HomeMy WebLinkAboutAgreement A-21-200 with Fresno County Superintendent of Schools.pdf1
FRESNO COUNTY INTER-AGENCY CONTINUUM OF CARE COLLABORATION
OF YOUTH AND FAMILY SERVICES MOU
SYSTEM PARTNERS: The County of Fresno (County), on behalf of its:
Department of Behavioral Health (DBH)
Department of Social Services (DSS)
Department of Public Health (DPH)
Probation Department (Probation)
Fresno County Superintendent of Schools FCSS)
Central Valley Regional Center (CVRC)
PURPOSE: Collaboration between local agencies to ensure
children and youth in the foster care system receive
services in a coordinated, timely, and trauma-informed
manner.
The above listed System Partners agree as follows:
VISION
Fresno County youth and their families will receive timely, effective, and collaborative services that
will allow them to be self-sufficient and keep themselves safe, healthy, at home, in school and/or
employed, out of trouble, and economically stable.
MISSION
The System Partners will work collaboratively to ensure their programs for youth and families
provide services in an integrated, comprehensive, culturally responsive, evidence-based/best-
practice manner, regardless of the agency door by which youth and families enter. This mission
includes an awareness of, and a commitment to, incorporate foster youth experience and voice
into county level collaborations and partnerships that manage or oversee the delivery of services
affecting youth in foster care.
PURPOSE
The goal of this Memorandum of Understanding (MOU) is to address systemic barriers to the
traditional provision of interagency services. System Partners’ intent is to create a single service
plan and maintain an administrative team with collaborative authority over the interrelated child
welfare, juvenile justice, education, and mental health youth services. This MOU seeks to ensure
that the System Partners' programs and polices reflect a coordinated, integrated and effective
delivery of services for youth and families.
System Partners have been designated by their respective governing bodies to provide oversight
and accountability for State and Federally funded programs and services, and to otherwise act as a
coordinating council and planning body related to the programs and services contained herein.
The System Partners agree that consistent inter-agency leadership is essential to successful
Agreement No. 21-200
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collaboration on behalf of youth and families.
The agencies do not delegate their legal authority with respect to any core function or power of
their agency, office, department or position. The System Partners are not establishing policies that
are intended to be averse to any relevant agency-wide policies, rules or agreements. However,
System Partners’ intent is to fully support the structure and processes contained in this MOU, and
to provide the framework that will guide their operations and the activities, decisions, and direction
of each of their employees regarding youth and family programming. Accordingly, this MOU
should be interpreted in light of this intent and purpose.
PRINCIPLES
The guiding principles of this collaboration are:
•To promote and provide services, which are outcome-focused, family-centered, strength-
based, culturally proficient, comprehensive, and integrated to the extent possible by a
single service plan, and which encourages families to use their own resources to resolve
problems.
•To identify, develop, and maintain service systems consistent with public/private,
community-based, school-linked and family partnership, which can intervene early or
prevent problems with at-risk youth and families.
•To provide services to youth and families in the least restrictive, least stigmatizing manner,
and in community-based settings, appropriate to meet their identified needs.
•To identify, develop, and monitor coordinated policies, procedures, resources and
implementation practices for the benefit of at-risk youth and families in Fresno County; and
to hold member agencies and their staffs accountable in these efforts.
•To adopt confidentiality standards consistent with and authorized by California Welfare and
Institutions Code (WIC) Section 18986.46, 34 Code of Federal Regulations (CFR),WIC
Section 10850, the Fresno County Superior Court, and consistent with its integrated family-
centered approach.
•To promote and maintain quality services that are cost effective, evidence-based and
appropriate with a unified service record, shared service authorization/re-authorization and
outcomes evaluation as allowed by law.
•To provide on-going support and direction to each agency and its staff in providing services
and resources for at-risk youth and families consistent with the Purpose and Principles, as
defined herein.
•To ensure the voices, experiences and wisdom of foster youth and their families and
caregivers are incorporated into the collaborations and partnerships captured by this MOU.
•To ensure the appropriate utilization of treatment and rehabilitation services for youth and
families in conjunction with appropriate court sanctions, while ensuring the safety of the
community and public-at-large.
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•To promote coordinated data collection, prioritized data exchange between the courts and
partners to minimize delays in service delivery, filing of documents, including electronic
filing between the courts, social services agencies, and other key partners and data
tracking that permits them to measure their performance.
