Refusal to learn is more deeply a refusal to do.

Abraham Maslow

Outline for Interagency Agreement

In order to facilitate the active interagency coordination of services for victims it is suggested that interagency agreements be developed between the service providers to these individuals. It is recommended that the agreement be reviewed by each center's legal personnel.

Interagency Agreement Format:

Introduction

• to provide a statement of parties participating in the agreement
• to provide a statement of purpose for the agreement
• to provide a time duration of the agreement

General Responsibilities

• - to provide a general purpose statement for each party of the agreement

• to provide a listing and definitions of all terms, phrases, words and their derivations as it pertains to the agreement

Specific Responsibilities

• to provide an explanation of the specific responsibilities and commitments made by the parties of the agreement (i.e., addressing areas of confidentiality, notice and enforcement)

Example: Under the terms of this agreement PARTY X will be prepared:

• to maintain the individual's confidentiality

Enforcement

• to provide the specific explanation of guidelines for adherence to the agreement which includes any personnel disciplinary action by each party of the agreement

Duration

• to provide guidelines (e.g., time specifications, notice) for the duration, review and cancellation of the agreement

Signature

• to provide the necessary signatures by designated parties

Agreement of Cooperation Between the Party A (Victim Services Center) and Party B (Mental Health Provider)

Introduction

This agreement between PARTY A and PARTY B will provide a referral procedure primarily to provide support to individuals who become victims of sexual assault while residing or participating in program at PARTY B. This agreement will be in effect for one year or until such time as a new agreement may be warranted.

General Responsibilities

PARTY A is a non-profit corporation chartered to provide support to victims of crime including but not limited to victims of rape, incest, child abuse and indecent assault. PARTY A is available to provide services twenty-four (24) hours a day to meet the needs of victims. PARTY B is a residential, private licensed center offering X service for persons with mental retardation.

Definitions

For the purpose of this agreement, the following terms, phrases, words and their derivations shall have meaning as follows:

A. Referral procedure: the process used to contact PARTY A

B. Support: support offered by PARTY A which can include counseling and court preparation and any other services necessary to assist the victim

C. Victim: an individual who was injured as a result of a sexual crime

D. Sexual assault: this includes crimes against the person such as rape, incest, child abuse/molestation, indecent assault, sexual harassment

E. Individual habilitation plan: a component of the life management plan as described in Chapter 4210 that is developed for a person on the basis of assessment data which specifies program interventions to attain a specific goal or objective

Specific Responsibilities

Under the terms of this agreement PARTY A will be prepared:

A. to maintain the victim's confidentiality

B. to treat the victim with dignity and respect

C. to respond twenty-four hours a day to the needs of the victim while participating with PARTY B

D. to advocate with and for the victim

E. to meet the victim at the hospital

F. to provide police and court accompaniment and court orientation

G. to provide crisis intervention, counseling and follow-up, information and referrals on terms requested by the victim

H. to obtain all necessary written releases from the victim before the case discussion with designated persons and/or agencies

Under the terms of this agreement PARTY B will be prepared:

A. to maintain the victim's confidentiality

B. to treat the victim with dignity and respect

C. to be non-judgmental

D. to provide as part of the individual's orientation to PARTY B program information about PARTY A's services

E. to provide the victim with written notification of available services from PARTY A and an explanation of her/his rights

F. to provide a private area for the victim to make any confidential contacts with PARTY A (i.e., telephone and/or counseling contacts)

Under the terms of this agreement PARTY B will be prepared:

A. to provide any assistance per the victim's request in contacting PARTY A (e.g., availability of TDD; qualified sign language interpreter; other)

B. to provide for ambulance transport in case of medical emergency

Enforcement

If for any reason this agreement is not adhered to by the designated parties, each party will follow the terms of this agreement and their respective personnel policies regarding warranted disciplinary action.

Duration

This agreement shall be effective immediately and shall remain in effect until terminated upon thirty (30) days written notice by one or all parties involved. It shall be reviewed at least annually and may be amended at any time by the mutual agreement of the participating parties. Amendments must be written and approved by each party and attached to the agreement.

Signatures