MOA with State of Washington Department of Veterans Affairs BEFORE THE BOARD OF COUNTY COMMISSIONERS
OF LEWIS COUNTY, WASHINGTON
IN RE:
Approve Memorandum of Agreement between the )
State of Washington Department of Veterans ) Resolution No. 18- M
Affairs and Lewis County )
WHEREAS, the Board of County Commissioners (BOCC), Lewis County,
Washington, has reviewed the Memorandum of Agreement, WDVA Contract No.:
305E-18-087, between Lewis County and the State of Washington Department of
Veterans Affairs (WDVA) from the date executed through June 30, 2021; AND
WHEREAS, the County shall designate the County Veteran Benefits Specialist
to become a VA Accredited Veteran Service Officer (VSO) accredited by the DVA
recognized Veteran Service Organization under Title 38, Code of Federal Regulations
Part 14.628. The VSO will receive training related to veterans' benefits and entitlement
and the VA claims process; AND
WHEREAS, there is no funding attached to this contract; AND
WHEREAS, it appears to be in the best public interest to authorize the execution
of said contract for Lewis County;
NOW, THEREFORE BE IT RESOLVED that the Memorandum of Agreement
between the State of Washington Department of Veterans Affairs and Lewis County
effective when executed through June 30, 2021, is hereby approved and the Director of
Public Health & Social Services is authorized to sign the same.
DONE IN OPEN SESSION this • day of --"r7 T , 2018.
APPROVED AS TO FORM: BOARD OF COUNTY COMMISSIONERS
Jonathan Meyer, ose sting Attorney LEWIS COUNTY, WASHINGTON
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By: Davit` Fine aria . Fund, Chair(J
Deputy Prosecuting Attorney
ATTEST: • Robert C. Jackson, Vice Chair
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Rieva Lester, Clerk of theFdsjNf=F "i ovary Stlimper, Member
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WDVA Contract No.: 305E-18-087
Memorandum of Agreement
("Agreement" or "Contract)
between the
State of Washington
DEPARTMENT OF VETERANS AFFAIRS
and
LEWIS COUNTY, WASHINGTON
This Contract is made and entered into by and between the state of Washington,
Department of Veterans Affairs, hereinafter referred to as the "AGENCY", and the below
named entity, hereinafter referred to as "COUNTY."
Lewis County, Washington
351 NW North St.
Chehalis, WA 98532
Phone: 360-740-1148
FAX: 360-740-1145
Email: sandi.andrus @lewiscountywa.gov
WA State UBI Number: 212-002-978
I. PURPOSE
The purpose of this Agreement is to provide information, referral services, and assistance
to veterans and their family members in processing claims applications for the various
veterans' benefits to which they may be entitled. The claims work produced under this
Agreement will be processed through the "Claims Quality-Assurance Program". This will
ensure that all claims are submitted to the federal Department of Veterans Affairs, Seattle
VA Regional Office, hereinafter referred to as VA, in a "Substantially Complete" status, and
that all efforts have been made to support claims that will result in a favorable VA decision
on behalf of the claimant. The "Claims Quality-Assurance Program" applies to all AGENCY
contracts and agreements, and this uniformly applied practice of Contracted Quality
Assurance will result in verifiable performance and result in an overall shortened claim
processing time for the VA; and will maximize the veterans' benefits within the state.
II. SCOPE OF WORK
A. Attachment A, attached hereto and incorporated by reference, contains the General
Terms and Conditions governing work to be performed under this Agreement, the
nature of the working relationship between the AGENCY and the COUNTY, and
specific obligations of both parties.
B. The COUNTY will provide services and staff, and otherwise do all things necessary
for or incidental to the performance of work, as set forth in Attachment B Statement of
Work.
WDVA Contract No.: 305E-18-087
C. Attachment C. attached hereto and incorporated by reference, contains the Sample
Claims Transmittal Cover Sheet
D. Attachment D, attached hereto and incorporated by reference, contains the Business
Associate Agreement, which ensures that Protected Health Information (PHI) is
appropriately safeguarded.
III. PERIOD OF PERFORMANCE
The period of performance under this Contract will be from June 1, 2018, or date of
execution, whichever is later, through June 30, 2021. This Agreement may be extended
for three additional one-year periods at the discretion of the AGENCY.
IV. CONTRACT MANAGEMENT
The Contract Manager for each of the parties shall be the contact person for all
communications and billings regarding the performance of this contract.
COUNTY Contract Manager Information AGENCY Contract Manager Information
Danette D. York Steven J. Gill
Director Veteran Services Administrator
Lewis County Public Health & Social Services Department of Veterans Affairs
360 NW North St P.O. Box 41150
Chehalis, WA 98532 Olympia, WA 98504-1150
Phone: 360-740-2774 Phone: (360) 725-2235
Fax: 360-740-1145 Fax: (360) 586-1093
Email address danette.york @lewiscountywa.gov Email address: steveng @dva.wa.gov
V. INSURANCE
The County certifies that it is a member of the Washington Counties Risk Pool (the
"Pool"), as provided by RCW 48.62.031, and that it is covered by the Pool's Joint Liability
Coverage Document. Claims submitted under Chapter 4.96 RCW ("Actions against
political subdivisions, municipal and quasi-municipal corporations") against the County, its
employees, officers, volunteers and agents and/or actions in connection with or incidental
to the performance of this agreement which the County and/or its employees, officers,
volunteers and agents are found to be liable for will be paid by the Pool and/or County.
The Pool's liability coverage limits of$10,000,000, per occurrence, exceed limits required
by the agreement and provides coverage for commercial general liability, auto liability, and
professional liability and shall respond to the same extent as if an insurance policy had
been purchased naming LESSOR as named insured.
Page 2 of 4
WDVA Contract No.: 305E-18-087
SELF-INSURANCE— Lewis County serf-insures losses incurred by COUNTY that are
determined not within coverage (occurrence date or exclusion) of the Pool's Joint Self-
Insurance Liability Policy, sets appropriate reserve levels for each occurrence and
identifies the source of funding for each liability within the Risk Management Department
liability Fund.
Lewis County also provides self-insurance for all property owned by the COUNTY.
PROOF OF INSURANCE —The Lewis County Director of Risk Management shall issue a
"Letter of Risk Pool Insurance Coverage" to the WDVA regarding the COUNTY'S
insurance coverage for this Agreement.
