HomeMy WebLinkAboutCONSENT Mental Health Therapy 615 Sheridan Street
Port Townsend, WA 98368
9ffason www.JeffersonCountyPublicHealth.org
�' Consent Agenda
Public Health
JEFFERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
AGENDA REQUEST
TO: Board of County Commissioners
Josh Peters, County Administrator
FROM: Apple Martine, Public Health Director
DATE: Jt,tt3 -71 242s
SUBJECT: Agenda Item — Amendment #3 to the Professional Services Agreement with
Olympic Educational Service District (OESD) #114; July 1, 2023- June 30, 2025;
$191,260.00
STATEMENT OF ISSUE:
Jefferson County Public Health (JCPH), as the fund manager of the Behavioral Health, 1/10th of 1% Sales Tax
Fund, is requesting Board approval of Amendment #3 to the Professional Services Agreement with the OESD;
July 1, 2023 -June 30, 2025. JCPH and OESD request consent to reallocate a portion of the funds awarded
to OESD under Amendment #2 for the period July 1, 2024 to June 30, 2025.
ANALYSIS/STRATEGIC GOALS/PROS and CONS:
This agreement is between JCPH and OESD (the"parties") for behavioral health counseling to children and
youth who are affected by mental health issues, enrolled in in the school districts of Port Townsend,
Chimacum, Quilcene and Brinnon in Jefferson County, Washington.
Contractor has unused funds from the 2024-2025 amendment (#2), a portion of which the parties wish to
reallocate. The parties ask that $1200 budgeted for"clinical supervision" be reallocated to "professional
development" (PD).
Contractor subcontracts with fully licensed mental health professionals (LICSWs and LMHCs). Per licensure
requirements, these clinicians do not require clinical supervision, and most already participate in their own
professional consultation groups or receive mentorship outside of their work with Contractor. While
Contractor offers clinical supervision as an additional support—consistent with its contractual obligation to
provide access"as required or needed"—it has been minimally utilized.
PD supports the clinicians in staying engaged and current with best practices, ethical standards, clinical skills,
knowledge, and emerging treatments, which directly improves outcomes for the students they serve.
Examples include:
Community Health Environmental Public Health
Developmental Disabilities 360-385-9444
360-385-9400 (f) 360-379-4487
360-385-9401 (f) Always working for a safer and healthier community
AD-23-040-A3
• Continuing Education Courses: Courses approved by professional boards that meet licensure
requirements and support ongoing learning in relevant clinical topics (e.g., trauma-informed care,
ethics, cultural competency, suicide prevention, etc.).
• Webinars and Online Trainings: Short- or long-form trainings that offer flexibility in scheduling while
providing current research, clinical tools, and emerging practices.
• Workshops and Conferences: In-person or virtual events offering interactive learning, peer
collaboration, and exposure to new therapeutic approaches or systems-level work.
• Specialty Certifications and Skill-Based Training: Structured programs that provide consultation and
training toward certification in specific modalities (e.g., EMDR, DBT, CBT, Somatic Experiencing, etc.).
PD includes paying for the services whether for a training, course, workshop, specialty certification and
consultation, etc. It does not include paying for staff time or travel to engage in these events.
FISCAL IMPACT/COST BENEFIT ANALYSIS:
This is County sales tax revenue, which is deposited into the 131 Fund; (1/10 of 1% Fund). The BoCC
allocates it, with input from the Behavioral Health Advisory Committee. The agreement states that funding is
subject to availability and if the County sales tax revenue decreases, the Vendor will be contacted and the
contract may be renegotiated.
This Amendment has no fiscal impact. It does not add additional funding to the existing Amendment #2.
Contractor anticipates returning unused funds to the County at the end of the current term.
RECOMMENDATION:
JCPH requests approval of Amendment #3 to the Professional Services Agreement with OESD; July 1, 2023 —
June 30, 2025. Amendment #3 requests reallocation of a portion of unused funds, in the amount of
$1,200.00, to be used for professional development for the period April 1, 2025 through June 30, 2025.
REVIEWED BY:
/a6
Josh ters, County Administrator Date
Community Health Environmental Public Health
Developmental Disabilities 360-385-9444
360-385-9400 (f) 360-379-4487
Always working for a safer and healthier community
CONTRACT REVIEW FORM I Clear Form
(INSTRUCTIONS ARE ON THE
19BNEXT PAGE)
CONTRACT WITH: Olympic Educational Service District#114 Contract No: AD-23-040-A3
Contract For: Mental Health -Therapy Services/School Districts Term: April 1, 2025 to June 30, 2025
COUNTY DEPARTMENT: Public Health
Contact Person: Apple Martine
Contact Phone: 360-385-9443
Contact email: amartine@co.jefferson.wa.us
AMOUNT: PROCESS: — Exempt from Bid Process
Revenue: Cooperative Purchase
Ixpenditure: Competitive Sealed Bid
Matching Funds Required: Small Works Roster
Sources(s) of Matching Funds Vendor List Bid
Fund # #131 ✓, RFPorRFQ
Munis OrgK bj 13156400 Other:
APPROVAL STEPS:
STEP 1: DEPARTMENT CERTIFIES COMPL E WI' ' .55.080 ANI) CHAPTER 42.23 .RCW.
CERTIFIED: ■ N/A:❑ G/--- June 9, 2025
Sign,fCure Date
STEP 2: DEPARTMENT CERTIFIES THE PERSON PROPOSED FOR CONTRACTING WITH THE
COUNTY (CONTRACTOR) HAS NOT BEE DEBAR1 4 D BY ANY FEDERAL, STATE, OR LOCAL
AGENCY.
CERTIFIED: El N/A: E
June 9, 2025
Signature Date
STEP 3: RISK MANAGEMENT REVIEW (will be added electronically through Laserfiche):
Electronically approved by Risk Management on 6/20/2025.
STEP 4: PROSECUTING ATTORNEY REVIEW (will be added electronically through Laserfiche):
Electronically approved as to form by PAO on 6/18/2025.
Amendment No. 3 reallocating use of funds. No increase to contract amount.
All prior amendments and original attached.
STEP 5: DEPARTMENT MAKES REVISIONS & RESUBMITS TO RISK MANAGEMENT ANI)
PROSECUTING ATTORNEY(IF REQUIRED).
STEP 6: CONTRACTOR SIGNS
STEP 7: SUBMIT TO 1)0CC FOR APPROVAL
1
CONTRACT AMENDMENT #3
For Professional Services
Between
Jefferson County
And
Olympic Educational Service District- (OESD) #114
WHEREAS, Olympic Educational Service District- (OESD) #114; ("the Contractor") and
Jefferson County ("the County") entered into an agreement on July 1, 2023; for Behavioral Health
counseling for children and youth who are affected by mental health issues; enrolled in in the
School Districts of Port Townsend, Chimacum, Quilcene and Brinnon in Jefferson County,
Washington; and
WHEREAS,the parties desire to amend the terms of that agreement;
IT IS AGREED BETWEEN BOTH PARTIES AS NAMED HEREIN AS FOLLOWS:
1. The parties wish to reallocate a portion of unused funds. Parties ask that $1200 budgeted
for"clinical supervision" be reallocated to professional development.
