HomeMy WebLinkAboutAgreement A-16-488 with Proteus Inc..pdf
1718689v1 / 16988.0001 Fresno Regional Workforce Development Board WIOA Partner MOU
MEMORANDUM OF UNDERSTANDING
Between
Fresno Regional Workforce Development Board
And
Proteus, Inc.
In accordance with the Workforce Innovation and Opportunities Act of 2014, Public Law 113-128,
29 U.S.C. 3101, et seq., as amended (hereafter referred to as "WIOA"), the Fresno Regional
Workforce Development Board (here inafter referred to as the "WDB") shall develop a local
plan, and enter into a Memorandum of Understanding ("MOU ") with local America’s Job Center
One-Stop Partners (as defined in Section IV(B) below) regarding the operation of the local
America’s Job Center One-Stop System of service delivery (the "local One -Stop System") and
the performance of the functions described in Section 121(e)(1) of the WIOA. MOUs must be
executed between the WDB and the America’s Job Center One -Stop Partners, with the
agreement of the Chief Local Elected Official. The Chief Local Elected Official in the WDB’s
Local Workforce Development Area (collectively, the City and County of Fresno) has delegated
to the WDB the ability to execute this MOU pursuant to that certain Joint Exercise of Powers
Agreement dated May 19, 2009, as amended (the “Joint Powers Agreement”).
I. VISION, MISSION AND GOAL OF THE FRESNO COUNTY AMERICA’S JOB CENTER OF
CALIFORNIA (AJCC) ONE-STOP SYSTEM
A. Vision
To fully engage all available public and private resources to ensure the Fresno Regional
Workforce Development system as the premier source for the human capital needs of
growth industry clusters within Fresno County. By integrating education and workforce
preparation to assist the best companies in Fresno County to remain and thrive in our local
community, to achieve sustainable economic growth. To concurrently assist our
unemployed and underemployed residents to achieve a higher quality of life by access to
such careers in growth industry sectors.
B. Mission
The Fresno Regional Workforce Development system, a Joint Powers Authority between
the City and County of Fresno, in partnership with both the public and private sectors,
exists primarily to assist local businesses in meeting their human capital needs. In this, we
both (1) screen and train prospective new employees and (2) assist in upskilling existing
employees. By offering such quality referral and training services, directly linked to local
industry needs, we are of greatest benefit to our unemployed and underemployed clients.
II. PURPOSE OF MEMORANDUM OF UNDERSTANDING
A. To define, establish, and reinforce relationships between the WDB and the designated
AJCC One-Stop Partners;
B. To define the roles and responsibilities of these entities in the performance of their
combined goal of establishing a workforce development system through the local One -
Stop System that is:
1. Integrated (offering as many employment, training, and education services as possible
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for employers and individuals seeking jobs or wishing to enhance their skills and
affording universal access to the system overall);
2. Comprehensive (offering to participant/customer a large array of useful information
with wide and easy access to needed services);
3. Participant/customer -focused (providing the means for judging the quality of services
and making informed choices); and
4. Performance-based (based on clear outcomes to be achieved, mutually negotiated
outcomes and methods for measurements, and the means for measuring and attaining
participant/customer satisfaction); and
C. To describe how cost of services and the operating cost of the local One -Stop System will
be funded.
III . STATEMENT OF ISSUE
As a partner under the WIOA, Proteus, Inc., hereinafter referred to as the “Partner”, enters into
an MOU with the WDB regarding the manner in which the Partner will participate and provide
access to their services through the local One -Stop System.
IV. DEFINITIONS
The following definitions apply to this MOU:
A. AJCC One-Stop Operator:
The WDB sub-contracted entity or entities designated to operate the local One -Stop
System, provide Basic Career Services (as defined in Section IV(D) below), and to
coordinate services within the local One -Stop System under the WIOA. Sometimes also
referred to herein as the "One -Stop Operator"
B. AJCC One-Stop Partner:
An entity that carries out one or more programs or activities described herein, makes those
programs or activities available to participants through the local One-Stop System, and
participates in the operation of the local One-Stop System consistent with the terms of this
MOU and with the requirements of the ir Authorizing Law (as defined in Section IV(C)
below) by which the programs or activities are authorized under the WIOA. Sometimes
also referred to herein as "Par tner"
C. Authorizing Law:
Refers to each respective Partner's legal authority to engage in the specific programs or
activities that the Partner will provide in connection with WIOA authorized programs,
activities, or services.
