Table Of ContentContracGrant Agreement Checkiést
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ECONOMIC ASSISTANCE
Memorandum of Agreement
‘This Agreemart is entered between Christian Adoption Services (Agency Provider),
‘The Village Femily Service Center antl the North Dakota Depariment af Hur
Services (NODHS),
NODHS is respansible for supervision of te Altematives to Alecrtion Program. The
Millage Family Service Center will adnrnisler the Alterallves lo Abortion Prograir
ricluding marseting, updating and raaintain'ny w lst of secvice providers. making
aymants to sarvice providers anc 1-800 service.
“The program will provide positive outcome-based information, counseling, end support
servioas with the follawing requirements aad expectations:
1. Provide serviogs fo pregnant women ar women who believe they may be
pregnant, who reside in North Dakota,
2. Promate childbirth though infounaticn, counesting and sducation fo assist
pregnant women ta choose childbirth
3, Assiet women In making infarmed decisions about adoption or parenting wth
respect to the oni
‘Avernatlves to Abortion services do not srclude rnecical suivices,
The Agency Provider dasires to provide Aleinativas ‘¢ Abortion services consistent with
the requirements 2f the Altematives to Atortons Program and to meet the requirements
SFN.D.C.G. § 50-08-26 air this Agraement. The Agsney Previder agrees to
4. Serasn each potential cle
believes she may be pregnant;
2. Snform each client trat i és her right to secure Alternatives to Aborticns services
from a provider cf those services fisled ia the Alternatives to Abortions brochure;
43. Assist NODS and The Vilage Family Seruce Center In gathering data lo
evaluate the Alternerives to Abaslions Program trom the clent's frst wi through
birth of the child,
4, Keep confidential the communications between a child and provider or ks
employees and agents, except as permitted by law or by the informed agreement
of the cliant;
5, Submit to NDDIS and The Village Farniy Service Center a aupy of prov car's
ability insurance policy for approval before requesting payment, and
6, Meintain approved Fabilty coverage ln eect af all imes services are being
provided under this Agreemert
‘establish that she is progrant or reasonably
Agency Provider agrees no! to:
+ Counset for, refer lot, encourege aborttans,
Aterratives le Azorlis cfant tp arather person ra
sing counseling [or referral for. erccuragen= §
ar abostian: of
2, Giseimina'e against Altersatives to Akotors ctonl er: Ihe basis uf raigion, 3
religious belie. @ refuse ie hold a ralgicts bade", of a tahisal Ip acvvely
pariopele in a sebgious practice
oF kuesanghy refer an
soy lar thes urpese ot
of the perfarmance of
Provider for Sltamalives to Abortions services sill ‘eceive «eisrbursement for serv'ees
provided based on a sate of $10.00 for each quatler hour of serace furnished by a
nataber of the clergy, a nurse fecased uraler N.D.C © oh, 43-12.1, a physiciae
Foensad under N-O.C.C. 0%. 43-17, apsycholog al lisanoed vnder N D.C.C. ch. Add. &
boclai worve’ Hoaagad und N.P.C.C. ch. 43-41. an edchclion courseior licensed under
ND2C. ch. 43-28, a counsslacflognced under ND.C.O ch 2-47, or a naviage ane
lamiy therapial Fnensed uncles N02 G.ch 42-53: and ew vale of $5.00 for each
querter hour af service lumnished by any afer incindual
“This Agrecmestis effective July 2017 and remains r.eltact unt ure 20, 2018. unless
Ienninaced by the Agency Provider, The Vilage Farry Service Center or KDDHE
‘This Agreement may be terra nated at ary lin'e By emutitzi consent nf pares, 1" UIn0m
a-days' wien notice by eke" parly. vith ar wikoul cause Fare by ne Agency
Pravidor te perform the lerins of fhis Agreement may rescIl i the immed ete termation
ol the Ageeement.
Agency Provider: __Chvistian Adoplien Sgnvives
signaros: (CE sf.
Tie fhe Mire
i
The Village Farmly Service Centar
—. Ai se _. vate _ ghd.
Big Vake, PraldeniOES
The Vilage Fantly Serve Center
6, Gaval Carlledye, Direstor
Economic Assisiaace Policy Division
North Cekota Degariment of Human Services