2. These reallocated funds will cover professional development costs from the period April 1,
2025 thru June 30, 2025.
3. Payment for the work provided by Contractor shall be made based on the rates and
outcomes as defined in Exhibit"B", attached hereto. The Contractor shall adhere to the
amended budget amounts, pursuant to this Agreement as outlined in Exhibit"B".
4. All other terms and conditions of the agreement will remain the same.
APPROVED AND ADOPTED this day of , 2025.
(SIGNATURES FOLLOW ON THE NEXT PAGE)
1
AD-23-040-A3
Docusign Envelope ID: D5F521CF-64B9-4A72-A47A-20A3B698BD94
SIGNATURE PAGE
JEFFERSON COUNTY
BOARD OF COMMISSIONERS
Heidi Eisenhour, Chair
Greg Brotherton, Member
S?L L,IC ESD #114 Heather Dudley-Nollette, Member
Pr. Qaro Lt- tLL
\--09u5S48r6DFJ4FD...
Dr. Aaron Leavell, Superintendent
6/23/2025
Date
�n• Initial —DS r DS
F59 Jr TS
Kristin Sandy Jason Tina
Schulte Gessner Rhodes Schulz
A 1TEST:
By:
Carolyn Gallaway,
Clerk of the Board
APPROVED AS T FORM ONLY:
r)7/2
,_
for 06/17/2025
Philip C. Hunsucker, Date
Chief Civil Deputy Prosecuting Attorney
2
EXHIBIT B
Budget Sheet
OESD #114 School-based Mental Health Services
July 1, 2024 —June 30, 2025
PERSONNEL COSTS REQUESTED FROM OTHER FUNDING tOTAL
SALES TAX SOURCE 13l DGET
FTE & Salaries/Benefits for
each Employee
Brinnon $715 x 1 day x 36 days= $25,740
$25,740
Quilcene $665 x 1 day x 36 days= $23,940
$23,940
Chimacum $615 x 2 days x 36 days= $44,280
$44,280
Port Townsend $615 x 3 days x 36 days= $66,420
$66,420
Supervision/Clinical Oversight- 5 Providers x 17 sessions x $11,900
$140 an hour=$11,900 $10,700
(reallocate$1200)
OESD Behavioral Health .20 FTE for project $25,078 $25,078
Coordinator coordination $0.00(match)
Administrative Assistance
Support
SUB-TOTAL PERSONNEL $172,280 $197,358
OPERATING COSTS
Supplies/Materials-(Please $1593 $93 general
Describe): snacks, fidgets and
calming materials, arts and crafts, $300/clinician
basic office supplies (5)for supplies
and snacks
Professional Development $1200 $1200
SUB-TOTAL-OPERATING $1593 $1593
COSTS
SUB-TOTAL $173,873 $198,951
Admin-(no more than 10%& $17,387 $17,387
please describe what charges are
to be included)
TOTAL COST $191,260 $216,338
Note: In-kind contributions/match are not required, however the County is interested in the total cost
to provide the service or program.
3
CONTRACT AMENDMENT#2
For Professional Services
Between
Jefferson County
And
Olympic Educational Service District-(OESD) #114
WHEREAS, Olympic Educational Service District- (OESD)#114; ("the Contractor") and
Jefferson County ("the County") entered into an agreement on July 1, 2023; for Behavioral Health
counseling for children and youth who are affected by mental health issues; enrolled in in the
School Districts of Port Townsend, Chimacum, Quilcene and Brinnon in Jefferson County,
Washington.
WHEREAS,the parties desire to amend the terms of that agreement.
IT IS AGREED BETWEEN BOTH PARTIES AS NAMED HEREIN AS FOLLOWS:
1. The term of the above referenced agreement ends June 30, 2024; but is now extended to
June 30, 2025.
2. The Contractor's contract will be increased by $191,260.00 in funding, for services
rendered during the term of July 1, 2024 through June 30, 2025. Total compensation under
this Agreement shall not exceed$382,520.00 without express written amendment signed
by both parties.
3. Payment for the work provided by Contractor shall be made based on the rates and
outcomes as defined in Exhibit`B", attached hereto. The Contractor shall adhere to the
amended budget amounts,pursuant to this Agreement as outlined in Exhibit`B".
4. Work performed between July 1, 2024 and the execution of this Agreement that is
consistent with the provisions of this Agreement is hereby ratified.
5. All other terms and conditions of the agreement will remain the same.
(SIGNATURES FOLLOW ON THE NEXT PAGE)
1
AD-23-040-A2
Docusign Envelope ID: E5D3AB17-6E44-4F21-AD97-329E5698A404
SIGNATURE PAGE
JEFFERSON COUNTY
BOARD OF COMMISSIONERS
Approved Telephonically b S 2,y
Kate Dean, hair Date
sTh
& 2y
r g Brotherton, Member Date
L../1 aS2y
OLYMPIC ESD #114 Heidi Eisenhour, Member Date
[DocuSIgned by.
Pr, aam. L.d,
triULB4826UFNIFU
Dr. Aaron Leavell, Superintendent
7/29/2024
Date
Initials:
[—‘•S r5D
� lir rtsOS
OS
Kristin Sandy Jason Tina oh„
4 a
Schutte Gessner Rhodes Schulz i4. ��' MIS CO%
GpM Sio GZ
�; 's
ATTEST: �tn• a
O• • .4O
#,„,, A S H IN `r,By: ' �..,,,,,,,..,�' S 2
Carolyn Ga laway, Date
Clerk ofith Board
APPROVED AS TO FORM,ONLY:
By: , `" "� June 27, 2024
Philip C. Hunsucker, Date
Chief Civil Deputy Prosecuting Attorney
2
EXHIBIT B
Budget Sheet
OESD #114 School-based Mental Health Services
July 1, 2024—June 30, 2025
PERSONNEL COSTS REQUESTED FROM OTHER FUNDING TOTAL
SALES TAX SOURCE BUDGET
FTE& Salaries/Benefits for
each Employee
Brinnon $715 x 1 day x 36 days = $25,740
$25,740
Quilcene $665 x 1 day x 36 days= $23,940
$23,940
Chimacum $615 x 2 days x 36 days= $44,280
$44,280
Port Townsend $615 x 3 days x 36 days= $66,420
$66,420
SUPERVISION/CLINICAL 5 Providers x 17 sessions x $11,900
OVERSIGHT- $140 an hour=$11,900
OESD Behavioral Health .20 FTE for project $25,078 $25,078
Coordinator coordination$0.00(match)
Administrative Assistance
Support
SUB-TOTAL PERSONNEL $172,280 $197,358
OPERATING COSTS
Supplies/Materials-(Please $1593 $93 general
Describe): snacks,fidgets and
calming materials,arts and crafts, $300/clinician
(5)for supplies
basic office supplies and snacks
SUB-TOTAL-OPERATING $1593 $1593
COSTS
SUB-TOTAL $173,873 $198,951
Admin-(no more than 10%& $17,387 $17,387
please describe what charges are
to be included)
TOTAL COST S191,260 $216,338
Note: In-kind contributions/match are not required,however the County is interested in the total cost
to provide the service or program.