D. Basic Career Services:
Services and resources available to the general public without enrollment into the WIOA
program or any Partner’s program. These services are overseen by the AJCC One-Stop
Operator. These services include but are not limited to the following services, and a re
provided either by the WDB or by the Partners, as appropriate, applicable and allowable:
1. Determination of eligibility to receive WIOA-enrolled services.
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2. Outreach, intake, and orientation to the services available through the One-Stop System.
3. Initial assessment of skill levels (including literacy, numeracy, and English language
proficiency), aptitudes, abilities (including skills gaps), and supportive service needs.
4. Labor exchange services, including the following:
a. Job search, placement assistance, and career counseling, including information on in-
demand industry sectors and occupations as well as nontraditional employment.
b. Recruitment and other business services on behalf of employers in the local area, such
as information and referral to specialized business services not traditionally offered
through the local One-Stop System.
5. Referrals to, and coordination of activities with, other programs and services, including
programs and services within the local One-Stop System and other workforce development
programs.
6. Workforce and labor market employment statistics information, including information
relating to local, regional, state, and national labor market areas, including the following:
a. Job vacancy listings and the job skills necessary to obtain them.
b. Information on local in-demand occupations and the earnings, skill requirements, and
opportunities for advancement that accompany them.
7. Information on performance and program cost of eligible providers of training services,
youth workforce development activities, adult education, career and technical education
activities at the postsecondary level, career and technical education activities available to
school dropouts, and vocational rehabilitation services.
8. Information regarding how the local area is performing on the local performance
accountability measures and any additional performance information with respect to the
local One-Stop System.
9. Information on, and referral to, supportive services or assistance, including the following:
a. Child care, child support, medical or child health assistance under title XIX or XXI of the
Social Security Act.
b. Benefits under the supplemental nutrition assistance program established under the
Food and Nutrition Act of 2008.
c. Assistance through the earned income tax credit under section 32 of the Internal
Revenue Code of 1986.
d. Assistance under a state program for temporary assistance for needy families funded
under part A of Title IV of the Social Security Act.
e. Other supportive services and transportation available in the local area.
10. Information and assistance regarding filing claims for unemployment compensation.
11. Assistance in establishing eligibility for programs of financial aid assistance for training and
education programs that are not funded under WIOA.
E. Business Services:
The terms “Business Services” means services and resources available to employers in the
local area and are provided by Partners and sub -contracted providers of services, with
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oversight by WDB staff, where applicable, appropriate and allowable. These services
include, but are not limited to:
1. Labor exchange activities and labor market information;
2. Customized screening and referral of qualified participants in training services to
employers;
3. Customized services to employers, employer associations, or other such organizations, on
employment-related issues;
4. Customized recruitment events and related services for employers including targeted job
fairs;
5. Human resource consultation services, including but not limited to assistance with:
a. Writing/reviewing job descriptions and employee handbooks;
b. Developing performance evaluation and personnel policies;
c. Creating orientation sessions for new workers;
d. Honing job interview techniques for efficiency and compliance;
e. Analyzing employee turnover; or
f. Explaining labor laws to help employers comply with wage/hour and safety/health
regulations;
6. Customized labor market information for specific employers, sectors, industries or clusters;
7. Rapid Response and lay-off aversion; and
8. Other similar customized services.
F. Individualized Career Services:
The term Individualized Career Services means services available to persons who meet the
eligibility requirements as defined in the WIOA and subsequent regulations. These s ervices
are provided by the WDB’s subcontracted service providers and Partners, where
applicable, appropriate and allowable. These services are subject to priority of service and
include, but are not limited to:
1. Comprehensive and specialized assessments of the skill levels and service needs of adults
and dislocated workers, which may include the following:
a. Diagnostic testing and use of other assessment tools.
b. In-depth interviewing and evaluation to identify employment barriers and appropriate
employment goals.
2. Development of an individual employment plan to identify the employment goals,
appropriate achievement objectives, and appropriate combination of services for the
participant to achieve the employment goals, including providing information on eligib le
providers of training services and career pathways to attain career objectives.