A Pool Certificate of Insurance will also be issued to the WDVA, identifying the Agreement
and naming the State of Washington as Certificate Holder.
VI. ASSURANCES
AGENCY and the COUNTY agree that all activity pursuant to this Contract will be in
accordance with all the applicable current federal, state and local laws, rules, and
regulations.
VII. ORDER OF PRECEDENCE
Each of the Attachments listed below is by this reference hereby incorporated into this
Contract. In the event of an inconsistency in this Contract, the inconsistency shall be
resolved by giving precedence in the following order:
1. Applicable federal and state of Washington statutes and regulations;
2. Special terms and conditions as contained in this basic Contract instrument;
3. Attachment A—General Terms and Conditions;
4. Attachment B— Statement of Work;
5. Attachment D — Business Associate Agreement; and
6. Any other provision, term or material incorporated herein by reference or otherwise
incorporated
VIII. ENTIRE AGREEMENT
This Contract, including referenced Attachments, represents all the terms and conditions
agreed upon by the parties. No other statements or representations, written or oral, shall
be deemed a part hereof.
IX. CONFORMANCE
If any provision of this Agreement violates any statute or rule of law of the state of
Washington, it is considered modified to conform to that statute or rule of law.
X. APPROVAL
Page 3 of 4
WDVA Contract No.: 305E-18-087
This Contract shall be subject to the written approval of the AGENCY'S authorized
representative and shall not be binding until so approved. The Contract may be altered,
amended, or waived only by a written amendment executed by both parties.
THIS CONTRACT, consisting of four (4) pages and four (4) attachment(s), is
executed by the persons signing below, who warrant they have the authority to execute
the Contract.
LEWIS COUNTY, WASHINGTON DEPART 'ENT OF VETE'ANS
AFF IRS
1 . .LA 1 .
Signatu a q•nat e
Danette D. York Michael Kashmar
Printed Name Printed Name
Director /Pr Chief Financial Officer «
Title Date Title Da e
Page 4 of 4
ATTACHMENT A
GENERAL TERMS AND CONDITIONS
1. DEFINITIONS - As used throughout this Contract, the following terms shall have the
meanings set forth below:
a. "CLIENT"shall mean an individual receiving service under this Contract.
b. "COUNTY" shall mean that agency, firm, provider organization, individual or other
entity performing services under this Contract. It shall include any subcontractor retained
by the COUNTY as permitted under the terms of this Agreement.
c. "AGENCY'S VETERANS SERVICES DIVISION ADMINISTRATOR" shall mean that
individual authorized to administrate this Agreement on behalf of the AGENCY.
d. "AGENCY" shall mean the AGENCY OF VETERANS AFFAIRS of the state of
Washington, any division, section, office, unit or other entity of the AGENCY or any of the
officers or other officials lawfully representing that AGENCY.
e. "PERSONAL INFORMATION" means information identifiable to any person,
including, but not limited to, information that relates to a person's name, health, finances,
education, business, use or receipt of governmental services or other activities,
addresses, telephone numbers, social security numbers, driver license numbers, other
identifying numbers, and any financial identifiers.
f. "SUBCONTRACTOR" shall mean one not an employee of the COUNTY, who is
performing all or part of those services under this Contract under a separate contract with
the COUNTY. The terms "subcontractor"and "subcontractors"mean subcontractor(s) in
any tier.
g. "SUBRECIPIENT" shall mean a non-federal entity that expends federal awards
received from a pass-through entity to carry out a federal program, but does not include
an individual that is a beneficiary of such a program. It also excludes CONTRACTORS
that receive federal funds in exchange for goods and/or services in the course of normal
trade or commerce.
2. AMERICANS WITH DISABILITIES ACT (ADA) OF 1990, PUBLIC LAW 101-336, also
referred to as the "ADA" 28 CFR Part 35 -The COUNTY must comply with the ADA, which
provides comprehensive civil rights protection to individuals with disabilities in the areas of
employment, public accommodations, state and local government services, and
telecommunications.
3. ASSIGNMENT— Neither this Contract, nor shall any claim arising under this Contract,
shall be transferred or assigned by the COUNTY without prior written consent of the
AGENCY.
4. CERTIFICATION REGARDING DEBARMENT, SUSPENSION AND INELIGIBILITY - If
federal funds are the basis for this Contract, the COUNTY certifies that neither it nor its
Page 1 of 8
WDVA Contract No.: 305E-18-087
principals are presently debarred, declared ineligible or voluntarily excluded from
participation in transactions by any federal department or agency.
5. CHANGE IN STATUS — In the event of substantive change in the legal status,
organizational structure or fiscal reporting responsibility of the COUNTY, COUNTY agrees
to notify the AGENCY of the change. COUNTY shall provide notice as soon as practicable,
but no later than thirty days after such a change takes effect.
6. CHANGES AND MODIFICATIONS - The AGENCY may, at any time, by written
notification to the COUNTY, and without notice to any known guarantor or surety, make
changes within the general scope of the services to be performed under the Contract. If
the COUNTY agrees to such changes, a written contract amendment reflecting such
change shall be executed by the parties. An equitable adjustment in cost or period of
performance or both may be made if required by the change. Any claim for adjustment in
price or period of performance must be received within thirty (30) days of the COUNTY's
receipt of the change notice.
The AGENCY may, however, receive and act upon any such claim at any time prior to final
payment under this Contract at his/her discretion.
Failure to agree to any adjustment made under this section shall be an issue and may be
reviewed as provided in the "Disputes" section of this Contract. Nothing in this section shall
excuse the COUNTY from proceeding with the Contract as changed.
7. CONFLICT OF INTEREST —The AGENCY may, in its sole discretion, by written notice
to the COUNTY, terminate this Contract if it finds, after due notice and examination by the
AGENCY that there is a violation of the Ethics in Public Service Act, Chapter 42.52 RCW;
or any similar statute involving the COUNTY in the procurement of or performance under,
this Contract.
In the event this Contract is terminated as provided above, the AGENCY shall be entitled
to pursue the same remedies against the COUNTY as it could pursue in the event of a
breach of this Contract by the COUNTY. The rights and remedies of the AGENCY provided
for in this clause shall not be exclusive and are in addition to any other rights and remedies
provided by law. The existence of facts upon which the AGENCY makes any determination
under this clause shall be an issue and may be reviewed as provided in the "Disputes"
clause of this Contract.
