. Fringe benefits are for t
category (A) and only for the percentage of time devoted to the project. Fringe benefits on overtime hours are limited to FICA, Workman's Compensa
Compensation. (Note: Use decimal numbers for the fringe benefit rates, an example is 7.65% should be shown as .0765)
Benefits (Medical, Pension, L&I, FICA, Medicare, PRML, Dental and Vision)
Description
Comp
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TOTAL
Fringe Benefits Narrative
Purpose of Travel Location
Item Cost Rate Basis for Rate Quantity Number of
People
Number of
Trips
Lodging 182.00 Per Diem 5 1 1
Meals 387.00 Per Diem 1
Mileage
Transportation:
Airfare
The Edmonds PD is requesting funding for the social worker's medical benefits. Medical benefits for the city of Edmonds average 30% of the annual salary. The r
benefits is based on the total salary for the social worker from Jan 1st, 2026 to June 30th, 2026.
Computation
C. Travel - Itemize travel expense of staff and personnel by purpose (e.g., staff to training, advisory group meeting, field interviews, etc.). Describe the
expenditure in reference to the project objectives. Show the basis of computation (e.g., six people to 3-day training at $X airfare, $X lodging, $X subsis
travel and meals for trainees should be listed separately. Show the number of trainees and the unit costs involved. Identify the location of travel, if kn
"location to be determined." Note: Travel expenses for consultants should be included in the "Contractual/Consultant" category.
Training for Social Worker. Atlanta, Georgia Conference
650.00 1
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Local Travel
Other
Baggage Fee
Subtotal
Purpose of Travel Location
Item Cost Rate Basis for Rate Quantity Number of
People
Number of
Trips
Lodging
Meals
Mileage
Transportation:
Local Travel
Other
Subtotal
Purpose of Travel Location
Item Cost Rate Basis for Rate Quantity Number of
People
Number of
Trips
Lodging
Meals
Mileage
Transportation:
Local Travel
Other
Computation
$700 1
Computation
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Subtotal
Purpose of Travel Location
Item Cost Rate Basis for Rate Quantity Number of
People
Number of
Trips
Lodging
Meals
Mileage
Transportation:
Local Travel
Other
Subtotal
Travel Narrative
The Edmonds PD would like to send our social worker to the Co-Responder Alliance Conference in Atlanta, Georgia, in June 2026. The conference would be highl
tactics. The conference covers a broad spectrum of issues that co-responders face, including mental health crises, safety protocols, leveraging resources, diver
techniques, and community initiatives. The registration fee is $700. This cost has been placed in the "other" cell on the travel chart. The total cost for this training $
on current rates for the June 2025 conference. There will be a conference in 2026, but no cost details have been posted. The lodging and meals are based on curr
Computation
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Quantity
TOT
Equipment Narrative
Full time use of Ford Escape (fleet vehicle) for work purposes (cost of vehicle fees assessed from fleet)
The community social worker position requires her to go out in the field as part of her job. To accomplish this, the department provides a designated city fleet vehi
$4,926, which is 50% of the total amount the fleet department charges the PD for a vehicle per year. Included in this are the maintenance and replacement charges
the vehicle as assessed by the city's fleet department.
D. Equipment - List non-expendable items that are purchased (Note: Organization's own capitalization policy for classification of equipment should be
should be included in the "Supplies" category. Applicants should analyze the cost benefits of purchasing versus leasing equipment, especially high cos
rapid technological advances. Rented or leased equipment costs should be listed in the "Contractual" category. Explain how the equipment is necessa
project, and describe the procurement method to be used.
Item
Comp
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Quantity/
Duration
T
Supplies Narrative
We will not request funds for supplies as we currently have all the supplies necessary to support a full-time community social worker.
Supply Item
Comp
E. Supplies - List items by type (office supplies, postage, training materials, copy paper, and expendable equipment costs costing less than $5,000, suc
recorders) and show the basis for computation. Generally, supplies include any materials that are expendable or consumed during the project.
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Fee Basis
$94
Subto
Consultant Fee Narrative
For the City liability insurance we have to have clinical oversight for our community social worker twice a month minimum. We will have a contract in place through
Outreach program for this clinical oversight. The $1,128.00 requested is to cover bi-monthly meetings from Jan 1st, 2026 to June 30th, 2026.
Kelli Roark, City of Everett Clinical oversight for community social worker
Consultant Fees: For each consultant enter the name, if known, service to be provided, hourly or daily fee (8 hour day), and estimated time on the pr
excess of $450 per day or $56.25 per hour require additional justification and prior approval from WASPC.
Name of Consultant Service Provided
Computation
F. Consultants/Contracts - Indicate whether applicant's formal, written Procurement Policy or the Federal Acquisition Regulations are followed.
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Purpose of Travel Location
Item Cost Rate Basis for Rate Quantity Number of
People
Number of
Trips
Lodging
Meals
Mileage 0.7 WA Gov't Rate 34 12
Transportation:
Local Travel
Other
Subtotal
Purpose of Travel Location
Item Cost Rate Basis for Rate Quantity Number of
People
Number of
Trips
Lodging
Meals
Mileage
Transportation:
Local Travel
Other
Subtotal
In person meetings for clinical
oversight
Traveling from 2930
Wetmore Ave. Everett, WA
to 250 5th Ave. N.
Edmonds, WA
Computation
Consultant Expenses: List all expenses to be paid from the grant to the individual consultants in addition to their fees (i.e., travel, meals, lodging, etc.). This includes
is not an employee of the applicant such as participants, volunteers, partners, etc.
Computation
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Purpose of Travel Location
Item Cost Rate Basis for Rate Quantity Number of
People
Number of
Trips
Lodging
Meals
Mileage
Transportation:
Local Travel
Other
Subtotal
Subtotal Consu
TOT
Consultant Expenses Narrative
As part of the contract with the City of Everett, milage rate is required.
Contracts: Provide a description of the product or service to be procured by contract and an estimate of the cost. Applicants are encouraged to prom
competition in awarding contracts. A separate justification must be provided for sole-source contracts in excess of $100,000
Computation
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
TOTAL Contracts
Contracts Narrative
Quantity Basis Cost
Item
G. Other Costs - List items (e.g. rent, reproduction, telephone, janitorial, or security services) by major type and the basis of computation. For exampl
of the cost per square foot for rent or provide a monthly rental cost and how many months to rent. The basis field is a text field to describe the quant
months, etc.
Description
Computation
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TOT
Other Costs Narrative
Budget Summary - When you have completed the budget worksheet, the totals for each category will appear in the spaces below. Verify the category
Budget Category Amount Requested
A. Personnel 42,285.00$
B. Fringe Benefits 12,685.50$
Funding Request Summary
C. Travel 2,647.00$
D. Equipment 4,926.00$
E. Supplies -$
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
F. Consultants/Contracts 1,413.60$
G. Other -$
PROJECT COST TO APPLICANT (NOT INCLUDING
FIGURES ABOVE)63,957.10$
63,957.10$
↑ + ↓
= ↓
LOCAL MATCH (IF APPLICABLE)-$
TOTAL GRANT REQUEST 63,957.10$
Local Match - Use the space below to identify and describe the dollar amounts or items that will be provided as local match or cost sharing for your p
listed here must be in conformance with 2 CFR § 200.306.