3. Group counseling.
4. Individual counseling.
5. Career planning.
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6. Short-term prevocational services, including development of learning skills, communication
skills, interviewing skills, punctuality, personal maintenance skills, and professional
conduct, to prepare individuals for unsubsidized employment or training.
7. Internships and work experiences linked to careers.
8. Workforce preparation activities.
9. Financial literacy services.
10. Out-of-area job search assistance and relocation assistance.
11. English language acquisition and integrated education and training programs.
G. AJCC Partner Services:
The term AJCC Partner Services means those services described in Section IX,
Description of Ser vices To Be Provided By Partner, of this MOU carried out under the
Partner's Authorizing Law.
H. Participant/customer:
The term participant/customer is defined as a person or persons receiving integrated local
One-Stop System employment, training, educationa l services, and/or business services for
employers from any AJCC partner.
I. Training Services:
The term Training Services means services available to persons who meet the eligibility
requirements as defined in the WIOA, subsequent regulations, and locally -defined
prerequisites. These services are provided by the WDB’s subcontracted service providers
and Partners, where applicable, appropriate and allowable. These services are subject to
priority of service and include, but are not limited to:
1. Occupational skills training, including training for nontraditional employment.
2. On-the-job training.
3. Incumbent worker training.
4. Programs that combine workplace training with related instruction, which may include
cooperative education programs.
5. Training programs operated by the private sector.
6. Skill upgrading and retraining.
7. Pre-Apprenticeship and Apprenticeship training
8. Entrepreneurial training.
9. Transitional jobs (Work Experience).
10. Job readiness training provided in combination with another training service.
11. Adult education and literacy activities, including activities of English language acquisition
and integrated education and training programs, provided concurrently or in combination
with another training service.
12. Customized training conducted with a commitment by an employer or group of employers
to employ an individual upon successful completion of the training.
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13. Other similar training services
V. AJCC ONE-STOP PARTNER PARTICIPATION
Partner agree s to participate in a joint planning process which results in the development of
the local and regional Strategic Plan submitted to the State in accordance with issued WIOA
guidelines (the "Strategic Plan"). Partners agree to engage in planning, plan develo pment,
and activities, to result in:
A. Continuous partnership building between all parties to this MOU;
B. Continuous partnership building and planning responsive to State requirements;
C. Continuous partnership between State and local representatives engaged in WIOA
activities and related workforce preparation and development;
D. Responsive to specific local and economic conditions, including employer needs;
E. Adherence to strategic planning principles adopted by the WIOA for long range planning,
including the re quirement for continuous improvement;
F. Adherence to common data collection and reporting, including needs for modification or
change;
G. Diligence in developing coordinated local leadership in workforce development through:
H. Responsiveness to participant/cus tomer needs;
I. Maintenance of system infrastructure;
J. Shared technology and information;
K. Performance management to measure the success of the local One -Stop System overall
and to enhance performance in a spirit of quality management and continuous
improvement.
L. Identification of each Partner’s appropriate contribution to meeting the performance
standards negotiated between the State of California and WDB.
VI. THE CUSTOMERS TO BE SERVED
The AJCC One-Stop Center will serve:
A. Those Fresno County residents, who are seeking employment, need guidance on how to
make career choices, and building basic educational or occupational skills.
1. Priority of Service will be given to those who are (in order of priority):
a. Veterans and eligible spouses who are also recipients of public assistance,
other low income individuals, or individuals who are basic skills deficient;
b. I ndividuals who are recipients of public assistance, other low income individuals,
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individuals who are basic skills deficient, or individuals with other barriers to
employment.
c. Veterans and eligible spouses who are not included in WIOA’s priority groups.
d. Other individuals not included in WIOA’s priority groups.
B. Those businesses who are seeking a skilled and stable workforce; need guidance in
various business operations or in need of assistance in case of reductions in force.
C. All AJCC One-Stop Center Services and Partner services will be available to all eligible
residents no matter their English language proficiency or physical abilities.
VII. AMERICAN’S WITH DISABILITIES ACT COMPLIANCE
Partner agrees to ensure that the policies and procedures as well as the programs and services
provided at the AJCC and Partner’s facilities are in compliance with the Americans with
Disabilities Act and its amendments. Additionally, partners agree to fully comply with the
provisions of WIOA, Title VII of the civil Rights act of 1964, the Age Decimation Act of 1975, Title
IX of the Education Amendments of 1972, 29 CRF Part 37 and all other regulations implementing
the aforementioned laws.