PART ONE – INTERAGENCY LEADERSHIP TEAM
The Interagency Leadership Team (ILT) serves as the governing and coordinating body of this
collaborative. The overarching goal of the ILT is to work together as a governing body to ensure
that coordinated, timely, and trauma-informed services are provided to children and youth in foster
care who have experienced severe trauma. The ILT both establishes the MOU and oversees the
execution of the MOU, to meet the overarching goals of a coordinated system of care for foster
children, youth, and families through sharing information, guiding staff, identifying and resolving
conflicts, and leveraging resources to ensure foster children, youth, and their families receive the
services they need to achieve safety, permanency, and well-being.
I.ILT Members and Attendees
A.Members – The ILT will consist of the following individuals, or their respective
designees:
•Director of DSS
•Director of DBH
•Director of DPH
•Chief Probation Officer
•FCSS
•CVRC Executive Director
B.Other Attendees
In addition to the ILT members, designated other experienced senior managers or staff
from the System Partners, or other involved agencies may also attend ILT meetings, as
regular and contributing participants.
II.ILT Governance Procedures
A.Forum – ILT meetings shall take place in a location and manner agreed upon by all
members of the ILT.
B.Frequency - At the beginning stages of the collaborative, the ILT shall meet on a
monthly basis to review established policies and requirements under Continuum of Care
Reform (CCR), discuss current processes, and identify gaps and barriers. The intent of
these meetings is to begin streamlining processes and address gaps and barriers; all
towards a greater coordination of care. Once established, the ILT shall meet at a
frequency based on project and/or agency, but no less than on a quarterly basis.
C.Structure
1. The ILT shall select a Chair who will lead the ILT meetings and process. The Chair
will serve as the designated communication authority when working with requests
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and correspondence.
2.The ILT shall designate an ILT member to collaboratively document the meeting
minutes, and share them with the participating members. Meeting minutes shall be
recorded and shared with the participating members and their requested designees.
3.ILT members will utilize a shared decision-making process for program and service
issues and concerns identified by the System Partners.
4.The ILT members shall receive reports from the Interagency Placement Committee
on a quarterly basis and invite them to participate in ILT meetings to discuss
findings and concerns.
5.Providers shall be invited to present annual reports on program issues, problems,
and outcomes.
6.The ILT members shall review this MOU on an annual basis, to ensure it remains
current and is updated in as timely a manner as possible.
III.Role of System Partners
1. Management, Administration and Service Delivery Staff:
a.Direct management and operation of the Fresno County Integrated Children’s
System of Care, including all new CCR-requirements.
b. Analyze opportunities and projects and make recommendations to the ILT.
Provide recommendations and direction on implementation of policies,
procedures, and programs included under this MOU.
c.Ensure that staff assigned to shared programming are provided the necessary
technical assistance, training, support and resources to ensure mandates are
fulfilled.
d. Assigned System Partners’ managers and supervisors will ensure that staff
and programs conform to the shared Purposes and Principles of this MOU.
2.Policy Development, Coordination, and Monitoring as a full System of Care
a.Review and, as necessary, recommend program direction for applicable
community partners or providers.
b.Agree to work collaboratively to review, discuss, and approve requests from
providers (e.g. Letters of Recommendation and other critical information for
Short-Term Residential Treatment Program (STRTP)) and to do so in a timely
manner.
c.Appoint and support staff to serve as liaisons to various shared projects to
ensure full continuum of care and linkage back to System Partner services.
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d.Work collaboratively to monitor the Intensive Services Foster Care (ISFC)
program.
e. Monitor programs for general compliance with statutory and regulatory
requirements; provide guidance and technical assistance to ensure program
practice is consistent with the values and principles of this inter-departmental
partnership.
f.Work with community agencies to ensure collaborative and integrated
strategies are promoted and utilized, using strength-based, family-focused
practice on a systems-wide basis.
PART TWO – INTEGRATED CORE PRACTICE MODEL
This MOU includes a mutual commitment by System Partners to use of the principles, values, and
practice behaviors of the California Integrated Core Practice Model (ICMP) in their programs,
processes, and interactions with youth and families. The ICPM, created in collaboration between
the Department of Health Care Services (DHCS) and the California Department of Social Services
(CDSS), is intended to provide practical guidance and direction to support county child welfare,
juvenile probation, behavioral health agencies, regional centers, and community partners to
improve delivery of timely, effective, and integrated services to children, youth, and families.