OVERALL PROGRAM VALUE
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Length of
Time
10000%42,285.00$
-$
-$
-$
ding narrative) must be
ws for the identification and
e project. Compensation paid
f the responsibilities and
is 25.50% should be shown as
Cost
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-$
OTAL Personnel 42,285.00$
Rate Cost
0.3 12,685.50$
-$
-$
-$
-$
-$
from Jan 1st, 2026 through June
the personnel listed in budget
tion and Unemployment
utation
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-$
-$
Fringe Benefits 12,685.50$
Cost
Cost
910.00
387.00
-
requested $12,685.50 in fringe
e purpose of each travel
stence). In training projects,
nown; or if unknown, indicate
650.00
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-
2,647.00
Cost
Cost
-
-
-
-
-
Cost
Cost
-
-
-
-
-
-
-
2,647.00$
700.00
-$
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-
Cost
Cost
-
-
-
-
-
TOTAL Travel 2,647.00$
-
-$
y valuable to our co-responder
rsity, drug use, de-escalation
$2,647 has been calculated based
ent government per diem rates.
-
-$
-
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Cost Cost
4,926.00$
-$
-$
-$
TAL Equipment 4,926.00$
cle for use. The cost listed is
s calculated based on the life of
e used). Expendable items
st items and those subject to
ary for the success of the
utation
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Cost Cost
-$
-$
-$
-$
-$
-$
TOTAL Supplies -$
utation
ch as books, hand held
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Quantity Cost
12 1,128.00$
-$
-$
-$
otal Consultants 1,128.00$
h the City of Everett's Community
oject. Consultant fees in
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Cost
Cost
-
-
285.60
-
-
285.60
Cost
Cost
-
-
-
-
-
- -$
-
285.60$
-
s travel expenses for anyone who
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Cost
Cost
-
-
-
-
-
-
ultant Expenses 285.60$
TAL Consultants 1,413.60$
ote free and open
-$
-
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Length of
Time
Cost
-$
-$
-$
-$
-$
-$
Cost
-$
e, provide the square footage
tity such as square footage,
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
-$
-$
-$
TAL Other Costs -$
y and total dollars requested.
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
rogram. Note that everything
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Budget Worksheet
Budget Worksheet Year 2
July 1, 2026 - June 30, 2027
Purpose: The Budget Detail Worksheet is provided for your use in the preparation of the budget and budget narrative. All required information (includ
must be provided. Any category of expense not applicable to your budget may be left blank. A specific area is available at the end of this spreadsheet
the identification and description of funds or items to be provided as program matching funds (cost sharing).
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Salary Basis Percentage
of Time
Length of
Time
87,107.10 Hourly 100%10000%
TOTAL Personnel
Personnel Narrative
The salary projections for this year include a 3% increase to account for possible COLA being added by the city of Edmonds.
Erin Nathan Community Social Worker
A. Personnel - List each position by title and name of employee, if available. Show the annual salary rate and percentage of time to be devoted to the
Compensation paid for employees engaged in grant activities must be consistent with that paid for similar work within the applicant organization. Incl
description of the responsibilities and duties of each position in relationship to fulfilling the project goals and objectives. (Note: Use whole numbers as
percentages of time, an example is 25.50% should be shown as 25.50)
Computation
Name Position
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Base Rate
87,107.10$ 0.3
TOTAL Fringe Benefits
Fringe Benefits Narrative
The Edmonds PD is requesting funding for the social worker's medical benefits. Medical benefits for the city of Edmonds average 30% of the annual salary. The
$26132.13 in fringe benefits is based on the total salary for the social worker from July 1st, 2026 to June 30, 2027.
Benefits (Medical, Pension, L&I, FICA, Medicare, PRML, Dental and Vision)
B. Fringe Benefits - Fringe benefits should be based on actual known costs. List the composition of the fringe benefit package. Fringe benefits are for t
listed in budget category (A) and only for the percentage of time devoted to the project. Fringe benefits on overtime hours are limited to FICA, Workm
Compensation and Unemployment Compensation. (Note: Use decimal numbers for the fringe benefit rates, an example is 7.65% should be shown as .
Computation
Description
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Purpose of Travel Location
Item Cost Rate Basis for Rate Quantity Number of
People
Number of
Trips Cost
Lodging -
Meals -
Mileage -
Transportation:
Airfare
Local Travel -
Other
Baggage Fee
Subtotal -
C. Travel - Itemize travel expense of staff and personnel by purpose (e.g., staff to training, advisory group meeting, field interviews, etc.). Describe the
each travel expenditure in reference to the project objectives. Show the basis of computation (e.g., six people to 3-day training at $X airfare, $X lodgin
subsistence). In training projects, travel and meals for trainees should be listed separately. Show the number of trainees and the unit costs involved. Id
location of travel, if known; or if unknown, indicate "location to be determined." Note: Travel expenses for consultants should be included in the
"Contractual/Consultant" category.
Computation
-
-
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Purpose of Travel Location
Item Cost Rate Basis for Rate Quantity Number of
People
Number of
Trips Cost
Lodging -
Meals -
Mileage -
Transportation:
Local Travel -
Other
Subtotal -
Purpose of Travel Location
Item Cost Rate Basis for Rate Quantity Number of
People
Number of
Trips Cost
Lodging -
Meals -
Mileage -
Transportation:
Local Travel -
Other
Subtotal -
-
-
-
Computation
-
Computation
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Purpose of Travel Location
Item Cost Rate Basis for Rate Quantity Number of
People
Number of
Trips Cost
Lodging -
Meals -
Mileage -
Transportation:
Local Travel -
Other
Subtotal -
TOTAL Travel
Travel Narrative
Computation
-
-
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Quantity Cost
100 10,000.00
TOTAL Equipment
Equipment Narrative
Computation
Item
Full time use of Ford Escape (fleet vehicle) for work purposes (cost of vehicle fees assessed from fleet)
The community social worker position requires her to go out in the field as part of her job. To accomplish this, the department provides a designated city fleet vehic
cost listed, $10,000, is the amount the fleet department charges the PD for this vehicle per year. This cost includes the maintenance and replacement charges calcu
the life of the vehicle as assessed by the city's fleet department.
D. Equipment - List non-expendable items that are purchased (Note: Organization's own capitalization policy for classification of equipment should be
Expendable items should be included in the "Supplies" category. Applicants should analyze the cost benefits of purchasing versus leasing equipment, e
cost items and those subject to rapid technological advances. Rented or leased equipment costs should be listed in the "Contractual" category. Explain
equipment is necessary for the success of the project, and describe the procurement method to be used.