VIII. NON-DISCRIMINATION AND EQUAL OPPORTUNITY
A. Partner agrees that no person shall, because of ethnic group identification, age, sex,
gender identification, sexual orientation, color, disability, medical condition, national
origin, race, ancestry, marital status, religion, religious creed, or political belief be
excluded from participation, be denied benefits of, or be subject to discrimination under
any program or activity receiv ing state or federal assistance. Such practices include
retirement, recruitment advert ising, hiring, layoff, termination, upgrading, demotion,
transfer, rates of pay or other forms of compensation, use of facilities, and other terms
and conditions of employment.
B. Partner assures compliance with the Americans with Disabilities Act (ADA) of 19 90, which
prohibits discrimination on the basis of disability, as well as applicable regulations and
guidelines issued pursuant to the ADA.
IX. DESCRIPTION OF SERVICES TO BE PROVIDED BY THE PARTNER
Partner agrees that they will provide access to all the services described below at the
designated AJCC One-Stop and any other satellite location deeme d appropriate by the
Partner. Partner will participate in the creation of the local One -Stop System which provides
for universal access and enables customers to become self -sufficient.
Partner will ensure that services are provided either by (i) assigning staff to the local AJCC
One-Stop(s); (ii) using a mutually developed referral process; (iii) training the One -Stop
Operator and other Partner staff to deliver information about the services available to eligible
individuals; and/or (iv)using technology to provide services to participants/customers, except
as noted below.
Partner will ensure that the needs of workers a nd youth, and individuals with barriers to
employment, including but not limited to individuals with disabilities and limited English
proficient individuals , are provided necessary and appropriate access to services, including
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access to technology and mate rials, available through the local One -Stop System.
Any Partner funded by Wagner -Peyser is required to be co -located in the Comprehensive
America's Job Center One -Stop Center (as defined and identified in Section XI(A) below).
Partner agrees that it will provide One-Stop Partner Core Services to participants/customers
and support local One -Stop System activities:
A. Outreach and Recruitment – Migrant Seasonal Farm Worker
B. Eligibility Determination
C. Case Management
D. Career Counseling
E. Orientation
F. Skills Assessment
G. Co-enrollment
H. Farmworker Youth Services
I. Job Placement
X. WDB RESPONSIBILITIES
As authorized under the WIOA, and pursuant to the Joint Powers Agreement, the WDB will
establish policies necessary for implementation of the WIOA in the local area and shall:
A. Develop and submit a local plan to the Governor;
B. Collaborate with other Workforce Development Boards to develop a Regional Plan
C. Identify eligible AJCC One-Stop Operators by awarding grants or contracts on a
competitive basis;
D. Conduct programmatic and fiscal reviews of the WIOA services provided by sub -
contracted program providers of services, training services providers and report to the
WDB the results of those reviews.
E. Identify eligible providers of youth activities in the local are a by awarding grants or
contracts on a competitive basis based on the recommendations of the local youth
council;
F. Identify eligible providers of training services in the local area by awarding grants or
contracts on a competitive basis;
G. Identify eligible providers of Individualized Career Services in the local area by awarding
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grants or contracts on a competitive basis;
H. Provide adequate facilities for the Partners as needed and as funding allows;
I. Develop a local One -Stop System budget f or the purpose of carrying out the duties of the
WDB;
J. Solicit and accept grants and donations from sources other than federal funds made
available under WIOA;
K. Conduct regular program and physical plant assessments for compliance to federal, state
and local Equal Opportunity and Americans with Disabilities Act regulations as required
by law.
L. Negotiate local performance measures;
M. Coordinate the workforce development activities carried out in the local area with
economic development strategies and develop other employer linkages with such
activities;
N. Promote participation by private sector employers in the statewide workforce development
system and help such employer s meet their hiring needs using the system by providing
connecting, brokering, and coaching activities to the employers;
O. Make available to the public, on a regular basis through open meetings and/or through
publications online, information regarding the a ctivities of the WDB, including information
regarding the Strategic Plan prior to submission of the Strategic Plan, membership, the
designation and certification of AJCC One-Stop Operator(s), the award of grants or
contracts to eligible providers of youth activities, and, on request, minutes of formal
meetings of the WDB;
P. Negotiate and enter into an MOU with each AJCC One-Stop Partner which meet the
requirements of the WIOA and sets forth their respective responsibilities for making a full
range of services available through the local One -Stop System; and shall modify this
MOU to add additional Partners as needed for the benefit of the community and system.
