Participation Agreement Instructions
1. Fill Out the Outside Party Information Sheet (OPIS)
The purpose of the OPIS is to confirm that your organization is eligible to enter a legal agreement with PHI and to identify the official representatives who will handle all communications. It also designates the Authorized Signer who will sign the Agreement on your behalf.
≈ 15 minutes
• Go to https://formstack.io/1DC9E and complete the form.
• Save a copy of the submitted form for your records.
When filling out the form, use the following information:
PHI Program: “Ventura County CIE”
PHI contact: Tarah Ranke
Contact email: Tranke@phi.org
The OPIS confirms your organization is allowed to enter a legal agreement with PHI. You may need to submit a new OPIS if it has been over one year since the last one or if major changes occurred, for example a change in CEO.
The OPIS gives PHI and VCCIE key details about your organization, including:
• Legal name and DBA
• Entity type
• Address
• Unique Entity Identifier if applicable
• Entity representatives
• Authorized Signer
The Authorized Signer is the person who will sign the Participation Agreement for your organization. The representatives listed on the OPIS will be the only people who receive communications from PHI about the Participation Agreement, though you may forward the information to others as needed.
2. Review the Participation Agreement
The purpose of reviewing the Participation Agreement is to give your team time to fully understand the responsibilities, data protections and expectations involved in participating in the VCCIE.
≈ 2 weeks
Download the corresponding Participation Agreement PDF below, key personnel at your organization should review the Agreement:
3. Sign the Participation Agreement
The purpose of the signing stage is to formally establish the legal relationship between your organization and PHI. This step ensures both parties have acknowledged, agreed to and documented the terms.
≈ 2–3 weeks
PHI will email the Participation Agreement to the entity representatives listed on your OPIS.
Have your Authorized Signer follow the instructions in the email to sign and return it. PHI will countersign and email back a fully executed copy — typically within two business days.
4. Submit Your Certificate of Insurance
The purpose of submitting your Certificate of Insurance is to show that your organization has the required liability coverage to participate safely. This protects both your organization and PHI, and ensures compliance with the insurance standards set for VCCIE partners.
≈ 1 week
Once the Participation Agreement is signed, send a copy of your Certificate of Insurance. Coverage should include general, professional and cyber liability (if applicable). Add Public Health Institute fbo VCCIE as an additional insured.
Coverage limits:
• Each occurrence: $1,000,000
• Products/completed operations aggregate: $2,000,000
• Personal and advertising injury: $1,000,000
• Professional liability: $1,000,000
• Cyber liability with extortion coverage: $500,000
• General aggregate: $3,000,000
PHI Additional Insured Information
Public Health Institute fbo VCCIE
1950 Franklin Street
#600
Oakland CA, 94612
Attn: Tarah Ranke Tranke@phi.org
CDEC PRIVACY & SECURITY
A Community Information Exchange (CIE) is an ecosystem comprised of
multidisciplinary network partners that use a shared language, a resource database,
and an integrated technology platform to deliver enhanced community care
planning. Care planning tools enable partners to integrate data from multiple
sources and make bi-directional referrals to create a shared longitudinal record.
Research & Insights
Discover national research, studies, educational priorities, and findings that help advance community development education.
Educator Resources
Find shared syllabi, instructional materials, teaching ideas, community engagement practices, and member contributions.
A Community Built for Educators
Our platform provides shared infrastructure, privacy and security policies, and strong legal data governance to improve coordination across communities. The CIE offers a “No Wrong Door” service referral system for your community
How Collaboration Works
Through a shared-cost model and scalable onboarding, we help communities start small, confirm value, and grow when ready.
Call To Participate
Together, we can lower costs, strengthen collaboration, and elevate outcomes for the people counties serve
Free and Open Participation
Membership is free and gives educators an opportunity to contribute resources, join the member directory, and receive relevant updates.
Data Exchange Infrastructure
The CDEC provides centralized functionality for your team. We provide the legal and technology framework that can be customized to your local community needs for care management, directory of local services, and prioritized use cases or strategic partnerships.
Consultation
CDEC staff offer customized 1:1 consultation service for communities: planning and governance work, selecting a technology platform, integration/data feeds, tailored report development, use case selection and strategy.
Technical Assistance
System administrators at CDEC are available to support 1:1 troubleshooting, system management, and reporting.
Resource Database
A standardized listing of health, human, and social services providers service offerings, eligibility, and intake information to efficiently match individuals with appropriate services.
Integrated Technology
A technology platform facilitates the integration of individual data from multiple partners' data systems to populate an easy-to-access single. longitudinal person record, enables bidirectional closed-loop referrals, and care coordination alerts.
Cross Sytem Care Planning
A CIE enables a proactive system of care enabling multidisciplinary partners to work collectively and contributing to a single care plan and identify system interaction.
Shared Language
The use of a unified individual longitudinal record reflects shared language defining needs, risk assessments, care planning, and individual outcomes.
Multidisciplinary Partners Network
CIE partners commit to a collective approach considering how the care they provide fits into the broader care delivery system. to better connect individuals and families to services, and share deeper levels of information
Dr. Melissa Carter
Development Educator
Prof. Daniel Brooks
University Faculty Member
Dr. Aisha Reynolds
Researcher and Educator