3
DocuSign Envelope ID:03E324CF-50D3-4BA7-54E5-DB9629819179
CONTRACT AMENDMENT#1
For Professional Services
Between
Jefferson County
And
Olympic Educational Service District-(OESD)#114
WHEREAS, Olympic Educational Service District- (OESD)#114; (Subcontractor) and Jefferson
County (County) entered into an agreement on July 1, 2023; for Behavioral Health counseling for
children and youth who are affected by mental health issues; enrolled in in the School Districts of
Port Townsend, Chimacum, Quilcene and Brinnon in Jefferson County, Washington; and
WHEREAS,the parties desire to amend the terms of that agreement;
IT IS AGREED BETWEEN BOTH PARTIES AS NAMED HEREIN AS FOLLOWS:
The term of the above referenced agreement ends June 30, 2024.
1. Subcontractor will make the following updates to the Budget Sheet/Fee Schedule:
Supervision/Clinical Oversight - 5 providers x 36 sessions x $140 an hour instead of 36
weeks of sessions.
2. Work performed between July 1,2023 and the execution of this Agreement that is consistent
with the provisions of this Agreement is hereby ratified.
3. All other terms and conditions of the agreement will remain the same.
Dated this ( { day of }{ U ,2(�j21 Z41 f
(SIGNATURES FOLLOW ON THE NEXT PAGE)
1
AD-23-040-A1
DocuSign Envelope ID:03E324CF-50133-4BA7-B4E5-D89629819179
SIGNATURE PAGE
JEFFER.S COUNTY
BO CO MISSIONERS
k
rotherto ,Chair
r.,,-
i,...,L________,
Kate an,Member
4Aj
f
OLYMPIC ESD#114 Heidi Eisenhour,Member
UocuSigned by:
1VvLtLL
r.E 8 t%avell,Superintendent
12/11/2023
Date
'fr
SSI '4 %Ini 'a i—os r )
tZ-S. LLY_e_ TS I io cv-P%44% O, .)S ,; SEAL *z =
Kristin Jason Tina I �`' -' `+ sz
Schutte Rhoads Schulz ' `'° "QC
''' O�'WAS''.
'r'r��1�llt.l 41 i14bi 4F,,cek,,
Attest:
,1 6 Vi /
Carolyn Gaway, i Date
Clerk of the Board
Approved as to form only:
0 C November 30,2023
Philip C.Hunsucker Date
Chief Civil Deputy Prosecuting Attorney
2
PROFESSIONAL SERVICES AGREEMENT
Between
Jefferson County
And
Olympic Educational Service District#114
THIS PROFESSIONAL SERVICES AGREEMENT("this Agreement") is entered into between the
County of Jefferson, a municipal corporation("the County"), and the Olympic Educational Service
District#114, ("the Contractor"), in consideration of the mutual benefits, terms, and conditions specified
below.
1. Project Designation. The Consultant is retained by the County to perform the following Project:
to provide mental health services in the School Districts of Port Townsend, Chimacum, Quilcene
and Brinnon; in Jefferson County, Washington.
2. Scope of Services. Contractor agrees to perform the services identified on Exhibit"A" attached
hereto including the provision of all labor.
3. Time for Performance. This Agreement shall commence on July 1, 2023 and continue through
June 30, 2024. Work performed consistent with this Agreement during its term, but prior to the
adoption of this Agreement, is hereby ratified. The Contractor shall perform all services pursuant
to this Agreement as outlined in Exhibit "A". Time is of the essence in the performance of this
Agreement.
4. Payment. The Contractor shall be paid by the County for completed work and for services
rendered under this Agreement as follows:
a. Payment for the work provided by Contractor shall be made on an hourly basis at the rate
as defined in Exhibit"B", attached hereto, provided that the total amount of payment to the
Contractor shall not exceed $191,260.00; without express written modification of the
Agreement signed by the County. The Contractor shall adhere to the budget amounts
pursuant to this Agreement as outlined in Exhibit"B".
b. Invoices must be submitted by the 10th of the month for the previous month's expenses.
Such invoices will be checked by the County, and upon approval thereof, payment will be
made to the Contractor in the amount approved. Failure to submit timely invoices and
reports pursuant to Exhibit"A" of the Agreement may result in a denial of reimbursement.
Invoices not submitted within 60 days may be denied.
c. Final payment of any balance due the Contractor, of the total contract price earned, will be
made promptly upon its ascertainment and verification by the County after the completion
of the work and submittal of reports under this Agreement and its acceptance by the
County.
Professional Services Agreement/OESD#114-2023-2024 Page 1 of 18
AD-23-040
d. Contractor shall provide invoices and necessary backup documentation for all services
including timesheets and statements (specifying the services provided). Any indirect
charges require the submittal of an indirect cost methodology and rate using 2 C.F.R. Part
255 and 2 C.F.R. Part 230.
e. The Contractor's records and accounts pertaining to this Agreement are to be kept
available for inspection by representatives of the County and state for a period of six (6)
years after final payments. Copies shall be made available upon request.
f. The County reserves first right to use as match, the Chemical Dependency or Mental
Health Treatment Sales and Use Tax, (now known as the 1/10th of 1%Behavioral Health
Sales Tax) and the services funded by them for purposes of qualifying for additional
funding and grants. The County may allow the Contractor to use the 1/10th of 1%
Behavioral Health Sales Tax funds as match, at the County's sole discretion. Should the
County decline to use the 1/10th of 1% Behavioral Health Sales Tax funds as match for
additional funding and/or grants,then the County may authorize the Contractor to use such
funds for match (see ATTACHMENT A).
g. Where Contractor proposes to use 1/10th of 1% Behavioral Health Sales Tax funds for
match, Contractor shall be solely responsible for compliance with all state and federal laws
and regulations, including, but not limited to DSHS, CMS and MCSR funding rules,
applicable to the use of 1/10th of 1% Behavioral Health Sales Tax funds as match.
Contractor shall document they have met this responsibility by submitting to the County
Administrator, in writing, their match formula, allocation plan and any other
documentation required of them pursuant to ATTACHMENT A, attached hereto and
incorporated in this Agreement.
h. The County may withhold authorization to utilize the 1/10th of 1% Behavioral Health Sales
Tax funds as match. Contractor's failure to provide adequate documentation does not
relieve the Contractor of their responsibility to comply with all state and federal laws and
regulations related to match.
i. The County reserves first right to use as match the 1/10th of 1% Behavioral Health Sales
Tax fund to the County Administrator, in writing,their match formula, allocation plan and
any other documentation required of them pursuant to ATTACHMENT A, attached hereto
and incorporated in this Agreement.