XI. LOCATION OF AMERICA’S JOB CENTER ONE -STOP SITES
A. The WDB will establish a minimum of one physical location called the "Comprehensive
AJCC" within the workforce development area in which all AJCC One-Stop Partners will
provide access to the services provided under the WIOA. The parties agree that the
Comprehensive AJCC shall be located at the Manchester Shopping Center, 3302 N.
Blackstone Avenue, Fresno, California 93726. This location may be changed by the WDB
during the term of this MOU upon thirty (30) days advance notice of such change to the
Partners. Each Partner agrees that it will provide access to the services described in this
MOU at such location and any other satellite location deemed appropriate by each Partner,
with concurrence of the WDB.
B. If the WDB establishes additional AJCC One-Stop Centers within its local workforce
development area, each Partner will determine the extent and manner in which it will
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participate in such additional centers. However, access to each Partner’s services will be
made available at all locations, either with on -site staff, via technology, or referral to the
nearest office of the Partner.
C. The Partner commits to providing information and access to all AJCC Partner services, as
described in this MOU, at each of its service locations.
XII. METHODS OF REFERRAL
A. The WDB, through its designated AJCC One-Stop Operator(s), and the Partners agree to
utilize the approved referral processes and forms for common intake and referral among the
AJCC One-Stop Partners and providers of services. The WDB and Partners developed a
universal referral system and form that is used for all cross-agency referrals, copies of which
are attached hereto, and incorporated herein, as Attachment 3
B. The WDB and Partner agree to train and provide technical assistance to the appropriate
staff of each of the other participating AJCC One-Stop Partners and sub-contracted
providers of services on topics that include but are not limited to eligibility for and scope of
allowable services for the partner’s programs.
C. Partner agrees to suggest appropriate referrals for its applicants and clients, the
availability of additional services from other AJCC partners if they determine the client
could benefit from those referral(s).
D. A listing of Partner Services Partner Sites and Locations can be found in Attachments 1
and 2, respectfully referral purposes.
XIII. CONFIDENTIALITY
Partner shall be in strict conformance with all applicable federal, State of California and/or
local laws and regulations relating to confidentiality including Welfare and Institutions Code
section 10850 and insure that all applications and records concern ing participants/customers
shall be kept confidential and shall not be opened to examination, publicized, disclosed, or
used for any purpose not directly connected with the administration of the local One -Stop
System. The Partner shall inform all of its employees, agents, officers, subcontractors, Board
members, or partners of this provision and that any person knowingly and intentionally
violating this provision is guilty of a misdemeanor.
A. All participant/customer applications and records related to servi ces provided under this
MOU, including eligibility for services, enrollment, and referral shall be confidential and
shall not be open to examination for any purpose not directly connected with the delivery
of such services. Signed information releases will be obtained where appropriate.
B. Partner agrees to share information either agreed upon by them or as interpreted by the
Chief Local Elected Official or designee to be necessary for the administration of the local
One-Stop System. Partner shall obtain sign ed releases allowing for the sharing of
participant/customer information necessary for provision of services under the WIOA; i.e.
assessment; universal intake; program or training referral; job development or placement
activities; and other services as nee ded for employment or program support purposes.
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C. At any time an America’s Job Center One -Stop Partner requests confidential information
regarding another Partner's participant/customer, the request shall be accompanied by a
written Release of Confidential Information signed by the participant/customer.
XIV. GRIEVANCES AND COMPLAINTS
Partner agrees to establish and maintain a procedure for grievance and complaints as outlined in
WIOA. The process for handling grievances and complaints is applicable to customers and
partners. These procedures will allow the customer or entity filing the complaint to exhaust every
administrative remedy in receiving a fair and complete hearing and resolution of their grievance.
The partner further agrees to communicate openly and directly to resolve any problems or
disputes related to the provision of services in a cooperative manner and at the lowest level of
intervention possible.
XV. COST ALLOCATION – Phase I
A. Partner agrees to financially participate in the operating costs related to the common costs
of the One-Stop System attributable to the Partner’s program(s).
