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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 hea lthandhuma nservices@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 iuly. <br />o Quarter 3 (July-September) report due on the last day of October. <br />o 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 lndicators and Evaluation <br />Workbook, including relevant successes and challenges. <br />2. A data summary of the following outputs as indicated in your Performance lndicators 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 />e) <br />ideation) <br />Number of individuals referred to crisis or other behavioral health services for suicide risk, <br />ideation, or behavior (total outgoing referrals) <br />Number of Release of lnformation forms signed and declined <br />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 />Number of individuals (staff) trained in suicide risk assessment as a result of the grant <br />f) <br />s) <br />h) <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 offunds. <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 Cou nty Agreement for Services (rev . 5/U/25l, <br />Page 8 of 22