Appendix A.13 - Sample Data Sharing Agreement

# Appendix A.13 – Sample Data Sharing Agreement

This sample data sharing agreement contains basic provisions that can guide the data collection responsibilities of an AmeriCorps Seniors sponsor and a station. 

This sample is based on the Performance Measure ED23A: Number of children demonstrating gains in school readiness.

The description of data, frequency of collection, and collection tool should be revised to fit the needs of the sponsor and station based on the performance measures included in its AmeriCorps Seniors grant. **Look for information in [brackets and highlighting] for guidance on what additional information to include in some areas.**

Collaboration with stations in selecting your performance measures and designing your data sharing procedures is strongly encouraged.

The material in this document may be integrated into a memorandum of understanding (MOU), added to an MOU as an appendix or exhibit, or used as a stand-alone agreement. 

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# Data Sharing Agreement

This agreement is entered into by and between ________________  (“Sponsor”) and ________________ (“Station”).

**Duration of Agreement**

This Data Sharing Agreement is effective from/through to coincide with current MOU dates. This agreement may be amended in writing at any time with the concurrence of both parties.

**Description of Data**

1. Station will track the number of children demonstrating gains in school readiness including but not limited to:

a. Social Relationships

b. Self-Concept and Self-Efficacy

c. Emotional and Behavioral Health

d. Literacy Skills

e. Alphabet Knowledge

f. Early Writing

g. Numeracy Skills

2. Numbers and Operations Station will utilize ________________ (“instrument”) found at ________________ to collect this information.

3. Sponsor will use this information to fulfill its contractual responsibilities to report on performance to AmeriCorps Serniors.

4. Sponsor may share data with internal and external stakeholders, including:

[List major parties with whom data will be shared, such as volunteers, Advisory Committee, etc.]

**Method of Data Access or Transfer**

1. Student gains data will be collected by the station for the period of ________________to ________________ each year. 

2. See AmeriCorps Performance Measure Instructions (available at https://www.nationalservice.gov/programs/senior-corps/managing-senior-corps-grants) for additional information on definitions of key terms and how to calculate/measure data. Further information is provided in the Sponsor’s work plan associated with this performance measure, included as Attachment 1. [Include the relevant work plan(s) as an attachment. Customize the reference as necessary.]

3. Station will share results with Sponsor no later than ________________ [date by which data is needed. Include some additional time before it must be reported if possible] by ________________ [individual at station responsible for providing data].

**Custodial Responsibility**

1. Station is responsible for collecting data on children demonstrating gains in school readiness.

2. Station will maintain data collected in a safe and secure manner.

3. Station will share results of data analysis in a timely manner.

4. Station will make available raw data collected to sponsor as requested.

**Confidentiality**

1. Sponsor and station agree to establish appropriate safeguards to protect the confidentiality of the data and to prevent unauthorized use or access to it.

2. Specifically, Sponsor will:

[Include specific measures you will take, such as limiting access to data to authorized staff and storing records in a secure location, limiting the use of PII in data collection sharing and destroying all PII three years after the child is no longer in a AmeriCorps supported program.]

3. The Station will:

[Include specific measures they will take, as necessary.]

**Authorized Signatures**

Authorized Station Representative					Date

Project Director	Date

[or other sponsor designated representative]

Version 2020.3	Pg. 1 of 3

This document is provided as a sample ONLY. Its use is optional and, if used, it should be customized as appropriate. *For all appendices, including editable versions of samples and templates, visit**https://www.nationalservice.gov/operations-handbook-appendices.*