Agenda - 09-28-2017 - Attachment A - Chapel Hill Carrboro City Schools

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Memorandum of Agreement: Chapel Hill Carrboro City Schools and MH agency students in compliance with the terms of this MOA, applicable federal and state laws, and Agency policies. 1. Agency will immediately call 911 in the event emergency services may be needed and will promptly provide the school principal or designee and the student's parent or guardian notice of the occurrence. m. Agency agrees not to use the names, symbols, trademarks, or service marks currently existing or subsequently established of CHCCS without the prior written consent of the District. n. Agency agrees to provide CHCCS with weekly updates about intake information, including but not limited to the number of active intakes and intakes in progress. Agency also agrees to provide intake information at the request of CHCCS. o. Agency agrees to provide CHCCS with family/student satisfaction survey reports at least quarterly, or more frequently if requested by CHCCS. Agency will provide CHCCS with a copy of Agency's satisfaction survey forms and will revise such forms if requested by CHCCS. p. Agency will provide the CHCCS: Department of Exceptional Children's Program and System of Care Executive Senior Director or designee and school contact with Agency's secure email rights to communicate via encrypted message. 2. CHCCS Responsibilities and Obligations. a. CHCCS agrees to provide consistent, furnished office space for the Agency's use at the assigned schools that will be appropriate for the mental health services described herein. The office space will either include a locked door or a locked filing cabinet to secure Agency files or equipment. CHCCS will provide Agency at least ten (10) days' notice prior to adding, dropping or changing schools participating in the school-based mental health program. CHCCS agrees to provide utilities and custodial services for the assigned space. The space will include a telephone for use in conjunction with the services provided by the Agency. b. CHCCS agrees to provide Agency staff members with a internal mailbox at each individual school and put notices in the box on a timely basis, such as school calendars, special event notices, testing schedules, IEP and other meeting schedules, so that Agency staff knows when students are unavailable and can schedule accordingly. c. CHCCS agrees that appropriate staff will participate in meetings with Agency to coordinate efforts, solve problems, and plan services for individual students and their families. 3 1Page CHCCS CO-LOCATED MENTAL HEALTH SERVICES Department of Exceptional Children's Program and System of Care 2017-2018 8/2017 129