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Quantity/
Duration Cost
TOTAL Supplies
Supplies Narrative
E. Supplies - List items by type (office supplies, postage, training materials, copy paper, and expendable equipment costs costing less than $5,000, suc
hand held recorders) and show the basis for computation. Generally, supplies include any materials that are expendable or consumed during the proje
Computation
Supply Item
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Fee Basis Quantity
$97 24
Subtotal Consultants
Consultant Fee Narrative
For the City liability insurance we have to have clinical oversight for our community social worker twice a month minimum. We will have a contract in place through
Everett's Community Outreach program for this clinical oversight. Included a 3% increase for 2026.
Kelli Roark, City of Everett Clinical oversight for community social worker
F. Consultants/Contracts - Indicate whether applicant's formal, written Procurement Policy or the Federal Acquisition Regulations are followed.
Consultant Fees: For each consultant enter the name, if known, service to be provided, hourly or daily fee (8 hour day), and estimated time on the pro
Consultant fees in excess of $450 per day or $56.25 per hour require additional justification and prior approval from WASPC.
Computation
Name of Consultant Service Provided
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Purpose of Travel Location
Item Cost Rate Basis for Rate Quantity Number of
People
Number of
Trips Cost
Lodging -
Meals -
Mileage 0.7 WA Gov't Rate 34 24 571.20
Transportation:
Local Travel -
Other -
Subtotal 571.20
Purpose of Travel Location
Item Cost Rate Basis for Rate Quantity Number of
People
Number of
Trips Cost
Lodging -
Meals -
Mileage -
Transportation:
Local Travel -
Other -
Subtotal -
-
Computation
Consultant Expenses: List all expenses to be paid from the grant to the individual consultants in addition to their fees (i.e., travel, meals, lodging, etc.). This includes
expenses for anyone who is not an employee of the applicant such as participants, volunteers, partners, etc.
Computation
In person meetings
for clinical oversight
Traveling from 2930
Wetmore Ave.
Everett, WA to 250
5th Ave. N.
Edmonds, WA
-
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Purpose of Travel Location
Item Cost Rate Basis for Rate Quantity Number of
People
Number of
Trips Cost
Lodging -
Meals -
Mileage -
Transportation:
Local Travel -
Other -
Subtotal -
Subtotal Consultant Expenses
TOTAL Consultants
Consultant Expenses Narrative
-
As part of the contract with the City of Everett, milage rate is required.
Computation
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
TOTAL Contracts
Contracts Narrative
$
$
$
$
$
Contracts: Provide a description of the product or service to be procured by contract and an estimate of the cost. Applicants are encouraged to promo
open competition in awarding contracts. A separate justification must be provided for sole-source contracts in excess of $100,000
Item Co
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Quantity Basis Cost Length of
Time
TOTAL Other Costs
Other Costs Narrative
G. Other Costs - List items (e.g. rent, reproduction, telephone, janitorial, or security services) by major type and the basis of computation. For example
square footage of the cost per square foot for rent or provide a monthly rental cost and how many months to rent. The basis field is a text field to des
quantity such as square footage, months, etc.
Computation
Description
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Local Match - Use the space below to identify and describe the dollar amounts or items that will be provided as local match or cost sharing for your pr
that everything listed here must be in conformance with 2 CFR § 200.306.
PROJECT COST TO APPLICANT (NOT
INCLUDING FIGURES ABOVE)126,138.43$
F. Consultants/Contracts 2,899.20$
G. Other -$
TOTAL GRANT REQUEST 126,138.43$
C. Travel -$
D. Equipment 10,000.00$
E. Supplies -$
Funding Request Summary
Budget Category Amount Requested
A. Personnel 87,107.10$
B. Fringe Benefits 26,132.13$
Budget Summary - When you have completed the budget worksheet, the totals for each category will appear in the spaces below. Verify the category
dollars requested.
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
= ↓
OVERALL PROGRAM VALUE 126,138.43$
↑ + ↓
LOCAL MATCH (IF APPLICABLE)-$
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
ding narrative)
that allows for
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
87,107.10$
-$
-$
-$
-$
87,107.10$
project.
lude a
s the
Cost
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Cost
26,132.13$
-$
-$
-$
-$
-$
-$
-$
26,132.13$
e requested
the personnel
man's
.0765)
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Cost
e purpose of
ng, $X
dentify the
-$
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Cost
Cost
-$
-$
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Cost
-$
-$
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Cost
10,000.00$
-$
-$
-$
10,000.00$
cle for use. The
ulated based on
e used).
especially high
n how the
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Cost
-$
-$
-$
-$
-$
-$
-$
h as books,
ect.
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Cost
2,328.00$
-$
-$
-$
2,328.00$
h the City of
oject.
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Cost
Cost
s travel
571.20$
-$
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Cost
571.20$
2,899.20$
-$
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
-
-
-
-
-
ote free and
ost
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Cost
-$
-$
-$
-$
-$
-$
e, provide the
scribe the
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
rogram. Note
y and total
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Budget Worksheet
Please ensure that you provide all relevant informaton for each year.
***THIS IS A MULTI YEAR BUDGET WORKSHEET***
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Budget Worksheet
Salary Basis Percentage
of Time
Length of
Time
42,285.00 Hourly 100%10000%42,285.00$
-$
-$
-$
-$
TOTAL Personnel 42,285.00$
Personnel Narrative
Budget Worksheet Year 1
July 1, 2025 - June 30, 2026
Purpose: The Budget Detail Worksheet is provided for your use in the preparation of the budget and budget narrative. All required information (including narrative) must be
provided. Any category of expense not applicable to your budget may be left blank. A specific area is available at the end of this spreadsheet that allows for the identification and
description of funds or items to be provided as program matching funds (cost sharing).
A. Personnel - List each position by title and name of employee, if available. Show the annual salary rate and percentage of time to be devoted to the project. Compensation paid
for employees engaged in grant activities must be consistent with that paid for similar work within the applicant organization. Include a description of the responsibilities and duties
of each position in relationship to fulfilling the project goals and objectives. (Note: Use whole numbers as the percentages of time, an example is 25.50% should be shown as 25.50)
PositionName
Computation
Erin Nathan Community Social Worker
Cost
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Base Rate Cost
42,285.00$ 0.3 12,685.50$
-$
-$
-$
-$
-$
-$
-$
TOTAL Fringe Benefits 12,685.50$
Fringe Benefits Narrative
The Edmonds Police Department has funding for our social worker through December 31, 2025. For year one we would need 42,285.00 for Erin Nathan's salary from Jan 1st, 2026 through June
30th, 26.
The Edmonds PD is requesting funding for the social worker's medical benefits. Medical benefits for the city of Edmonds average 30% of the annual salary. The requested $12,685.50 in fringe
benefits is based on the total salary for the social worker from Jan 1st, 2026 to June 30th, 2026.