B. Partner commits to work collaboratively with the WDB and other AJCC One -Stop Partners
to participate in the implementation of the Resource Sharing Ag reement (RSA) process in
order to have finalized RSAs by December 31, 2017 for Prog ram Year 2017-2018.
XVI. TERM AND RENEWAL OF MOU
A. The term of this MOU is from July 1, 2016 to June, 30, 2019, unless it is terminated earlier
as provided in Section X VIII, below.
B. This MOU is of no force or effect until signed by authorized representatives of the
participating America’s Job Center One -Stop Partner and the WDB. Once signed thereby,
this MOU is effective commencing upon July 1, 2016, and shall supersede in its entiret y
any MOU entered into previously by and between the participating AJCC One-Stop Partner
and the WDB.
C. The MOU, once signed, becomes a part of the local Strategic Plan.
XVII. REVISIONS AND MODIFICATIONS
This MOU may be revised or modified with the approv al of both the WDB and of the Partner.
XVIII. TERMINATION
Partner may terminate its participation in this MOU upon thirty (30) days written notice to
the WDB; or The WDB may terminate this MOU upon thirty (30) days written notice of such
termination to partner.
XIX. NOTICE
Any notice required or permitted to be given by any party to this MOU shall be deemed given
upon personal delivery to the other parties or two (2) days after being deposited in the United
States mail, postage prepaid, first class mai l addressed to the other parties at the following
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addresses or to such other address as the parties may provide by written notice given in
accordance herewith:
Fresno Regional Workforce Development Board
Attn: Blake Konczal, Executive Director
2125 Kern Street, Suite 208
Fresno, CA 93721
Partner's address as identified on
the signature page below.
XX. ADMINISTRATIVE AND OPERATIONAL MANAGEMENT
It is understood that the Partner and its staff are subject to their existing personnel policies,
procedures, regulations and statutes as well as applicable collective bargaining agreements.
The WDB will assure to the extent possible that the One -Stop Operator will work with all
Partners in developing and implementing policies and procedures for the One -Stop System, in
order to avoid inconsistencies with their respective policies, procedures, regulat ions and
collective bargaining agreements.
XXI. SHARED INFORMATION AND SYSTEM SECURITY
WIOA emphasizes technology as a critical tool for making all aspects of information exchange
possible, including client tracking, common case management, reporting, and data collection.
To support the use of these tools, each AJCC Partner agrees to the following:
A. Comply with the applicable provisions of WIOA, Welfare and Institutions Code, California
Education Code, Rehabilitation Act, and any other applicable statutes or requirements.
B. Commit to share information to the greatest extent allowable under their governing legislation
and confidentiality requirements.
C. System security provisions shall be agreed upon by all partners.
XXII. PUBLIC COMMUNICATIONS AND BRANDING RELATED TO WIOA SERVICES
A. All communications must be approved by the WDB Marketing Manager or Executive Director
prior to the communication.
B. Partner agrees to utilize the AJCC logo developed by the State of California and the Local
Board on buildings identified for AJCC usage.
XXIII. DISPUTE RESOLUTION
The parties ag ree to try to resolve policy and practice disputes at the lowest level, starting
with the site supervisor(s) and staff. If issues cannot be resolved at this level, they shall
be referred to the management staff or the respective staff employer and the WDB, for
discussion and resolution.
XXI V. INDEMNIFICATION
Except as otherwise expressly provided in this MOU and to the fullest extent of the law, each
party shall indemnify and ho ld harmless (the "Indemnifying Party") the other parties, including
the One-Stop Operator and the WDB, and their respective partners, directors, officers, agents,
customers and employees (the "Indemnified Parties") from and against any and all losses,
costs, expenses (including reasonable attorneys', experts' and consultants' fees and court
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costs at all levels of proceedings), damages and/or liabilities which any of the Indemnified
Parties may sustain or incur in connection with or arising out of the performance of this MOU or
any breach by the Indemnifying Party of its obligations under this MOU, except t o the extent
the foregoing is caused by the gross negligence or willful misconduct of the Indemnified
Parties. The terms of this Section XXIV shall survive the termination of this MOU.