The ICPM is based on five (5) key components and ten (10) guiding principles:
The Five Key Components of the ICPM Model include:
•Engagement
•Assessment
•Service Planning/Implementation
•Monitoring/Adapting
•Transitions
The Ten Guiding Principles include:
•Team-based
•Family voice and choice
•Natural Supports
•Collaboration and integration
•Community-based
•Culturally Respectful
•Individualized
•Strengths-based
•Persistence
•Outcomes-based
To ensure awareness and utilization of the ICPM, a copy of the current ICPM will be distributed to
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ILT members and all necessary partners in a timely manner. The ICPM values and principles shall
be used in decision-making and integrated, as appropriate, in process development and program
development. System Partners agree to train their staff on the principles of ICPM and its
implementation with participating system partners. System Partners agree to collaborate in
support of these efforts.
Updates or revisions to the current iteration of the ICPM shall be shared with all necessary partners
in a timely manner. System Partners agree to adhere to new or updated requirements, in a timely
manner.
PART THREE – INFORMATION AND DATA SHARING
The System Partners agree, to the fullest extent allowed by law, to share necessary and relevant
client specific information in order to conduct treatment, coordinate care and ensure the highest
quality care is available to youth and caregivers. System Partners shall maintain efforts towards
the utilization of a single, uniform Release of Information (ROI) form across all agencies.
Fresno County maintains an agreement with CDSS to share client specific information, in order to
foster timely and appropriate care and to share in the State’s pursuit of outcomes that inform
improved services to youth served by its systems.
The System Partners acknowledge that DSS is authorized to disclose information to the Medi-Cal
funded system partners for purposes directly related to the administration of its program [42 United
States Code (U.S.C.) § 671(a)(8)(A)]. Medi-Cal funded providers are likewise authorized to
disclose information to DSS for purposes directly related to the administration of the Medi-Cal
program. “Directly related” includes determining the amount of Medi-Cal assistance and providing
services for recipients [42 U.S.C. § 1396(a)(7); 42 C.F.R. § 421.302 (2009)].
The System Partners of this MOU shall be in strict conformance with all applicable Federal and
State of California laws and regulations, including but not limited to Sections 5328, 10850, and
14100.2 et seq. of the Welfare and Institutions Code, Sections 2.1 and 431.300 et seq. of Title 42,
Code of Federal Regulations (CFR), Section 56 et seq. of the California Civil Code, Sections
11977 and 11812 of Title 22 of the California Code of Regulations, and the Health Insurance
Portability and Accountability Act (HIPAA), including but not limited to Section 1320 D et seq. of
Title 42, United States Code (USC) and its implementing regulations, including, but not limited to
Title 45, CFR, Sections 142, 160, 162, and 164. The Health Information Technology for Economic
and Clinical Health Act (HITECH) regarding the confidentiality and security of patient information,
and the Genetic Information Nondiscrimination Act (GINA) of 2008 regarding the confidentiality of
genetic information.
Additionally, Assembly Bill 2083 provides that:
•Members of the ILT may disclose and exchange information with one another that may be
designated as confidential under State law if the member of the team having that
information reasonably believes it is generally relevant to the identification, reduction, or
elimination of barriers to services for, or to placement of, children and youth in foster care or
to improve provision of those services or those placements. ILT members who receive
disclosed or exchanged information shall only use the information for the purposes set forth
in the preceding sentence.
•Members of the ILT who receive disclosed or exchanged information shall destroy or return
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that information once the purposes for which it was disclosed or exchanged are satisfied.
Any information disclosed or exchanged shall be confidential and shall not be open to
public inspection, unless the information is aggregated and de-identified in a manner that
prevents the identification of an individual who is a subject of that information. Any
discussion concerning the disclosed or exchanged information during a team meeting shall
be confidential and shall not be open to public inspection.
•Members of an Interagency Placement Committee, child abuse multidisciplinary personnel
team, or Child and Family Team that is convened for the purpose of implementing the
provisions of this MOU developed pursuant to this subdivision shall comply with applicable
statutory confidentiality provisions for that committee or team.