8. COVENANT AGAINST CONTINGENT FEES — The COUNTY warrants that no person
or selling agent has been employed or retained to solicit or secure this Contract upon an
agreement or understanding for a commission, percentage, brokerage or contingent fee,
excepting bona fide employees or bona fide established agent maintained by the COUNTY
for the purpose of securing business. The AGENCY shall have the right, in the event of
breach of this clause by the COUNTY, to annul this Contract without liability or, in its
discretion, to deduct from this Contract price or consideration or recover by other means
the full amount of such commission, percentage, brokerage or contingent fees.
9. DISPUTES - Except as otherwise provided in this Contract, when a dispute arises
between the parties and it cannot be resolved by direct negotiation, either party may request
a dispute hearing with the AGENCY's Director or his or her designee.
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WDVA Contract No.: 305E-18-087
a. The request for a dispute hearing must:
Be in writing;
State the disputed issues;
State the relative positions of the parties;
State the COUNTY's name, address, and this Contract number; and
Be mailed to the agent and the other party's (respondents) within 3 working days
after the parties agree that they cannot resolve the dispute.
b. The respondent shall send a written answer to the requestor's statement to both the
agent and the requestor within 5 working days.
c. The agent shall review the written statements and reply in writing to both parties
within 10 working days. The agent may extend this period if necessary by notifying
the parties.
d. The decision shall be admissible in any succeeding judicial or quasi-judicial
proceeding.
e. The parties agree that this dispute process shall precede any action in a judicial or
quasi-judicial tribunal.
10. GOVERNING LAW - This Contract shall be construed and interpreted in accordance
with the laws of the state of Washington and the venue of any action brought hereunder
shall be in Superior Court for Thurston County.
11. INDEMNIFICATION — Each party to this Agreement shall be responsible for the
negligence of its officers, employees, and agents in the performance of this Agreement. No
party to this Agreement shall be responsible for the acts and/or omissions of entities or
individuals not party to this Agreement. The Agency and the County shall cooperate in the
defense of tort lawsuits, when possible. Both parties agree and understand that such
cooperation may not be feasible in all circumstances. The Agency and the County agree to
notify the attorneys of record in any tort lawsuit where both are parties if either Agency or
the County enters into settlement negotiations. It is understood that the notice shall occur
prior to any negotiations, or as soon as possible thereafter, and the notice may be either
written or oral.
12. INDEPENDENT CAPACITY—The parties intend that an independent CONTRACTOR
relationship will be created by this Contract. The COUNTY and his or her employees or
agents performing under this Contract are not employees or agents of the AGENCY. The
COUNTY will not hold himself/herself out as nor claim to be an officer or employee of the
AGENCY or of the state of Washington by reason hereof, nor will the COUNTY make any
claim of right, privilege or benefit that would accrue to such employee under law. Conduct
and control of the work will be solely with the COUNTY.
13. LICENSING AND ACCREDITATION STANDARDS - The COUNTY shall comply with
all applicable local, state, and federal licensing, accreditation and registration
requirements/standards, necessary in the performance of this Contract.
14. LIMITATION OF AUTHORITY-Only the AGENCY or its delegate by writing (delegation
to be made prior to action) shall have the express, implied or apparent authority to alter,
amend, modify or waive any clause or condition of this Contract. Furthermore, any
alteration, amendment, modification or waiver of any clause or condition of this Contract is
not effective or binding unless made in writing and signed by the AGENCY.
Page 3 of 8
WDVA Contract No.: 305E-18-087
15. NONDISCRIMINATION — During the performance of this Contract, the COUNTY shall
comply with all federal and state nondiscrimination laws, regulations and policies. In the
event of the COUNTY's noncompliance or refusal to comply with any nondiscrimination law,
regulation or policy, this Contract may be rescinded, canceled or terminated in whole or in
part, and the COUNTY may be declared ineligible for further contracts with the AGENCY.
The COUNTY shall, however, be given a reasonable time in which to cure this
noncompliance. Any dispute may be resolved in accordance with the"Disputes" procedure
set forth herein.
16. PERFORMANCE MEASUREMENT AND MONITORING — Impacts and outcomes
achieved as a result of the delivery of services may be measured and evaluated by the
AGENCY in a Periodic Performance Report form, in accordance with Attachment B. The
AGENCY may evaluate COUNTY's performance at Contract completion and at least once
a year. An annual evaluation will be conducted during the sixty-day period following this
Contract anniversary date, except AGENCY can establish which better accommodates the
AGENCY's particular needs. The evaluation will cover a period ending with an established
date. The AGENCY may utilize the standardized Period Performance Report form and/or
supplement the process with special performance factors peculiar to the specific contractual
needs. Each evaluation shall include an assessment of the COUNTY's efforts toward
achieving AGENCY objectives. The form is designed to aid the AGENCY in referrals, clarify
COUNTY's duties and AGENCY expectations, and inform COUNTYS of their performance
strengths and weaknesses.
17. PRIVACY - Personal information collected, used or acquired in connection with this
Contract shall be used solely for the purposes of this Contract. COUNTY and its
subcontractors agree not to release, divulge, publish, transfer, sell or otherwise make
known to unauthorized persons personal information without the express written consent of
the agency or as provided by law. COUNTY agrees to implement physical, electronic and
managerial safeguards to prevent unauthorized access to personal information.
The AGENCY reserves the rights to monitor, audit or investigate the use of personal
information collected, used or acquired by the COUNTY through this Contract. The
monitoring, auditing or investigating may include but is not limited to "salting" by the
AGENCY. COUNTY shall certify the return or destruction of all personal information upon
expiration of this Contract. Salting is the act of placing a record containing unique but false
information in a database that can be used later to identify inappropriate disclosure of data
contained in the database.
Any breach of this provision may result in termination of the Contract and the demand for
return of all personal information. The COUNTY agrees to indemnify and hold harmless
the AGENCY for any damages related to the COUNTY's unauthorized use of personal
information.
For the purposes of this provision, personal information includes but is not limited to
information identifiable to an individual that relates to a natural person's health, finances,
education, business, use or receipt of governmental services or other activities, names,
addresses, telephone numbers, social security numbers, driver license numbers, financial
profiles, credit card numbers, financial identifiers and other identifying numbers.