B. Fringe Benefits - Fringe benefits should be based on actual known costs. List the composition of the fringe benefit package. Fringe benefits are for the personnel listed in budget
category (A) and only for the percentage of time devoted to the project. Fringe benefits on overtime hours are limited to FICA, Workman's Compensation and Unemployment
Compensation. (Note: Use decimal numbers for the fringe benefit rates, an example is 7.65% should be shown as .0765)
Benefits (Medical, Pension, L&I, FICA, Medicare, PRML, Dental and Vision)
Description
Computation
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Purpose of Travel Location Cost
Item Cost Rate Basis for Rate Quantity Number of
People
Number of
Trips Cost
Lodging 182.00 Per Diem 5 1 1 910.00
Meals 387.00 Per Diem 1 387.00
Mileage -
Transportation:
Airfare
Local Travel -
Other
Baggage Fee
Subtotal 2,647.00
Purpose of Travel Location Cost
Item Cost Rate Basis for Rate Quantity Number of
People
Number of
Trips Cost
Lodging -
Meals -
Mileage -
Transportation:
$700 1
Computation
C. Travel - Itemize travel expense of staff and personnel by purpose (e.g., staff to training, advisory group meeting, field interviews, etc.). Describe the purpose of each travel
expenditure in reference to the project objectives. Show the basis of computation (e.g., six people to 3-day training at $X airfare, $X lodging, $X subsistence). In training projects,
travel and meals for trainees should be listed separately. Show the number of trainees and the unit costs involved. Identify the location of travel, if known; or if unknown, indicate
"location to be determined." Note: Travel expenses for consultants should be included in the "Contractual/Consultant" category.
2,647.00$
700.00
Training for Social Worker. Atlanta, Georgia Conference
650.00 1 650.00
Computation
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Local Travel -
Other
Subtotal -
Purpose of Travel Location Cost
Item Cost Rate Basis for Rate Quantity Number of
People
Number of
Trips Cost
Lodging -
Meals -
Mileage -
Transportation:
Local Travel -
Other
Subtotal -
Purpose of Travel Location Cost
Item Cost Rate Basis for Rate Quantity Number of
People
Number of
Trips Cost
Lodging -
Meals -
Mileage -
Transportation:
Local Travel -
Other
Subtotal -
TOTAL Travel 2,647.00$
-
-$
-
-
-
Computation
Computation
-
-$
-$
-
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Travel Narrative
Quantity Cost Cost
4,926.00$
-$
-$
-$
TOTAL Equipment 4,926.00$
Equipment Narrative
Full time use of Ford Escape (fleet vehicle) for work purposes (cost of vehicle fees assessed from fleet)
The community social worker position requires her to go out in the field as part of her job. To accomplish this, the department provides a designated city fleet vehicle for use. The cost listed is
$4,926, which is 50% of the total amount the fleet department charges the PD for a vehicle per year. Included in this are the maintenance and replacement charges calculated based on the life of
the vehicle as assessed by the city's fleet department.
D. Equipment - List non-expendable items that are purchased (Note: Organization's own capitalization policy for classification of equipment should be used). Expendable items
should be included in the "Supplies" category. Applicants should analyze the cost benefits of purchasing versus leasing equipment, especially high cost items and those subject to
rapid technological advances. Rented or leased equipment costs should be listed in the "Contractual" category. Explain how the equipment is necessary for the success of the
project, and describe the procurement method to be used.
Item
Computation
The Edmonds PD would like to send our social worker to the Co-Responder Alliance Conference in Atlanta, Georgia, in June 2026. The conference would be highly valuable to our co-responder
tactics. The conference covers a broad spectrum of issues that co-responders face, including mental health crises, safety protocols, leveraging resources, diversity, drug use, de-escalation
techniques, and community initiatives. The registration fee is $700. This cost has been placed in the "other" cell on the travel chart. The total cost for this training $2,647 has been calculated based
on current rates for the June 2025 conference. There will be a conference in 2026, but no cost details have been posted. The lodging and meals are based on current government per diem rates.
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Quantity/
Duration Cost Cost
-$
-$
-$
-$
-$
-$
TOTAL Supplies -$
Supplies Narrative
We will not request funds for supplies as we currently have all the supplies necessary to support a full-time community social worker.
Consultant Fees: For each consultant enter the name, if known, service to be provided, hourly or daily fee (8 hour day), and estimated time on the project. Consultant fees in excess
of $450 per day or $56.25 per hour require additional justification and prior approval from WASPC.
F. Consultants/Contracts - Indicate whether applicant's formal, written Procurement Policy or the Federal Acquisition Regulations are followed.
Supply Item
Computation
E. Supplies - List items by type (office supplies, postage, training materials, copy paper, and expendable equipment costs costing less than $5,000, such as books, hand held
recorders) and show the basis for computation. Generally, supplies include any materials that are expendable or consumed during the project.
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Fee Basis Quantity Cost
$94 12 1,128.00$
-$
-$
-$
Subtotal Consultants 1,128.00$
Consultant Fee Narrative
Purpose of Travel Location Cost
Item Cost Rate Basis for Rate Quantity Number of
People
Number of
Trips Cost
Lodging -
Meals -
Mileage 0.7 WA Gov't Rate 34 12 285.60
Transportation:
Local Travel -
Other -
In person meetings for clinical
oversight
Traveling from 2930
Wetmore Ave. Everett, WA
to 250 5th Ave. N.
Edmonds, WA
-
For the City liability insurance we have to have clinical oversight for our community social worker twice a month minimum. We will have a contract in place through the City of Everett's Community
Outreach program for this clinical oversight. The $1,128.00 requested is to cover bi-monthly meetings from Jan 1st, 2026 to June 30th, 2026.
Consultant Expenses: List all expenses to be paid from the grant to the individual consultants in addition to their fees (i.e., travel, meals, lodging, etc.). This includes travel expenses for anyone who
is not an employee of the applicant such as participants, volunteers, partners, etc.
Computation
Kelli Roark, City of Everett Clinical oversight for community social worker
Name of Consultant Service Provided
Computation
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Subtotal 285.60
Purpose of Travel Location Cost
Item Cost Rate Basis for Rate Quantity Number of
People
Number of
Trips Cost
Lodging -
Meals -
Mileage -
Transportation:
Local Travel -
Other -
Subtotal -
Purpose of Travel Location Cost
Item Cost Rate Basis for Rate Quantity Number of
People
Number of
Trips Cost
Lodging -
Meals -
Mileage -
Transportation:
Local Travel -
Other -
Subtotal -
Subtotal Consultant Expenses 285.60$
TOTAL Consultants 1,413.60$
Consultant Expenses Narrative
Computation
-$
-
-$
285.60$
-
Computation
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
TOTAL Contracts
Contracts Narrative
-$
-$
-$
-$
As part of the contract with the City of Everett, milage rate is required.
Contracts: Provide a description of the product or service to be procured by contract and an estimate of the cost. Applicants are encouraged to promote free and open competition
in awarding contracts. A separate justification must be provided for sole-source contracts in excess of $100,000
CostItem
-$
G. Other Costs - List items (e.g. rent, reproduction, telephone, janitorial, or security services) by major type and the basis of computation. For example, provide the square footage
of the cost per square foot for rent or provide a monthly rental cost and how many months to rent. The basis field is a text field to describe the quantity such as square footage,
months, etc.