5. Ownership and Use of Documents. All non-confidential or de-identified documents, drawings,
specifications, and other materials produced by the Contractor in connection with the services
rendered under this Agreement shall be the property of the County whether the project for which
they are made is executed or not. The Contractor shall be permitted to retain copies, including
reproducible copies, of drawings and specifications for information, reference and use in
connection with Contractor's endeavors. Contractor shall not be held liable for reuse of
documents or modifications thereof, including electronic data, by County or its representatives for
any purpose other than the intent of this Agreement.
Professional Services Agreement/OESD#114-2023-2024 Page 2 of 18
6. Compliance with laws. Contractor shall, in performing the services contemplated by this
Agreement, faithfully observe and comply with all federal, state, and local laws, ordinances and
regulations, applicable to the services to be rendered under this Agreement.
7. Audit. An audit will be submitted to the County upon request. Upon request, Contractor will
submit the most recent financial audit within 30 days.
a. Upon request the County shall have the option of performing an onsite review of all
records, statements, and documentation.
b. If the County finds indications of potential non-compliance during the monitoring process,
the County shall notify Contractor within ten(10) days. County and Contractor shall meet
to discuss areas of contention in an attempt to resolve issues.
c. Audit will provide statements consistent with the guidelines of Reporting for Other Non-
Profit Organizations AICPA SOP 78-10, and is performed in accordance with generally
accepted auditing standards and with Federal Standards for Audit of Governmental
Organizations, Programs, Activities and Functions, and meeting all requirements of 2
C.F.R. Part 200, as applicable.
8. Indemnification. The Contractor shall defend, indemnify and hold the County, its officers,
officials, employees, agents and volunteers (and their marital communities)harmless from any
claims, injuries, damages, losses or suits, including attorney's fees, arising out of or resulting from
the acts, errors or omissions of the Contractor in performance of this Agreement, except for
injuries and damages caused by the sole negligence of the County. Should a court of competent
jurisdiction determine this Agreement is subject to RCW 4.24.115 if liability for damages occurs
arising out of bodily injury to persons or damages to property caused by or resulting from the
concurrent negligence of the Contractor and the County, its officers, officials, employees, agents
and volunteers (and their marital communities) the Contractor's liability, including the duty and
cost to defend, shall be only for the Contractor's negligence. It is further specifically understood
that the indemnification provided constitutes the Contractor's waiver of immunity under Industrial
Insurance, Title 51 RCW, solely for the purposes of this indemnification. This waiver has been
mutually negotiated by the parties. This section shall survive the expiration or termination of this
Agreement.
9. Insurance. Prior to commencing work, the Contractor shall obtain at its own cost and expense the
following insurance coverage specified below and shall keep such coverage in force during the
terms of the Agreement.
a. Commercial Automobile Liability Insurance providing bodily injury and property damage
liability coverage for all owned and non-owned vehicles assigned to or used in the
performance of the work for a combined single limit of not less than$500,000 each
occurrence with the County named as an additional insured in connection with the
Contractor's performance of this Agreement. This insurance shall indicate on the
certificate of insurance the following coverage: (a) Owned automobiles; (b) Hired
automobiles; and, (3)Non-owned automobiles.
Professional Services Agreement/OESD#114-2023-2024 Page 3 of 18
b. Commercial General Liability Insurance in an amount not less than a single limit of one
million dollars ($1,000,000)per occurrence and an aggregate of not less than two (2)times
the occurrence amount($2,000,000.00 minimum) for bodily injury, including death and
property damage, unless a greater amount is specified in the contract specifications. The
insurance coverage shall contain no limitations on the scope of the protection provided and
include the following minimum coverage:
i. Broad Form Property Damage, with no employee exclusion;
ii. Personal Injury Liability, including extended bodily injury;
iii. Broad Form Contractual/Commercial Liability—including coverage for products
and completed operations;
iv. Premises—Operations Liability (M&C);
v. Independent Contractors and subcontractors;
vi. Blanket Contractual Liability.
c. Professional Liability Insurance. The Contractor shall maintain professional liability
insurance against legal liability arising out of activity related to the performance of this
Agreement, on a form acceptable to Jefferson County Risk Management in the amounts of
not less than $1,000,000 Each Claim and $2,000,000 Aggregate. The professional liability
insurance policy should be on an"occurrence" form. If the professional liability policy is
"claims made,"then an extended reporting periods coverage (tail coverage) shall be
purchased for three (3) years after the end of this Agreement, at the Contractor's sole
expense. The Contractor agrees the Contractor's insurance obligation to provide
professional liability insurance shall survive the completion or termination of this
Agreement for a minimum period of three (3) years.
d. The County shall be named as an"additional named insured" under all insurance policies
required by this Agreement, except Professional Liability Insurance when not allowed by
the insurer.
e. Such insurance coverage shall be evidenced by one of the following methods: (a)
Certificate of Insurance; or, (b) Self-insurance through an irrevocable Letter of Credit from
a qualified financial institution.
f. The Contractor shall furnish the County with properly executed certificates of insurance
that, at a minimum, shall include: (a) The limits of overage; (b) The project name to which
it applies; (c) The certificate holder as Jefferson County, Washington and its elected
officials, officers, and employees with the address of Jefferson County Public Health 615
Sheridan Street, Port Townsend, WA 98368, and, (d) A statement that the insurance policy
shall not be canceled or allowed to expire except on thirty (30) days prior written notice to
the County. If the proof of insurance or certificate indicating the County is an"additional
insured"to a policy obtained by the Contractor refers to an endorsement (by number or
name) but does not provide the full text of that endorsement, then it shall be the obligation
of the Contractor to obtain the full text of that endorsement and forward that full text to the
County. Certificates of coverage as required by this section shall be delivered to the
County within fifteen(15) days of execution of this Agreement.
Professional Services Agreement/OESD#114-2023-2024 Page 4 of 18
g. Failure of the Contractor to take out or maintain any required insurance shall not relieve
the Contractor from any liability under the Agreement, nor shall the insurance
requirements be construed to conflict with or otherwise limit the obligations concerning
indemnification of the County.
h. The Contractor's insurers shall have no right of recovery or subrogation against the County
(including its employees and other agents and agencies), it being the intention of the
parties that the insurance policies, with the exception of Professional Liability Insurance,
so affected shall protect both parties and be primary coverage for all losses covered by the
above described insurance.
i. Insurance companies issuing the policy or policies shall have no recourse against the
County (including its employees and other agents and agencies) for payment of any
premiums or for assessments under any form of policy.
j. All deductibles in the above described insurance policies shall be assumed by and be at the
sole risk of the Contractor.
k. Any deductibles or self-insured retention shall be declared to and approved by the County
prior to the approval of this Agreement by the County. At the option of the County,the
insurer shall reduce or eliminate deductibles or self-insured retention, or the Contractor
shall procure a bond guaranteeing payment of losses and related investigations, claim
administration and defense expenses.