18. RECORDS, DOCUMENTS, AND REPORTS — The COUNTY shall maintain all books,
records, documents, data and other evidence relating to this Contract and performance of the
Page 4 of 8
WDVA Contract No.: 305E-18-087
services described herein, including but not limited to accounting procedures and practices,
which sufficiently and properly reflect all direct and indirect costs of any nature expended in
the performance of this Contract. COUNTY shall retain such records for a period of six (6)
years following the date of final payment. At no additional cost, these records, including
materials generated under this Contract, shall be subject at all reasonable times to inspection,
review or audit by the AGENCY, personnel duly authorized by the AGENCY, the Office of the
State Auditor, and federal and state officials so authorized by law, regulation or agreement.
If any litigation, claim or audit is started before the expiration of the six (6) year period, the
records shall be retained until all litigation, claims or audit findings involving the records have
been resolved.
19. RIGHT OF INSPECTION -The COUNTY shall provide right of access to its facilities to
the AGENCY or any of their officers at all reasonable times, in order to monitor and evaluate
performance, compliance, and/or quality assurance under this Contract on behalf of the
AGENCY. All inspections and evaluations shall be performed in such a manner that will
not unduly interfere with the COUNTY's business or work hereunder.
20. RIGHTS IN DATA- Unless otherwise provided, data that originates from this Contract
shall be "works made for hire" as defined by the U.S. Copyright Act of 1976 and shall be
owned by the AGENCY. Data shall include, but not be limited to, reports, documents,
pamphlets, advertisements, books, magazines, surveys, studies, computer programs,films,
tapes, and/or sound reproductions. Ownership includes the right to copyright, patent,
register and the ability to transfer these rights.
Data that is delivered under this Contract, but that does not originate therefrom, shall be
transferred to the AGENCY with a nonexclusive, royalty free, irrevocable license to publish,
translate, reproduce, deliver, perform, dispose of, and to authorize others to do so; provided
that such license shall be limited to the extent that the COUNTY has a right to grant such a
license.
The COUNTY shall exert all reasonable effort to advise the AGENCY, at the time of delivery
of data furnished under this Agreement, of all known or potential invasions of privacy
contained therein and of any portion of such document, which was not produced in the
performance of this Agreement. The AGENCY shall receive prompt written notice of each
notice or claim or copyright infringement received by the COUNTY with respect to any data
delivered under this Agreement. The AGENCY shall have the right to modify or remove
any restrictive markings placed upon the data by the COUNTY.
21. SAFEGUARDING OF INFORMATION - The COUNTY shall not use or disclose any
Personal Information gained by reason of this Contract or Information that may be classified
as confidential for any purpose not directly connected with the administration of this
Contract except (1)with prior written consent of the AGENCY or (2) as may be required by
law. The COUNTY shall safeguard such information and shall return or certify destruction
of the information upon this Contract expiration or termination.
22. SAVINGS - In the event funding from state, federal or other sources is withdrawn,
reduced or limited in any way after the effective date of this Contract and prior to normal
completion, the AGENCY may terminate this Contract under the "Termination for
Convenience" clause, without advance notice.
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WDVA Contract No.: 305E-18-087
23. SEVERABILITY — If any provision of this Contract or any provision of any document
incorporated by reference shall be held invalid, such invalidity shall not affect the other
provisions of this Contract that can be given effect without the invalid provision, if such
remainder conforms to the requirements of applicable law and the fundamental purpose of
this Contract, and to this end the provisions of this Contract are declared to be severable.
24. SUBCONTRACTING - Neither the COUNTY nor any Subcontractor shall enter into
subcontracts for any of the work contemplated under this Contract without obtaining prior
written approval of the AGENCY. In no event shall the existence of the subcontract operate
to release or reduce the liability of the COUNTY to the AGENCY for any breach in the
performance of the COUNTY's duties. This clause does not include contracts of
employment between the COUNTY and personnel assigned to work under this Contract.
25. TERMINATION FOR CONVENIENCE - Except as otherwise provided in this Contract,
the AGENCY or the COUNTY may, by thirty (30) days written notice, beginning on the
second day after the mailing, terminate this Contract in whole or in part. If this Contract is
so terminated, the AGENCY shall be liable only for payment required under the terms of
this Contract for services rendered or goods delivered prior to the effective date of
termination.
26. TERMINATION FOR DEFAULT-The AGENCY may terminate this Contract for default,
in whole or in part, by written notice to the COUNTY if the AGENCY has a reasonable basis
to believe that the COUNTY has:
a. Failed to meet or maintain any requirement for Contracting with the AGENCY;
h. Failed to ensure the health or safety of any client for whom services are being
provided under this Contract;
c. Failed to perform under or otherwise breached, any term or condition of this
Contract; and/or
d. Violated any applicable law or regulation.
If it is later determined that the COUNTY was not in default, the termination shall be
considered a termination for convenience.
27. TERMINATION PROCEDURE - Upon termination of this Contract, the AGENCY, in
addition to any other rights provided in this Contract, may require the COUNTY to deliver to
the AGENCY any property specifically produced or acquired for the performance of such
part of this Agreement as has been terminated. The provisions of the "Treatment of Assets"
clause shall apply in such property transfer.
The AGENCY shall pay to the COUNTY the agreed upon price, if separately stated, for
completed work and services accepted by the AGENCY and the amount agreed upon by
the COUNTY and the AGENCY for (a) completed work and services for which no separate
price is stated, (b) partially completed work and services, (c) other property or services that
are accepted by the AGENCY, and (d) the protection and preservation of the property,
unless the termination is for default, in which case the AGENCY shall determine the extent
of the liability of the AGENCY. Failure to agree with such determination shall be a dispute
within the meaning of the "Disputes" clause of this Agreement.
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WDVA Contract No.: 305E-18-087
The AGENCY may withhold from any amounts due the COUNTY for such completed work
or services such sum as the AGENCY determines to be necessary to protect the AGENCY
against potential loss or liability.
The rights and remedies of the AGENCY provided in this section shall not be exclusive and
are in addition to any other rights and remedies provided by law or under this Agreement.