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Quantity Basis Cost Length of
Time
Cost
-$
-$
-$
-$
-$
TOTAL Other Costs -$
Other Costs Narrative
Budget Summary - When you have completed the budget worksheet, the totals for each category will appear in the spaces below. Verify the category and total dollars requested.
Budget Category Amount Requested
A. Personnel 42,285.00$
B. Fringe Benefits 12,685.50$
Description
Computation
Funding Request Summary
C. Travel 2,647.00$
D. Equipment 4,926.00$
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
F. Consultants/Contracts 1,413.60$
G. Other -$
PROJECT COST TO APPLICANT (NOT INCLUDING
FIGURES ABOVE)63,957.10$
E. Supplies -$
63,957.10$
↑ + ↓
= ↓
LOCAL MATCH (IF APPLICABLE)-$
TOTAL GRANT REQUEST 63,957.10$
Local Match - Use the space below to identify and describe the dollar amounts or items that will be provided as local match or cost sharing for your program. Note that everything
listed here must be in conformance with 2 CFR § 200.306.
OVERALL PROGRAM VALUE
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Budget Worksheet
Salary Basis Percentage
of Time Length of Time
87,107.10 Hourly 100%10000%87,107.10$
-$
-$
-$
-$
TOTAL Personnel 87,107.10$
Erin Nathan Community Social Worker
Budget Worksheet Year 2
July 1, 2026 - June 30, 2027
Purpose: The Budget Detail Worksheet is provided for your use in the preparation of the budget and budget narrative. All required information (including narrative)
must be provided. Any category of expense not applicable to your budget may be left blank. A specific area is available at the end of this spreadsheet that allows for
the identification and description of funds or items to be provided as program matching funds (cost sharing).
A. Personnel - List each position by title and name of employee, if available. Show the annual salary rate and percentage of time to be devoted to the project.
Compensation paid for employees engaged in grant activities must be consistent with that paid for similar work within the applicant organization. Include a
description of the responsibilities and duties of each position in relationship to fulfilling the project goals and objectives. (Note: Use whole numbers as the
percentages of time, an example is 25.50% should be shown as 25.50)
Computation
CostNamePosition
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Personnel Narrative
Base Rate Cost
87,107.10$ 0.3 26,132.13$
-$
-$
-$
-$
-$
-$
-$
TOTAL Fringe Benefits 26,132.13$
Benefits (Medical, Pension, L&I, FICA, Medicare, PRML, Dental and Vision)
The salary projections for this year include a 3% increase to account for possible COLA being added by the city of Edmonds.
B. Fringe Benefits - Fringe benefits should be based on actual known costs. List the composition of the fringe benefit package. Fringe benefits are for the personnel
listed in budget category (A) and only for the percentage of time devoted to the project. Fringe benefits on overtime hours are limited to FICA, Workman's
Compensation and Unemployment Compensation. (Note: Use decimal numbers for the fringe benefit rates, an example is 7.65% should be shown as .0765)
Computation
Description
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Fringe Benefits Narrative
Purpose of Travel Location Cost
Item Cost Rate Basis for Rate Quantity Number of
People
Number of
Trips Cost
Lodging -
Meals -
Mileage -
Transportation:
Airfare
Local Travel -
Other
Baggage Fee
Subtotal -
Purpose of Travel Location CostComputation
The Edmonds PD is requesting funding for the social worker's medical benefits. Medical benefits for the city of Edmonds average 30% of the annual salary. The requested $26132.13
in fringe benefits is based on the total salary for the social worker from July 1st, 2026 to June 30, 2027.
C. Travel - Itemize travel expense of staff and personnel by purpose (e.g., staff to training, advisory group meeting, field interviews, etc.). Describe the purpose of
each travel expenditure in reference to the project objectives. Show the basis of computation (e.g., six people to 3-day training at $X airfare, $X lodging, $X
subsistence). In training projects, travel and meals for trainees should be listed separately. Show the number of trainees and the unit costs involved. Identify the
location of travel, if known; or if unknown, indicate "location to be determined." Note: Travel expenses for consultants should be included in the
"Contractual/Consultant" category.
Computation
-$
-
-
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Item Cost Rate Basis for Rate Quantity Number of
People
Number of
Trips Cost
Lodging -
Meals -
Mileage -
Transportation:
Local Travel -
Other
Subtotal -
Purpose of Travel Location Cost
Item Cost Rate Basis for Rate Quantity Number of
People
Number of
Trips Cost
Lodging -
Meals -
Mileage -
Transportation:
Local Travel -
Other
Subtotal -
Purpose of Travel Location Cost
Item Cost Rate Basis for Rate Quantity Number of
People
Number of
Trips Cost
Lodging -
Meals -
Mileage -
Computation
-$
-
-$
-
-
Computation
-
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Transportation:
Local Travel -
Other
Subtotal -
TOTAL Travel -$
Travel Narrative
Quantity Cost Cost
100 10,000.00 10,000.00$
-$
-$
Computation
Item
Full time use of Ford Escape (fleet vehicle) for work purposes (cost of vehicle fees assessed from fleet)
D. Equipment - List non-expendable items that are purchased (Note: Organization's own capitalization policy for classification of equipment should be used).
Expendable items should be included in the "Supplies" category. Applicants should analyze the cost benefits of purchasing versus leasing equipment, especially high
cost items and those subject to rapid technological advances. Rented or leased equipment costs should be listed in the "Contractual" category. Explain how the
equipment is necessary for the success of the project, and describe the procurement method to be used.
-$
-
-
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
-$
TOTAL Equipment 10,000.00$
Equipment Narrative
Quantity/
Duration Cost Cost
-$
-$
-$
-$
-$
-$
TOTAL Supplies -$
E. Supplies - List items by type (office supplies, postage, training materials, copy paper, and expendable equipment costs costing less than $5,000, such as books,
hand held recorders) and show the basis for computation. Generally, supplies include any materials that are expendable or consumed during the project.
Computation
Supply Item
The community social worker position requires her to go out in the field as part of her job. To accomplish this, the department provides a designated city fleet vehicle for use. The
cost listed, $10,000, is the amount the fleet department charges the PD for this vehicle per year. This cost includes the maintenance and replacement charges calculated based on
the life of the vehicle as assessed by the city's fleet department.
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Supplies Narrative
Fee Basis Quantity Cost
$97 24 2,328.00$
-$
-$
-$
Subtotal Consultants 2,328.00$
Consultant Fee Narrative
Kelli Roark, City of Everett Clinical oversight for community social worker
F. Consultants/Contracts - Indicate whether applicant's formal, written Procurement Policy or the Federal Acquisition Regulations are followed.
Consultant Fees: For each consultant enter the name, if known, service to be provided, hourly or daily fee (8 hour day), and estimated time on the project.
Consultant fees in excess of $450 per day or $56.25 per hour require additional justification and prior approval from WASPC.