1. Insurance companies issuing the Contractor's insurance policy or policies shall have no
recourse against the County (including its employees and other agents and agencies) for
payment of any premiums or for assessments under any form of insurance policy.
m. Any judgments for which the County may be liable, in excess of insured amounts required
by this Agreement, or any portion thereof, may be withheld from payment due, or to
become due,to the Contractor until the Contractor shall furnish additional security
covering such judgment as may be determined by the County.
n. Any coverage for third party liability claims provided to the County by a"Risk Pool"
created pursuant to Ch. 48.62 RCW shall be non-contributory with respect to any policy of
insurance the Contractor must provide in order to comply with this Agreement.
o. The County may, upon the Contractor's failure to comply with all provisions of this
Agreement relating to insurance, withhold payment or compensation that would otherwise
be due to the Contractor.
p. The Contractor's liability insurance provisions shall be primary and noncontributory with
respect to any insurance or self-insurance programs covering the County, its elected and
appointed officers, officials, employees, and agents.
q. Any failure to comply with reporting provisions of the insurance policies shall not affect
coverage provided to the County, its officers, officials, employees, or agents.
r. The Contractor's insurance shall apply separately to each insured against whom claim is
made or suit is brought, except with respect to the limits of the insurer's liability.
Professional Services Agreement/OESD#114-2023-2024 Page 5 of 18
s. The Contractor shall include all subcontractors as insured under its insurance policies or
shall furnish separate certificates and endorsements for each subcontractor. All insurance
provisions for subcontractors shall be subject to all the requirements stated herein.
t. The insurance limits mandated for any insurance coverage required by this Agreement are
not intended to be an indication of exposure nor are they limitations on indemnification.
u. The Contractor shall maintain all required insurance policies in force from the time
services commence until services are completed. Certificates, insurance policies, and
endorsements expiring before completion of services shall be promptly replaced. All the
insurance policies required by this Agreement shall provide that thirty (30) days prior to
cancellation, suspension, reduction or material change in the policy, notice of same shall be
given to the Jefferson County Public Health Contracts Manager by registered mail,return
receipt requested.
v. The Contractor shall place insurance with insurers licensed to do business in the State of
Washington and having A.M. Best Company ratings of no less than A-, with the exception
that excess and umbrella coverage used to meet the requirements for limits of liability or
gaps in coverage need not be placed with insurers or re-insurers licensed in the State of
Washington.
w. The County reserves the right to request additional insurance on an individual basis for
extra hazardous contracts and specific service agreements.
10. Worker's Compensation (Industrial Insurance).
a. If and only if the Contractor employs any person(s) in the status of employee or employees
separate from or in addition to any equity owners, sole proprietor, partners, owners or
shareholders of the Contractor, the Contractor shall maintain workers' compensation
insurance at its own expense, as required by Title 51 RCW, for the term of this Agreement
and shall provide evidence of coverage to Jefferson County Public Health, upon request.
b. Worker's compensation insurance covering all employees with limits meeting all
applicable state and federal laws. This coverage shall include Employer's Liability with
limits meeting all applicable state and federal laws.
c. This coverage shall extend to any subcontractor that does not have their own worker's
compensation and employer's liability insurance.
d. The Contractor expressly waives by mutual negotiation all immunity and limitations on
liability, with respect to the County, under any industrial insurance act, disability benefit
act, or other employee benefit act of any jurisdiction which would otherwise be applicable
in the case of such claim.
e. If the County incurs any costs to enforce the provisions of this subsection, all cost and fees
shall be recoverable from the Contractor.
11. Independent Contractor. The Contractor and the County agree that the Contractor is an
independent contractor with respect to the services provided pursuant to this Agreement. The
Contractor specifically has the right to direct and control Contractor's own activities, and the
activities of its subcontractors, employees, agents, and representatives, in providing the agreed
services in accordance with the specifications set out in this Agreement. Nothing in this
Agreement shall be considered to create the relationship of employer and employee between the
parties. Neither Contractor nor any employee of Contractor shall be entitled to any benefits
accorded County employees by virtue of the services provided under this Agreement, including,
but not limited to: retirement, vacation pay; holiday pay; sick leave pay; medical, dental, or other
Professional Services Agreement/OESD#114-2023-2024 Page 6 of 18
insurance benefits; fringe benefits; or any other rights or privileges afforded to Jefferson County
employees. The County shall not be responsible for withholding or otherwise deducting federal
income tax or social security or for contributing to the state industrial insurance program,
otherwise assuming the duties of an employer with respect to Contractor, or any employee of
Contractor.
12. Subcontracting Requirements.
a. The Contractor is responsible for meeting all terms and conditions of this Agreement
including standards of service, quality of materials and workmanship, costs, and schedules.
Failure of a subcontractor to perform is no defense to a breach of this Agreement. The
Contractor assumes responsibility for and all liability for the actions and quality of services
performed by any subcontractor.
b. Every subcontractor must agree in writing to follow every term of this Agreement. The
Contractor must provide every subcontractor's written agreement to follow every term of
this Agreement before the subcontractor can perform any services under this Agreement.
The Public Health Director or their designee must approve any proposed subcontractors in
writing.
c. Any dispute arising between the Contractor and any subcontractors or between
subcontractors must be resolved without involvement of any kind on the part of the County
and without detrimental impact on the Contractor's performance required by this
Agreement.
13. Covenant Against Contingent Fees. The Contractor warrants that he has not employed or retained
any company or person, other than a bona fide employee working solely for the Contractor, to
solicit or secure this Agreement, and that he has not paid or agreed to pay any company or person,
other than a bona fide employee working solely for the Contractor, any fee, commission,
percentage, brokerage fee, gifts, or any other consideration contingent upon or resulting from the
award or making of this Agreement. For breach or violation of this warranty, the County shall
have the right to annul this Agreement without liability or, in its discretion to deduct from the
contract price or consideration, or otherwise recover, the full amount of such fee, commission,
percentage, brokerage fee, gift, or contingent fee.
14. Discrimination Prohibited. The Contractor, with regard to the work performed by it under this
Agreement, will not discriminate on the grounds of race, color, national origin,religion, creed,
age, gender, sexual orientation, material status, sex, or the presence of any physical or sensory
handicap in the selection and retention of employees or procurement of materials or supplies.
15. No Assignment. The Contractor shall not sublet or assign any of the services covered by this
Agreement without the express written consent of the County. Assignment does not include
printing or other customary reimbursable expenses that may be provided in an agreement.
16. Non-Waiver. Waiver by the County of any provision of this Agreement or any time limitation
provided for in this Agreement shall not constitute a waiver of any other provision.
17. Termination.
a. The County reserves the right to terminate this Agreement at any time by giving ten (10)
days written notice to the Contractor.
b. In the event of the death of a member, partner, or officer of the Contractor, or any of its
supervisory personnel assigned to the project, the surviving members of the Contractor
hereby agree to complete the work under the terms of this Agreement, if requested to do so
Professional Services Agreement/OESD#114-2023-2024 Page 7 of 18
by the County. This section shall not be a bar to renegotiations of this Agreement between
surviving members of the Contractor and the County, if the County so chooses.
c. The County reserves the right to terminate this contract in whole or in part, with 10 days'
notice, in the event that expected or actual funding from any funding source is withdrawn,
reduced, or limited in any way after the effective date of this agreement. In the event of
termination under this clause, the County shall be liable for only payment for services
rendered prior to the effective date of termination.