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APPROVED BY THE COUNTY OF FRESNO AS TO ITS CAPACITY AS CHIEF LOCAL
ELECTED OFFICIAL (CLEO):
By:~~~
Ernest Buddy Mendes, Chair an
Board of Supervisors
BERNICE E. SEIDEL, CLERK
Board of Supervisors
APPROVED AS TO LEGAL FORM:
DANIEL C. CEDERBORG , COUNTY COUNSEL
By: ~7 ~
Date: 7-.}. S -/'
1718689v1/16988.0001 Fresno Regional Workforce Development Board WIOA Partner MOU
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Fresno Regional Workforce Development Board Page 1 of 1 Form# REG-100, revised 060616 1801764v1 / 16988.0001
Universal Voluntary Consent to Exchange Information
Name of Client: _________________________________________ WIOA Application #: _______________
Purpose. The Fresno Regional Workforce Development Board (“FRWDB”) needs your permission to share
personal information about you with certain organizations in order to best serve you.
Voluntary. Your consent is voluntary. If you do not consent, you will still receive Workforce Innovation and
Opportunity Act (“WIOA”) services; however, these services will be limited because, among other things, FRWDB will
not be able to refer your case to another agency, co-enroll you in additional services, contact an employer to review
your performance, or discuss your case with a school or training provider.
Scope of Information. This Consent covers all information that is personal to you, including, but not limited
to, academic status and performance, employment status, skill assessment information, as well as services
provided by other private or government agencies. This Consent does not authorize the exchange of any health
(mental or physical) information.
Use of Information. By signing this Consent, you allow FRWDB to collect, use, and exchange your personal
information with participating partners, employers, contractors, vocational training providers, public and private
education institutions, and other entities with which FRWDB interacts or contracts on your behalf. FRW DB
will use this information only to support and document your activities and outcomes, to post exit information, and
to assess, plan, and facilitate the delivery of services for your benefit. FRWDB may share or receive this
information either verbally, in writing, or by computer data transfer.
Release. By signing this Consent, you agree to release FRWDB, the City and County of Fresno, and all of their
directors, officers, boards, employees, volunteers, agents, participating partners, and contractors from and
against any liability and claims rel ated to an unauthorized or accidental release of your personal information.
Expiration. This Consent automatically expires 15 months after you exit from your WI OA program. You may
also revoke your consent earlier at any time by sending written notice to FRWDB's Quality Manager at the
following address: 2125 Kern Street, Suite 208, Fresno, California 93721.
Signatures. This Consent is only valid if signed in the presence of an authorized member of your service
provider ’s staff. A properly completed and sig ned photocopy of this Consent is as valid as the original. By
signing, you acknowledge that you have received a copy of this Consent.
Minors. If a client is under 18, this Consent is only valid if signed by the client ’s parent or legal guardian. If
you are signing on behalf of a minor child, an authorized staff member of your child ’s service provider will verify
your parent or guardian status prior to accepting your signature.
Signed: _________________________ Dated: _______ Signed: _________________________ Dated: _______
Client Authorized Staff
Signed: _________________________ Dated: _______ Signed: _________________________ Dated: _______
Client's Parent/Legal Guardian Relationship to Client ____________________________
This Consent was translated to ____________________ by _________________________ Dated: _______
Language Translator
Agency Summary of Services Provided
Non-Medical or Psychiatric
Fresno Regional Workforce Development Board Form# REG-101, revised 060616
Date: _____________
Referring Agency: ___________________________________
Participant Name: ___________________________________
Our agency is providing the services identified below, as of the date indicated above, to the named client.
Note to Agency: Please place an “X” in the first column if the service listed is being provided by your agency. Please
provide comments, if applicable, in the third column.