Computation
Name of Consultant Service Provided
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Purpose of Travel Location Cost
Item Cost Rate Basis for Rate Quantity Number of
People
Number of
Trips Cost
Lodging -
Meals -
Mileage 0.7 WA Gov't Rate 34 24 571.20
Transportation:
Local Travel -
Other -
Subtotal 571.20
Purpose of Travel Location Cost
Item Cost Rate Basis for Rate Quantity Number of
People
Number of
Trips Cost
Lodging -
Meals -
Mileage -
Transportation:
Computation
For the City liability insurance we have to have clinical oversight for our community social worker twice a month minimum. We will have a contract in place through the City of
Everett's Community Outreach program for this clinical oversight. Included a 3% increase for 2026.
Consultant Expenses: List all expenses to be paid from the grant to the individual consultants in addition to their fees (i.e., travel, meals, lodging, etc.). This includes travel expenses
for anyone who is not an employee of the applicant such as participants, volunteers, partners, etc.
Computation
In person meetings
for clinical oversight
Traveling from 2930
Wetmore Ave.
Everett, WA to 250
5th Ave. N. Edmonds,
WA
571.20$
-
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Local Travel -
Other -
Subtotal -
Purpose of Travel Location Cost
Item Cost Rate Basis for Rate Quantity Number of
People
Number of
Trips Cost
Lodging -
Meals -
Mileage -
Transportation:
Local Travel -
Other -
Subtotal -
Subtotal Consultant Expenses 571.20$
TOTAL Consultants 2,899.20$
Consultant Expenses Narrative
-$
-
As part of the contract with the City of Everett, milage rate is required.
-
Computation
-$
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
TOTAL Contracts
Contracts Narrative
Quantity Basis Cost Length of Time Cost
-$
-$
G. Other Costs - List items (e.g. rent, reproduction, telephone, janitorial, or security services) by major type and the basis of computation. For example, provide the
square footage of the cost per square foot for rent or provide a monthly rental cost and how many months to rent. The basis field is a text field to describe the
quantity such as square footage, months, etc.
Computation
Description
-$
-$
-$
-$
Contracts: Provide a description of the product or service to be procured by contract and an estimate of the cost. Applicants are encouraged to promote free and
open competition in awarding contracts. A separate justification must be provided for sole-source contracts in excess of $100,000
Item Cost
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
-$
-$
-$
-$
TOTAL Other Costs -$
Other Costs Narrative
F. Consultants/Contracts 2,899.20$
C. Travel -$
D. Equipment 10,000.00$
E. Supplies -$
Funding Request Summary
Budget Category Amount Requested
A. Personnel 87,107.10$
B. Fringe Benefits 26,132.13$
Budget Summary - When you have completed the budget worksheet, the totals for each category will appear in the spaces below. Verify the category and total
dollars requested.
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
= ↓
OVERALL PROGRAM VALUE 126,138.43$
Local Match - Use the space below to identify and describe the dollar amounts or items that will be provided as local match or cost sharing for your program. Note
that everything listed here must be in conformance with 2 CFR § 200.306.
PROJECT COST TO APPLICANT (NOT
INCLUDING FIGURES ABOVE)126,138.43$
↑ + ↓
LOCAL MATCH (IF APPLICABLE)-$
G. Other -$
TOTAL GRANT REQUEST 126,138.43$
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Budget Worksheet
Please ensure that you provide all relevant informaton for each year.
***THIS IS A MULTI YEAR BUDGET WORKSHEET***
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Budget Worksheet
Salary Basis Percentage
of Time Length of Time
43,621.32 hourly 85%10000%37,078.12$
-$
-$
-$
-$
TOTAL Personnel 37,078.12$
Budget Worksheet Year 1
January 1, 2026 - June 30,
2026
Purpose: The Budget Detail Worksheet is provided for your use in the preparation of the budget and budget narrative. All required information (including narrative)
must be provided. Any category of expense not applicable to your budget may be left blank. A specific area is available at the end of this spreadsheet that allows for
the identification and description of funds or items to be provided as program matching funds (cost sharing).
A. Personnel - List each position by title and name of employee, if available. Show the annual salary rate and percentage of time to be devoted to the project.
Compensation paid for employees engaged in grant activities must be consistent with that paid for similar work within the applicant organization. Include a
description of the responsibilities and duties of each position in relationship to fulfilling the project goals and objectives. (Note: Use whole numbers as the
percentages of time, an example is 25.50% should be shown as 25.50)
PositionName
Computation
Erin Nathan Community Social Worker
Cost
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Personnel Narrative
Base Rate Cost
37,078.12$ 0.3 11,123.44$
37,078.12$ -$
37,078.12$ -$
37,078.12$ -$
37,078.12$ -$
37,078.12$ -$
37,078.12$ -$
37,078.12$ -$
TOTAL Fringe Benefits 11,123.44$
The Edmonds Police Department has funding for our social worker through December 31, 2025. For year one, we would need 37,078.12.00 for Erin Nathan's salary from Jan 1st,
2026, through June 30th, 2026.
B. Fringe Benefits - Fringe benefits should be based on actual known costs. List the composition of the fringe benefit package. Fringe benefits are for the personnel
listed in budget category (A) and only for the percentage of time devoted to the project. Fringe benefits on overtime hours are limited to FICA, Workman's
Compensation and Unemployment Compensation. (Note: Use decimal numbers for the fringe benefit rates, an example is 7.65% should be shown as .0765)
Benefits (Medical, Pension, L&I, FICA, Medicare, PFML, Dental and Vision)
Description
Computation
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Fringe Benefits Narrative
Purpose of Travel Location Cost
Item Cost Rate Basis for Rate Quantity Number of
People
Number of
Trips Cost
Lodging -
Meals -
Mileage -
Transportation:
Airfare
Local Travel -
Other
Baggage Fee
Subtotal -
Purpose of Travel Location Cost
The Edmonds PD is requesting funding for the social worker's benefits provided by the City of Edmonds. Benefits average 30% of the members annual salary. The requested
$11,123.44 in fringe benefits is based on the total salary for the social worker from Jan 1st, 2026 to June 30th, 2026.
Computation
C.Travel - Itemize travel expense of staff and personnel by purpose (e.g., staff to training, advisory group meeting, field interviews, etc.). Describe the purpose of
each travel expenditure in reference to the project objectives. Show the basis of computation (e.g., six people to 3-day training at $X airfare, $X lodging, $X
subsistence). In training projects, travel and meals for trainees should be listed separately. Show the number of trainees and the unit costs involved. Identify the
location of travel, if known; or if unknown, indicate "location to be determined." Note: Travel expenses for consultants should be included in the
"Contractual/Consultant" category.
-$
-
-
Computation
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Item Cost Rate Basis for Rate Quantity Number of
People
Number of
Trips Cost
Lodging -
Meals -
Mileage -
Transportation:
Local Travel -
Other
Subtotal -
Purpose of Travel Location Cost
Item Cost Rate Basis for Rate Quantity Number of
People
Number of
Trips Cost
Lodging -
Meals -
Mileage -
Transportation:
Local Travel -
Other
Subtotal -
Purpose of Travel Location Cost
Item Cost Rate Basis for Rate Quantity Number of
People
Number of
Trips Cost
Lodging -
Meals -
Mileage -
-
-$
-
-
Computation
Computation
-
-$
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Transportation:
Local Travel -
Other
Subtotal -
TOTAL Travel -$
Travel Narrative
Quantity Cost Cost
-$
-$
-$
D. Equipment - List non-expendable items that are purchased (Note: Organization's own capitalization policy for classification of equipment should be used).