18. Notices. All notices or other communications which any party desires or is required to give shall
be given in writing and shall be deemed to have been given if hand-delivered, sent by facsimile,
email, or mailed by depositing in the United States mail, prepaid to the party at the address listed
below or such other address as a party may designate in writing from time to time.
Notices to the County shall be sent to the following address:
Jefferson County Public Health
ATT: Anna Mc Enery-DD/BH County Coordinator
615 Sheridan Street
Port Townsend, WA 98368
Notices to Contractor shall be sent to the following address:
Olympic Educational Service District#114
ATT: Meghan Zenteno
105 National Ave North
Bremerton, WA 98312
19. Integrated Agreement. This Agreement together with attachments or addenda represents the entire
and integrated Agreement between the County and the Contractor and supersedes all prior
negotiations, representations, or agreements written or oral. No representation or promise not
expressly contained in this Agreement has been made. This Agreement supersedes all prior or
simultaneous representations, discussions, negotiations, and agreements, whether written or oral,
by the County within the scope of this Agreement. The Contractor ratifies and adopts all
statements, representations, warranties, covenants, and agreements contained in its proposal, and
the supporting material submitted by the Contractor, accepts this Agreement and agrees to all of
the terms and conditions of this Agreement.
20. Modification of this Agreement. This Agreement may be amended only by written instrument
signed by both County and Contractor.
21. Disputes. The Parties agree to use their best efforts to prevent and resolve disputes before they
escalate into claims or legal actions. Any disputed issue not resolved pursuant to the terms of this
Agreement shall be submitted in writing within 10 days to the County Risk Manager, whose
decision in the matter shall be final, but shall be subject to judicial review. If either party deem it
necessary to institute legal action or proceeding to enforce any right or obligation under this
Agreement, each party in such action shall bear the cost of its own attorney's fees and court costs.
Any legal action shall be initiated in the Superior Court of the State of Washington for Jefferson
County. The parties agree that all questions shall be resolved by application of Washington law
and that the parties have the right of appeal from such decisions of the Superior Court in
accordance with the laws of the State of Washington. The Contractor hereby consents to the
personal jurisdiction of the Superior Court of the State of Washington for Jefferson County.
22. Section Headings. The headings of the sections of this Agreement are for convenience of
reference only and are not intended to restrict, affect, or be of any weight in the interpretation or
construction of the provisions of the sections or this Agreement.
Professional Services Agreement/OESD#114-2023-2024 Page 8 of 18
23. Limits of Any Waiver of Default. No consent by either party to, or waiver of, a breach by either
party, whether express or implied, shall constitute a consent to, waiver of, or excuse of any other,
different, or subsequent breach by either party.
24. No Oral Waiver. No term or provision of this Agreement will be considered waived by either
party, and no breach excused by either party, unless such waiver or consent is in writing signed on
behalf of the party against whom the waiver is asserted. Failure of a party to declare any breach or
default immediately upon the occurrence thereof, or delay in taking any action in connection with,
shall not waive such breach or default.
25. Severability. Provided it does not result in a material change in the terms of this Agreement, if
any provision of this Agreement or the application of this Agreement to any person or
circumstance shall be invalid, illegal, or unenforceable to any extent, the remainder of this
Agreement and the application this Agreement shall not be affected and shall be enforceable to the
fullest extent permitted by law.
26. Binding on Successors, Heirs and Assigns. This Agreement shall be binding upon and inure to
the benefit of the parties' successors in interest, heirs, and assigns.
27. No Assignment. The Contractor shall not sell, assign, or transfer any of rights obtained by this
Agreement without the express written consent of the County.
28. No Third-party Beneficiaries. The parties do not intend, and nothing in this Agreement shall be
construed to mean, that any provision in this Agreement is for the benefit of any person or entity
who is not a party.
29. Signature in Counterparts. The parties agree that separate copies of this Agreement may be signed
by each of the parties and this Agreement shall have the same force and effect as if all the parties
had signed the original.
30.Facsimile and Electronic Signatures. The parties agree that facsimile and electronic signatures
shall have the same force and effect as original signatures.
31. Arms-Length Negotiations. The parties agree that this Agreement has been negotiated at arms-
length, with the assistance and advice of competent, independent legal counsel.
32. Public Records Act. Notwithstanding the provisions of this Agreement to the contrary,to the
extent any record, including any electronic, audio, paper or other media, is required to be kept or
indexed as a public record in accordance with the Washington Public Records Act, Chapter 42.56
RCW, as may hereafter be amended,the Contractor agrees to maintain all records constituting
public records and to produce or assist the County in producing such records, within the time
frames and parameters set forth in state law. The Contractor further agrees that upon receipt of
any written public record request, Contractor shall, within two business days, notify the County by
providing a copy of the request per the notice provisions of this Agreement.
33. Confidentiality. With respect to all information relating to County that is confidential and clearly
so designated, as required by the Health Insurance Portability and Accountability Act(HIPAA)
and any other applicable privacy laws, the Contractor agrees to keep such information
confidential. The Contractor shall not disclose, transfer, or sell any such information to any party,
except as provided by law or, in the case of personal information, with the prior written consent of
the person to whom the personal information pertains. The Contractor shall maintain the
confidentiality of all personal information and other information gained by reason of this
Agreement, and shall return or certify the destruction of such information if requested in writing
by Jefferson County. This Agreement, once executed, will be a"public record" subject to
Professional Services AgreemenbOESD#114-2023-2024 Page 9 of 18
production to a third party if same is requested pursuant to• the Washington Public Records Act,
Chapter 42.56 RCW, as may hereafter be amended.
34. Criminal 1Jistorv/Background Check. Each of the Contractor's employees, the employees of any
of the Contractor's approved subcontractor, or volunteers used by the Contractor shall submit to a
Washington State Patrol fingerprint identity and criminal history check before they are authorized
to perform services for the Project. The County agrees to bear all reasonable costs incurred in the
performance of this fingerprint identity and criminal history check. Contractors who may or will
have regular access or limited access to any juveniles shall also:
a. Require that each of the Contractor's employees, the employees of any of the Contractor's
approved subcontractor, or volunteers used by the Contractor undergo not less often than
once every three (3) years another Jefferson County approved criminal history and
background check;
b. Ensure all employees, subcontractors, or volunteers are knowledgeable about the
requirements of RCW 13.40.570 and of the new crimes included in RCW 9A.44, Sexual
Offense;
c. Sign the Contractor Requirements for Responding to Situation of Sexual Misconduct Form,
and shall submit to Jefferson County with signed Agreement.
DATED this / day of ► ,' 3" r , 20 2 .