After receipt of a notice of termination, and except as otherwise directed by the AGENCY,
the COUNTY shall:
a. Stop work under the Agreement on the date and to the extent specified in the notice;
b. Place no further orders or subcontracts for materials, services or facilities except as
necessary to complete such portion of the work not terminated;
c. Assign to the AGENCY, in the manner, at the times, and to the extent directed by the
AGENCY, all of the rights, titles, and interest of the COUNTY under the orders and
subcontracts in which case the AGENCY has the right, at its discretion, to settle or pay
any or all claims arising out of the termination of such orders and subcontracts.
d. Settle all outstanding liabilities and all claims arising out of such termination of orders
and subcontracts, with the approval or ratification of the AGENCY to the extent he/she
may require, which approval or ratification shall be final for all the purposes of this
clause;
e. Transfer title to the AGENCY and deliver, in the manner, at the times and to the extent
as directed by the AGENCY, any property which, if the Contract had been completed,
would have been required to be furnished to the AGENCY;
f. Complete performance of such part of the work not terminated by the AGENCY; and,
g. Take such action as may be necessary or as the AGENCY may direct, for the protection
and preservation of the property related to this Contract that is in the possession of the
COUNTY and in which the AGENCY has or may acquire and interest.
28. TREATMENT OF ASSETS - Title to all property financed or furnished by the AGENCY
shall remain in the AGENCY. Title to all property purchased by the COUNTY, for which
the COUNTY is entitled to be reimbursed as a direct item of cost under this Contract, shall
pass to and vest in the AGENCY upon delivery of such property to the COUNTY. Title to
other property, the cost of which is reimbursable to the COUNTY under the Contract, shall
pass to and vest in the AGENCY upon (i) issuance for use of such property in the
performance of this Contract or (ii) commencement of use of such property in the
performance of this Contract or (iii) reimbursement of the cost thereof by the AGENCY in
whole or in part, whichever first occurs.
Any property of the AGENCY furnished to the COUNTY shall, unless otherwise provided
herein or approved by the AGENCY, be used only for the performance of this Contract.
The COUNTY shall be responsible for any loss or damage to property of the AGENCY that
results from the negligence of the COUNTY or that results from the failure on the part of
the COUNTY to maintain and administer that property in accordance with sound
management practices.
If any AGENCY property is lost, destroyed or damaged, the COUNTY shall notify the
AGENCY and shall take all reasonable steps to protect the property from further damage.
Page 7 of 8
WDVA Contract No.: 305E-18-087
The COUNTY shall surrender to the AGENCY all property of the AGENCY prior to
settlement upon completion, termination or cancellation of this Contract.
All reference to the COUNTY under this clause shall include COUNTY's employees,
agents or subcontractors.
29. WAIVER OF DEFAULT -Waiver of any default or breach shall not be deemed to be a
waiver of any subsequent default or breach. Waiver shall not be construed to be a
modification of the terms of the Contract unless stated to be such in writing, signed by the
AGENCY.
Page 8 of 8
ATTACHMENT B
STATEMENT OF WORK
A. The COUNTY will provide services, and otherwise do all things necessary for or
incidental to the performance of work, as set forth below:
1. The COUNTY understands and shall comply with the following section of Title 38,
Code of Federal Regulations Part 14.628(d)(2)(i) "...neither the organization nor its
accredited representatives will charge or accept a fee or gratuity for service to a
claimant..."
2. The COUNTY shall designate a "County Veteran Service Officer" who will become
a VA "Accredited Veteran Service Organization Representative" accredited by the
AGENCY or a VA recognized veteran service organization under Title 38, Code of
Federal Regulations Part 14.628. If the County Veteran Service Officer is to become
accredited by the AGENCY they must be a paid employee of the COUNTY working
for it not less than 1,000 hours annually.
3. The COUNTY shall submit all VA claims produced to the AGENCY or other
appropriate veterans Service Organization (VSO) "Claims Quality-Assurance
Officer"for quality-assurance (Q-A)and entry into the Q-A database, before delivery
to the VA for promulgation. The COUNTY shall support the Quality-Assurance
Program process by ensuring that each claim is submitted to the appropriate
Veterans Service Organization's Q-A Officer, in a "Substantially Complete" status.
All services and claims support for veterans and their family members shall be
provided at absolutely no cost to the veteran or claimant.
4. The COUNTY shall submit all claims to the Claims Quality-Assurance Officer with
the AGENCY's Claims Quality-Assurance Program Cover Sheet. The COUNTY
shall retain copies of the cover sheets.
5. The COUNTY agrees to work with the AGENCY's Veterans Services Division
Administrator should modification of activities be deemed necessary to adequately
provide quality service for veterans and their family members.
6. The COUNTY shall support the AGENCY's contracted local Post Traumatic Stress
Disorder (PTSD) counselors in the form of information assistance and referral
services as appropriate. All PTSD referrals will be handled in a confidential manner.
7. The COUNTY shall maintain current resource materials for veterans' benefits
information and claims development.
8. The COUNTY shall be evaluated based on the approval rate or "Batting Average"
of the VA claims that they submit.
B. The AGENCY will provide services, and otherwise do all things necessary for or
incidental to the performance of work, as set forth below:
1 of 2
WDVA Contract No.: 305E-18-087
1. The AGENCY shall provide training for the COUNTY's designated County Veteran
Service Officer related to veterans' benefits and entitlement and the VA claims
process. This training may include but shall not be limited to:
a. The Basic Training Course for Veterans Benefits developed by the National
Veterans Legal Services Program;
b. Training Responsibly Involvement in Preparation of Claims (TRIP)
developed by the VA;
c. Veteran service organization training conferences; and
d. Direct training with AGENCY representatives.
2. The AGENCY shall provide VA Accreditation as a Veteran Service Organization
Representative under Title 38, Code of Federal Regulations Part 14.629 as a County
Veteran's Service Officer.
3. The AGENCY shall maintain a report of the COUNTY's VA claims approval rating
or"Batting Average".
4. The AGENCY shall represent the VA appeals for veterans or claimants under the
AGENCY's VA Power of Attorney (POA) through the AGENCY's "Appeals-
Management Process" program.
C. All cover sheets must be mailed or faxed to the AGENCY's Veterans Services Division
Administrator's designated staff, at:
Washington State Department of Veterans Affairs
915 2nd AVE, ROOM 1050
Seattle WA 98174
Fax: (206) 341-8666
D. The activities pursuant to and in consideration of this Agreement will in no way alter or
attenuate the role of COUNTY as advocate for the Veteran. The ultimate responsibility
remains on the veteran in all actions taken in support of his or her petition for benefits.
Nor will it be construed to obviate or mitigate the responsibility of the US Department of
Veterans Affairs to fulfill its legal obligations including duty to notify, duty to inform, and
duty to assist veterans in the prosecution of a claim for benefits. Furthermore, the
provisions of this Agreement do not establish the COUNTY as an agent of the
Department of Veterans Affairs. All provisions contained herein will comply with Federal
and State Privacy and Disclosure Acts.