•Members of teams convened for purposes of implementing this MOU shall comply with
applicable records retention policies for their respective agencies or programs.
PART FOUR – SCREENING, ASSESSMENT, and ENTRY TO CARE
Each System Partner shall follow its own distinct processes and tools, as well as Federal, State,
and local mandates, to determine eligibility and need for services. To the extent permitted by laws
and regulations, the System Partners may choose to use a single shared assessment process,
share information from different assessment tools or processes, or partner on specific assessment
tools, in order to enhance unified service planning, reduce impact on youth and caregivers, reduce
administrative costs to partners, and reduce redundancy. System Partners agree to share
assessment outcomes and processes to facilitate care coordination through the Child and Family
Team process and reduce youth and family impact wherever it is permissible and legally
appropriate.
If a developmental delay or disability is suspected or confirmed, CVRC will be contacted to
determine current status of the child’s case. If eligibility has not been previously determined by
CVRC, a referral will need to be made by the referring agency to determine eligibility for
services. For children who have been previously determined eligible for services but, their case is
currently inactive, reactivation will be requested by the referring agency. For children that have an
open case with CVRC, the assigned Service Coordinator will be contacted for assistance. CVRC
uses a variety of assessment tools and reports to determine eligibility. Records are requested as
part of the intake process so as to not duplicate any assessments previously completed and assist
with the eligibility determination process.
PART FIVE – CHILD AND FAMILY TEAMING
System Partners aim to provide a single, unified Child and Family Teaming (CFT) process via a
meeting comprised of the youth, their family/caregiver(s), and other agency partners and natural
supportive relationships relevant to their care. Collaboration from within the CFT includes family
engagement, assessment, service planning, delivery, coordination, care management, monitoring
and adapting services, and transition.
Typically, the agency with legal jurisdiction will convene CFT meetings and document CFT
outcomes. Attendees contribute specialized expertise and experience in identifying child and
family needs that may, potentially and unintentionally, not be identified or addressed by other
service delivery systems. All parties should participate as required, on time, and in accordance
with State mandates.
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Of particular interest to the System Partners, is the coordination of mental health care and
educational services for youth in the foster care system. Accordingly, System Partners agree to
develop a policy to enact the following:
• Ensure participation of an individual from the local educational agency (LEA) who is
knowledgeable about the child and able to provide feedback on significant relationships that
the child may have formed with a teacher, counselor, coach, or other meaningful person
and how changing schools would impact his or her academic, social, or emotional well-
being.
• Facilitate the transfer of educational records for students in foster care who enter or exit a
school within or between LEAs.
• Facilitate enrollment for students in foster care who enter a school within a LEA.
• Request education records from the school of origin for students in foster care who enter a
school within a LEA.
• Facilitate data sharing consistent with the Family Educational Rights and Privacy Act
(FERPA), California Education Code Sections 49073 et seq., Individuals with Disabilities
Education Act (IDEA), and other privacy laws and policies.
PART SIX – INTERAGENCY PLACEMENT COMMITTEE
The Interagency Placement Committee (IPC) is a multi-agency, multi-disciplinary team that
supports children and youth, including Non-Minor Dependents (NMD), with significant behavioral,
emotional, medical and/or developmental needs through a collaborative review process whereby a
child/youth’s treatment and placement needs are determined. The IPC review process includes
consideration of available assessments/evaluations, treatment information, and other relevant
information regarding the child/youth/NMD’s history and current services and needs.
The primary purpose of the IPC is to review and approve the initial treatment of children, youth,
and NMDs within a STRTP, and/or WRAP, consistent with State law. The IPC assessment shall
determine or confirm whether the child meets one of the following criteria:
1. Youth meets the medical necessity criteria for Medi-Cal specialty mental health
services.
2. Youth’s individual behavior or treatment needs can only be met by the level of care
provided by a STRTP, and/or WRAP, and not a lower level of care.
I. IPC Members – the IPC shall be comprised of representatives from the following:
• DSS
• A licensed mental health professional from DBH
• Probation
• FCSS
• DPH
• CVRC as appropriate
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II.IPC Governance Procedures
A.Each of the collaborating agencies designates a representative to sit on the IPC as a
voting member. Each designee completes training provided by DSS for STRTPs and
the contracted vendor for WRAP.
B.The IPC meets on a weekly basis in a format agreed upon by attendees.
