Become a Vendor Agency

If your agency would like to become a vendor agency in High Fidelity Wraparound Erie County, below you will find an example of some of the things you will need to provide as part of your application:
  • List of Proposed HFW Service Codes – The services you would like to provide for High Fidelity Wraparound Erie County
  • List of Current and Past Licenses, Contracts, Approved Programs, and Certifications
  • Statement Describing Other Agency Affiliations Demonstrating Interagency Cooperative Ventures
  • Statement Detailing Your Agency’s Ability to Serve Youth in Erie County Children’s System of Care
  • Agency Mission and Vision
  • History of the Agency
  • Populations Currently Served by the Agency
  • Agency Governing Body/Board of Directors
  • Agency Organizational Chart – Specifically detailing how your vendor program will operate and be supervised
  • Supervision Policy
  • Corporate Compliance Policy
  • Confidentiality and HIPAA Policies
  • Cultural and Linguistic Competency Policy
  • Risk Management Policy – Including incident reporting and grievance procedures
  • Quality Assurance & Quality Improvement Policies
  • New Hire Policy – Including training requirements
  • Proof of Ability to Provide State Central Registry and NYS Justice Center Background Checks
  • Agency Proof of Insurance Coverage
  • Agency Proof of Status to do Business in NYS
  • 3 Letters of Recommendation – At least one must be from a current member of High Fidelity Wraparound Erie County Children’s System of Care

Vendor Agency Application
Sample Contract