Bundled WERT Organizational License and BAA for Alliances

•    The California Department of Social Services (CA DSS) supports Wraparound providers and counties that have opted-in to the California Wraparound Evaluation and CQI pilot project;
•    The Innovations Institute at the University of Connecticut to support states that receive training and technical assistance from the National Wraparound Implementation Center (NWIC);
•    University of Illinois System Offices Office of Medicaid Innovation to support Wraparound providers in the state of Illinois;
•    Case Western University and the OhioRISE program to support Wraparound providers in the state of Ohio.

Through these “Alliances” WERT provides a suite of tools to support Wraparound sites, research the efficacy of the Wraparound process, and increase the well-being of children and their families.

Who should execute this license?

RECOGNIZED ALLIANCE PARTICIPANTS – This license is only for Organizations within the Alliances listed above.  If you are participating in one of the above Alliances, please execute this license.  If you are not participating in one of these Alliances, please visit the WERT website to learn more about how to get access to the WERT tools.

AUTHORIZED USERS - Authorized Users are the people who plan to use the software and tools provided by WERT.

What will you need to execute this license?

o    YOUR CONTACT INFORMATION:
       o    Name
       o    Title
       o    Email

o    YOUR ORGANIZATION’S:
       o    Name
       o    Address
       o    Phone Number

o    YOUR ORGANIZATION’S LEAD EVALUATOR:  (The project lead at your organization)
       o    Name
       o    Email

o    NAME OF ALLIANCE:  You must state which of the above Alliances you are working with.  This information will be reviewed upon completion of this agreement.

o    COVERED ENTITY’S DESIGNATED PRIVACY OFFICE CONTACT: The Covered Entity's Designated Privacy Office is the appointed office or official tasked with ensuring that a HIPAA-covered entity — such as a health plan, healthcare clearinghouse, or healthcare provider — adheres to HIPAA privacy standards. This includes crafting, applying, and supervising privacy policies and procedures for safeguarding protected health information (PHI).
       o    Name:
       o    Title:
       o    Email:
       o    Phone:
       o    Full Mailing Address:

How can you get started?

If you are a member of one of these Alliances, please proceed by clicking the button that leads to the license. Once you do, fill in the necessary details and complete the process by accepting the click-through agreement.

Please be aware that we only accept agreements completed in this manner; PDFs or other forms of agreement submissions will not be considered valid.

What happens next?

Once you agree to this license, it will undergo an internal review to ensure the fields are completed correctly.  If the license is approved, WERT will contact the Organization to provide access to the initial survey and the software tools.