X Type of Service Comments
Assessment (Comprehensive)
Assessment (Initial)
Assessment (Skill Level)
Basic Labor Exchange
CalFresh
CalLearn
CalWorks
Child Care
Classroom Training
Community Service
Follow-up Services
General Relief
Homeless Assistance
Housing
Job Search/Job Placement
Medi-Cal
Occupational Skills Training
On The Job Training
Refugee Assistance
Transportation
Veteran Outreach
Vocational Rehabilitation
Welfare to Work
Work Experience
Workshops (specialized) Describe:
Other:
Other:
Other:
Workforce Connection – Interest Worksheet
Fresno Regional Workforce Development Board Form# REG-104, revised 060616
Name: _________________________________________ Date: _____________________ Badge # ______________
Please check the following services you are interested in:
Job Search Assistance
Former Military Service Disabilities Assistance Central Valley Professionals Farm Workers
Ticket to Success Migrant Seasonal Farm Worker Senior Employment Assistance
WIOA Services – CASAS Reading & Math Appraisal + Self Reliance Team (SRT) Interview
Youth Services
Youth, ages 14-24
Workshops
First Things First Career Pillar Interview Mentor
Career Development
Health Manufacturing
Government Infrastructure
Housing Assistance
Rental Assistance/Section 8 Home Ownership Programs
Homeless Assistance Emergency Shelter
Temporary Public Assistance
CalWORKS Cash Assistance to Families with Children General Relief Food Stamps Medical Services
Educational Opportunities
GED Community College Adult Basic Education English as a Second Language High School Diploma
Other ______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
Please present this worksheet to your friendly Customer Service Specialist at the
reception desk for further information & direction.
Fresno County America’s Job Center of California
Level I Referral Form
Fresno Regional Workforce Development Board Form# REG-108, rev 060616
Date: Name: Last 4 of SSN: xxx-xx-
Phone#: Email:
From:
WIOA Career Services Providers Other WIOA Providers
CLC-P Adult-Dislocated Urban Youth Program (list provider, region, office)
WHCCD Adult-Dislocated Rural West Office: Other:
Office:
Proteus Adult-Dislocated Rural East Office:
AJCC Partners
EDD, Dept: Fresno County DSS, Dept: SCCCD campus:
California Indian Manpower Adult School, Name: AARP Older Americans
WHCCD campus: Dept. Of Rehabilitation, Dept: Housing Authority; Dept:
Proteus, Program: FEOC-Community Block Grant Dept:
Other: , Dept:
To:
WIOA Career Services Providers Other WIOA Providers
CLC-P Adult-Dislocated Urban Youth Program (list provider, region, office)
WHCCD Adult-Dislocated Rural West Office: Other: Office:
Proteus Adult-Dislocated Rural East Office:
AJCC Partners
EDD, Dept: Fresno County DSS, Dept: SCCCD campus:
California Indian Manpower Adult School, Name: AARP Older Americans
WHCCD campus: Dept. Of Rehabilitation, Dept: Housing Authority; Dept:
Proteus, Program: FEOC-Community Block Grant Dept:
Other: , Dept:
Other Community Services
(list name of agency and department or location)
Agency Name Location Phone # Contact
Referral Reason:
Fresno County America’s Job Center of California
Level II Referral Form
Fresno Regional Workforce Development Board Form# REG-109, rev 060616
Date: Name: Last 4 of SSN: xxx-xx-
Phone#: Email:
From:
WIOA Career Services Providers Other WIOA Providers
CLC-P Adult-Dislocated Urban Youth Program (list provider, region, office)
WHCCD Adult-Dislocated Rural West Office: Other: Office:
Proteus Adult-Dislocated Rural East Office:
AJCC Partners
EDD, Dept: Fresno County DSS, Dept: SCCCD campus:
California Indian Manpower Adult School, Name: AARP Older Americans
WHCCD campus: Dept. Of Rehabilitation, Dept: Housing Authority; Dept:
Proteus, Program: FEOC-Community Block Grant Dept:
EDD, Dept:
To:
WIOA Career Services Providers Other WIOA Providers
CLC-P Adult-Dislocated Urban Youth Program (list provider, region, office)
WHCCD Adult-Dislocated Rural West Office: Other: Office:
Proteus Adult-Dislocated Rural East Office:
AJCC Partners
EDD, Dept: Fresno County DSS, Dept: SCCCD campus:
California Indian Manpower Adult School, Name: AARP Older Americans
WHCCD campus: Dept. Of Rehabilitation, Dept: Housing Authority; Dept:
Proteus, Program: FEOC-Community Block Grant Dept:
Other: , Dept:
Other Community Services
(list name of agency and department or location)
Agency Name Location Phone # Contact
Referral Reason:
Signed Release of information on file Y N Employment Plan: Y N Being Developed N/A
Assessment Completed: Y N List assessment type: Results:
Orientation: Y N
Appointment Time: Date: Appointment with: Phone#:
Address:
I understand this referral is being made to better assist me in my employment goals.
Client Signature_____________________________ Date: __________________
Outcome: