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ATTACHMENT "D" <br />REPORTING <br />Contractor shall provide quarterly progress reports using the template provided. Please submit progress reports <br />to the clerk at healthandhumanservices@co.kittitas.wa.us. <br />Due Dates are as follows: <br />Quarter 1 (January -March) report due on the last day of April. <br />o Quarter 2 (April -June) report due on the last day of July. <br />• Quarter 3 (July -September) report due on the last day of October. <br />Quarter 4 (October -December) report due on the last day of January. <br />The report shall include, at a minimum: <br />1. A brief progress update on each of the activities in your approved Performance Indicators and Evaluation <br />Workbook, including relevant successes and challenges. <br />2. A data summary of the following outputs as indicated in your Performance Indicators and Evaluation <br />Workbook (submitted in application process) and additional county requests: <br />a) Number of incoming referrals and their source <br />b) Total number of individuals seen by CCMs <br />c) Number of individuals screened for suicidal ideation <br />d) Number of individuals screened for behavioral health or related interventions (other than suicidal <br />ideation) <br />e) Number of individuals referred to crisis or other behavioral health services for suicide risk, <br />ideation, or behavior (total outgoing referrals) <br />f) Number of Release of Information forms signed and declined <br />g) Number of individuals receiving or participating in evidence -based behavioral health -related <br />services as a result of the grant (how many people accessed care from outgoing referrals vs <br />dropping out) <br />h) Number of individuals (staff) trained in suicide risk assessment as a result of the grant <br />The County retains the right to request clarification or additional information of the applicant as needed to assess <br />project progress and/or appropriate use of funds. <br />Failure to submit the required reports may result in delayed reimbursement payments, denial of invoices, or <br />contract termination. <br />Contracts, reporting, and invoicing documentation is subject to public disclosure. Please refrain from using <br />individual names in these documents. These documents may be posted to the Kittitas County Public Department's <br />Website at any time to provide transparency in the use of tax funding. <br />Kittitas County Agreement for Services (rev. 5/14/25) <br />Page 8 of 22 <br />