C.The cases being reviewed are presented by the relevant Social Worker or Probation
Officer.
D.The IPC shall:
1.Review youth and family service plans.
2.Review requests for STRTP and/or WRAP placements. Review of these
requests shall include a review of the current services and needs of each client
and the determination of how to meet those needs in the least-restrictive
setting.
3.If a youth requires placement within an STRTP for longer than six (6) months,
the case is presented to the DSS Deputy Director, who reviews and provides
approval.
4.A youth’s continued participation in the WRAP program is discussed and
determined by the CFT.
5. Provide the ILT with quarterly reports to include, but not be limited to, Quality
Improvement on services/systems, need for new or redesigned service
delivery, areas for improvement, and the status of implementation of the
California Integrated Core Practice Model for Children, Youth, and Families.
E.Decisions/recommendations made by the IPC may become the recommendations of
the responsible agency which referred the youth. Any involved staff member
associated with the youth’s care who disagrees with the IPC’s recommended action
may raise an objection to the recommended action or may advocate for a different
action through the use of the Appeal process, as outlined herein.
IPC Case Specific Appeals:
Appeals of youth/family or case specific IPC recommendations/decisions will be made
via the following process, immediately following the IPC meeting or, if not possible,
within two (2) working days.
•The staff member wishing to appeal the IPC recommendation(s) will notify
their respective manager.
•The staff’s manager will forward any questions or subsequent appeal to the
Assistant Probation Chief or the DSS Deputy Director, as appropriate.
•The appropriate Department will proceed through their chain of command up to
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and including the Department Head until the concerns have been resolved.
•If necessary, other System Partners may be brought into the discussion.
PART SEVEN – ALIGNMENT AND COORDINATION OF SERVICES
Children and youth with complex challenges and needs typically receive (or are eligible to receive)
services from multiple agencies throughout County’s system of care. Coordination of services is
required to minimize confusion for families and achieve desired outcomes. Care coordination
permits a unifying integration of services among service agencies to support the child and family.
Integration and coordination of services also makes it possible for each agency to maximize its
resources to serve children, youth, and families through greater efficiencies.
The System Partners agree to work collaboratively to align timelines for all aspects of care – from
screening and assessment to service delivery. This collaboration shall be implemented and
supported with fidelity to the ICPM and other team-based system planning processes carried out
by the ILT, IPC, and the CFT. Under each of these teams, collaborating agencies are seen as
equal partners and remain well-informed of individual roles and responsibilities. Additionally,
System Partners are committed to ensuring that stakeholders important to the child’s support and
success are included in the care planning process.
Care planning is meant to be an investigative process that is responsive to the unique
circumstances and needs of each child and family. Alignment and coordination of services
includes the following:
1.Identifying the specific needs and strengths of the child and their family;
2.Identifying services and community supports that the youth and their family require to
address the challenges they face as a result of their needs;
3.Identifying which partner agency, or agencies, can provide these services and
community supports to address the needs of the youth and their family; and
4.Developing a care plan that considers the youth and family’s voice and choice and
provides them with realistic supports to address their needs in a timely and appropriate
manner.
If the end result of case planning does not lead to a well-coordinated and aligned care plan, the ILT
shall revisit this MOU, and rewrite policies and procedures to facilitate effective processes that
incorporate the ICPM principles and lead to a more effective coordination of care.
PART EIGHT – STAFF RECRUITMENT, TRAINING, AND COACHING
The System Partners acknowledge the value of having highly trained, competent staff teams. In
order to ensure social workers, probation officers, therapists, doctors, clinicians, rehabilitation
specialists, support and administrative personnel are fully prepared to deliver seamless and
integrated trauma-informed services as outlined in this MOU, the System Partners agree to follow
each agency’s own established process to ensure recruitment, training and appropriate coaching
of staff.
When possible, training resources will be used in the most flexible and adaptable manner
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possible to facilitate cross-training and preparation of staff members.
PART NINE – FINANCIAL RESOURCE MANAGEMENT
System Partners shall ensure efforts towards the identification of available Federal, State, local,
and/or private resources that can be utilized to serve children, youth, and families. System
Partners have a shared commitment toward leveraging existing resources and understanding their
limitations, in order to support a streamlined implementation process for services and supports for
children and their families.