Expendable items should be included in the "Supplies" category. Applicants should analyze the cost benefits of purchasing versus leasing equipment, especially high
cost items and those subject to rapid technological advances. Rented or leased equipment costs should be listed in the "Contractual" category. Explain how the
equipment is necessary for the success of the project, and describe the procurement method to be used.
Item
Computation
-
-$
-
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
-$
TOTAL Equipment -$
Equipment Narrative
Quantity/
Duration Cost Cost
-$
-$
-$
-$
-$
-$
TOTAL Supplies -$
Supply Item
Computation
E.Supplies - List items by type (office supplies, postage, training materials, copy paper, and expendable equipment costs costing less than $5,000, such as books,
hand held recorders) and show the basis for computation. Generally, supplies include any materials that are expendable or consumed during the project.
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Supplies Narrative
Fee Basis Quantity Cost
$94 6 564.00$
-$
-$
-$
Subtotal Consultants 564.00$
Consultant Fee Narrative
Kelli Roark, City of Everett Clinical oversight for the community social worker
Consultant Fees: For each consultant enter the name, if known, service to be provided, hourly or daily fee (8 hour day), and estimated time on the project.
Consultant fees in excess of $450 per day or $56.25 per hour require additional justification and prior approval from WASPC.
Name of Consultant Service Provided
Computation
F. Consultants/Contracts - Indicate whether applicant's formal, written Procurement Policy or the Federal Acquisition Regulations are followed.
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Purpose of Travel Location Cost
Item Cost Rate Basis for Rate Quantity Number of
People
Number of
Trips Cost
Lodging -
Meals -
Mileage 0.7 WA Gov't Rate 34 6 142.80
Transportation:
Local Travel -
Other -
Subtotal 142.80
Purpose of Travel Location Cost
Item Cost Rate Basis for Rate Quantity Number of
People
Number of
Trips Cost
Lodging -
Meals -
Mileage -
Transportation:
In person meeting
for clinical oversight
Traveling from 2930
Wetmore Ave.
Everett, WA to 250
5th Ave. N. Edmonds,
WA
142.80$
-
Computation
For our City liability insurance (WCIA), we are required to have clinical oversight for our community social worker, minimum of once a month. We have an interlocal agreement in
place through the City of Everett's Community Outreach program for this clinical oversight. The $564.00 requested is to cover monthly oversight from Jan 1st, 2026, to June 30th,
2026.
Consultant Expenses: List all expenses to be paid from the grant to the individual consultants in addition to their fees (i.e., travel, meals, lodging, etc.). This includes travel expenses
for anyone who is not an employee of the applicant such as participants, volunteers, partners, etc.
Computation
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Local Travel -
Other -
Subtotal -
Purpose of Travel Location Cost
Item Cost Rate Basis for Rate Quantity Number of
People
Number of
Trips Cost
Lodging -
Meals -
Mileage -
Transportation:
Local Travel -
Other -
Subtotal -
Subtotal Consultant Expenses 142.80$
TOTAL Consultants 706.80$
Consultant Expenses Narrative
As part of the agreement with the City of Everett, mileage rates are required.
Computation
-$
-
-$
-
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
TOTAL Contracts
Contracts Narrative
Quantity Basis Cost Length of Time Cost
-$
-$
-$
-$
-$
Contracts: Provide a description of the product or service to be procured by contract and an estimate of the cost. Applicants are encouraged to promote free and
open competition in awarding contracts. A separate justification must be provided for sole-source contracts in excess of $100,000
CostItem
-$
G.Other Costs - List items (e.g. rent, reproduction, telephone, janitorial, or security services) by major type and the basis of computation. For example, provide the
square footage of the cost per square foot for rent or provide a monthly rental cost and how many months to rent. The basis field is a text field to describe the
quantity such as square footage, months, etc.
Description
Computation
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
-$
-$
-$
-$
TOTAL Other Costs -$
Other Costs Narrative
Budget Summary - When you have completed the budget worksheet, the totals for each category will appear in the spaces below. Verify the category and total
dollars requested.
Budget Category Amount Requested
A.Personnel 37,078.12$
B.Fringe Benefits 11,123.44$
Funding Request Summary
F. Consultants/Contracts 706.80$
C.Travel -$
D. Equipment -$
E. Supplies -$
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
G. Other -$
PROJECT COST TO APPLICANT (NOT
INCLUDING FIGURES ABOVE)48,908.36$
48,908.36$
↑ + ↓
= ↓
LOCAL MATCH (IF APPLICABLE)-$
TOTAL GRANT REQUEST 48,908.36$
Local Match - Use the space below to identify and describe the dollar amounts or items that will be provided as local match or cost sharing for your program. Note
that everything listed here must be in conformance with 2 CFR § 200.306.
OVERALL PROGRAM VALUE
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Budget Worksheet
Salary Basis Percentage
of Time Length of Time
87,242.64 Hourly 85%10000%74,156.24$
-$
-$
-$
-$
TOTAL Personnel 74,156.24$
Erin Nathan Community Social Worker
Budget Worksheet Year 2
July 1, 2026 - June 30, 2027
Purpose: The Budget Detail Worksheet is provided for your use in the preparation of the budget and budget narrative. All required information (including narrative)
must be provided. Any category of expense not applicable to your budget may be left blank. A specific area is available at the end of this spreadsheet that allows for
the identification and description of funds or items to be provided as program matching funds (cost sharing).
A. Personnel - List each position by title and name of employee, if available. Show the annual salary rate and percentage of time to be devoted to the project.
Compensation paid for employees engaged in grant activities must be consistent with that paid for similar work within the applicant organization. Include a
description of the responsibilities and duties of each position in relationship to fulfilling the project goals and objectives. (Note: Use whole numbers as the
percentages of time, an example is 25.50% should be shown as 25.50)
Computation
CostNamePosition
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Personnel Narrative
Base Rate Cost
74,156.24$ 0.3 22,246.87$
74,156.24$ -$
74,156.24$ -$
74,156.24$ -$
74,156.24$ -$
74,156.24$ -$
74,156.24$ -$
74,156.24$ -$
TOTAL Fringe Benefits 22,246.87$
Benefits (Medical, Pension, L&I, FICA, Medicare, PFML, Dental and Vision)
For year two, the social worker's salary from July 1st, 2026, to June 30th, 2027, will be $74,156.24. This number includes a 3% increase to account for COLA.
