Application Instructions for Early Intervention Services Local Lead Agency Contract
For the Federal Fiscal Year 18 (July 1, 2018 – June 30, 2019)
For Local Lead Agencies (LLAs) currently under contract for EIS in a geographic service area: Please review all of the documents listed below and complete ONLY the application Documents 01 and 04 as instructed below.
- Document 01: DCYF Intake Form. The Program Contact on this form will be designated on page one of the contract as the Contract Manager. The Contract and Fiscal Contacts will each receive a copy of the final contract document for signature. Also, please use this DEL Intake form to update your contact information as changes occur throughout the contract year.
- Document 02: FFY 2018 Allotments LLA – State & Federal Funds. Refer to this form for your funding allotment.
- Document 03: Exhibit A, Contract Statement of Work – material changes have been highlighted.
- Document 04: Exhibit B, Budget Forms & Position Descriptions. Attached budget and subcontractor forms, as applicable, will be used to generate the contract’s Exhibit B. If applicable, scroll across the tabs at the bottom of the Excel workbook to LLA Subcontractor tab, for the Subcontractor Budget form(s). Note: When subcontractor budget(s) are submitted with the application, approval of the application constitutes approval to subcontract. If budget changes occur, during the contract period, the changes must be approved by ESIT before implementation. If budgeting for Salaries and/or Benefits payment points, attach position descriptions. No specific format is required.
- *Exhibit C, General Terms and Conditions is not attached here but will be included in your contract*
- Document 05: Exhibit D, Deliverables Schedule
- Document 06: Exhibit E, Budget Definitions and Instructions – use this to develop your budget.
- Document 07: Exhibit F, Family Resources Coordinators Training and Registration Procedure
- Document 08: Exhibit G, Local Interagency Coordinating Council Requirements
- Document 09: Exhibit H, Subcontract Requirements
- Document 10: Exhibit J, Local IAA and Local EIS Plan Requirements
- *Attachment I, Federal Certifications and Assurances is not attached here but will be included in your contract*
- *Attachment 2, Certification of Data Disposition is not attached here but will be included in your contract*
- *Attachment 3, Confidential Non-Disclosure Agreement is not attached here but will be included in your contract*
- Document 11: Attachment 4, EIS Agency and Independent Provider Contact Information Form
- Document 12: Attachment 5a, Local Team Self-Assessment Process form
- Document 13: Attachments 5b, Local Child Outcomes Measurement System Self-Assessment Form
- Document 14: Attachment 6, State and Local Public Direct Service Revenue form
- Document 15: Attachment 7, Contractor Financial Disclosure Certification form
- Document 16: Attachment 8, Optional DCYF Non-Employee Travel Reimbursement form
Documents 03 through 16 will be incorporated into the contract, as applicable. To complete the application process, please e-mail all the completed bolded documents, listed above (Documents 01 and 04 in their original format (not pdfs)) with original signatures, to ESIT.Reports@del.wa.gov, by 12:00 a.m. on April 20, 2018. Your agency’s designated Contract and Fiscal Contacts will receive the contract for signature, along with further instructions.
If you haven’t already done so, please develop a plan to have your contract signed and returned to the DEL no later than June 29, 2018.