Page 2 of 2
ATTACHMENT C
REPORTING DOCUMENT
Washington State Department of Veterans Affairs Claims Transmittal Cover Sheet
(SAMPLE ONLY)
Washington State Department of Veterans Affairs
, .
Claim Transmittal Curer Sheet
State Dç A Sat lit Offica Asiatics Qatar Plasancia
astir.AgiC111■W FAX (206)341-6666
V apnea:
Clathrautt-
Addle vs.:
Plow,
Type of Claim
o FDC(Fully Devekgped Claim) 0 Electronic Submits:ions(SEP)
10 010—Bartel CpS or More'sales 0 110—Initial Comp 7 or Less Issues
0 020—Reopened Claim 0 130—Reopened Pension Claim
0 020—Addltag New Issue 0020—RequeMn.g'Increase
0 140—Initial Death Cation 0 160—Plot and Burial Benefits
0 1S —Tith1Dabthty Ranier 0 190—1=41 Death Pension
0 170—Appeal Documents 0 Homeless Veterans
0 01F1 OFF
Lawn
1. 6
7.
3. a
5. I
The Enclosed Forms;Materials are Sib/Bitted in Support of the Above Veterans Qaim-
020-572 021-4135 021-534
021-0779 0214140-1 021-636c O5TIL's
O21-07st 0314142 021-0416 OVet Statement
0214701a 0214192 0214940 Otitamogs- Confirms
021- S45 021-21-4502 0204900 0Death Certificate
021-0547 021-526 ODBQ's
021-22 021-526b 0Buddy statement
021-2680 021-527EZ ODD-219 /
OWDVA 055 021-530 0E-Benefits APP
Service Officer: Date:
QA Officer: Date:
REY 11/15/2.013
Page 1 of 1
ATTACHMENT D
BUSINESS ASSOCIATE AGREEMENT
THIS BUSINESS ASSOCIATE AGREEMENT ("Agreement") is entered into by and
between Washington State Department of Veterans Affairs ("Covered Entity"), and Lewis
County, Washington ("Business Associate").
RECITALS:
A. Covered Entity, including facilities/agencies owned and operated by Covered Entity,
is designated as a "Covered Entity," as defined by the federal Health Insurance
Portability and Accountability Act of 1996 and its promulgating regulations("HIPAA"),
and as amended by the regulations promulgated pursuant to the Health Information
Technology for Economic and Clinical Health Act("HITECH").
B. Business Associate has an underlying business relationship ("Underlying Contract")
with Covered Entity, in which Business Associate performs functions or activities, or
provides certain services, on behalf of Covered Entity.
C. In the course of providing such services, Business Associate may have access to,
receive from, maintain, transmit, create, and/or receive on behalf of Covered Entity,
Protected Health Information ("PHI").
D. Covered Entity and Business Associate intend to protect the privacy and provide for
the security of PHI disclosed to Business Associate pursuant to this Agreement and in
order to comply with HIPAA and its implementing regulations including the Privacy
Rule (defined below), the Security Rule (defined below) and the Breach Notification
Rule (defined below).
NOW, THEREFORE, in consideration of these recitals and the mutual promises
contained in this Agreement and for other good and valuable consideration, the receipt and
sufficiency of which are hereby acknowledged, Covered Entity and Business Associate, intending
to be legally bound, agree as follows:
AGREEMENT:
I. DEFINITIONS
A. "Breach" shall have the meaning given to such term at 45 C.P.R. §
164.402.
B. "Breach Notification Rule" shall mean the rule related to breach notification for
Unsecured Protected Health Information at 45 C.P.R. Parts 160 and 164.
C. "Electronic protected health information" or ("EPHI") shall have the same meaning
given to such term under the Security Rule, including, but not limited to, 45 C.P.R. §
Page 1 of 8
160.103 limited to the information created or received by Business Associate from
or on behalf of Covered Entity.
D. "HIPAA Rules" shall mean the Privacy, Security, Breach Notification and
Enforcement Rules.
E. "Privacy Rule" shall mean the Standards for Privacy of Individually Identifiable
Health Information, codified at 45 C.P.R. Parts 160 and Part 164, Subparts A and E.
F. "Protected Health Information" or "PHI" shall have the meaning given to such phrase
under the Privacy and Security Rules at 45 C.P.R. § 160.103, limited to
the information created or received by Business Associate from or on behalf
of the Covered Entity.
G. "Security Rule" shall mean the Security Standards for the Protection of
Electronic
Protected Health Information, codified at 45 C.P.R. § 164 Subparts A and C.
H. "Unsecured PHI" shall have the meaning given to such phrase under the
Breach
Notification Rule at 45 C.P.R. § 164.402.
I. Other terms used, but not otherwise defined, in this Agreement shall have the same
meaning as those terms in the Privacy, Security or Breach Notification Rules and
the Underlying Contract. Where there is a conflict between meanings in either this
Agreement together with the Privacy, Security or Breach Notification Rules and
the Underlying Contract, then the meanings in this Agreement together with the
Privacy, Security or Breach Notification Rules shall govern.
II. OBLIGATIONS OF THE PARTIES WITH RESPECT TO PHI.
A. Obligations of Business Associate. Business Associate shall:
1. Not use or disclose PHI other than as permitted or required by the
Underlying
Contract or as required by law;
2. Not use or disclose PHI in a manner that would violate the Privacy Rule
if done by the Covered Entity, unless expressly permitted to do so pursuant
to the Privacy Rule and this Agreement, provided that if Business
Associate carries out one or more of Covered Entity's obligations under
the Privacy Rule pursuant to the Underlying Contract, Business Associate
shall fully comply with the Privacy Rule requirements that would apply
to Covered Entity in the performing those obligations;
3. Use appropriate safeguards, and comply with the Security Rule at Subpart
C of 45 CFR Part 164 with respect to EPHI, to prevent use or disclosure of
PHI other than as provided for by the Agreement;
Page 2 of 8
4. Report to Covered Entity immediately, and in no case later than five
(5) calendar days of Business Associate's discovery, any use or disclosure
of PHI not provided for by the Agreement of which it becomes aware, any
Breaches of Unsecured PHI as required at 45 CFR 164.410, any security
incident of which it becomes aware, or any breach as such may be defined
under relevant state data breach laws ("State Law Breach"). Any notice of a
Breach or State Law Breach referenced in this Section IV will include the
results of the risk assessment of whether there is a low probability that the
PHI has been compromised based on the required factors set forth in 45 CFR
164.402 if the Breach is discovered on or after September 23, 2013,
and to the extent possible, the identification of each individual whose
Unsecured PHI has been, or is reasonably believed by Business Associate
to have been accessed, acquired, used, or disclosed during such Breach.