(SIGNATURES FOLLOW ON THE NEXT PAGE)
Professional Services AgreementlOESD#114-2023-2024 Page 10 of 18
SIGNATURE PAGE
JEFFERSON 'OUNTY
BO MISSIONERS
Greg Brothe ,Chair
K to ean,IvI tuber
3
OLY Ind ESD #114 Heidi Eisenhour,Member
.Aaron veil, Superintendent
q _ 5-- 72)2,3
Date I
'1
-- t fir'
mein Susan Jung Jason Tina I> 1,' rw i.
Schulte Lathropthoads Schulz
Attest: / /
ltr ,,nn\ ( "I 'f.("131I 3
Carolyn G�a�llaway, Date
Clerk of the Board
Approved as to form only:
U. C "� r
� August 25, 2023
Philip C. Hunsucker Date
Chief Civil Deputy Prosecuting Attorney
Professional Services Agreement/OESD#114-2023-2024 Page 11 of 18
EXHIBIT A
Scope of Work
OESD #114 School-based Mental Health Services
July 1, 2023 —June 30, 2024
RESPONSIBILITIES:
The County, as administrator of the 1/10t of 1% Sales and Use Tax Funds, and the Olympic Educational
Service District#114 agree that the Olympic Educational Service District#114 will provide services to
individuals as described in this Contract, including EXHIBIT A: Scope of Work; EXHIBIT B: Budget
Sheet/Fee Schedule; and EXHIBIT C: Logic Model and Performance Measures; and further agrees
to comply with the stipulations contained in ATTACHMENT A attached hereto and incorporated herein.
The Olympic Educational Service District#114, (OESD) as a contracted Vendor agrees to:
1. Provide four(4) school districts with mental health, intervention and treatment services in the
schools; for children or youth grades K-12 who identify with Behavioral Health issues.
OESD #114 hours will be distributed per the following:
a. One day a week at Brinnon SD during the 2023-2024 school year.
b. One day a week at Quilcene SD during the 2023-2024 school year.
c. Two days a week at Chimacum SD during the 2023-2024 school year.
d. Two and a half days a week at Port Townsend SD during the 2023-2024 school year.
2. 85% of that time is spent seeing students in clinical services and 15%is spent on charting,travel
or meetings.
3. Staff each site with licensed therapists, licensed therapist associates, licensed independent clinical
social workers or licensed independent clinical social workers, licensed independent clinical social
workers who consistently work at the same site, except for personal leave. Exceptions will be
granted with the written approval of OESD #114.
4. Provide the names of licensed therapists, licensed therapist associates, licensed independent
clinical social workers or licensed independent clinical social workers, licensed independent
clinical social workers associates working in each school to School Districts and JCPH.
5. Notify JCPH and the School Districts of any Counselor changes in writing, (before they occur).
6. Notify each School District of any extended leave of absence for Counselors in writing, (before
they occur).
Professional Services Agreement/OESD#114-2023-2024 Page 12 of 18
7. Notify the School District and the SBHC, if a Counselor is out sick and unable to make an
appointment.
8. Provide background checks for all OESD#114 employees or subcontractors working with
children or youth, who provide services under this contract. School districts have different
requirements and all require out of state FBI background checks for employees new to
Washington State. (Please verify requirements with the School District offices.)
9. Upon request,provide copies of background checks & Counselor resumes to JCPH.
10. Maintain a secure and confidential records system guaranteeing HIPPA for Behavioral Health and
treatment services.
11. Assure that Counselors work with identified youth and their families throughout the school year to
provide individual counseling on a variety of issues and concerns. Including, but not limited to;
anger management, depression, stress, conflict resolution, relationship issues, feelings of suicide,
counseling for grief or loss, sexual and physical abuse, eating disorders, domestic violence, mental
illness, adjustment disorders, crisis events and substance use.
12. Assure that Counselors provide education, support, and consultation for the teachers and staff in
each School District.
13. Assure that Counselors assist teachers and staff in each School District to identify and develop
strategies to assist students with Behavioral Health issues.
14. Assure that a Project Supervisor is available to meet with the School Superintendents and
Principals at the Quilcene and Brinnon School Districts, as needed.
15. Assure that Counselors work collaboratively with local mental health and substance abuse
treatment agencies for identified clients.
16. Assure that Counselors provide crisis interventions and emergency response services within the
subcontracted licensed provider's scope of practice.
17. Assure that Counselors work with children or youth to provide support services and referrals to
Behavioral Health or other treatment programs. Assist with the application and eligibility
paperwork necessary to receive outside services.
18. Assure that Counselors provide on-going supportive counseling as needed, to all youth. Services
are not dependent on Medicaid eligibility.
19. Assure that Counselors contact parents or guardians of children or youth by following HIPPA
laws and Washington State laws concerning age of consent.
Professional Services Agreement/OESD#114-2023-2024 Page 13 of 18
20. Assure that Counselors work with social services or other agencies as needed for dually served
children or youth with Behavioral Health and/or chemical dependency issues.
21. Assure that a Clinical Supervisor is available to provide weekly clinical and supervisory oversight,
for the therapists providing services in this program, as required or needed.
22. Assure that a OESD Project Manager or a Counselor is available to attend Clinician meetings and
quarterly SBHC Advisory meetings in Port Townsend, Chimacum and Quilcene School Districts.
23. Assure that Counselors collaborate in regular consults with the SBHC team of health and school
professionals.
24. Assure that Counselor's offer each student an opportunity for session feedback by providing a
Hope Scale at the first session and again by at the last session and a Satisfaction Questionnaire at
the last session too.
25. Assure that Counselor's provide a new"new client sheet" for every new client to services at each
School.
26. Assure that each Counselor fills out a"visit details sheet"to collect information about the reasons
for the visit, referrals, and satisfaction with services, at every session.
27. Assure that each Counselor provides program data from the new client and visit detail sheets, the
number, types of Behavioral Health issues, intervention and treatment services provided, and will
electronically upload it to the SBHC data base system.
28. Assure that an Epidemiologist of the Kitsap County Health District has continued access to the
SBHC data system.
29. Quarterly electronic reports, (created by the Public Health contracted Epidemiologist)will be
based on data provided by Counselors and will be completed by the Epidemiologist in a form as
specified by Jefferson County Public Health and/or Kitsap County Health District, as outlined in
the Quarterly Evaluation Reporting Template.
30. The Epidemiologist of the Kitsap County Health District will generate a yearly report on client
(students and families), utilization, referrals and outcomes.
31. Upon request, additional reports of activities and services will be provided to the JCPH Contract
Representative.
32. Upon request, attend a Behavioral Health Advisory meeting once a year, to present a progress
report about the mental health services provided by the 1/10th of 1%fund.
