disclosures: 0627571c8a0b80b4b47a11a01853ec96692a122b2c890d8cfd7e5d21b1308a98
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| 0627571c8a0b80b4b47a11a01853ec96692a122b2c890d8cfd7e5d21b1308a98 | 2025/Noyes,_Jayleene_930CMR6.07_disclosure_5.22.25_2.pdf | 2025 | Jayleene Noyes | Department of Developmental Services | DDS Approval DISCLOSURE BY STATE EMPLOYEE OF FINANCIALRINCEREST IN A CONTRACT TO PROVIDE SOCIAÉ SERVICES COMMISSION PURSUANT TO 930 CMR 6.07 2025 MAY 22 AM 48 STATE EMPLOYEE INFORMATION Name of state Jayleene Noyes employee: Title/ Position: Transition Coordinator (Human Services Coordinator I) Agency/Department: Department of Developmental Services Agency Address: 100 Cummings Center Suite 419E Beverly MA 01915 Office phone: 978-896-3984 Office e-mail Jayleene.A.Noyes@mass.gov I am a state employee, and I seek to have a financial interest in a contract or agreement made by a state agency listed below, or by a provider or organization funded by a state agency listed below: A state agency within the following Executive Offices: Executive Office of Health and Human Services, including the Human Service Transportation Office; Executive Office of Public Safety and Security, Executive Office of Elder Affairs, Executive Office of Veteran's Services, or A sheriff's office. The purpose of the contract is: - To provide personal services to a person or persons who receive services from, or have services paid for by, these state agencies; or - To provide educational services to people who work for these state agencies or for providers or organizations funded by these state agencies. I seek approval of the arrangement from the agency for which I serve as a state employee and from the state agency above that made the contract. FINANCIAL INTEREST IN A CONTRACT WITH A STATE AGENCY PLEASE CHECK OFF ONE OF THE THREE STATEMENTS BELOW AND PROVIDE THE REQUESTED INFORMATION. 1) Service to a state agency I will provide personal or educational services to a state agency listed above. Please identify the state agency and also the Executive Office it is in, if applicable. 2) Service to a provider or I will provide personal or educational services to a provider or organization funded by a state organization agency listed above. Please provide the name and address of the provider or organization. The agency that I am looking to work for part-time outside of my DDS position, is called "Shine Your Star". Their address is 200 Washington Street, Boxford MA, 01921. Please identify the state agency that funds the provider or organization, and the Executive Office it is in, if applicable. Mass Health EOHHS DDS EOHHS 3) Service to a person or persons I will provide personal services directly to a person or persons who receive services from, or have services paid for by, a state agency listed above. Please identify the state agency that provides services to, or pays for services for, the person or persons, and also the Executive Office it is in, if applicable. Some of the families that I will work with at Shine Your Star may have MassHealth insurance for the ABA services they receive or may be DDS child eligible and receiving DDS supports. Please describe the Please provide information about the type of personal or educational services you will provide. services you will Please do not include the name of any individual who receives services. provide. The duty of this part-time job is to provide 1:1 ABA services for the children in their home or at the ABA clinic. I would be tracking data and behaviors as well as implementing behavior plans. I would be working under a BCBA to provide these services. What will you be Please include a dollar amount, if possible. paid, or what other financial interest will you have? I will be paid by Shine Your Star $30/Hour to provide ABA services. Employee signature Jayleene A. Noyes (electronically signed on 5/7/25 @ 4:16pm) Date: 5/7/2025 APPROVAL BY AGENCY YOU SERVE AS A STATE EMPLOYEE Name and title of appointing authority Kelly Lawless - Reginal Director for DDS Office phone Office e-mail Kelly.d.Lawless@mass.gov Signature by By signing here, I indicate that I have reviewed the facts that the state employee has appointing authority disclosed above and approve the arrangement proposed by the state employee. Kelly Lawless Date: 5/19/2025 APPROVAL BY AGENCY THAT MADE THE CONTRACT (IF DIFFERENT) Name and title of person giving approval at the state agency that made the contract Office phone Office e-mail Signature by person By signing here, I indicate that I have reviewed the facts that the state employee has giving approval disclosed above and approve the arrangement proposed by the state employee. Date: Attach additional pages if necessary. File with: State Ethics Commission One Ashburton Place, Room 619 Boston, MA 02108 Form revised February, 2012 | 2025/Noyes,_Jayleene_930CMR6.07_disclosure_5.22.25_2.pdf |