Notwithstanding the generally categorical nature of each System Partner’s revenues, partners may
inform the ILT membership about available funding.
PART TEN – DISPUTE RESOLUTION PROCESS
While ILT member agencies and leaders may utilize a shared decision-making process for the
programs and services identified by the System Partners, challenges and disagreements may
arise. These disagreements are sometimes due to conflicting statute, regulations, policy,
guidance, or in differing opinions as to what services are needed in a particular case. System
Partners will attempt in good faith to resolve any dispute or disagreement arising out of this MOU,
by focusing on the shared vision, values, and practices of the ICPM.
For other types of disputes typically associated with direction, sharing of resources, strategy or
related cross-agency issues, the System Partners will seek to settle relevant disputes by focusing
on the shared vision, values, and practices of the ICPM.
Consensus will be the preferable model. However, if consensus cannot be reached, System
Partners shall follow an escalation procedure to invite additional discussion, clarification, and
direction from agency directors and/or State representatives. The level of escalation needed shall
be determined by the nature of the dispute.
PART ELEVEN – RESOURCE FAMILIES AND THERAPEUTIC FOSTER CARE SERVICES
Resource families play a critical role in the life of children when out-of-home placement is needed
to keep the child safe. DSS and Probation make diligent efforts to identify, consider, and evaluate
relatives, family friends, and those closely tied to the family as the primary placement option.
When placement with a closely tied adult is not an option, the placing agency makes effort to
actively recruit and support resource families so that a child may be provided with a feeling of
safety, permanence, and well-being. Some resource families are identified to provide Intensive
Services Foster Care – an alternative to congregate care placement and a critical resource in the
foster care and behavioral health continuum of care.
While recruitment, retention, and support of all resource families have been viewed as the sole
responsibility of the child welfare and probation systems, other System Partners have a parallel
responsibility to support youth in need of safety and resources. The System Partners are
committed to practicing collaborative, consistent efforts to recruit, train and support professional
Resource Family caregivers in order to foster safe, permanent, and healthy out-of-home
placement, when necessary.
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PART TWELVE – MUTUAL INDEMNIFICATION AND INSURANCE
Each party agrees to indemnify, defend and hold the other party, including officials, officers,
directors, agents, employees and volunteers, harmless against any and all losses, claims, expenses
(including reasonable attorneys’ fees), fines, penalties, damages, judgments or liabilities, including
bodily injury, property damage and death, as a result of an action brought by a party arising out of
this agreement or any breach thereof, but only to the extent such liabilities have been caused by
the negligence, recklessness or willful misconduct of that party with respect to its obligations under
this Agreement.
In the event of concurrent negligence on the part of Parties, including any of its officials, officers,
directors, agents, employees or volunteers, the liability for any and all such claims, demands and
actions in law or equity for such losses, fines, penalties, forfeitures, costs and damages shall be
apportioned under the State of California's theory of comparative negligence as presently
established or as may be modified hereafter. However, no System Partner shall be indemnified
hereunder for any loss, liability, damage, or expense resulting from its own negligence or willful
misconduct.
Required Insurance. Without limiting the indemnification of each party as stated herein, it is
understood and agreed that the Parties shall each maintain, at their sole expense, insurance policies
or self-insurance programs including, but not limited to, an insurance pooling arrangement and/or
Joint Powers Agreement to fund their respective liabilities including general liability, automotive
liability, workers’ compensation, employers liability, professional liability, Molestation liability (if
required) and cyber liability.
PART THIRTEEN - TERMINATION
This MOU and its agreed upon protocols may be terminated by any System Partner upon the
giving of thirty (30) days advance written notice of an intention to terminate to all other System
Partners. Written notice of termination given by a System Partner to the other System Partners
shall only be effective as to the MOU in relation to the System Partner giving notice and shall have
no effect on the MOU with respect to all other System Partners.
IN WITNESS WHEREOF , the System Partners have executed this Memorandum of Understanding
effective upon execution by all System Partners .
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Ste en Br dau, Chairman of the
Board of Supervisors
of the County of Fresno
ATTEST:
Bernice E. Seidel ,
Clerk of the Board of Supervisors
County of Fresno , State of Cal ifornia
By d_,.1p ', ~
Deputy
PLEASE SEE ADDITIONAL
SIGNATURE PAGES ATTACHED