Professional Services Agreement/OESD#114-2023-2024 Page 14 of 18
EXHIBIT B
Budget Sheet/ Fee Schedule
OESD #114 School-based Mental Health Services
July 1, 2023 —June 30, 2024
PERSONNEL COSTS REQUESTED EttoNI OTnt;ti FUNDIM; To r ki,
SALES TAX Sot itct: lit DC:i:1
FTE & Salaries/Benefits for
each Employee
Brinnon $650x 1 day x 36 weeks= $23,400
$23,400
Quilcene $650x 1 day x 36 weeks= $23,400
$23,400
Chimacum $600 x 2 days x 36 weeks $43,200
=$43,200
Port Townsend $600 x 2.5 days x 36 weeks $54,000
=$54,000
SUPERVISION/CLINICAL 5 Providers x 36 weeks x$140 $25,200
OVERSIGHT- an hour= $25,200
OESD Behavioral Health .20 FTE for project coordination $23,201
Coordinator =$23,201 (match)
Administrative Assistance .025 FTE=$2,001 (match) $2001
Support
SUB-TOTAL PERSONNEL $169,200 $194,402
OPERATING COSTS
Supplies/Materials-(Please $1,923 general $ $
Describe) $350/clinician for PD and
$200/for snacks/supplies x 5
provides=$2,750
SUB-TOTAL-OPERATING $4673 $4673
COSTS
SUB-TOTAL $173,873 $199,075
Admin-(no more than 10%& $17,387 $ $17,387
please describe what charges are
to be included)
TOTAL COST 191,260.00 $ $216,462
Note: In-kind contributions/match are not required, however the County is interested in the total
cost to provide the service or program.
Professional Services Agreement/OESD#114-2023-2024 Page 15 of 18
EXHIBIT C
Logic Model
OESD #114 School-based Mental Health Services
July 1, 2023 —June 30, 2024
, ...so
so
Outcome
_____"--0. _,__n Output 1) Participating
students will have
Process reduced mental
Beginning with... health and substance
1) Participating use symptoms in the
student's progress classroom,in
.—....._F—i-
1) Eligible students in will be monitored school,and at home.
public schools in and evidenced by
Jefferson County data taken at every 2) The participating
Input have access to session. students'quality of
mental health life will be improved
support and therapy. 2) Individuals that in areas of self-
1) Eligible participants are require higher level perception,family
students in Jefferson 2) Each Student that is of treatment will be dynamics,and
County school districts referred and eligible referred to school involvement.
with mental health or for services will be appropriate levels of
assessed for risk care. DBH,Trauma 3) The school
drug and alcohol abuse factors(i.e.ACEs) Therapist,or another community will
symptoms. experience
and protective Therapist in the
2) Mental Health factors(i.e. community. decreased suicidality
Associated/Licensed strengths/resiliency). and disruptive
Therapists employed 3) The Therapist,with behavior.
will beplaced in each 3) Data will be consent,will
gathered according coordinate with 4. Schools and students
school district. to the guidelines of Jefferson School will report improved
3) Mental Health Jefferson County Districts,School confidence in their
Therapist/Professionals Behavioral Health Based Health Clinic, ability to manage
will provide services to- Committee& the DBH,JHC, mental health and
Public Health Jefferson County substance abuse
Port Townsend, challenges.
Chimacum,Quilcene, Epidemiologist,and Jail,Port Townsend
Brinnon,schools inserted into the Police,Safe Harbor, 5) Student participation
4) Clinical supervision will
SBHC Data System. Dove House or other in the classroom will
resources. increase.
be provided to school- 4) Sessions of 30 to 45
based Mental Health minutes of 6) There will be fewer
Therapist/Professionals. evidenced based behavioral issues
therapy will be leading to punitive
provided as needed suspensions and
until symptoms expulsions.
resolve.
Professional Services Agreement/OESD#114-2023-2024 Page 16 of 18
ATTACHMENT A
JEFFERSON COUNTY 1/10th of 1% BEHAVIORAL HEALTH SALES TAX FUNDING-
MATCH POLICY
Definitions:
Match: is a requirement for the grantee to provide contributions of a specified amount or
percentage to match funds provided by another grantor. Matching can be in the form of cash or
in-kind contributions.
Regulations: The specific requirements for matching funds are unique to each federal or state
program. The A-102 Common Rule provides criteria for acceptable costs and contributions in
regard to match.
Jefferson County Policy:
In 2005, the Washington State Legislature created an option for counties to raise the local sales tax by 0.1
percent, (the 1/10th of 1% sales tax initiative)to augment state funding for behavioral health treatment.
Jefferson County collects and distributes the 1/10th of 1% Behavioral Health Sales Tax fund. Services
purchased by the County are allocated through a formal Request for Proposal (RFP)process, review and
contracting; staffed by Jefferson County Public Health, overseen by Jefferson County Behavioral Health
Advisory Committee and adopted by the Board of County Commissioners, (BoCC). BoCC does not
assume any fiscal responsibility/liability for any of the Contractors they contract for services with.
Jefferson County reserves the first right to use as match the 1/10th of 1% Behavioral Health Sales Tax
funds and the services funded by them for purposes of qualifying for additional funding and grants.
County may make available to the Contractor the 1/10th of 1% Behavioral Health Sales Tax funds for the
Contractor to propose as match to state, federal or other entities, at the County's sole discretion.
Contractor shall not use the 1/10th of 1%Behavioral Health Sales Tax funds for match without prior
authorization by the Jefferson County Administrator and County fiscal team. To request authorization of
availability of the funds for match, Contractor must apply to the County Administrator in writing, and
include their match formula and allocation plan and may include other documentation to support their
request. The County Administrator will authorize or deny the availability of match funds in writing
within 30 days of the application.
If the County informs the Contractor of the availability of the 1/10th of 1% Behavioral Health Sales Tax
funds for match, then the Contractor shall be solely responsible for compliance with all state and federal
laws and regulations, including, but not limited to DSHS, CMS and BIRR funding rules, applicable to the
use of 1/10th of 1%Behavioral Health Sales Tax funds as match. Following state, federal and local
guidelines for match is the responsibility of the Contractor.
Professional Services Agreement/OESD#114-2023-2024 Page 17 of 18
For example, if a Contractor provides Title XIX Medicaid services (the Policy 19.50.02 or 42CFR
430.30)they are required by those rules to actually bill Medicaid for the services at the same time. If no
Medicaid billing exists, the match would not comply with state and federal guidelines for match.
Concurrent with its request for authorization of the availability of match, Contractor shall document it has
met its responsibility to follow state, federal and local guidelines for match by submitting in writing to the
County Administrator their match formula, allocation plan, and other documentation made mandatory
pursuant to this Agreement and this Attachment A. At a minimum, the Contractor shall also provide the
following to the County Administrator:
1. DSHS requires contractors to complete and submit a"Local Match Certification" form
(DSHS 06-155) or a form that has equivalent data elements prior to any agreement for
DSHS services. Submit a copy of this application and form when requesting match
availability from the County and at each monthly billing.
2. Submit the current administrative policy within WA State regulating your services and the
use of local match.
3. Submit to the County your last financial audit showing your use of match, County funds
and tracking systems.
4. Submit to the County the terms of the agreement showing the MH/SA allocation is an
allowable source of match.
5. Provide documentation that your financial reporting system tracks matching funds at a
level that meets the level of documentation required by federal or state statutes.
The County may reject permission for Contractor to utilize the 1/10th of 1%Behavioral Health Sales Tax
funding as match.
Professional Services Agreement/OESD#114-2023-2024 Page 18 of 18