Notwithstanding anything set forth in this Agreement or the Underlying
Contract, Business Associate shall be responsible for the cost of the
risk assessment and any breach mitigation expenses and shall indemnify,
defend and hold Covered Entity and its officers, directors, affiliates,
employees, agents, successors and assigns harmless, from and against
any and all losses, claims, actions, demands, liabilities, damages, costs
and expenses (including costs, expenses incurred in notifying individuals,
the media or government agencies in connection therewith) and any
judgments, settlements, court costs and reasonable attorneys' fees
actually incurred (collectively, "Breach Claims") arising from or related to: (i)
the use or disclosure of PHI in violation of the terms of this Agreement or
applicable law, and (ii) whether in oral, paper or electronic media, any
HIPAA Breach of unsecured PHI and/or State Law Breach. If Business
Associate assumes the defense of a Breach Claim, Covered Entity shall
have the right, at its expense, to participate in the defense of such Breach
Claim. Business Associate shall not take any final action with respect to
any Breach Claim without the prior written consent of Covered Entity. To
the extent permitted by law, Business Associate shall be fully liable to
Covered Entity for any acts, failures or omissions of its agents and
subcontractors in furnishing the services as if they were the Business
Associate's own acts, failures or omissions;
5. Make available PHI in a designated record set to Covered Entity in the
form and format as necessary to satisfy Covered Entity's obligations under
45 CFR
164.524 within five (5) business days of receiving a request from
Covered
Entity;
6. Provide access, at the request of Covered Entity, and in no case later than
five (5) business days after such request, to PHI in a Designated Record Set,
to Covered Entity or, as directed by Covered Entity, to an Individual or
third party designated by the Individual, in the form or format requested
if it is readily producible in such form or format in order for the Covered
Entity to meet the requirements under the Privacy Rule;
Page 3 of 8
7. Make any PHI contained in a Designated Record Set available to Covered
Entity (or an Individual as directed by Covered Entity) within five (5)
business days of a request for purposes of amendment per 45 C.P.R.
§164.526. If an Individual requests an amendment of PHI directly from
Business Associate or its Subcontractors, Business Associate shall forward the
request to Covered Entity within two business days;
8. Maintain and make available the information required to provide an
accounting of disclosures to Covered Entity as necessary to satisfy Covered
Entity's obligations under 45 CPR 164.528. If an accounting of disclosures is
requested by an individual directly to Business Associate, the Business
Associate will forward the request to Covered Entity within two (2) business
days;
9. To the extent the Business Associate is to carry out one or more of Covered
Entity's obligation(s) under Subpart E of 45 CPR Part 164, comply with the
requirements of Subpart E that apply to Covered Entity in the performance of
such obligation(s) and to the extent any such obligations involve disclosures
of PHI to health plans, comply with the requirements of 45 CPR 164.522
regarding requested restrictions on health plan disclosures;
10. Make its internal practices, books and records, including policies and
procedures, relating to the use and disclosure of PHI available to the
Secretary of HHS and to Covered Entity for purposes of determining Covered
Entity's compliance with the HIPAA Rules;
1 1 . Use appropriate safeguards to prevent use or disclosure of PHI other than
as provided for by this Agreement. Implement administrative, physical, and
technical safeguards that reasonably and appropriately protect the
confidentiality, integrity, and availability of EPHI as required by 45 C.P.R.
Part 164 Subpart C ("Security Rule"). With respect to EPHI, Business
Associate shall comply with all applicable state laws governing information
security breaches;
12. Ensure that any agents and Subcontractors that create, receive, maintain
or transmit PHI on behalf of Business Associate agree to the same
restrictions and conditions that apply through this Agreement to Business
Associate with respect to such information. Business Associate shall ensure
that any agent or Subcontractor to whom Business Associate provides EPHI
agrees to implement reasonable and appropriate safeguards to protect EPHI.
13. To the extent permitted by law, cooperate with Covered Entity to ensure that
legal process conforms with the applicable requirements of the HIPAA Rules,
or, if necessary in Covered Entity's opinion, obtain a qualified protective
order to limit or prevent the disclosure of PHI in the event of the receipt of a
subpoena, court or administrative order or other discovery request.
Page 4 of 8
B. Permitted Uses or Disclosures by Business Associate. Business Associate may
use or disclose PHI only:
1. As necessary to perform the services set forth in the Underlying Contract,
provided that Business Associate must be specifically authorized in writing
by an authorized representative of Covered Entity to use PHI to de-identify
the information in accordance with 45 CPR 164.514(a)-(c);
2. As required by law;
3. I f uses and disclosures and requests for PHI are consistent with
Covered Entity's minimum necessary policies and procedures;
4. In a manner that would not violate Subpart E of 45 CPR Part 164 if done by
Covered Entity, except that Business Associate may use PHI to carry out the
legal responsibilities of the Business Associate only if Business Associate
obtains reasonable assurances from the person to whom the information is
disclosed that the information will remain confidential and used or further
disclosed only as required by law or for the purposes for which it was
disclosed to the person, and the person agrees to notify Business Associate of
any instances of which it is aware in which the confidentiality of the information
has been breached;and
5. To provide data aggregation services relating to the health care operations of
Covered Entity only if authorized to do so in the Underlying Contract.
C. Covered Entity Privacy Practices and Restrictions.
1. Covered Entity shall notify Business Associate of any limitation(s) in the
notice of privacy practices of Covered Entity under 45 CPR 164.520, to the
extent that such limitation may affect Business Associate's use or disclosure
of PHI.
2. Covered Entity shall notify Business Associate of any changes in, or
revocation of, the permission by an individual to use or disclose his or her
PHI, to the extent that such changes may affect Business Associate's use or
disclosure of PHI.
3. Covered Entity shall notify Business Associate of any restriction on the use or
disclosure of PHI that Covered Entity has agreed to or is required to abide by
under 45 CPR 164.522, to the extent that such restriction may affect Business
Associate's use or disclosure of PHI.
