Table Of Content

age CantracliGrant Agreement Checklist soupleved the rogram supervisors wed sachet othe comasvgeem rei arc Reward Ww he igen tet ot noes er le se PO or appeovs, der an fee PeslrCED' mre Cer soa some e Se Gruden ae ones 2 oad Cinincnt seer Reeuda Balt pais ‘eones Peale regina, = Pura ra: OS = AA rigins: Rata ee Sue Gouin, {Eph ose Lo fa new i Renata Commerce agsenem vite vile Charities Hoe: Pe Stony of Soe tony bell sk of Cotas Ape Frit Sa TypentConmtiirat Aewment owes Ratt $M Mere onan mune Ova ete Sew lea fo exceed? 509 Posen Rick the Cranbtion Orin Supervisor Recewat by Taps Pr amber con Deets Sigh SP ornare Dts Cornastveacngromem signe ty cx gda ly —wowitnin pf RECEIVED melt AGG 16 201 Memorandum of Agreement This Agreements entered batwcon Catholic Charities ND (Agency Provider), The Vilage Family Service Center and the North Dakota Department of Hurran Services (NDOHS), NDDHS ie responsible for supervision of the Allernatives to Abortion Program. The Village Farnily Service Center will administer tho Allornativas to Aboition Program including maiketing, updating and maintaining a lst of service providers, making paymonts to servios provide’s and 1-800 service. ‘The program will provide positive outcome-based information, counseling, and support services wih the following requirements and expectations: 1, Provide services te pregnant woman or wemen who believa they may be pregnant, who raside in North Dakota, 2. Promote chlidbir through information, counseling and education to assist pregnant women to choose childbirth 3. Assist waren in making isfoirned desisions about adoption or parenting wth respect to the child Alternatives to Abortion serviggs do not inelude mecleal services, ‘The Ageney Provider desires tu provide Alternatives to Aborticn services consisiet with the reqsitemente of the Altemativos to Abortions Program end to meet the reculrements of N.D.C,C. § $9 06 26 and this Agreement, ‘The Agency Provider agreos to: 1. Screen each potential cent fo establish that she is pregnant or teasonably believes she may be preg, 2, Inform each clont tnt it ls her sght to secure Aternatives to Abortions services from a provider of thosa services fisted in the Alteratives fo Abortions brochure; 3, Assist NDDHS and The Vilage Family Service Center in gathering data to evalcata the Alteratives to Aborions Program ftom the certs fest visi hveugh birt ofthe child 44, Keop con'dentia’ the communications hetween 2 child and provider or its ‘employoas and agents, except as permitted by law er by the informed agrocmnent ofthe alent 5. Submit to NDDHS and The Vilage Fesnily Survive Center a copy of provider's labilly insurance policy for approval before requesting payment anc 6, Maintain approved fablty coverage in effet al al mes services are being provided undar this Agreement Agency Provider agrees not to: 4, Counsel far, refer for, encourage, or perfor atortions, or knowingly refer a ‘Alternatives to Abortions client lo anather perscn or agency for the purpase of recelving counssling ter, referral for, encouragement fer, or tha parformance of a1 abortion; oF 2, Discriminate against Alternatives to Abortions alient on the basis of religion, a rollgious belief, a efusal to hok! @ religious bevif, of a refusal to actively parlicipate in a religious practice. Provider for Alternatives (o Abortions services wil receive reimbursement for servioes provided besed on a rate of $10.00 for each quaster hour of service furnished by & member of the clevgy, a nursa ticonsed under N.D.C.C. ch. 43-12.1, « pliysioian ‘jeenead undar N.D.C.C, ch, 43-17, a asychologistficensed under N.D.C.C. ch. 43.32, a social worker licenced under N.0.C.C. ch, 43-41, an addiction counsolor licensed undar N.D.G.C. ch, 43-48, 2 counselor licensed under N.D.C.C. ch. 48-47, of a maniage atid amily therapist lcensed under N.D.C.C. ch. 43-53, and at a rate of $5.00 for each quarter hour af service furnished by any other individual Tris Agreements effective July 1, 2017 and remains in effect until June 30. 2019, unless terminated by the Agency Provider, The Vilage Kamily Service Center or NDBHS, Tris Agreement may be (erminated at any time by mutual consent of parties, of upon 30-days' writen notice by elther party, with or without cause. Failure by the Agency Provider fo perform tho toms ofthis Agreement may result in the immediate termination of the Agreement Agency any Gathgle Cherities ND ‘The Vitage Family Service Center hive . vate: etal Doxa ving, ‘he Vilage Faniy Serves Center : Carol Cartledye, Dhector Economic Acelstanoe Policy Division, NUDHS