B. Fringe Benefits - Fringe benefits should be based on actual known costs. List the composition of the fringe benefit package. Fringe benefits are for the personnel
listed in budget category (A) and only for the percentage of time devoted to the project. Fringe benefits on overtime hours are limited to FICA, Workman's
Compensation and Unemployment Compensation. (Note: Use decimal numbers for the fringe benefit rates, an example is 7.65% should be shown as .0765)
Computation
Description
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Fringe Benefits Narrative
Purpose of Travel Location Cost
Item Cost Rate Basis for Rate Quantity Number of
People
Number of
Trips Cost
Lodging -
Meals -
Mileage -
Transportation:
Airfare
Local Travel -
Other
Baggage Fee
Subtotal -
Purpose of Travel Location CostComputation
Edmonds PD is requesting funding for the social worker's benefit package. Benefits for City Employees average 30% of their annual salary. The requested $22,246.87 in fringe
benefits is based on the total salary for the social worker from July 1st, 2026 to June 30, 2027.
C.Travel - Itemize travel expense of staff and personnel by purpose (e.g., staff to training, advisory group meeting, field interviews, etc.). Describe the purpose of
each travel expenditure in reference to the project objectives. Show the basis of computation (e.g., six people to 3-day training at $X airfare, $X lodging, $X
subsistence). In training projects, travel and meals for trainees should be listed separately. Show the number of trainees and the unit costs involved. Identify the
location of travel, if known; or if unknown, indicate "location to be determined." Note: Travel expenses for consultants should be included in the
"Contractual/Consultant" category.
Computation
-$
-
-
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Item Cost Rate Basis for Rate Quantity Number of
People
Number of
Trips Cost
Lodging -
Meals -
Mileage -
Transportation:
Local Travel -
Other
Subtotal -
Purpose of Travel Location Cost
Item Cost Rate Basis for Rate Quantity Number of
People
Number of
Trips Cost
Lodging -
Meals -
Mileage -
Transportation:
Local Travel -
Other
Subtotal -
Purpose of Travel Location Cost
Item Cost Rate Basis for Rate Quantity Number of
People
Number of
Trips Cost
Lodging -
Meals -
Mileage -
Computation
-$
-
-$
-
-
Computation
-
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Transportation:
Local Travel -
Other
Subtotal -
TOTAL Travel -$
Travel Narrative
Quantity Cost Cost
-$
-$
-$
Computation
Item
D. Equipment - List non-expendable items that are purchased (Note: Organization's own capitalization policy for classification of equipment should be used).
Expendable items should be included in the "Supplies" category. Applicants should analyze the cost benefits of purchasing versus leasing equipment, especially high
cost items and those subject to rapid technological advances. Rented or leased equipment costs should be listed in the "Contractual" category. Explain how the
equipment is necessary for the success of the project, and describe the procurement method to be used.
-$
-
-
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
-$
TOTAL Equipment -$
Equipment Narrative
Quantity/
Duration Cost Cost
-$
-$
-$
-$
-$
-$
TOTAL Supplies -$
E. Supplies - List items by type (office supplies, postage, training materials, copy paper, and expendable equipment costs costing less than $5,000, such as books,
hand held recorders) and show the basis for computation. Generally, supplies include any materials that are expendable or consumed during the project.
Computation
Supply Item
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Supplies Narrative
Fee Basis Quantity Cost
$97 12 1,164.00$
-$
-$
-$
Subtotal Consultants 1,164.00$
Consultant Fee Narrative
Kelli Roark, City of Everett Clinical oversight for the community social worker
F.Consultants/Contracts - Indicate whether applicant's formal, written Procurement Policy or the Federal Acquisition Regulations are followed.
Consultant Fees: For each consultant enter the name, if known, service to be provided, hourly or daily fee (8 hour day), and estimated time on the project.
Consultant fees in excess of $450 per day or $56.25 per hour require additional justification and prior approval from WASPC.
Computation
Name of Consultant Service Provided
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Purpose of Travel Location Cost
Item Cost Rate Basis for Rate Quantity Number of
People
Number of
Trips Cost
Lodging -
Meals -
Mileage 0.7 WA Gov't Rate 34 12 285.60
Transportation:
Local Travel -
Other -
Subtotal 285.60
Purpose of Travel Location Cost
Item Cost Rate Basis for Rate Quantity Number of
People
Number of
Trips Cost
Lodging -
Meals -
Mileage -
Transportation:
Computation
For our liability insurance (WCIA), we are required to have clinical oversight for our community social worker once a month, minimum. We have an interlocal agreement in place
through the City of Everett's Community Outreach program for this oversight. The $1,164.00 requested covers monthly meetings from July 1st, 2026, to June 30th, 2027, and
reflects a potential increase over the previous years' rates.
Consultant Expenses: List all expenses to be paid from the grant to the individual consultants in addition to their fees (i.e., travel, meals, lodging, etc.). This includes travel expenses
for anyone who is not an employee of the applicant such as participants, volunteers, partners, etc.
Computation
In person meetings
for clinical oversight
Traveling from 2930
Wetmore Ave.
Everett, WA to 250
5th Ave. N. Edmonds,
WA
285.60$
-
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
Local Travel -
Other -
Subtotal -
Purpose of Travel Location Cost
Item Cost Rate Basis for Rate Quantity Number of
People
Number of
Trips Cost
Lodging -
Meals -
Mileage -
Transportation:
Local Travel -
Other -
Subtotal -
Subtotal Consultant Expenses 285.60$
TOTAL Consultants 1,449.60$
Consultant Expenses Narrative
-$
-
As part of the agreement with the City of Everett, mileage reimbursement is required.
-
Computation
-$
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
TOTAL Contracts
Contracts Narrative
Quantity Basis Cost Length of Time Cost
-$
-$
G.Other Costs - List items (e.g. rent, reproduction, telephone, janitorial, or security services) by major type and the basis of computation. For example, provide the
square footage of the cost per square foot for rent or provide a monthly rental cost and how many months to rent. The basis field is a text field to describe the
quantity such as square footage, months, etc.
Computation
Description
-$
-$
-$
-$
Contracts: Provide a description of the product or service to be procured by contract and an estimate of the cost. Applicants are encouraged to promote free and
open competition in awarding contracts. A separate justification must be provided for sole-source contracts in excess of $100,000
Item Cost
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
-$
-$
-$
-$
TOTAL Other Costs -$
Other Costs Narrative
F. Consultants/Contracts 1,449.60$
C. Travel -$
D. Equipment -$
E. Supplies -$
Funding Request Summary
Budget Category Amount Requested
A. Personnel 74,156.24$
B. Fringe Benefits 22,246.87$
Budget Summary - When you have completed the budget worksheet, the totals for each category will appear in the spaces below. Verify the category and total
dollars requested.
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA
= ↓
OVERALL PROGRAM VALUE 97,852.72$
Local Match - Use the space below to identify and describe the dollar amounts or items that will be provided as local match or cost sharing for your program. Note
that everything listed here must be in conformance with 2 CFR § 200.306.
PROJECT COST TO APPLICANT (NOT
INCLUDING FIGURES ABOVE)97,852.72$
↑ + ↓
LOCAL MATCH (IF APPLICABLE)-$
G. Other -$
TOTAL GRANT REQUEST 97,852.72$
Docusign Envelope ID: 64AD71BB-D04E-4BF3-956D-7FC1E8FBCABA