Last revised: 3/10/11
San Francisco Family Economic Success Workgroup
Family Economic Success Provider Certification Agreement
As a site interested in supporting San Francisco’s families to access critical economic supports, I agree to participate in the Family Economic Success (FES) Provider Certification Program including the following:
Pre-Certification Responsibilities
· Staff from the site will successfully complete or test out of a series of 14 FES topic trainings
· Staff from the site will complete an Enhanced Information and Referral training
· A team of staff from the site including managers and direct service staff will participate in a training followed-up by a one-on-one consulting/coaching session on how to integrate FES into the site’s organizational culture
· After participating in the 1:1 sessions, the site will develop an individualized FES Benefits Coverage Plan.
· The site will register itself and each computer used for benefits screening and application with BenefitsSF.
Post Certification Responsibilities
· Ensure that staff demonstrate competency on each of the FES training topics
· Ensure that staff demonstrate competency on Enhanced Information and Referral
· Ensure that managers and direct service staff will participate in a training followed-up by a one-on-one consulting/coaching session on how to integrate FES into their organizational culture
· Complete, maintain, and annually update a FES Benefits Coverage Plan
· Serve as a hub of FES resources for San Francisco families by providing enhanced referral or more on each of the FES benefits
· Utilize BenefitsSF to assist families in accessing benefits
· Share relevant information, resources, and expertise with other FES Certified Providers
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Executive Director Name Signature Date
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Organization Site
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Site Address
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Site Contact Person (Name/Title)
(______)______(______)______
Phone Number Fax Number
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Email Address Website
Please make a copy of this document for your records and mail or fax the original with the completed FES Readiness Assessment form to: San Francisco Family Support Network
1390 Market Street, Suite 900, San Francisco, CA 94102
Fax: (415) 554-8965
If you have any questions, please contact: Liz Cheng, SFFSN Training Coordinator
or (415) 934-4837