Page 5 of 8
III. TERM AND TERMINATION.
A. Term. This Agreement shall be effective as of the date set forth above and shall
continue until Business Associate ceases to perform the services defined in the
Underlying Contract.
B. Termination for Cause. Covered Entity may immediately terminate this Agreement in
the event that Business Associate materially breaches any provision of this
Agreement or the Underlying Contract.
In its sole discretion, Covered Entity may permit Business Associate the opportunity
to cure or to take substantial steps to cure such material breach to Covered Entity's
satisfaction within thirty(30) days after receipt of written notice from Covered Entity.
C. Obligations of Business Associate upon Termination. Upon the expiration or
termination of this Agreement for any reason, Business Associate,with respect to PHI
received from Covered Entity, shall:
1. Retain only that PHI which is necessary for Business Associate to continue its
proper management and administration or to carry out its legal
responsibilities;
2. Return to Covered Entity or destroy all PHI in any form, including such
information in possession of Business Associate's Subcontractors, and retain
no copies, if it is feasible to do so;
3. If return or destruction is not feasible, extend all protections, limitations and
restrictions contained in this Agreement to Business Associate's use and/or
disclosure of any retained PHI, and to limit further uses and/or disclosures to
only those purposes that make the return or destruction of the PHI infeasible;
4. Not use or disclose PHI retained by Business Associate other than for the
purposes for which such PHI was retained and subject to the same conditions
set forth above in section B under "Permitted Uses and Disclosures by
Business Associate"which applied prior to termination.
5. Return to Covered Entity the PHI retained by Business Associate when it is no
longer needed by Business Associate for its proper management and
administration or to carry out its legal responsibilities.
This provision and the breach reporting provisions in Section II (A)(4) shall survive the
termination or expiration of this Agreement and/or any Underlying Contract.
Page 6 of 8
Iv.
MISCELLANEOUS.
A. Amendment. Amendments to this Agreement may be necessary to comply
with modifications to the HIPAA Rules. Covered Entity and Business Associate
agree to use good-faith efforts to develop and execute any amendments to this
Agreement as may be required for compliance the HIPAA Rules. This
Agreement may be amended or modified only in writing signed by Covered
Entity and Business Associate.
B. Severability. In the event any provision of this Agreement is held to
be unenforceable for any reason, the unenforceability thereof shall not affect
the remainder of the Agreement, which shall remain in full force and effect and
enforceable in accordance with its terms.
C. Independent Contractor. For purpose of its obligations under this Agreement,
Business Associate is an independent contractor of Covered Entity and shall not
be considered an agent of Covered Entity.
D. Limited Liability Exclusion. To the extent that Business Associate has limited
its liability under the terms of the Underlying Contract, whether with a maximum
recovery for direct damages or a disclaimer against any consequential, indirect
or punitive damages, or other such limitations, all limitations shall exclude any
damages to Covered Entity arising from Business Associate's breach of its
obligations relating to the use and disclosure of PHI.
E. Equitable Remedies. Business Associate stipulates that its unauthorized use or
disclosure of PHI would cause irreparable harm to Covered Entity, and in such
event, Covered Entity shall be entitled to institute proceedings in any court of
competent jurisdiction to obtain damages and injunctive relief.
F. Ownership of PHI. Under no circumstances shall Business Associate be deemed
in any request to be the owner of any PHI used or disclosed by or to Business
Associate by Covered Entity.
G. No Third Party Beneficiaries. Nothing expressed or implied in this Agreement
is intended to confer, nor shall anything herein actually confer, upon any person
other than Covered Entity, Business Associate and, to the extent specified
above, their respective parent entities, subsidiaries, affiliates, facilities, insurers,
employees, directors, officers, subcontractors, agents or other members of their
respective workforces, successors or assigns, any rights, remedies, obligations
or liabilities whatsoever.
H. Waiver. No provision of this Agreement or any breach thereof shall be
deemed waived unless such waiver is in writing and signed by the party
claimed to have waived such provision or breach. No waiver of a breach shall
constitute a waiver of or excuse any different or subsequent breach.
I. Assignment. Neither Party may assign (whether by operating or law or
otherwise) any of its rights or delegate or subcontract any of its obligations under
Page 7 of 8
this Agreement without the prior written consent of the other party.
Notwithstanding the foregoing, Covered Entity shall have the right to assign its
rights and obligations hereunder to any entity that is an affiliate or successor of
Covered Entity, without the prior approval of Business Associate.
J. Counterparts. This Agreement may be executed in multiple counterparts,
each of which will be deemed an original but all of which together will constitute
one and the same instrument. Facsimile or electronic signatures shall be
treated as original signatures.
K. Construction. This Agreement shall be construed as broadly as necessary
to implement and comply with the HIPAA Rules. Any ambiguity in this
Agreement shall be interpreted to permit compliance with the HIPAA Rules.
IN WITNESS WHEREOF, Covered Entity and Business Associate have executed this
Agreement as of the date first set forth above.
BUSINESS ASSOCIATE WA HINGTON STATE
DEP T EN V N �FFAIRS
By: By:
Danette D. York Michael Kashmar
Printed Name: Printed Name
Director 6 Chief Financial Officer 1(
Title Date: Title Date:
Page 8 of 8
•
BOCC AGENDA ITEM SUMMARY
Resolution: BOCC Meeting Date: Aug 27, 2018
Suggested Wording for Agenda Item: Agenda Type: Consent
Approve Memorandum of Agreement between the State of Washington Department of Veterans Affairs and
Lewis County
Contact Danette York Phone: 2774
Department: Public Health and Social Services
Action Needed: Approve Resolution
Description
Our County Veteran Benefits Specialist will take on the role as Veteran Service Officer(VSO) and receive
training which will require that he provide services necessary for or incidental to the performance of work in
such capacity. The VSO will provide information,referral services, and assistance to veterans and their family
members in processing claims applications for the various veterans' benefits to which they may be entitled. The
claims work produced under this agreement will be processed through the "Claims Quality-Assurance
Program".
Approvals:
User I Group Status
York, Danette ICY— Approved
Whiton,Wayne Pending
Cover Letter To
David Thatcher
DEPARTMENT OF VETERANS AFFAIRS
1102 Quince St. SE
PO Box 41150
Olympia,WA 98504-1150
Additional Copies
Sandi Andrus
George Dodd
Lewis County VAB